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  1. Burn injury reduces neutrophil directional migration speed in microfluidic devices.

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    Kathryn L Butler

    Full Text Available Thermal injury triggers a fulminant inflammatory cascade that heralds shock, end-organ failure, and ultimately sepsis and death. Emerging evidence points to a critical role for the innate immune system, and several studies had documented concurrent impairment in neutrophil chemotaxis with these post-burn inflammatory changes. While a few studies suggest that a link between neutrophil motility and patient mortality might exist, so far, cumbersome assays have prohibited exploration of the prognostic and diagnostic significance of chemotaxis after burn injury. To address this need, we developed a microfluidic device that is simple to operate and allows for precise and robust measurements of chemotaxis speed and persistence characteristics at single-cell resolution. Using this assay, we established a reference set of migration speed values for neutrophils from healthy subjects. Comparisons with samples from burn patients revealed impaired directional migration speed starting as early as 24 hours after burn injury, reaching a minimum at 72-120 hours, correlated to the size of the burn injury and potentially serving as an early indicator for concurrent infections. Further characterization of neutrophil chemotaxis using this new assay may have important diagnostic implications not only for burn patients but also for patients afflicted by other diseases that compromise neutrophil functions.

  2. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection

    DEFF Research Database (Denmark)

    Calum, H.; Moser, C.; Jensen, P. O.;

    2009-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6% third-degree burn...... infected burn wound. Furthermore, the oxidative burst and the phagocytic capacity of the PMNs were reduced in the group of mice with burn wound. Using this novel mouse model of thermal injury a decline of peripheral leucocytes was observed, whereas the increased local inflammatory response at the site of...... injury was induced in mice with a hot-air blower. The third-degree burn was confirmed histologically. The mice were allocated into five groups: control, shave, burn, infection and burn infection group. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of...

  3. Estrogen treatment following severe burn injury reduces brain inflammation and apoptotic signaling

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    Idris Ahamed H

    2009-10-01

    Full Text Available Abstract Background Patients with severe burn injury experience a rapid elevation in multiple circulating pro-inflammatory cytokines, with the levels correlating with both injury severity and outcome. Accumulations of these cytokines in animal models have been observed in remote organs, however data are lacking regarding early brain cytokine levels following burn injury, and the effects of estradiol on these levels. Using an experimental animal model, we studied the acute effects of a full-thickness third degree burn on brain levels of TNF-α, IL-1β, and IL-6 and the protective effects of acute estrogen treatment on these levels. Additionally, the acute administration of estrogen on regulation of inflammatory and apoptotic events in the brain following severe burn injury were studied through measuring the levels of phospho-ERK, phospho-Akt, active caspase-3, and PARP cleavage in the placebo and estrogen treated groups. Methods In this study, 149 adult Sprague-Dawley male rats received 3rd degree 40% total body surface area (TBSA burns. Fifteen minutes following burn injury, the animals received a subcutaneous injection of either placebo (n = 72 or 17 beta-estradiol (n = 72. Brains were harvested at 0.5, 1, 2, 4, 6, 8, 12, 18, and 24 hours after injury from the control (n = 5, placebo (n = 8/time point, and estrogen treated animals (n = 8/time point. The brain cytokine levels were measured using the ELISA method. In addition, we assessed the levels of phosphorylated-ERK, phosphorylated-Akt, active caspase-3, and the levels of cleaved PARP at the 24 hour time-point using Western blot analysis. Results In burned rats, 17 beta-estradiol significantly decreased the levels of brain tissue TNF-α (~25%, IL-1β (~60%, and IL-6 (~90% when compared to the placebo group. In addition, we determined that in the estrogen-treated rats there was an increase in the levels of phospho-ERK (p p p p Conclusion Following severe burn injury, estrogens decrease both

  4. Systemic Responses to Burn Injury

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    ÇAKIR, Barış; YEĞEN, Berrak Ç.

    2004-01-01

    The major causes of death in burn patients include multiple organ failure and infection. It is important for the clinician to understand the pathophysiology of burn injury and the effects it will have on the pharmacokinetics of a drug. The local and systemic inflammatory response to thermal injury is extremely complex, resulting in both local burn tissue damage and deleterious systemic effects on all other organ systems distant from the burn area itself. Thermal injury initiates systemic infl...

  5. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

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    Kemalettin Koltka

    2011-01-01

    A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. ...

  6. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

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    Kemalettin Koltka

    2011-07-01

    Full Text Available A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. In zone of hyperemia tissue perfusion is increased. At the beginning, cardiac output falls and systemic vascular resistance increases; cardiac performance improves as hypovolemia is corrected with fluid resuscitation. While cardiac output increases systemic vascular resistance falls below normal values and a hypermetabolic state develops. Pulmonary vascular resistance increases immediately after thermal injury and this is more prolonged. To avoid secondary pulmonary complications, the smallest resuscitation volume of fluids that maintains adequate tissue perfusion should be given. Changes parallel to the cardiovascular response develop in other organ systems. The reasons of burn injury can be thermal, electrical, chemical or radiation. It is important to know the exact mechanism of burn injury because of different therapies for a specific cause. In this review information about burn depth, local and systemic responses to burn injury and major causes of burn injury are presented. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl:1-6

  7. [Burn injuries and mental health].

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    Palmu, Raimo; Vuola, Jyrki

    2016-01-01

    Currently a large proportion of patients with severe burn injuries survive. This gives increasing challenges also for psychological recovery after the trauma. More than half of burn patients have mental disorders already before the burn injury but also patients who previously had no mental disorders may suffer from them. Some of the hospitalize burn patients have injuries due to suicidal attempts. Only a small proportion of burn patients receive appropriate psychiatric care although psychosocial interventions specifically planned for burn victims exist. More frequent screening of symtoms of mental disorders and psychiatric consultation, also after acute care in hospital, could lead to better management of post-burn psychiatric care as well as better management of the burn treatment and rehabilitation itself. PMID:27089616

  8. National programme for prevention of burn injuries

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    Gupta J

    2010-10-01

    Full Text Available The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

  9. Alcohol use and burn injury.

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    Jones, J D; Barber, B; Engrav, L; Heimbach, D

    1991-01-01

    Charts of 108 consecutive adult patients with flame burns of 20% to 70% total body surface area were reviewed to determine the incidence of acute alcohol intoxication and the likelihood that intoxicated patients were chronic alcohol abusers, to assess morbidity and mortality in the alcoholic patient with burns, and to characterize the intervention used in postdischarge treatment of the alcoholic patient with burns who survives. Twenty-seven percent of patients were acutely intoxicated at the time of injury. Evidence for chronic alcohol abuse was apparent in 90% of intoxicated patients, compared to only 11% of nonintoxicated patients (p = 0.0001). Alcoholic patients with burns not only had an overall mortality rate three times that of nonalcoholics (p = 0.001) but also died of smaller burns (p less than 0.05). Surviving alcoholic patients with burns required significantly more intravenous antibiotics and a longer hospitalization. Social service evaluation of use of alcohol was made in 84% of the cases of surviving intoxicated burn victims. Further intervention was undertaken in two thirds of these cases, usually involving an outpatient treatment program. PMID:2050723

  10. Early Enteral Nutrition for Burn Injury

    OpenAIRE

    Mandell, Samuel P.; Gibran, Nicole S.

    2014-01-01

    Significance: Nutrition has been recognized as a critical component of acute burn care and ultimate wound healing. Debate remains over the appropriate timing of enteral nutrition and the benefit of supplemental trace elements, antioxidants, and immunonutrition for critically ill burn patients. Pharmacotherapy to blunt the metabolic response to burn injury plays a critical role in effective nutritional support.

  11. Epidemiology and Statistical Modeling in Burn Injuries

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    Sadeghi Bazargani, Homayoun

    2010-01-01

    An important issue in assessing the epidemiology of injuries, including burns, is the investigation of appropriate methodologies and statistical modeling techniques to study injuries in an efficient and trustworthy manner. The overall aim of this thesis is to analyze epidemiological patterns and assess the appropriateness of supervised statistical models to investigate burn risks and patterns. This thesis contains four papers: the first two concern descriptive epidemiology of burns in Arda...

  12. Frequencies of micronucleated polychromatic erythrocytes in mouse bone marrow induced by combined radiation-burn injury

    International Nuclear Information System (INIS)

    Objective: In order to detect if any analysis of frequency of micronucleated polychromatic erythrocytes (fMPCE) in mouse bone marrow was possible to diagnose combined radiation-burn injuries. Methods: By using the index of fMPCE, the investigation was carried out in the conditions of burn injury alone, radiation injury alone and combined radiation-burn injury. Results: The fMPCE induced by 10% and 20% body surface area (BSA) burns were not significantly increased at 24h compared with untreated groups. The fMPCE induced by combined radiation-burn injury significantly lower than those by radiation alone, and the fMPCE in the 20% BSA combined radiation-burn injury groups were lower than those in 10% BSA groups. Conclusion: These results indicate that radiation combined burns have an effect to reduce the fMPCE induced by radiation injury. The reason may be due to the frequency of increase of PCE after burn injury

  13. Burn Injury Arise From Flying Balloon Toys

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    Yalcin Kulahci

    2007-08-01

    Full Text Available Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloons flame. 80 person was injured from flying toy ballons flame in a meeting in 2002. Although this potential risks of acetylene, helium have not any of some risk. But helium was provided from other countries and have more price. The injuries which caused from acetylene burns like 1st -2nd degree burns. Consequently that was known helium is more avaliable for using in toy sector, and never cause burn injuries like this. [TAF Prev Med Bull. 2007; 6(4: 291-296

  14. New treatment strategies to reduce burn wound progression

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    Schmauss, Daniel

    2014-01-01

    Full Text Available [english] Background: After a burn injury certain superficial partial-thickness burn wounds spontaneously progress into deep partial-thickness or full-thickness burn wounds. This poorly understood phenomenon is called burn wound progression. The aim of this study was to investigate whether treatment strategies using warm water (preservation of microcirculation on the one side and erythropoietin (EPO (molecule with anti-inflammatory, anti-apoptotic, vasodilatory and neoangiogenic properties can prevent, delay and/or reduce secondary burn wound progression in a rat model.Methods: We used a burn comb model in 63 rats, creating eight rectangular contact burns (2x1 cm each intercalated by unburned zones (2x0.5 cm prone to burn wound progression. In a first experimental set we treated burn wounds with locally applied warm (37°C or cold (17°C water for 20 minutes.In a second experimental set, animals were treated systemically with EPO at two different dosages of 500 and 2,500 IU/kg bodyweight (bw and initiated at 2 different time-points (45 minutes vs. 6 hours after burn injury. Evaluation of microcirculatory perfusion, interspace necrosis and burn depth was performed using respectively laser Doppler flowmetry, planimetry and histology. For statistical analysis the two-way ANOVA-test followed by an adequate post-hoc test (Bonferroni were used. Results: In untreated control animals a conversion from superficial to full-thickness burns was observed within 24 hours. Warm and cold water treatment significantly delayed burn depth progression, nevertheless after 4 days, burn depth was similar in all three groups. Warm water significantly reduced interspace necrosis compared to untreated controls and cold water with a significantly improved perfusion in the warm water group. Surface extension and particularly burn depth progression were significantly decreased by EPO only if administered at a dosage of bw and initiated 45 minutes after burn injury. EPO

  15. Analgesic effects of dexamethasone in burn injury

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    Werner, Mads U; Lassen, Birgit Vibeke; Kehlet, Henrik

    2002-01-01

    BACKGROUND AND OBJECTIVES: Glucocorticoids are well-known adjuvant analgesics in certain chronic pain states. There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn m...... administration of dexamethasone 2 hours before a burn injury does not reduce the inflammatory-mediated changes in quantitative sensory thresholds, pain perception, or skin erythema in humans....... differences between treatments in regard to skin erythema (P >.8), thermal or mechanical thresholds (P >.2), thermal or mechanical pain response (P >.2), or mechanical secondary hyperalgesia (P >.2). Dexamethasone had no analgesic effects in normal skin. CONCLUSIONS: The study indicates that systemic...... model of acute inflammatory pain in humans. METHODS: Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Intravenous dexamethasone 8 mg or placebo was administered on 2 separate study days. Two hours after drug administration, a first-degree burn...

  16. Sexual Function Following Burn Injuries: Literature Review.

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    Pandya, Atisha A; Corkill, Helen A; Goutos, Ioannis

    2015-01-01

    Sexual function is a profound facet of the human personality. Burns due their sudden and devastating nature can have longstanding effects on intimate function by virtue of physical sequelae as well as alterations in body image and perceived desirability. A considerable number of patients encounter problems with intimate function in burns rehabilitation; nevertheless, the topic appears to be poorly addressed in specialist centers worldwide. Review of the literature suggests that a number of parameters can affect the quality of sexual life following burn injuries including age at the time of injury, location, and severity of the burn as well as coping mechanisms employed by the individual survivor. Addressing issues of intimacy relies on awareness, education, and a holistic approach on behalf of the multidisciplinary team members and, to this effect, recommendations are made on managing sexual function concerns in burns rehabilitation. PMID:25423439

  17. Calcium and ER Stress Mediate Hepatic Apoptosis after Burn Injury

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    Jeschke, Marc G.; Gauglitz, Gerd G.; Song, Juquan; Kulp, Gabriela A; Finnerty, Celeste C.; Cox, Robert A.; Barral, José M.; Herndon, David N; Boehning, Darren

    2009-01-01

    A hallmark of the disease state following severe burn injury is decreased liver function, which results in gross metabolic derangements that compromise patient survival. The underlying mechanisms leading to hepatocyte dysfunction post-burn are essentially unknown. The aim of the present study was to determine the underlying mechanisms leading to hepatocyte dysfunction and apoptosis post-burn. Rats were randomized to either control (no burn) or burn (60% total body surface area burn) and sacri...

  18. Epidemiology of severe burn injuries in a Tertiary Burn Centre in Tehran, Iran

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    Mohammadi-Barzelighi, H.; Alaghehbandan, R.; Motevallian, A.; Alinejad, F.; Soleimanzadeh-Moghadam, S.; Sattari, M.; A R Lari

    2011-01-01

    The aim of the study was to examine the epidemiological characteristics of hospitalized burn patients in a tertiary burn centre in Tehran, Iran. A hospital-based cross-sectional study of all hospitalized patients with burn injuries was conducted in Motahari Burn and Reconstruction Center in Tehran from August to December 2010. Medical records of all hospitalized burn patients were reviewed and pertinent information was captured. A total of 135 patients with severe burns requiring hospitalizat...

  19. Physical Fitness in People After Burn Injury : A Systematic Review

    NARCIS (Netherlands)

    Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.; Van Baar, Margriet E.; Mouton, Leonora J.

    2011-01-01

    Disseldorp LM, Nieuwenhuis MK, Van Baar ME, Mouton U. Physical fitness in people after burn injury: a systematic review. Arch Phys Med Rehabil 2011;92:1501-10. Objective: To gain insight into the physical fitness of people after burn injury compared with healthy subjects, and to present an overview

  20. Characterization of burn injuries using terahertz time-domain spectroscopy

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    Arbab, M. Hassan; Dickey, Trevor C.; Winebrenner, Dale P.; Chen, Antao; Mourad, Pierre D.

    2011-03-01

    The accuracy rates of the clinical assessment techniques used in grading burn injuries remain significantly low for partial thickness burns. In this paper, we present experimental results from terahertz characterization of 2nd and 3rd degree burn wounds induced on a rat model. Reflection measurements were obtained from the surface of both burned and normal skin using pulsed terahertz spectroscopy. Signal processing techniques are described for interpretation of the acquired terahertz waveform and differentiation of burn wounds. Furthermore, the progression of burn injuries is shown by comparison between acute characterization and 72-hours survival studies. While the water content of healthy and desiccated skin has been considered as a source of terahertz signal contrast, it is demonstrated that other biological effects such as formation of post-burn interstitial edema as well as the density of the discrete scattering structures in the skin (such as hair follicles, sweat glands, etc.) play a significant role in the terahertz response of the burn wounds.

  1. Baux’s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury

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    Peeyush Dahal

    2016-01-01

    Full Text Available jdjdBackground & Objectives: Prediction of outcome for patients with major thermal injury is important to inform clinical decision making, alleviate individual suffering and improve hospital resource allocation. Early prediction of outcome (i.e., survival or mortality may help triage effectively, and to implement medical and surgical interventions efficiently as soon as possible. Burn mortality has decreased markedly with the improvement in burn management in the past 100 years, and multiple burn mortality prediction models have been developed over these times in response to that decline. But these services are still not enough to reduce the burn related injuries in low income country like Nepal. So we did a study to observe the effectiveness of two different but very popular models (Baux and ABSI in our context.Materials & Methods: This was a prospective observational study where 92 cases of severe burn injury was selected and the results were compared with Baux and ABSI scoring system.Results: Total admission was 140 and mortality was 33. Out of these admission 92 cases of severe burn injury was selected for the study. Most (85.8 % of were among the young group 16-40 years. It comprises 41.3 % in total. In total 63.7 % were female. Mortality with severe burn injury was 29.3%. No death had occurred below the Baux’s score 30 and there was more than 51% mortality above the score of 60. There was no mortality with ABSI scoring < 3 and mortality was high in ABSI scoring > 6.Conclusion: Baux and ABSI score systems are simple to calculate and ABSI is more accurate for prediction of acute burn injury.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 24-27

  2. Music therapy for children with severe burn injury

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    Edwards, Jane

    1998-01-01

    peer-reviewed Music therapy for children with severe burns is a developing field of practice and research interest in pediatric music therapy. The following article presents an overview of the nature of severe burn injury and provides a rationale for the use of music therapy in the Burn Unit. The application of song writing techniques to address needs of children receiving care for severe burns in a hospital setting is presented.

  3. THE PATHOPHYSIOLOGIC RESPONSE TO SEVERE BURN INJURY

    Science.gov (United States)

    Jeschke, Marc G; Chinkes, David L; Finnerty, Celeste C; Kulp, Gabriela; Suman, Oscar E; Norbury, William B; Branski, Ludwik K; Gauglitz, Gerd G; Mlcak, Ronald P; Herndon, David N

    2014-01-01

    Objective To improve clinical outcome and to determine new treatment options, we studied the pathophysiologic response postburn in a large prospective, single center, clinical trial. Summary Background Data A severe burn injury leads to marked hypermetabolism and catabolism, which are associated with morbidity and mortality. The underlying pathophysiology and the correlations between humoral changes and organ function have not been well delineated. Methods Two hundred forty-two severely burned pediatric patients [>30% total body surface area (TBSA)], who received no anabolic drugs, were enrolled in this study. Demographics, clinical data, serum hormones, serum cytokine expression profile, organ function, hypermetabolism, muscle protein synthesis, incidence of wound infection sepsis, and body composition were obtained throughout acute hospital course. Results Average age was 8 ± 0.2 years, and average burn size was 56 ± 1% TBSA with 43 ± 1% third-degree TBSA. All patients were markedly hypermetabolic throughout acute hospital stay and had significant muscle protein loss as demonstrated by a negative muscle protein net balance (−0.05% ± 0.007 nmol/100 mL leg/min) and loss of lean body mass (LBM) (−4.1% ± 1.9%); P < 0.05. Patients lost 3% ± 1% of their bone mineral content (BMC) and 2 ± 1% of their bone mineral density (BMD). Serum proteome analysis demonstrated profound alterations immediately postburn, which remained abnormal throughout acute hospital stay; P < 0.05. Cardiac function was compromised immediately after burn and remained abnormal up to discharge; P < 0.05. Insulin resistance appeared during the first week postburn and persisted until discharge. Patients were hyperinflammatory with marked changes in IL-8, MCP-1, and IL-6, which were associated with 2.5 ± 0.2 infections and 17% sepsis. Conclusions In this large prospective clinical trial, we delineated the complexity of the postburn pathophysiologic response and conclude that the postburn

  4. Calcium and ER stress mediate hepatic apoptosis after burn injury

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    Gauglitz, Gerd G.; Song, Juquan; Kulp, Gabriela A.; Finnerty, Celeste C.; Cox, Robert A.; Barral, José M.; Herndon, David N.; Boehning, Darren

    2009-01-01

    Abstract A hallmark of the disease state following severe burn injury is decreased liver function, which results in gross metabolic derangements that compromise patient survival. The underlying mechanisms leading to hepatocyte dysfunction after burn are essentially unknown. The aim of the present study was to determine the underlying mechanisms leading to hepatocyte dysfunction and apoptosis after burn. Rats were randomized to either control (no burn) or burn (60% total body surface area burn) and sacrificed at various time‐points. Liver was either perfused to isolate primary rat hepatocytes, which were used for in vitro calcium imaging, or liver was harvested and processed for immunohistology, transmission electron microscopy, mitochondrial isolation, mass spectroscopy or Western blotting to determine the hepatic response to burn injury in vivo. We found that thermal injury leads to severely depleted endoplasmic reticulum (ER) calcium stores and consequent elevated cytosolic calcium concentrations in primary hepatocytes in vitro. Burn‐induced ER calcium depletion caused depressed hepatocyte responsiveness to signalling molecules that regulate hepatic homeostasis, such as vasopressin and the purinergic agonist ATP. In vivo, thermal injury resulted in activation of the ER stress response and major alterations in mitochondrial structure and function – effects which may be mediated by increased calcium release by inositol 1,4,5‐trisphosphate receptors. Our results reveal that thermal injury leads to dramatic hepatic disturbances in calcium homeostasis and resultant ER stress leading to mitochondrial abnormalities contributing to hepatic dysfunction and apoptosis after burn injury. PMID:20141609

  5. Children with burn injuries-assessment of trauma, neglect, violence and abuse

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    Antoinette Runge

    2011-07-01

    Full Text Available Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child’s palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists.

  6. Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

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    Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

    2016-05-01

    Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. PMID:27088728

  7. Predictors of insulin resistance in pediatric burn injury survivors 24 to 36 months post-burn

    Science.gov (United States)

    Chondronikola, Maria; Meyer, Walter J.; Sidossis, Labros S.; Ojeda, Sylvia; Huddleston, Joanna; Stevens, Pamela; Børsheim, Elisabet; Suman, Oscar E.; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Background Burn injury is a dramatic event with acute and chronic consequences including insulin resistance. However, factors associated with insulin resistance have not been previously investigated. Purpose To identify factors associated with long-term insulin resistance in pediatric burn injury survivors. Methods The study sample consisted of 61 pediatric burn injury survivors 24 to 36 months after the burn injury, who underwent an oral glucose tolerance test. To assess insulin resistance, we calculated the area under the curve for glucose and insulin. The diagnostic criteria of the American Diabetes Association were used to define individuals with impaired glucose metabolism. Additional data collected include body composition, anthropometric measurements, burn characteristics and demographic information. The data were analyzed using multivariate linear regression analysis. Results Approximately 12% of the patients met the criteria for impaired glucose metabolism. After adjusting for possible confounders, burn size, age and percent body fat were associated with the area under the curve for glucose (p<0.05 for all). Time post-burn and lean mass were inversely associated with the area under the curve for glucose (p<0.05 for both). Similarly, older age predicted higher insulin area under the curve. Conclusion A significant proportion of pediatric injury survivors suffer from glucose abnormalities 24–36 months post-burn. Burn size, time post-burn, age, lean mass and adiposity are significant predictors of insulin resistance in pediatric burn injury survivors. Clinical evaluation and screening for abnormal glucose metabolism should be emphasized in patients with large burns, older age and survivors with high body fat. PMID:24918945

  8. Study on acute burn injury survivors and the associated issues

    Institute of Scientific and Technical Information of China (English)

    Jonathan Bayuo; Pius Agbenorku; Richcane Amankwa

    2016-01-01

    Objective: To explore the phenomenon of surviving burn injury and its associated issues and concerns. Methods: A cross sectional survey approach was utilized to obtain data from one hundred burn survivors who were purposely selected. Descriptive statistics and content analysis were used to analyze data. Results: Findings from the study indicate that burns from flames stood out as a major cause of burns. Physical discomfort/pain, anxiety, needing assistance in meeting self-care needs, financial and social limitations were identified as the major impact of the injury. Furthermore, participants perceived the existence of societal stigma. In addition, hope in God or a spiritual being as well as family support were the two key resources participants relied on to cope effectively. Conclusions: Surviving burn injury is associated with varied physical, social and psy-chological factors and survivors may need professional assistance to fully adjust after discharge.

  9. Burn Injury: A Challenge for Tissue Engineers

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    Yerneni LK

    2009-01-01

    Full Text Available Ever since man invented fire he has been more frequently burning himself by this creation than by the naturally occurring bushfires. It is estimated that over 1.152 million people in India suffer from burn injuries requiring treatment every year and majority of them are women aged between 16-40 years and most of them occur in the kitchen. The treatment for burns basically involves autologous skin grafting, which originated in India more than two thousand years ago (Sushruta Samhita, is still the gold standard for the wound resurfacing, although, autografting is difficult where graftable donor sites are limited. Although, Cadaver skin, porcine or bovine xenografts are used alternatively over the past thirty years, modern approaches like the Bioengineering of skin substitutes emerged during the past 20 years as advanced wound management technologies with no social impediment. They can be broadly categorized as Acellular and Cellular biotechnological products. The acellular products like Alloderm (LifeCell Corporation, Integra (Integra Life Sciences act like template and depend on natural regeneration, while the cellular ones are either ‘Off-the-Shelf’ products like Apligraf (Organogenesis Inc and Orcel (Ortec International have allogenic elements and ‘home grown’ autologous cell products like Cultured Epithelial Autograft (CEA and epidermal-dermal composite skin use synthetic or natural non-human matrices. The CEA is based on the ex-vivo epidermal stem cell-expansion and our laboratory has been engaged in CEA technique development with innovative cost-effective approach and yielded promising preliminary clinical success. The basic methodological approach in CEA technique which is still clinically adopted by several developed countries involves the use of growth arrested mouse dermal fibroblasts as growth supportive matrix and is thus considered a drawback as a whole. Additionally, there is no superior enough method available to augment the

  10. Burns and injuries resulting from the use of gel candles.

    Science.gov (United States)

    Pickus, E J; Lionelli, G T; Parmele, J B; Lawrence, W T; Korentager, R A

    2001-01-01

    Scented gel candles are common decorative household items composed of gelled mineral oil, fragrances, and dye. Like traditional wax candles, they have an open flame. Because of defective design, there have been several burns and injuries caused by these products. Here we report our experience with a scald burn from a gel candle and describe 34 additional injuries attributed to gel candles previously unreported in the medical literature. PMID:11403248

  11. Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy

    International Nuclear Information System (INIS)

    Burn trauma produces significant fluid shifts that, in turn, reduce cardiac output and tissue perfusion. Treatment approaches to major burn injury include administration of crystalloid solutions to correct hypovolemia and to restore peripheral perfusion. While this aggressive postburn volume replacement increases oxygen delivery to previously ischemic tissue, this restoration of oxygen delivery is thought to initiate a series of deleterious events that exacerbate ischemia-related tissue injury. While persistent hypoperfusion after burn trauma would produce cell death, volume resuscitation may exacerbate the tissue injury that occurred during low flow state. It is clear that after burn trauma, tissue adenosine triphosphate (ATP) levels gradually fall, and increased adenosine monophosphate (AMP) is converted to hypoxanthine, providing substrate for xanthine oxidase. These complicated reactions produce hydrogen peroxide and superoxide, clearly recognized deleterious free radicals. In addition to xanthine oxidase related free radical generation in burn trauma, adherent-activated neutrophils produce additional free radicals. Enhanced free radical production is paralleled by impaired antioxidant mechanisms; as indicated by burn-related decreases in superoxide dismutase, catalase, glutathione, alpha tocopherol, and ascorbic acid levels. Burn related upregulation of inducible nitric oxide synthase (iNOS) may produce peripheral vasodilatation, upregulate the transcription factor nuclear factor kappa B (NF-κB), and promote transcription and translation of numerous inflammatory cytokines. NO may also interact with the superoxide radical to yield peroxynitrite, a highly reactive mediator of tissue injury. Free radical mediated cell injury has been supported by postburn increases in systemic and tissue levels of lipid peroxidation products such as conjugated dienes, thiobarbituric acid reaction products, or malondialdehyde (MDA) levels. Antioxidant therapy in burn therapy

  12. Acute Kidney Injury Predicts Mortality after Charcoal Burning Suicide.

    Science.gov (United States)

    Chen, Yu-Chin; Tseng, Yi-Chia; Huang, Wen-Hung; Hsu, Ching-Wei; Weng, Cheng-Hao; Liu, Shou-Hsuan; Yang, Huang-Yu; Chen, Kuan-Hsin; Chen, Hui-Ling; Fu, Jen-Fen; Lin, Wey-Ran; Wang, I-Kuan; Yen, Tzung-Hai

    2016-01-01

    A paucity of literature exists on risk factors for mortality in charcoal burning suicide. In this observational study, we analyzed the data of 126 patients with charcoal burning suicide that seen between 2002 and 2013. Patients were grouped according to status of renal damage as acute kidney injury (N = 49) or non-acute kidney injury (N = 77). It was found that patients with acute kidney injury suffered severer complications such as respiratory failure (P = 0.002), myocardial injury (P = 0.049), hepatic injury (P acute kidney injury. Moreover, patients with acute kidney injury suffered longer hospitalization duration (16.9 ± 18.3 versus 10.7 ± 10.9, P = 0.002) and had higher mortality rate (8.2% versus 0%, P = 0.011) than patients without injury. In a multivariate Cox regression model, it was demonstrated that serum creatinine level (P = 0.019) and heart rate (P = 0.022) were significant risk factors for mortality. Finally, Kaplan-Meier analysis revealed that patients with acute kidney injury suffered lower cumulative survival than without injury (P = 0.016). In summary, the overall mortality rate of charcoal burning suicide population was 3.2%, and acute kidney injury was a powerful predictor of mortality. Further studies are warranted. PMID:27430168

  13. Sodium butyrate protects against severe burn-induced remote acute lung injury in rats.

    Directory of Open Access Journals (Sweden)

    Xun Liang

    Full Text Available High-mobility group box 1 protein (HMGB1, a ubiquitous nuclear protein, drives proinflammatory responses when released extracellularly. It plays a key role as a distal mediator in the development of acute lung injury (ALI. Sodium butyrate, an inhibitor of histone deacetylase, has been demonstrated to inhibit HMGB1 expression. This study investigates the effect of sodium butyrate on burn-induced lung injury. Sprague-Dawley rats were divided into three groups: 1 sham group, sham burn treatment; 2 burn group, third-degree burns over 30% total body surface area (TBSA with lactated Ringer's solution for resuscitation; 3 burn plus sodium butyrate group, third-degree burns over 30% TBSA with lactated Ringer's solution containing sodium butyrate for resuscitation. The burned animals were sacrificed at 12, 24, and 48 h after burn injury. Lung injury was assessed in terms of histologic changes and wet weight to dry weight (W/D ratio. Tumor necrosis factor (TNF-α and interleukin (IL-8 protein concentrations in bronchoalveolar lavage fluid (BALF and serum were measured by enzyme-linked immunosorbent assay, and HMGB1 expression in the lung was determined by Western blot analysis. Pulmonary myeloperoxidase (MPO activity and malondialdehyde (MDA concentration were measured to reflect neutrophil infiltration and oxidative stress in the lung, respectively. As a result, sodium butyrate significantly inhibited the HMGB1 expressions in the lungs, reduced the lung W/D ratio, and improved the pulmonary histologic changes induced by burn trauma. Furthermore, sodium butyrate administration decreased the TNF-α and IL-8 concentrations in BALF and serum, suppressed MPO activity, and reduced the MDA content in the lungs after severe burn. These results suggest that sodium butyrate attenuates inflammatory responses, neutrophil infiltration, and oxidative stress in the lungs, and protects against remote ALI induced by severe burn, which is associated with inhibiting HMGB1

  14. Burn injuries in eastern Zambia: impact of multidisciplinary teaching teams.

    Science.gov (United States)

    Edwards, Dianna; Heard, Jason; Latenser, Barbara A; Quinn, Keely Y; van Bruggen, Jaap; Jovic, Goran

    2011-01-01

    The American Burn Association/Children's Burn Foundation (ABA/CBF) sponsors teams who offer burn education to healthcare providers in Zambia, a sub-Saharan country. The goals of this study are 1) to acquire burn-patient demographics for the Eastern Province, Zambia and 2) to assess the early impact of the ABA/CBF-sponsored burn teams. This is a retrospective chart review of burn patients admitted in one mission hospital in Katete, Zambia, July 2002 to June 2009. July 2002 to December 2006 = data before ABA/CBF burn teams and January 2007 to June 2009 = burn care data during/after burn outreach. There were 510 burn patients hospitalized, male:female ratio 1.2:1. Average age = 15.6 years, with 44% younger than 5 years. Average TBSA burned = 11% and mean fatal TBSA = 25%. Average hospital length of stay = 16.9 days survivors and 11.6 days nonsurvivors. Most common mechanisms of burn injuries: flame (52%) and scald (41%). Ninety-two patients (18%) died and 23 (4.5%) left against medical advice. There were 191 (37.4%) patients who underwent 410 surgical procedures (range 1-13/patient). There were 138 (33.7%) sloughectomies, 118 (28.7%) skin grafts, 39 (9.5%) amputations, and 115 (28.1%) other procedures. Changes noted in the 2007 to 2009 time period: more patients had burn diagrams (48.6 vs 27.6%, P set for a sub-Saharan region in Africa. There has been a statistically significant improvement in documentation of burn size as well as administration of analgesics, validating the efficacy of the ABA/CBF-sponsored burn teams. Continued contact with burn teams may lead to increased use of resuscitation fluids, topical antimicrobials, and more patients undergoing operative intervention, translating into improved burn patient outcomes. PMID:21131848

  15. Burn injury differentially alters whole-blood and organ glutathione synthesis rates: An experimental model

    Directory of Open Access Journals (Sweden)

    Zhe-Wei Fei

    2013-09-01

    Full Text Available Previous studies from our laboratories revealed a reduced rate of whole-blood (WB glutathione (GSH synthesis in severely burned patients. To determine whether WB GSH metabolism is an indicator of the status of GSH metabolism in one or more of the major organs, we used a burn rabbit model to determine GSH concentrations and rates of synthesis in WB, liver, lungs, kidney, and skeletal muscle. L-[1- 13 C]-cysteine was infused intravenously for 6 h in rabbits at 3 days post-burn and in sham burn controls. WB and organ 13 C-enrichment of cysteine and GSH was determined by gas chromatography/mass spectrometry. Plasma cysteine metabolic flux was increased significantly (P < 0.01 following burn injury. WB, liver, and lung GSH concentrations (P = 0.054, P < 0.05, and P < 0.05, respectively and fractional rates of GSH synthesis (P < 0.05, P< 0.01, and P< 0.05, respectively were reduced at 3 days post-burn. Kidney was unaffected. There also appears to be an increased rate of GSH transport out of the liver after burn injury. Hence, there is a differential impact of burn injury on tissue and organ GSH status, with WB qualitatively reflecting the changes in lung and liver. It will be important to determine whether these changes are due to alterations in the intrinsic capacity for GSH synthesis and/or availability of amino acid precursors of GSH.

  16. Changes in Fat Distribution in Children Following Severe Burn Injury

    Science.gov (United States)

    Patel, Pavankumar; Sallam, Hanaa S.; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Abstract Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution. Methods: We studied body composition, fat distribution, and inflammatory cytokines changes in children with severe burn injury up to 6 months from discharge. Sixty-two boys and 35 girls (burn ≥30% of total body surface area) were included. Results: We found a decrease in total body fat and subcutaneous peripheral fat at 6 months (6% and 2%, respectively; P<0.05 each). An inverse correlation between the decrease in peripheral fat content at 6 months and the extent of burn injury (r=−041, P=0.02) was also observed. In addition, there was a 12% increase in serum tumor necrosis factor-α (TNF-α) (P=0.01 vs. discharge) and 9% decrease in serum interleukin-10 (IL-10) (P<0.0001 vs. discharge) over 6 months after burn. Conclusion: Severe burn injury in children is associated with changes in body fat content and distribution up to 6 months from hospital discharge. These changes, accompanied by persisting systemic inflammation, could possibly mediate the observed persistence of insulin resistance, predisposing burn patients to the development of T2DM and CVD. PMID:25211297

  17. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    Directory of Open Access Journals (Sweden)

    Ashley N. Guillory

    2016-01-01

    Full Text Available Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of drugs targeted at reducing aspects of the post-burn hypermetabolic response such as heart rate and cardiac work, there is still a paucity of knowledge regarding the underlying mechanisms that induce cardiac dysfunction in the severely burned. There are many animal models of burn injury, from rodents, to sheep or swine, but the majority of burn related cardiovascular investigations have occurred in rat and mouse models. This literature review consolidates the data supporting the prevalent role that β-adrenergic receptors play in mediating post-burn cardiac dysfunction and the idea that pharmacological modulation of this receptor family is a viable therapeutic target for resolving burn-induced cardiac deficits.

  18. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    Science.gov (United States)

    Guillory, Ashley N.; Clayton, Robert P.; Herndon, David N.; Finnerty, Celeste C.

    2016-01-01

    Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of drugs targeted at reducing aspects of the post-burn hypermetabolic response such as heart rate and cardiac work, there is still a paucity of knowledge regarding the underlying mechanisms that induce cardiac dysfunction in the severely burned. There are many animal models of burn injury, from rodents, to sheep or swine, but the majority of burn related cardiovascular investigations have occurred in rat and mouse models. This literature review consolidates the data supporting the prevalent role that β-adrenergic receptors play in mediating post-burn cardiac dysfunction and the idea that pharmacological modulation of this receptor family is a viable therapeutic target for resolving burn-induced cardiac deficits. PMID:26729111

  19. Children with burn injuries-assessment of trauma, neglect, violence and abuse

    OpenAIRE

    Antoinette Runge; Walter Meyer; John Francis Fraser; Arceneaux, Lisa L.; Dirk Manfred Maybauer; Michael Howard Toon; Marc Oliver Maybauer

    2011-01-01

    Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electri...

  20. Etiology of Burn Injuries Among 0-6 Aged Children in One University Hospital Burn Unit, Bursa, Turkey

    Directory of Open Access Journals (Sweden)

    Neriman Akansel

    2013-01-01

    Full Text Available Background; Children whose verbal communications are not fully developed are the ones at risk for burn injuries. Causes of burn injuries vary among different age groups and scald injuries are the common cause of burn injuries among children. The majority of burns result from contact with thermal agents such as flame, hot surfaces, or hot liquids.Aim: The aim of this study was to determine etiologic factors of the burn injured children Methods: Data were collected for burn injured children treated in Uludag University Medical Hospital Burn Unit between January 2001 – December 2008. Patients’ demographic variables, etiology of burn injury, TBSA(total body surface area, degree of the burn injury, duration of hospitalization was detected from medical records of the hospitalized patients.Results: The mean age of the children was 2.5±1.5 (median=2. Although 4.6 % of burned patients were under one year of age, most of the children (67.8% were between 1-3 years. All of the patients were burned as a result of accident and house environment was the place where the burn incident occurred. Burn injuries occurredmostly during summer (29.9% and spring (28.7%. Scald injuries (75.3% were mostly seen burn injury types all among other burn injuries.Conclusions: Lack of supervision and observation are usually the most common causes of burn injuries in children. Statistical differences were found among age groups according to their burn etiology (p<0.05. An effect of TBSA on patient survival was statistically significant (p<0.000 and also statistically significant results were seen among age groups according to their TBSA’s (p<0.005.

  1. Summer camps for children with burn injuries: a literature review.

    Science.gov (United States)

    Maslow, Gary R; Lobato, Debra

    2010-01-01

    The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended. PMID:20644489

  2. Treatment of burn injuries with keratinocyte cultures

    International Nuclear Information System (INIS)

    The German Institute for Cell and Tissue Replacement (DIZG) provides burned patients with skin and amnion for a temporary wound closure. Severely burned patients (>60% BSA for adults, >40% BSA for children) were supplied with autologous and allogenic grafts from cultured keratinocytes. The keratinocyte culture is done under GMP-conditions using the method of Rheinwald and Green. The 3T3 fibroblasts were irradiated with 60 Gy and used as feeder cells to produce keratinocyte sheets within 3 weeks. In this time up to 6.000 cm are available. The sheets were harvested by detachment with dispase (1,2 U/ml), fixed to gauze and transported to the hospital. The DIZG has a 3 years experience in the treatment of burns with keratinocyte sheets. The sheets were transplanted to patients in different hospitals, the total transplanted area is about 30.000 cm. This paper describes the experiences with ten severely burned patients treated with keratinocyte sheet

  3. High voltage electrical burn injuries in teenage children: case studies with similarities (an indian perspective)

    OpenAIRE

    Mathangi Ramakrishnan, K.; Babu, M.; Mathivanan,; B. Ramachandran; Balasubramanian, S.; Raghuram, K

    2013-01-01

    From 1992 to 2012, a total of 911 paediatric burns were admitted and treated at Kanchi Kamakoti Childs Trust Hospital Intensive Burn Care Unit, of these 28 children had suffered electrical injuries and burns. 7 teenagers suffered high voltage electrical burn injuries: 2 were involved in train accidents which caused fatal electrical injuries, and 5 had electrical burn injuries caused by similar types of accidents, requiring Paediatric Intensive Care Unit (PICU) care, repeated surgeries and ext...

  4. Comparative study on effects of burn-blast combined injury and burn-firearm combined injury complicated with seawater immersion on vascular endothelial cells

    Institute of Scientific and Technical Information of China (English)

    YAN Hong; LAI Xi-nan; GE Heng-jiang

    2005-01-01

    Objective: To comparatively study the effects and mechanisms of burn-blast combined injury and burn-firearm combined injury complicated with seawater immersion on vascular endothelial cells. Methods: A total of 40 healthy adult hybrid dogs of both sexes, weighing 12-15 kg, were used in this study. Randomly-selected 20 dogs were established as models of burn-blast combined injury (the burn-blast injury group) and the other 20 dogs as models of burn-firearm combined injury (the burn-firearm injury group). Then the wounds of all the dogs were immediately immersed in seawater for 4 hours, and then they were taken out from the seawater. Blood samples were withdrawn from the central vein of the dogs before injury, and at 4, 7, 10, 20, and 28 hours after injury to measure the circulating endothelial cells and the von Willebrand factor. Results: Circulating endothelial cells increased significantly at 4 hours after injury in all the dogs. But they reached peak at 7 hours after injury in the burn-blast injury group and at 28 hours after injury in the burn-firearm injury group. The changes of circulating endothelial cells in the burn-blast injury group were significantly different from those in the burn-firearm injury group at 4, 7, 20, and 28 hours after injury (P<0.01). The von Willebrand factor reached peak at 4 hours after injury in the burn-blast injury group and at 28 hours in the burn-firearm injury group. The changes of von Willebrand factor in the burn-blast injury group were significantly different from those in the burn-firearm injury group at 4, 20, and 28 hours after injury (P<0.01).Conclusions: In burn-blast injury combined with seawater immersion, the vascular endothelial cells changed most significantly at 4 hours or 7 hours after injury, while burn-firearm injury combined with seawater immersion have the same at 20 hours or 28 hours after injury.

  5. Burning more than calories: treadmill friction injuries in children.

    LENUS (Irish Health Repository)

    Davidson, C C

    2012-02-01

    Treadmill injuries in young children are a serious but little documented problem. Friction burns occur when the hands come into contact with the moving belt resulting in deep burns that often require hospital admission and surgery. The aim of this study was to assess the nature and prevalence of injuries sustained and to highlight treadmill friction burns as a public health issue previously undocumented in Ireland. A retrospective chart review from January 2006 until March 2008 was performed and functional outcome was assessed by the modified Michigan Hand Outcomes Questionnaire. Eight girls and four boys from one year and seven months to seven years and five months were treated. Eight children required admission to hospital and to date three have required surgery for their injuries. This is a new and increasing problem in Ireland which must be highlighted.

  6. Functioning, Disability, and Social Adaptation Six Months After Burn Injury.

    Science.gov (United States)

    Palmu, Raimo; Partonen, Timo; Suominen, Kirsi; Vuola, Jyrki; Isometsä, Erkki

    2016-01-01

    Major injuries commonly cause long-standing functional impairment. The authors investigated the levels of and predictors for functioning, disability, and social adaptation 6 months after a burn injury. The overall level of functioning at 6 months postburn was assessed among 87 (81%) of the 107 consecutive acute adult burn patients (mean TBSA 9.7%) admitted to the Helsinki Burn Centre during an 18-month period. Social and Occupational Functioning Assessment Scale (SOFAS) was used to evaluate functioning overall, and Sheehan Disability Scale (SDS) to assess the domains of working capacity, social life, and family life. Social Adaptation Self-Evaluation Scale (SASS) was used to measure social adaptation. Structured clinical interview was used to assess mental disorders at baseline and 6 months after injury. The mean SOFAS score was 69.7 (SD = 20.8), indicating some impairment in social and occupational functioning. The strongest independent predictors of SOFAS were mental disorders during follow-up (P personality disorders (P = .007). Six months after a burn injury, some difficulties in social and occupational functioning remained. Level of functioning was predicted strongly and consistently by mental disorders, particularly depression. Length of stay and hand burns also predicted functioning, more in a clinician's evaluation (SOFAS) than in self-reported measures (SDS and SASS). PMID:26056759

  7. Investigating the phenomenology of imagery following traumatic burn injuries.

    Science.gov (United States)

    Cockerham, Elaine Sara; Çili, Soljana; Stopa, Lusia

    2016-06-01

    Intrusive images related to adverse experiences are an important feature of a number of psychological disorders and a hallmark symptom of posttraumatic stress disorder (PTSD). Depression, anxiety, and PTSD are all common reactions following a burn injury. However, the nature of burn-related trauma memories and associated intrusions and their contribution to psychological disorders is not well understood. The aim of the study was to take a broad look at the nature of imagery experienced by people who have sustained a burn injury. Nineteen participants completed self-report questionnaires assessing depression, anxiety, and PTSD symptoms and were administered a semi-structured interview which explored the characteristics (vividness, sensory modalities, intrusions, emotion intensity) of imagery formed in relation to their burn injuries. Ongoing intrusive imagery was reported by over half the participants and there were significant correlations between frequency of intrusive images and posttraumatic symptoms, and between intensity of emotions associated with intrusive images and depression and posttraumatic symptoms. A thematic analysis of the memory narratives revealed four main themes: threat to self, view of the world, view of others, and positive psychological change. These results are discussed in relation to existing trauma theory and burn injury literature. Implications for clinical practice and recommendations for further research are proposed. PMID:27005586

  8. Umbilical cord mesenchymal stem cell transplantation ameliorates burn-induced acute kidney injury in rats.

    Science.gov (United States)

    Lu, Gang; Huang, Sha; Chen, Yongbin; Ma, Kui

    2013-09-01

    Excessive systemic inflammation following burns could lead to acute kidney injury (AKI). Mesenchymal stromal cells (MSCs) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. However, autologous MSCs are not vital enough for the treatment because of the severely burned patients' deleterious condition. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) could be a suitable substitute cell candidate but no data are available on the therapeutic effectiveness of UC-MSCs transplantation for burn injury and its consequences. In this study, UC-MSCs or ulinastatin was administered intravenously in the rats with burn trauma, and the therapeutic effects of UC-MSCs on the survival of severe burn-induced AKI rats and functional protection of kidney were analyzed. Results showed that UC-MSCs promoted the survival and prevented commitment to apoptosis of resident kidney cells and reduced organ microscopic damage in kidneys after thermal trauma. Thus, our study demonstrates that intravenously delivered UC-MSCs protected the host from death caused by kidney injury subsequent to severe burn, identifying UC-MSCs transplantation may be an attractive candidate for cell-based treatments for burns and induced organ damage. PMID:24043673

  9. [Current status in rehabilitation of burn injury in China].

    Science.gov (United States)

    Chiyu, Jia; Xiaofang, Zou

    2015-06-01

    Along with the advance in national economy, modern concept of burn rehabilitation from major burn injury implies that measures should be taken to help the patients return to society with dignity. This article briefly reviews the development and achievement of burn rehabilitation in our country, as well as the current difficulties in carrying out rehabilitation measures such as outmoded ideology, lack of trained personnel, low rat of popularization, outdated techniques and methodology, and relatively low level in scientific research, etc. The future development of burn rehabilitation in our country needs more social support, popular attention, and multidisciplinary joint efforts to help burn patients return to society with dignity. In order to fulfill this goal, we still have a long way to go. PMID:26564559

  10. Genitalia burn: accident or violence? Concerns that transcend injury treatment

    OpenAIRE

    Ana Lúcia Ferreira; Juliana Montez Ferreira; da Silva, Paula Marques C.; Dilene Francisco Constancio

    2014-01-01

    OBJECTIVE: To describe a case of genital burn which raised the suspicion of maltreatment (sexual abuse and neglect by lack of supervision). CASE DESCRIPTION: An infant was taken to the Emergency Room of a pediatric hospital with an extensive burn in the vulva and perineum. The mother claimed the burn had been caused by a sodium-hydroxide-based product. However, the injury severity led to the suspicion of sexual abuse, which was then ruled out by a multidisciplinary team, based on the consiste...

  11. The leading causes of death after burn injury in a single pediatric burn center

    OpenAIRE

    Williams, Felicia N.; Herndon, David N; Hawkins, Hal K.; Lee, Jong O; Cox, Robert A.; Kulp, Gabriela A; Finnerty, Celeste C.; Chinkes, David L.; Jeschke, Marc G.

    2009-01-01

    Introduction Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories a...

  12. Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

    Directory of Open Access Journals (Sweden)

    Terence J Coderre

    2000-01-01

    Full Text Available Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

  13. Changes in Fat Distribution in Children Following Severe Burn Injury

    OpenAIRE

    Patel, Pavankumar; Hanaa S. Sallam; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N; Abate, Nicola

    2014-01-01

    Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution.

  14. Development of an Animal Model for Burn-Blast Combined Injury and Cardiopulmonary System Changes in the Early Shock Stage.

    Science.gov (United States)

    Hu, Quan; Chai, Jiake; Hu, Sen; Fan, Jun; Wang, Hong-Wei; Ma, Li; Duan, Hong-Jie; Liu, Lingying; Yang, Hongming; Li, Bai-Ling; Wang, Yi-He

    2015-12-01

    The purposes of this study were to establish an animal model for burn-blast combined injury research and elaborate cardiopulmonary system changes in the early shock stage. In this study, royal demolition explosive or RDX (hexagon, ring trimethylene nitramine) was used as an explosive source, and the injury conditions of the canine test subjects at various distances to the explosion (30, 50, and 70 cm) were observed by gross anatomy and pathology to determine a larger animal model of moderate blast injury. The canines were then subjected to a 35 % total body surface area (TBSA) full-thickness flame injury using napalm, which completed the development of a burn-blast combined injury model. Based on this model, the hemodynamic changes and arterial blood gas analysis after the burn-blast combined injury were measured to identify the cardiopulmonary system characteristics. In this research, RDX explosion and flame injury were used to develop a severe burn-blast injury animal model that was stable, close to reality, and easily controllable. The hemodynamic and arterial blood gas changes in the canine subjects after burn-blast injury changed distinctly from the burn and blast injuries. Blood pressure and cardiac output fluctuated, and the preload was significantly reduced, whereas the afterload significantly increased. Meanwhile, the oxygen saturation (SO2) decreased markedly with carbon dioxide partial pressure (PCO2), and lactic acid (Lac) rose, and oxygen partial pressure (PO2) reduced. These changes suggested that immediate clinical treatment is important during burn-blast injury both to stabilize cardiac function and supply blood volume and to reduce the vascular permeability, thereby preventing acute pneumonedema or other complications. PMID:27011494

  15. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    OpenAIRE

    Finnerty, Celeste C.; Herndon, David N; Jeschke, Marc G.

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in...

  16. Military and civilian burn injuries during armed conflicts.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Hayek, S N

    2007-12-31

    Burn injury is a ubiquitous threat in the military environment, and war burns have been described for more than 5,000 years of written history. Fire was probably utilized as a weapon long before that. With the ever-increasing destructive power and efficiency of modern weapons, casualties, both fatal and non-fatal, are reaching new highs, particularly among civilians who are becoming the major wartime targets in recent wars, accounting for most of the killed and wounded. Even though medical personnel usually believe that a knowledge of weaponry has little relevance to their ability to effectively treat injuries and that it may in some way be in conflict with their status, accorded under the Geneva and Hague treaties, it is imperative that they know how weapons are used and understand their effects on the human body. The present review explores various categories of weapons of modern warfare that are unfamiliar to most medical and paramedical personnel responsible for burn treatment. The mechanisms and patterns of injury produced by each class of weapons are examined so that a better understanding of burn management in a warfare situation may be achieved. PMID:21991098

  17. Military and Civilian Burn Injuries During Armed Conflicts

    OpenAIRE

    Atiyeh, B.S.; Gunn, S.W.A.; Hayek, S.N.

    2007-01-01

    Burn injury is a ubiquitous threat in the military environment, and war burns have been described for more than 5,000 years of written history. Fire was probably utilized as a weapon long before that. With the ever-increasing destructive power and efficiency of modern weapons, casualties, both fatal and non-fatal, are reaching new highs, particularly among civilians who are becoming the major wartime targets in recent wars, accounting for most of the killed and wounded. Even though medical pe...

  18. Acute kidney injury in burns: a story of volume and inflammation

    OpenAIRE

    COLPAERT, KIRSTEN; Hoste, Eric A

    2008-01-01

    Acute kidney injury occurs in approximately one-quarter to one-third of patients with major burn injury. Apart from the usual suspects – such as older age, severity of burn injury, sepsis and multiple organ dysfunction – volume overload probably has an important role in the pathogenesis of acute kidney injury.

  19. The effect of burn injury on adolescents autobiographical memory.

    Science.gov (United States)

    Stokes, D J; Dritschel, B H; Bekerian, D A

    2004-11-01

    Autobiographical memory recall was investigated in two female adolescent groups; one group who had experienced a burn injury and a matched control group. The Burn group was not currently depressed or anxious, but scored significantly higher on the intrusion subscale of the impact of event scale compared to controls. Two autobiographical memory tasks, the autobiographical memory cueing task and the Children's Autobiographical Memory Inventory (CAMI), were used. For the cueing task, the Burn group was significantly slower to recall specific memories. This group also recalled significantly fewer specific memories and significantly more extended overgeneral memories. For the CAMI, the burns group produced significantly lower semantic and episodic recall. The Burn group also produced significant correlations between sub-scales of the impact of event scale and selected measures on the autobiographical memory tasks. Higher intrusion scores were associated with less detailed episodic recall. Higher avoidance scores were associated with longer latencies to recall memories to negative cue words and fewer specific memories to all cue words. These results are discussed from the perspective that the Burn group experienced intrusive thoughts which interfered with normal autobiographical functioning. PMID:15381443

  20. Frailty score on admission predicts outcomes in elderly burn injury.

    Science.gov (United States)

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  1. Terahertz spectroscopy for the assessment of burn injuries in vivo.

    Science.gov (United States)

    Arbab, M Hassan; Winebrenner, Dale P; Dickey, Trevor C; Chen, Antao; Klein, Matthew B; Mourad, Pierre D

    2013-07-01

    A diagnosis criterion is proposed for noninvasive grading of burn injuries using terahertz radiation. Experimental results are presented from in vivo terahertz time-domain spectroscopy of second- and third-degree wounds, which are obtained in a 72-hour animal study. During this period, the change in the spectroscopic response of the burned tissue is studied. It is shown that terahertz waves are sensitive not only to the postburn formation of interstitial edema, but also to the density of skin structures derived from image processing analysis of histological sections. Based on these preliminary results, it is suggested that the combination of these two effects, as probed by terahertz spectroscopy of the tissue, may ultimately be used to differentiate partial-thickness burns that will naturally heal from those that will require surgical intervention. PMID:23860943

  2. Risks for skin and other cancers up to 25 years after burn injuries

    DEFF Research Database (Denmark)

    Mellemkjaer, Lene; Hölmich, Lisbet R; Gridley, Gloria;

    2006-01-01

    BACKGROUND: Malignant degeneration of chronic ulcers such as nonhealed burn wounds has been described in the literature, but this phenomenon has never been quantified in an epidemiologic study. We investigated the risks for skin and other cancers among patients with a prior burn. METHODS: We...... general population of Denmark. RESULTS: Patients with burn had 139 skin cancers, with 189 expected, yielding a standardized incidence ratio of 0.7 (95% confidence interval = 0.6-0.9). This reduced risk was due mainly to deficits of basal cell carcinoma and malignant melanoma, whereas the number of...... squamous cell carcinomas observed was close to expected. We saw no consistent increases in risk for skin cancer in the subgroups of patients with the most severe injuries or with the longest periods of follow up. CONCLUSIONS: The tendency to malignant degeneration of burn scars, described in previous...

  3. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  4. Ustioni da fuoco / Burn injuries / Les brûlures

    Directory of Open Access Journals (Sweden)

    Liliana Copertino

    2008-04-01

    Full Text Available Severe burn injuries require high specialistic treatment. Burn injuries are common in disasters and war scenarios, so war medicine has been fundamental to improve treatment protocols for burn patients..Burn injuries are classified according to the etiopathogenetic agent (physical, chemical or radiation, that determines different anatomoisthologic aspects.An estimation of the depth and extension are fundamental for defining the gravity of the burn. Critical burn patients have to be transported in specialistic Centers. There they are treated by multispecialistic teams from the resuscitation phase to the reconstructive surgery and specialist rehabilitation.. This process can continue for two years with the objective to return patients to a quiet normal life. Les brûlures sont des lésions traumatiques qui requièrent un traitement spécialisé. Lors de catastrophes et de guerres, les brûlures sont des lésions très fréquentes et la médecine de guerre a contribué à faire avancer la science de manière importante, dans le traitement de cette pathologie.Les brûlures sont classées en fonction de l'agent étiopathogénique (agents physiques, chimiques ou radiations dont le mécanisme d'action qui provoque la lésion cause des aspects anatomohistologiques caractéristiques.Pour définir la sévérité d'une brûlure, il est aussi fondamental d'éstimer l'extension de la surface corporelle et la profondeur de l'épiderme, et éventuellement du derme, atteints. Les patients gravement brûlés doivent être hospitalisés dans des Centres Spécialisés où des équipes multispécialistes les suivent de la phase initiale de la réanimation aux phases de chirurgie reconstructive et au processus de réhabilitation. Ces dernières phases peuvent se prolonger pendant les deux années suivant le traumatisme avant qu'une réintégration dans une vie sociale acceptable ne puisse être faite.

  5. Genitalia burn: accident or violence? Concerns that transcend injury treatment

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Ferreira

    2014-06-01

    Full Text Available OBJECTIVE: To describe a case of genital burn which raised the suspicion of maltreatment (sexual abuse and neglect by lack of supervision.CASE DESCRIPTION: An infant was taken to the Emergency Room of a pediatric hospital with an extensive burn in the vulva and perineum. The mother claimed the burn had been caused by a sodium-hydroxide-based product. However, the injury severity led to the suspicion of sexual abuse, which was then ruled out by a multidisciplinary team, based on the consistent report by the mother. Besides, the lesion type matched those caused by the chemical agent involved in the accident and the family context was evaluated and considered adequate. The patient had a favorable outcome and was discharged after four days of hospitalization. Outpatient follow-up during six months after the accident enabled the team to rule out neglect by lack of supervision.COMMENTS: Accidents and violence are frequent causes of physical injuries in children, and the differential diagnosis between them can be a challenge for healthcare workers, especially in rare clinical conditions involving patients who cannot speak for themselves. The involvement of a multidisciplinary trained team helps to have an adequate approach, ensuring child protection and developing a bond with the family; the latter is essential for a continued patient follow-up.

  6. Sibling experiences after a major childhood burn injury.

    Science.gov (United States)

    Lehna, Carlee

    2010-01-01

    The purpose of this research project was to understand, primarily from the sibling perspective, the effect of a child's major burn injury on his or her sibling. A mixed method qualitative dominant design was implemented using the life story method for the qualitative portion. Additionally, the Sibling Relationship Questionnaire -Revised (SRQ-R) was used as a structured interview guide and for calculating scoring data to explore sibling relationship factors of warmth/closeness, rivalry, conflict, and relative status/power. Participants from 22 family cases (one or multiple family members) and 40 individuals were interviewed. To capture impact on the family over time, interviews began a minimum of two years post-burn. The central thematic pattern for the sibling relationship in families having a child with a major burn injury was that of normalization. Two components of normalization were described: areas of normalization and the process of adjustment. Areas of normalization were found in play and other activities, in school and work, and in family relations with siblings. The process of adjustment was varied and often gradual, involved school and work re-entry, and in some instances, seemed to change life perspective. Clinical implications in providing family-centered care can focus on promoting normalization by assessing and supporting siblings who may only be occasionally seen in the hospital or clinic. PMID:21067076

  7. HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

    OpenAIRE

    Ssentongo Robert; Chalya Phillipo L; Kakande Ignatius

    2011-01-01

    Abstract Background HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting and to compare the outcome of these patients who are HIV positive with those who are HIV negative. Methods This was a prospective cohort study involving burn injury patients admitted to Mulago Hospital between November 2005 and February 2006. Patients were stratified...

  8. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS’ EXPERIENCE

    OpenAIRE

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-01-01

    Objective: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to present...

  9. HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

    Directory of Open Access Journals (Sweden)

    Ssentongo Robert

    2011-06-01

    practice universal precautions in order to reduce the risk of exposure to HIV infection and post-exposure prophylaxis should be emphasized. The outcome of burn injury in HIV infected patients is dependent upon multiple variables such as age of the patient, inhalation injury and %TBSA and not the HIV status alone.

  10. Burn Rehabilitation

    OpenAIRE

    Koray Aydemir; Mehmet Ali Taşkaynatan

    2011-01-01

    Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The t...

  11. Hot asphalt burns: a review of injuries and management options.

    Science.gov (United States)

    Bosse, George M; Wadia, Shernaz A; Padmanabhan, Pradeep

    2014-07-01

    Hot asphalt burns to human tissue can increase the likelihood of infection and potential conversion of partial thickness to full-thickness injuries. Successful intervention for hot asphalt burns requires immediate and effective cooling of the asphalt on the tissue followed by subsequent gradual removal of the cooled asphalt. A review of the literature reveals that multiple substances have been used to remove asphalt, including topical antibiotics, petroleum jelly, a commercial product known as De-Solv-It (ORANGE-SOL, Chandler, AZ), sunflower oil, baby oil, liquid paraffin, butter, mayonnaise, and moist-exposed burn ointment (MEBO). Although many of these products may be effective in the removal of asphalt, they may not be readily available in an emergency department setting. Topical antibiotics are readily available, are more commonly described in the medical literature, and would be expected to be effective in the removal of asphalt. We developed guidelines for on scene (first-aid) management and the initial care of such patients upon presentation to a health care facility. These guidelines emphasize the principles of early cooling, gradual removal of adherent asphalt using topical antibiotics, and avoidance of the use of topical agents, which are likely to result in tissue toxicity. PMID:24630605

  12. Secondary hyperalgesia to heat stimuli after burn injury in man

    DEFF Research Database (Denmark)

    Pedersen, J L; Kehlet, H

    1998-01-01

    The aim of the study was to examine the presence of hyperalgesia to heat stimuli within the zone of secondary hyperalgesia to punctate mechanical stimuli. A burn was produced on the medial part of the non-dominant crus in 15 healthy volunteers with a 50 x 25 mm thermode (47 degrees C, 7 min), and...... assessments were made 70 min and 40 min before, and 0, 1, and 2 h after the burn injury. Hyperalgesia to mechanical and heat stimuli were examined by von Frey hairs and contact thermodes (3.75 and 12.5 cm2), and pain responses were rated with a visual analog scale (0-100). The area of secondary hyperalgesia...... to punctate stimuli was assessed with a rigid von Frey hair (462 mN). The heat pain responses to 45 degrees C in 5 s (3.75 cm2) were tested in the area just outside the burn, where the subjects developed secondary hyperalgesia, and on the lateral crus where no subject developed secondary hyperalgesia...

  13. Early postoperative alterations of ventilation parameters after tracheostomy in major burn injuries

    Directory of Open Access Journals (Sweden)

    Mailänder, Peter

    2010-01-01

    Full Text Available Purpose: In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS. Materials: A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered. Results: A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52±19 years. Mean abbreviated burned severity index (ABSI was 8.3±2.2. A mechanical ventilation was required for 14.3±4.8 days. TS was performed on day 7±4. Inspiratory oxygen concentration (FiO2 (p<0.001, peak inspiratory pressure (p<0.001, positive end-expiratory pressure (p=0.003 and pulmonary resistance (p<0.001 were reduced significantly after TS. The arterial partial pressure of oxygen/FiO2-ratio increased significantly after TS (p<0.001. Conclusions: We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.

  14. An alteration of the gut-liver axis drives pulmonary inflammation after intoxication and burn injury in mice.

    Science.gov (United States)

    Chen, Michael M; Zahs, Anita; Brown, Mary M; Ramirez, Luis; Turner, Jerrold R; Choudhry, Mashkoor A; Kovacs, Elizabeth J

    2014-10-01

    Approximately half of all adult burn patients are intoxicated at the time of their injury and have worse clinical outcomes than those without prior alcohol exposure. This study tested the hypothesis that intoxication alters the gut-liver axis, leading to increased pulmonary inflammation mediated by burn-induced IL-6 in the liver. C57BL/6 mice were given 1.2 g/kg ethanol 30 min prior to a 15% total body surface area burn. To restore gut barrier function, the specific myosin light chain kinase inhibitor membrane-permeant inhibitor of kinase (PIK), which we have demonstrated to reduce bacterial translocation from the gut, was administered 30 min after injury. Limiting bacterial translocation with PIK attenuated hepatic damage as measured by a 47% reduction in serum alanine aminotransferase (P intoxicated and burn-injured mice without PIK. This mitigation of hepatic damage was associated with a 49% decline in pulmonary neutrophil infiltration (P antibiotics before intoxication and burn injury. Overall, these data suggest that the gut-liver axis is deranged when intoxication precedes burn injury and that limiting bacterial translocation in this setting attenuates hepatic damage and pulmonary inflammation. PMID:25104501

  15. High voltage electrical burn injuries in teenage children: case studies with similarities (an indian perspective)

    Science.gov (United States)

    Mathangi Ramakrishnan, K.; Babu, M.; Mathivanan; Ramachandran, B.; Balasubramanian, S.; Raghuram, K.

    2013-01-01

    Summary From 1992 to 2012, a total of 911 paediatric burns were admitted and treated at Kanchi Kamakoti Childs Trust Hospital Intensive Burn Care Unit, of these 28 children had suffered electrical injuries and burns. 7 teenagers suffered high voltage electrical burn injuries: 2 were involved in train accidents which caused fatal electrical injuries, and 5 had electrical burn injuries caused by similar types of accidents, requiring Paediatric Intensive Care Unit (PICU) care, repeated surgeries and extensive rehabilitation. A common factor among these latter 5 patients was that they were injured by overhead high electrical voltage cables. Their management was labour intensive and highly costly. In this report, the type of accident, the electrical voltage that produced burns and the treatment details are elaborated. Findings included similarities in age and type of accident, and failure to implement safety procedures and apply standard norms of high voltage transmission feeder lines. PMID:24563637

  16. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    Science.gov (United States)

    Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in the study. Inhalation injury was diagnosed by bronchoscopy during the first operation. Blood was collected within 24 hours of admission and again at five to seven days following admission. Cytokine expression was profiled using multi-plex antibody-coated beads. Significance was accepted at a p value of less than 0.05. Results The mean percentages of total body surface area burned were 67% ± 4% (56% ± 6%, third-degree burns) in the inhalation injury group and 60% ± 3% (45% ± 3%, third-degree burns) in the non-inhalation injury group (p value not significant [NS]). Mean age was 9 ± 1 years in the inhalation injury group and 8 ± 1 years in the non-inhalation injury group (p value NS). Time from burn to admission in the inhalation injury group was 2 ± 1 days compared to 3 ± 1 days in the non-inhalation injury group (p value NS). Mortalities were 40% in the inhalation injury group and 12% in the non-inhalation injury group (p < 0.05). At the time of admission, serum interleukin (IL)-7 was significantly increased in the non-inhalation injury group, whereas IL-12p70 was significantly increased in the inhalation injury group compared to the non-inhalation injury group (p < 0.05). There were no other significant differences between groups. Five to seven days following admission, all cytokines decreased with no differences between the inhalation injury and non-inhalation injury cohorts. Conclusion In the present study, we show that an inhalation injury causes alterations in IL-7

  17. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    Objective To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Design Retrospective, descriptive cohort study. Setting 10-bed burn PICU facility. Patients All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Measurements and results Data of 12...

  18. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Retrospective, descriptive cohort study. 10-bed burn PICU facility. All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Data of 123 patients were studied. The incidence of AKI w...

  19. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    OpenAIRE

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C.; Cox, Robert A.; Song, Juquan; Jeschke, Marc G.

    2015-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and m...

  20. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    OpenAIRE

    Guillory, Ashley N.; Clayton, Robert P.; Herndon, David N; Finnerty, Celeste C.

    2016-01-01

    Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of ...

  1. Coping with burns : the role of coping self-efficacy in the recovery from traumatic stress following burn injuries

    OpenAIRE

    Bosmans, Mark W. G.; Hofland, Helma W.; De Jong, Alette E.; van Loey, Nancy E.

    2015-01-01

    We conducted a three-wave prospective study among patients with burns (N = 178) to examine the prospective influence of coping self-efficacy (CSE) perceptions on trajectories of posttraumatic stress symptoms in the first 12 months after burn injuries. Using linear growth curve modeling, we corrected for demographics, the number of surgeries during initial admittance, trait coping styles, and changing levels of health-related quality of life. CSE during initial admission was by far the stronge...

  2. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects.

    Science.gov (United States)

    Zang, Tuo; Broszczak, Daniel A; Broadbent, James A; Cuttle, Leila; Lu, Haitao; Parker, Tony J

    2016-01-01

    Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity. PMID:26581649

  3. Epidemiology of burn injuries in the East Mediterranean Region: a systematic review

    Directory of Open Access Journals (Sweden)

    Kendrick Denise

    2010-02-01

    Full Text Available Abstract Background Burn injuries remain one of the leading causes of injury morbidity and mortality in the World Health Organization's East Mediterranean Region. To provide an overview on the epidemiology of burn injuries in this region, a systematic review was undertaken. Methods Medline, Embase and CINAHL were searched for publications on burns in this region published between 01/01/1997 and 16/4/2007. Data were extracted to a standard spreadsheet and synthesised using a narrative synthesis. No attempt has been made to quantitatively synthesise the data due to the large degree of clinical heterogeneity between study populations. Results Seventy one studies were included in the review, from 12 countries. Burn injuries were found to be one of the leading causes of injury morbidity and mortality. The reported incidence of burns ranged from 112 to 518 per 100,000 per year. Burn victims were more frequently young and approximately one third of the victims were children aged 0-5 years. Hospital mortality ranged from 5 to 37%, but was commonly above 20%. Intentional self-harm burns particularly involving women were common in some countries of the region and were associated with a very high mortality of up to 79%. Conclusion Burn injuries remain an important public health issue in the East Mediterranean Region therefore further research is required to investigate the problem and assess the effectiveness of intervention programmes.

  4. MILD OBESITY IS PROTECTIVE AFTER SEVERE BURN INJURY

    Science.gov (United States)

    Jeschke, Marc G.; Finnerty, Celeste C.; Emdad, Fatemeh; Rivero, Haidy G.; Kraft, Robert; Williams, Felicia N; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective To assess the impact of obesity on morbidity and mortality in severely burned patients. Background Despite the increasing number of people with obesity, little is known about the impact of obesity on postburn outcomes. Methods A total of 405 patients were prospectively enrolled as part of the multicenter trial Inflammation and the Host Response to Injury Glue Grant with the following inclusion criteria: 0 to 89 years of age, admitted within 96 hours after injury, and more than 20% total body surface area burn requiring at least 1 surgical intervention. Body mass index was used in adult patients to stratify according to World Health Organization definitions: less than 18.5 (underweight), 18.5 to 29.9 (normal weight), 30 to 34.9 (obese I), 35 to 39.9 (obese II), and body mass index more than 40 (obese III). Pediatric patients (2 to ≤18 years of age) were stratified by using the Centers for Disease Control and Prevention and World Health Organization body mass index-for-age growth charts to obtain a percentile ranking and then grouped as underweight (<5th percentile), normal weight (5th percentile to <95th percentile), and obese (≥95th percentile). The primary outcome was mortality and secondary outcomes were clinical markers of patient recovery, for example, multiorgan function, infections, sepsis, and length of stay. Results A total of 273 patients had normal weight, 116 were obese, and 16 were underweight; underweight patients were excluded from the analyses because of insufficient patient numbers. There were no differences in primary and secondary outcomes when normal weight patients were compared with obese patients. Further stratification in pediatric and adult patients showed similar results. However, when adult patients were stratified in obesity categories, log-rank analysis showed improved survival in the obese I group and higher mortality in the obese III group compared with obese I group (P < 0.05). Conclusions Overall, obesity was not

  5. Effect of fasting on the metabolic response of liver to experimental burn injury.

    Directory of Open Access Journals (Sweden)

    Mehmet A Orman

    Full Text Available Liver metabolism is altered after systemic injuries such as burns and trauma. These changes have been elucidated in rat models of experimental burn injury where the liver was isolated and perfused ex vivo. Because these studies were performed in fasted animals to deplete glycogen stores, thus simplifying quantification of gluconeogenesis, these observations reflect the combined impact of fasting and injury on liver metabolism. Herein we asked whether the metabolic response to experimental burn injury is different in fed vs. fasted animals. Rats were subjected to a cutaneous burn covering 20% of the total body surface area, or to similar procedures without administering the burn, hence a sham-burn. Half of the animals in the burn and sham-burn groups were fasted starting on postburn day 3, and the others allowed to continue ad libitum. On postburn day 4, livers were isolated and perfused for 1 hour in physiological medium supplemented with 10% hematocrit red blood cells. The uptake/release rates of major carbon and nitrogen sources, oxygen, and carbon dioxide were measured during the perfusion and the data fed into a mass balance model to estimate intracellular fluxes. The data show that in fed animals, injury increased glucose output mainly from glycogen breakdown and minimally impacted amino acid metabolism. In fasted animals, injury did not increase glucose output but increased urea production and the uptake of several amino acids, namely glutamine, arginine, glycine, and methionine. Furthermore, sham-burn animals responded to fasting by triggering gluconeogenesis from lactate; however, in burned animals the preferred gluconeogenic substrate was amino acids. Taken together, these results suggest that the fed state prevents the burn-induced increase in hepatic amino acid utilization for gluconeogenesis. The role of glycogen stores and means to increase and/or maintain internal sources of glucose to prevent increased hepatic amino acid

  6. Gendered pattern of burn injuries in India: a neglected health issue.

    Science.gov (United States)

    Bhate-Deosthali, Padma; Lingam, Lakshmi

    2016-05-01

    There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women's groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage. PMID:27578343

  7. Myosin light chain kinase mediates intestinal barrier disruption following burn injury.

    Directory of Open Access Journals (Sweden)

    Chuanli Chen

    Full Text Available BACKGROUND: Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC phosphorylation mediated by MLC kinase (MLCK is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. METHODOLOGY/PRINCIPAL FINDINGS: Male balb/c mice were assigned randomly to either sham burn (control or 30% total body surface area (TBSA full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg, an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. CONCLUSIONS/SIGNIFICANCE: The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury.

  8. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    OpenAIRE

    Gauglitz, Gerd G.; Finnerty, Celeste C.; Herndon, David N; Mlcak, Ronald P.; Jeschke, Marc G.

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different s...

  9. Nonpharmacological interventions for acute wound care distress in pediatric patients with burn injury: a systematic review.

    Science.gov (United States)

    Hanson, Mark D; Gauld, Mary; Wathen, C Nadine; Macmillan, Harriet L

    2008-01-01

    Acute wound care distress among burn-injured pediatric patients is of major clinical concern. This systematic review evaluates the benefits of nonpharmacological interventions to reduce this distress. MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and the Cochrane Library databases were searched using appropriate search terms for articles reporting overall psychological effects of pediatric burn injury. Key references were hand-searched. Searches yielded approximately 900 unique citations. Two authors reviewed each abstract, and 198 articles were retrieved, of which 34 were selected for full review. Of these 34 articles, 12 focused on acute wound care distress and nonpharmacological interventions. Critical appraisal of individual studies was conducted using the methods of the US Preventive Services Task Force, with a particular focus on assessing nonrandomized controlled trial designs. Twelve articles were reviewed and categorized according to intervention types child mediated (CM), parent mediated (PM), and health care provider mediated (HCPM). Using the US Preventive Services Task Force criteria, 7 of the 12 articles were rated "fair" or "good" and five were rated as having "poor" internal validity. The HCPM and CM intervention categories reported patient benefit. The two PM studies were both rated "poor." Studies of nonpharmacological interventions to reduce pediatric burn distress were few, with a significant proportion (5/12) having concerns about internal validity. Patient benefit was reported for HCPM and CM interventions. Research designs incorporating control groups in studies that are adequately powered are needed. Additional research is required in the area of PM interventions in particular. PMID:18695617

  10. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    OpenAIRE

    Jeschke, Marc G.; Gauglitz, Gerd G.; Kulp, Gabriela A; Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Oscar E Suman; Mlcak, Ronald P.; Herndon, David N

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three yea...

  11. Long-term persistance of the pathophysiologic response to severe burn injury.

    OpenAIRE

    Jeschke, Marc G.; Gauglitz, Gerd G.; Kulp, Gabriela A; Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Oscar E Suman; Mlcak, Ronald P.; Herndon, David N

    2011-01-01

    Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-bur...

  12. Applications of visible near-infrared spectroscopy and imaging in burn injury assessment

    Science.gov (United States)

    Leonardi, Lorenzo; Sowa, Michael G.; Payette, Jeri R.; Hewko, Mark D.; Schattka, Bernhard J.; Matas, Anna; Mantsch, Henry H.

    2000-05-01

    The major objective of the project is to develop a noninvasive method to assess thermal burns. Currently, the diagnosis relies primarily upon visual assessment of the injury by a burn specialist and/or plastic surgeon. The diagnosis is based on the surface appearance of the wound to determine the type or depth of the burn. Near IR spectroscopic measurements of injured tissue provide an objective means of distinguishing between surface and subsurface changes related to the tissue injury. An acute porcine model is employed to investigate the potential of near IR spectroscopy to accurately distinguish between burns of varying severity in the early postburn period. Parallel factor analysis is used to investigate the spectral changes related to burns of varying severity. Burn injuries drastically alter the physical and optical properties of the tissue. Thermal destruction of cutaneous vasculature disrupts perfusion and oxygen delivery to the affected tissue. Tissue blood oxygenation decreases with increased severity of the burn. The result demonstrate that near IR spectroscopy may provide a new tool for objective clinical assessment of burn injuries.

  13. Micronucleus frequency in peripheral lymphocytes for the differential diagnosis of radiation injuries combined with thermal burns

    International Nuclear Information System (INIS)

    An investigation was conducted to determine if any analysis of micronucleus frequency in human peripheral lymphocytes was useful to diagnostically differentiate radiation injuries in the presence of thermal burns. In the first part of the study, 27 patients with burns of various degrees were tested to determine if the peripheral lymphocytes stimulated in vitro for mitotic division would contain micronuclei--a type of chromosomal aberration inducible by many genotoxic substances. Data showed that the frequency of micronuclei did not increase with burn injury but did correlate with age. Therefore, it is suggested that in cases of radiation injuries combined with burns, the pathologic process related to the latter type of injury does not influence the differential diagnostic value of the micronucleus test. In the second part of the study, the validity of this hypothesis was tested in guinea pigs exposed to various doses of gamma-radiation (between 0.5 and 4.0 Gy) and then inflicted with thermal burns. The results confirmed that when radiation injuries and thermal burns coexist, the micronucleus test is a reliable biologic indicator of radiation injury

  14. Long-term persistance of the pathophysiologic response to severe burn injury.

    Directory of Open Access Journals (Sweden)

    Marc G Jeschke

    Full Text Available BACKGROUND: Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. METHODOLOGY/PRINCIPAL FINDINGS: PATIENTS: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. CONCLUSIONS: Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified

  15. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    Science.gov (United States)

    Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Suman, Oscar E.; Mlcak, Ronald P.; Herndon, David N.

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. Methodology/Principal Findings Patients: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. Conclusions Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for

  16. Minor burn injuries in children: inpatient versus outpatient treatment?

    Science.gov (United States)

    La Ferla, G. A.; Fyfe, A. H.; Drainer, I. K.

    1983-01-01

    Seventy-two children with minor superficial burns presented at our casualty department over a 5-month period. Half were treated as inpatients and the other half as outpatients. The colonisation rates were similar in the two groups. Colonised and sterile burns treated as inpatients showed no significant difference in healing rates. The healing time, however, was prolonged in colonised outpatient treated burns. Cosmetic results were satisfactory overall. In the absence of a definite benefit from inpatient treatment, outpatient care of a child with a minor burn should therefore be used if circumstances allow. PMID:6357035

  17. Epidemiology of Pediatric Burn Injuries in Isfahan, Iran

    OpenAIRE

    Rafii, Mohammad Hadi; Saberi, Hamid Reza; Hosseinpour, Mehrdad; Fakharian, Esmaeil; Mohammadzadeh, Mahdi

    2012-01-01

    Background Burns are major cause of death and disability worldwide, particularly in the developing countries. Objectives The aim of this study was to determine the incidence and causes of burns in children under the age of 15 years in Isfahan province, Iran. Patients and Methods All children admitted to the burn center of Isfahan, the largest city in central Iran, between 2007 and 2009 were enrolled in this study. We analyzed the data on age, sex, location, cause and spread of the burn, durat...

  18. Changes of some immune functions in combined radiation-burn injury in rats

    International Nuclear Information System (INIS)

    The characteristics of some immune functions in radiation injury (6 Gy), burn injury (15%, III deg) and combined radiation-burn injury (CRBI) were studied in rats. The results showed that the functions of splenocytes and thymocytes in radiation injury group (RIG) were depressed more markedly 24-72 h after injury. The degree of thymocyte depression in burn injury group (BIG) was significantly lower than that in RIG and recovered more easily. The characteristics of the CRBI effects were as follows: (1) The combined depression effect on thymocytes in CRBI as compared with that in RIG was deeper and the recovery was slower. (2) The depression course of splenocytes was similar to that in RIG, but the depression degree in the early stage was significantly more heavy than that in RIG. (3) In the later stage of CRBI the level of recovery of TH cells was significantly lower than that in RIG. (4) Eschar-excision plus skin grafting at 24 h after combined injury was helpful for the recovery of thymocyte and splenocytes function. The results showed that the depression and recovery of immune functions in combined injury were closely related to the wound of burn

  19. Impaired respiratory function and heightened pulmonary inflammation in episodic binge ethanol intoxication and burn injury.

    Science.gov (United States)

    Shults, Jill A; Curtis, Brenda J; Chen, Michael M; O'Halloran, Eileen B; Ramirez, Luis; Kovacs, Elizabeth J

    2015-11-01

    Clinical data indicate that cutaneous burn injuries covering greater than 10% of the total body surface area are associated with significant morbidity and mortality, in which pulmonary complications, including acute respiratory distress syndrome (ARDS), contribute to nearly half of all patient deaths. Approximately 50% of burn patients are intoxicated at the time of hospital admission, which increases days on ventilators by 3-fold, and doubles the length of hospitalization, compared to non-intoxicated burn patients. The most common drinking pattern in the United States is binge drinking, where an individual rapidly consumes alcoholic beverages (4 for women, 5 for men) in 2 h. An estimated 38 million Americans binge drink, often several times per month. Experimental data demonstrate that a single binge-ethanol exposure, prior to scald injury, impairs innate and adaptive immune responses, thereby enhancing infection susceptibility and amplifying pulmonary inflammation, neutrophil infiltration, and edema, and is associated with increased mortality. Since these characteristics are similar to those observed in ARDS burn patients, our study objective was to determine whether ethanol intoxication and burn injury and the subsequent pulmonary congestion affect physiological parameters of lung function, using non-invasive and unrestrained plethysmography in a murine model system. Furthermore, to mirror young adult binge-drinking patterns, and to determine the effect of multiple ethanol exposures on pulmonary inflammation, we utilized an episodic binge-ethanol exposure regimen, where mice were exposed to ethanol for a total of 6 days (3 days ethanol, 4 days rest, 3 days ethanol) prior to burn injury. Our analyses demonstrate mice exposed to episodic binge ethanol and burn injury have higher mortality, increased pulmonary congestion and neutrophil infiltration, elevated neutrophil chemoattractants, and respiratory dysfunction, compared to burn or ethanol intoxication alone

  20. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  1. Central activation of TRPV1 and TRPA1 by novel endogenous agonists contributes to mechanical and thermal allodynia after burn injury

    Science.gov (United States)

    Green, Dustin P; Ruparel, Shivani; Gao, Xiaoli; Ruparel, Nikita; Patil, Mayur; Akopian, Armen

    2016-01-01

    The primary complaint of burn victims is an intense, often devastating spontaneous pain, with persistence of mechanical and thermal allodynia. The transient receptor potential channels, TRPV1 and TRPA1, are expressed by a subset of nociceptive sensory neurons and contribute to inflammatory hypersensitivity. Although their function in the periphery is well known, a role for these TRP channels in central pain mechanisms is less well defined. Lipid agonists of TRPV1 are released from peripheral tissues via enzymatic oxidation after burn injury; however, it is not known if burn injury triggers the release of oxidized lipids in the spinal cord. Accordingly, we evaluated whether burn injury evoked the central release of oxidized lipids. Analysis of lipid extracts of spinal cord tissue with HPLC-MS revealed a significant increase in levels of the epoxide and diol metabolites of linoleic acid: 9,10-DiHOME, 12,13-DiHOME, 9(10)-EpOME, and 12(13)-EpOME, that was reduced after intrathecal (i.t.) injection of the oxidative enzyme inhibitor ketoconazole. Moreover, we found that these four lipid metabolites were capable of specifically activating both TRPV1 and TRPA1. Intrathecal injection of specific antagonists to TRPV1 (AMG-517) or TRPA1 (HC-030031) significantly reduced post-burn mechanical and thermal allodynia. Finally, i.t. injection of ketoconazole significantly reversed post-burn mechanical and thermal allodynia. Our data indicate that spinal cord TRPV1 and TRPA1 contributes to pain after burn and identifies a novel class of oxidized lipids elevated in the spinal cord after burn injury. Since the management of burn pain is problematic, these findings point to a novel approach for treating post-burn pain. PMID:27411353

  2. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    OpenAIRE

    Sadeghi-Bazargani H; Maghsoudi H; Soudmand-Niri M; Ranjbar F; Mashadi-Abdollahi H

    2011-01-01

    Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological con...

  3. Application of Silver Sulfadiazine Cream With Early Surgical Intervention in Patients Suffering From Combined Burn-Blast Injury Facial Tattoos

    OpenAIRE

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied...

  4. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    OpenAIRE

    Disseldorp Laurien M; Mouton Leonora J; Takken Tim; van Brussel Marco; Beerthuizen Gerard IJM; Van der Woude Lucas HV; Nieuwenhuis Marianne K

    2012-01-01

    Abstract Background Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children an...

  5. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    OpenAIRE

    Disseldorp, Laurien M.; Mouton, Leonora J.; Takken, Tim; van Brussel, Marco; Beerthuizen, Gerard I. J. M.; van der Woude, Lucas H. V.; Nieuwenhuis, Marianne K

    2012-01-01

    Background: Burn injuries have a major impact on the patient's physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children and adoles...

  6. Burns

    Science.gov (United States)

    ... Chemical burns Burns can be the result of: House and industrial fires Car accidents Playing with matches ... hairs Burned lips and mouth Coughing Difficulty breathing Dark, black-stained mucus Voice changes Wheezing

  7. Experimental study of extremely severe combined radiation-burn injury in dogs

    International Nuclear Information System (INIS)

    Thirty adult healthy dogs were equally divided into three groups: 1) Radiation injury group (RIG): whole body irradiated with 4 Gy of gamma rays; 2) Burn group (BG): inflicted with flash burn (8% TBSA III deg, 12% TBSA II deg burn); 3) Combined radiation-burn injury group (CRIG): exposed to both radiation and burn. All animals in RIG and CRIG died; the mean survival times were 11 and 8 days, respectively. Three dogs of BG died with survival time of 10 days.The main clinical manifestation and course of dogs in CRIG were similar to those in RIG. Since it was a combined injury, an addition effect was observed. The characteristics of combined effect was as follows: 1) The relationship between the radiation doses and combined effects of mortality and infection showed an S curve; 2) The incidence of sepsis in burn wound was high and it was the main portal of bacterial invasion; and 3) Negative nitrogen balance, gastrointestinal pathological changes, digestive and absorptive disturbances, and anorexia were observed after injury. Besides, the mechanism of lower rate of lymphocyte transformation is discussed

  8. Burns injury in children: Is antibiotic prophylaxis recommended?

    Directory of Open Access Journals (Sweden)

    Jamila Chahed

    2014-01-01

    Full Text Available Background: Wound infection is the most frequent complication in burn patients. There is a lack of guidelines on the use of systemic antibiotics in children to prevent this complication. Patients and Methods: A prospective study is carried out on 80 patients to evaluate the role of antibiotic prophylaxis in the control of infections. Results: The mean age was 34 months (9 months to 8 years. There was a male predominance with sex ratio of 1.66. The mean burn surface size burn was 26.5% with total burn surface area ranging from 5% to 33%, respectively. According to American Burn Association 37% (30/80 were severe burns with second and third degree burns >10% of the total surface body area in children aged <10 years old. Scalds represented 76.2% (61/80 of the burns. Burns by hot oil were 11 cases (13.7%, while 8 cases (10% were flame burns. The random distribution of the groups was as follow: Group A (amoxicilline + clavulanic acid = 25 cases, Group B (oxacilline = 20 cases and Group C (no antibiotics = 35 cases. Total infection rate was 20% (16/80, distributed as follow: 8 cases (50% in Group C, 5 cases (31.2% in Group A and 3 cases in Group B (18.7%. Infection rate in each individual group was: 22.9% (8 cases/35 in Group C, 20% (5 cases/25 in Group A and 15% (3 cases/20 in Group B (P = 0.7. They were distributed as follow: Septicaemia 12 cases/16 (75%, wound infection 4 cases/16 (25%. Bacteria isolated were with a decreasing order: Staphylococcus aureus (36.3%, Pseudomonas (27.2%, Escherichia coli (18.1%, Klebsiella (9% and Enterobacteria (9%. There is a tendency to a delayed cicatrisation (P = 0.07 in case of hot oil burns (65.18 ± 120 days than by flame (54.33 ± 19.8 days than by hot water (29.55 ± 26.2 days. Otherwise no toxic shock syndrome was recorded in this study. Conclusion: It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are

  9. Variation in Inpatient Rehabilitation Utilization After Hospitalization for Burn Injury in the United States.

    Science.gov (United States)

    Greene, Nathaniel H; Pham, Tam N; Esselman, Peter C; Rivara, Frederick P

    2015-01-01

    Approximately 45,000 individuals are hospitalized annually for burn treatment. Rehabilitation after hospitalization can offer a significant improvement in functional outcomes. Very little is known nationally about rehabilitation for burns, and practices may vary substantially depending on the region based on observed Medicare post-hospitalization spending amounts. This study was designed to measure variation in rehabilitation utilization by state of hospitalization for patients hospitalized with burn injury. This retrospective cohort study used nationally collected data over a 10-year period (2001 to 2010), from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs). Patients hospitalized for burn injury (n = 57,968) were identified by ICD-9-CM codes and were examined to see specifically if they were discharged immediately to inpatient rehabilitation after hospitalization (primary endpoint). Both unadjusted and adjusted likelihoods were calculated for each state taking into account the effects of age, insurance status, hospitalization at a burn center, and extent of burn injury by TBSA. The relative risk of discharge to inpatient rehabilitation varied by as much as 6-fold among different states. Higher TBSA, having health insurance, higher age, and burn center hospitalization all increased the likelihood of discharge to inpatient rehabilitation following acute care hospitalization. There was significant variation between states in inpatient rehabilitation utilization after adjusting for variables known to affect each outcome. Future efforts should be focused on identifying the cause of this state-to-state variation, its relationship to patient outcome, and standardizing treatment across the United States. PMID:25423440

  10. How to Help a Person with a Serious Burn Injury

    Science.gov (United States)

    ... Study Ways to Give Give Monthly Membership Gifts Corporate Support Current Partners Workplace Giving Create a Legacy ... the patient and unable to fulfill their normal responsibilities. There are many ... and social aspects of burn recovery. All Rights Reserved. The ...

  11. Reducing violent injuries: priorities for pediatrician advocacy.

    Science.gov (United States)

    Dolins, J C; Christoffel, K K

    1994-10-01

    A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries. PMID:7936890

  12. Local cooling does not prevent hyperalgesia following burn injury in humans

    DEFF Research Database (Denmark)

    Werner, Mads U; Lassen, Birgit Vibeke; Pedersen, Juri L;

    2002-01-01

    -inflammatory or anti-hyperalgesic potential of early cooling after thermal injury. Twenty-four healthy volunteers participated in this randomized, single-blinded study. Following baseline measurements, which included inflammatory variables (skin temperature, erythema index) and sensory variables (thermal and...... the burns. One of the thermodes cooled the burn (8 degrees C for 30 min) whereas the other thermode was a non-active dummy on the control burn. Inflammatory and sensory variables were followed for 160 min after end of the cooling procedure. The burn injury induced significant increases in skin...... temperature (P<0.0005), erythema index (P<0.0001), thermal pain responses (P<0.0005), mechanical pain responses (P<0.005) and secondary hyperalgesia, and significant decreases in heat pain threshold (P<0.0005) and mechanical pain threshold (P<0.0005). There were no post-cooling effects on skin temperature (P...

  13. Cardiac contraction and calcium transport function aftersevere burn injury in rats

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To examine the function change of myocardial calcium transports and determined what role the change plays in cardiac dysfunction after severe burn injury in rats. Methods: The contraction and relaxation properties of the left ventricle (LV) were studied in the isolated hearts preparations of Wistar rats at 3, 8, and 24 h after a 30%TBSA (total body surface area) full-thickness burn. The calcium transport function of the sarcoplasmic reticulum (SR) was measured by the millipore filtration technique. Results: The maximal rate of LV pressure (± dp/dtmax) of the burn group was significantly lower than that of the control group (P < 0.01). In addition, the calciumdependent ATPase activity and the coupling ratio of SR were also markedly depressed. Conclusions: It indicates that the decrease in the SR calcium transport function is one of the important mechanisms for the cardiac contractile dysfunction after severe burn injury.

  14. The Development of a New Way of a Combined Burning Injury Modeling

    Directory of Open Access Journals (Sweden)

    Peretyagin S.P.

    2011-06-01

    Full Text Available The objective of the study is to develop a new way of a combined burning injury modeling enabling to consider all pathogenic mechanisms of injury occurrence. Materials and Methods. There has been designed an original inhalation chamber: a disiccator with a ground stopper and a tray. Two groups of white Wistar rats (n=50 have taken part in the experiment. Results. There has been suggested a new way of a combined burning injury modeling consisting of applying a contact burn to an animal (damage area is 20% of body surface with an additional thermoinhalation exposure of hot air and combustion products within 20—30 sec in the conditions of an inhalation chamber.

  15. Propranolol Improves Impaired Hepatic Phosphatidylinositol 3-Kinase/Akt Signaling after Burn Injury

    OpenAIRE

    Brooks, Natasha C; Song, Juquan; Boehning, Darren; Kraft, Robert; Finnerty, Celeste C.; Herndon, David N; Jeschke, Marc G.

    2012-01-01

    Severe burn injury is associated with induction of the hepatic endoplasmic reticulum (ER) stress response. ER stress leads to activation of c-Jun N-terminal kinase (JNK), suppression of insulin receptor signaling via phosphorylation of insulin receptor substrate 1 and subsequent insulin resistance. Marked and sustained increases in catecholamines are prominent after a burn. Here, we show that administration of propranolol, a nonselective β1/2 adrenergic receptor antagonist, attenuates ER stre...

  16. Burn Injury Reveals Altered Phenotype in Mannan-Binding Lectin-Deficient Mice

    OpenAIRE

    Møller-Kristensen, Mette; Hamblin, Michael R.; Thiel, Steffen; Jensenius, Jens Chr.; Takahashi, Kazue

    2007-01-01

    Burn injury destroys skin, the second largest innate immune organ in the body, and triggers chaotic immune and inflammatory responses. The pattern recognition molecule, mannan-binding lectin (MBL), plays an important role in the first-line host defense against infectious agents. MBL initiates the lectin complement pathway and acts as an opsonin. Recent studies suggest that MBL also modulates inflammatory responses. We report that local responses after burn in MBL null mice differ from those f...

  17. A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care

    OpenAIRE

    Wallis, Lee A; Julian Fleming; Marie Hasselberg; Lucie Laflamme; Johan Lundin

    2016-01-01

    Background Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns exp...

  18. Intentional burn injury: an evidence-based, clinical and forensic review.

    Science.gov (United States)

    Greenbaum, Adam R; Donne, Jeremy; Wilson, Diana; Dunn, Kenneth W

    2004-11-01

    Burn injury can be inflicted intentionally either by one person to another whenever one has the ability to physically control the other, or it can be self-inflicted. There is scant evidential basis for much that is written about and practiced in the evaluation and care of patients that have sustained intentional burn injuries. Yet this is an area in which medical personnel must necessarily be trained in both the therapeutic and forensic aspects of a complex problem. Failure to appreciate the complexity of medical and forensic interactions may have far reaching effects. A missed diagnosis can result in inappropriate medical care, on-going abuse and future fatality. Inept management can result on the one hand, in blame levelled inappropriately placing incomparable strain on family units and innocent parties, and on the other, allow abusers to continue unchecked. This is the first review on the subject in which lawyers and doctors collaborate to produce a holistic approach to this subject. In it we describe the legal considerations that medical staff must appreciate when approaching patients who may have suffered intentional burns. We analyse the various scenarios in which intentional burning can be found and challenge the clinical dogma with much of the management of paediatric inflicted burns has become imbued. We suggest a rational and balanced approach to all intentional burn injuries-especially when children are involved. In the light of current case law in which dogmatic medical evidence has been implicated in wrongful convictions for child abuse in the UK, it is imperative that medical professionals gather evidence carefully and completely and apply it with logic and impartiality. This paper will aid clinicians who may not be experienced in dealing with burn injuries, but find themselves in the position of seeing a burn acutely, to avoid common mistakes. PMID:15475134

  19. Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2011-11-01

    Full Text Available Abstract Background Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. Methods A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. Results A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%. The trunk was the most commonly involved body region (57.3%. Majority of patients (48.0% sustained superficial burns. Eight (2.3% patients were HIV positive. Most patients (89.8% presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9% was performed in 44 (12.9% of patients. The overall average of the length of hospital stay (LOS was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P P Conclusion Childhood burn injuries still remain a menace in our

  20. Changes of interleukin-3 expression after combined radiation-burn injury in mice

    International Nuclear Information System (INIS)

    Objective: To study the changes of IL-3 expression after 5 Gy irradiation, 30% total body surface area burn and combined radiation-burn injury in mice. Methods: Northern dot blotting, production of mRNA, cell culture, assay of IL-3 biological activity, etc. Results: The IL-3 mRNA was markedly decreased by 77% and 21% on the 3rd day and the 14th day after irradiation, respectively. The IL-3 protein was decreased by 83% and 36% on 3rd and 14th day, respectively. There was a significant inhibition of IL-3 expression on the 3rd day after simple burn and slight increase of IL-3 expression on the 14th day. In groups with combined injury, IL-3 was more than that in the irradiated groups but less than that in the groups with burn injury. The changes of IL-3 expression were parallel with the changes of bone marrow cells. Conclusion: Inhibition of IL-3 expression is one of the reasons of hematopoietic failure caused by radiation and combined radiation-burn injury in mice

  1. Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

    Science.gov (United States)

    Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

    2016-07-01

    Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns. PMID:26997326

  2. Sleep Onset Insomnia Symptoms during Hospitalization for Major Burn Injury Predict Chronic Pain

    OpenAIRE

    Smith, Michael T; Klick, Brendan; Kozachik, Sharon; Edwards, Robert E.; Holavanahalli, Radha; Wiechman, Shelley; Blakeney, Patricia; Lezotte, Dennis; Fauerbach, James A.

    2008-01-01

    Both cross-sectional studies of chronic pain and sleep deprivation experiments suggest a bi-directional relationship between sleep and pain. Few longitudinal studies, however, have assessed whether acute-insomnia following traumatic injury predicts the development of persistent pain. We sought to evaluate: 1) whether in-hospital insomnia independently predicts long-term pain after burn injury and 2) whether in-hospital pain predicts future insomnia symptoms. We analyzed data on 333 subjects h...

  3. Does naloxone reinstate secondary hyperalgesia in humans after resolution of a burn injury?

    DEFF Research Database (Denmark)

    Pereira, Manuel P; Werner, Mads U; Ringsted, Thomas K; Rowbotham, Michael C; Taylor, Bradley K; Dahl, Joergen B

    2013-01-01

    Development of secondary hyperalgesia following a cutaneous injury is a centrally mediated, robust phenomenon. The pathophysiological role of endogenous opioid signalling to the development of hyperalgesia is unclear. Recent animal studies, carried out after the resolution of inflammatory pain, h......, have demonstrated reinstatement of tactile hypersensitivity following administration of μ-opioid-receptor-antagonists. In the present study in humans, we analyzed the effect of naloxone when given after the resolution of secondary hyperalgesia following a first-degree burn injury....

  4. Organ-specific inflammation following acute ethanol and burn injury

    OpenAIRE

    Bird, Melanie D.; Kovacs, Elizabeth J

    2008-01-01

    Clinical and experimental evidence demonstrates that ethanol exposure prior to injury alters local and systemic inflammatory responses, increasing morbidity and mortality. Moreover, the aberrant inflammatory responses can directly and indirectly lead to the poor prognosis after injury by altering leukocyte infiltration into the wound site and remote organs and by suppressing immunity leading to increased susceptibility to opportunistic infections. Recent studies from our laboratory have focus...

  5. Development of a long-term ovine model of cutaneous burn and smoke inhalation injury and the effects of early excision and skin autografting

    OpenAIRE

    Yamamoto, Yusuke; Enkhbaatar, Perenlei; Sakurai, Hiroyuki; Rehberg, Sebastian; Asmussen, Sven; Ito, Hiroshi; Sousse, Linda E.; Cox, Robert A.; Deyo, Donald J.; Traber, Lillian D.; TRABER, MARET G.; Herndon, David N.; Traber, Daniel L.

    2012-01-01

    Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal e...

  6. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    OpenAIRE

    Traber, Maret G.; Leonard, Scott W.; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G.; Finnerty, Celeste C.; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status.

  7. EXPERIENCE IN TREATING SECONDARY SYSTEMIC MYCOTIC INFECTION AFTER SEVERE BURNS ASSOCIATED WITH ELECTRIC INJURY

    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝

    1995-01-01

    One patient with wound surface sepsis caused by secondary pyocyanic infection after extensive burns associated with visceral injuries (peptic ulcer hemorrhage, renal insufficiency and hepatic dysfunction) and generalized candidiasis albicans was cured after anti-infection treatment with proper antibiotics, removal of the infected focus, and effective anti-fungal drugs.

  8. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS’ EXPERIENCE

    Science.gov (United States)

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-01-01

    Objective: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to presents our experience of 38 children with hand burn injuries, admitted and treated at the Department of Plastic Surgery, UCCK-Pristina, Kosovo, during the years 2012-2015. Methods: Physical therapy is focused on active/passive range of motion in affected joints, management of cicatrix, strengthening exercise, coordination and use of splints for correction contractures. Patients were evaluated in three, six months and the definitive evaluation is done after 9 months of physical therapy and splinting. Results: We have improvement in range of motion (ROM), functionality, coordination, muscle force, decrease of keloids scars. Conclusion: This study shows the importance of physical therapy and splinting, achieving good results in preventing contracture, improving range of motion, muscle force and good cosmetic results. PMID:26889095

  9. Nosocomial Infections in Iranian Pediatric Patients With Burn Injuries: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2015-07-01

    Full Text Available Context: Nosocomial infections (NIs are the most common life-threatening complications and leading cause of morbidity and mortality in pediatric patients with burn injuries. It is estimated that annually two million infections, 90000 deaths, and 4.5 billion USD in excess healthcare costs are imposed by NIs. Herein, we reviewed the articles related to NIs in Iranian pediatric patients with burn injuries. Evidence Acquisition: A review of epidemiologic studies on NI in pediatric patients with burn injuries in Iran was performed by searching studies indexed in PubMed, Google scholar, Iranmedex, Magiran, SID databases, published in English language in 2014. Keywords for searching included “Nosocomial Infections”, “Hospital- acquired infection”, “Healthcare- associated infections”, “burn”, “children”, “pediatric”, and “Iran”. All articles related to NIs in pediatric patients with burn injuries or about general population with burn injuries, which included pediatric population up to the age 18 years in Iran, were included. Articles out of the definition for age group or lack of significant data, outpatients, and patients selected for reconstructive surgeries were excluded. Results: Of 43 reviewed articles, nine eligible articles were selected. The male to female ratio was 1.6:1. The age ranged from birth to 18 years with the mean of 3.4 years. Overall incidence of NIs was 20.94%. Pseudomonas aeruginosa (30.39%, Klebsiella pneumonia (17.54%, Acinetobacter (17.47%, and Staphylococcus aureus (14.98% were the most common prominent isolates with high antibiotic resistance isolated from the cultures of different sites of infections including burn wound. Vancomycin was highly specific antibiotic against Gram-positive bacteria isolates. All spices of Acinetobacter were multidrug resistant. The mean of mortality rate was 8.75%. Conclusions: In spite of higher incidence of NIs in children with burn injuries, there are no well

  10. Involvement of NADPH oxidases in alkali burn-induced corneal injury.

    Science.gov (United States)

    Gu, Xue-Jun; Liu, Xian; Chen, Ying-Ying; Zhao, Yao; Xu, Man; Han, Xiao-Jian; Liu, Qiu-Ping; Yi, Jing-Lin; Li, Jing-Ming

    2016-07-01

    Chemical burns are a major cause of corneal injury. Oxidative stress, inflammatory responses and neovascularization after the chemical burn aggravate corneal damage, and lead to loss of vision. Although NADPH oxidases (Noxs) play a crucial role in the production of reactive oxygen species (ROS), the role of Noxs in chemical burn-induced corneal injury remains to be elucidated. In the present study, the transcription and expression of Noxs in corneas were examined by RT-qPCR, western blot analysis and immunofluorescence staining. It was found that alkali burns markedly upregulated the transcription and expression of Nox2 and Nox4 in human or mouse corneas. The inhibition of Noxs by diphenyleneiodonium (DPI) or apocynin (Apo) effectively attenuated alkali burn-induced ROS production and decreased 3-nitrotyrosine (3-NT) protein levels in the corneas. In addition, Noxs/CD11b double‑immunofluorescence staining indicated that Nox2 and Nox4 were partially co-localized with CD11b. DPI or Apo prevented the infiltration of CD11b-positive inflammatory cells, and inhibited the transcription of inflammatory cytokines following alkali burn-induced corneal injury. In our mouse model of alkali burn-induced corneal injury, corneal neovascularization (CNV) occurred on day 3, and it affected 50% of the whole area of the cornea on day 7, and on day 14, CNV coverage of the cornea reached maximum levels. DPI or Apo effectively attenuated alkali burn‑induced CNV and decreased the mRNA levels of angiogenic factors, including vascular endothelial growth factor (VEGF), VEGF receptors and matrix metalloproteinases (MMPs). Taken together, our data indicate that Noxs play a role in alkali burn-induced corneal injury by regulating oxidative stress, inflammatory responses and CNV, and we thus suggest that Noxs are a potential therapeutic target in the future treatment of chemical-induced corneal injury. PMID:27221536

  11. Pain and anxiety experiences of South African adult burn injury patients during physiotherapy management

    Directory of Open Access Journals (Sweden)

    L.D. Morris

    2010-02-01

    Full Text Available A dequate management of procedural pain during physiotherapy management plays an important role in building a trusting relationship betweenthe burn victim and the physiotherapist, and in ensuring desirable functional outcomes. However, the burn pain management regimens currently utilized inburn units, primarily consist of traditional pharmacologic analgesics which areassociated with numerous side-effects and alone are often reported as inadequateto alleviate procedural pain, warranting safer and effective adjunct therapies.Prior to the introduction and implementation of adjunct therapies into a developing world, it is imperative that the current situation in a burn unit, in terms of whether or not the pain management regimens in place are adequate, is first assessed, due to cost concerns. The following short report exemplifies the pain and anxiety experiences of a small number of burn injury patients during physiotherapy at the Tygerberg Hospital adult burn unit, South A frica.  It was hypothesized that the results of this study would underpin whether adult burn injury patients in a developing countryrequire adjunct therapies during physiotherapy management to supplement traditional pharmacologic analgesics inmanaging their procedural pain and subsequent anxiety.

  12. Propranolol Improves Impaired Hepatic Phosphatidylinositol 3-Kinase/Akt Signaling after Burn Injury

    Science.gov (United States)

    Brooks, Natasha C; Song, Juquan; Boehning, Darren; Kraft, Robert; Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2012-01-01

    Severe burn injury is associated with induction of the hepatic endoplasmic reticulum (ER) stress response. ER stress leads to activation of c-Jun N-terminal kinase (JNK), suppression of insulin receptor signaling via phosphorylation of insulin receptor substrate 1 and subsequent insulin resistance. Marked and sustained increases in catecholamines are prominent after a burn. Here, we show that administration of propranolol, a nonselective β1/2 adrenergic receptor antagonist, attenuates ER stress and JNK activation. Attenuation of ER stress by propranolol results in increased insulin sensitivity, as determined by activation of hepatic phosphatidylinositol 3-kinase and Akt. We conclude that catecholamine release is responsible for the ER stress response and impaired insulin receptor signaling after burn injury. PMID:22396018

  13. Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2014-07-01

    Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

  14. IL-15 Superagonist Expands mCD8+ T, NK and NKT Cells after Burn Injury but Fails to Improve Outcome during Burn Wound Infection.

    Directory of Open Access Journals (Sweden)

    Naeem K Patil

    Full Text Available Severely burned patients are highly susceptible to opportunistic infections and sepsis, owing to the loss of the protective skin barrier and immunological dysfunction. Interleukin-15 (IL-15 belongs to the IL-2 family of common gamma chain cytokines and stimulates the proliferation and activation of T (specifically memory CD8, NK and NKT cells. It has been shown to preserve T cell function and improve survival during cecal ligation and puncture (CLP-induced sepsis in mice. However, the therapeutic efficacy of IL-15 or IL-15 superagonist (SA during infection after burn injury has not been evaluated. Moreover, very few, if any, studies have examined, in detail, the effect of burn injury and infection on the adaptive immune system. Thus, we examined the effect of burn and sepsis on adaptive immune cell populations and the effect of IL-15 SA treatment on the host response to infection.Mice were subjected to a 35% total body surface area burn, followed by wound infection with Pseudomonas aeruginosa. In some experiments, IL-15 SA was administered after burn injury, but before infection. Leukocytes in spleen, liver and peritoneal cavity were characterized using flow cytometry. Bacterial clearance, organ injury and survival were also assessed.Burn wound infection led to a significant decline in total white blood cell and lymphocyte counts and induced organ injury and sepsis. Burn injury caused decline in CD4+ and CD8+ T cells in the spleen, which was worsened by infection. IL-15 treatment inhibited this decline and significantly increased cell numbers and activation, as determined by CD69 expression, of CD4+, CD8+, B, NK and NKT cells in the spleen and liver after burn injury. However, IL-15 SA treatment failed to prevent burn wound sepsis-induced loss of CD4+, CD8+, B, NK and NKT cells and failed to improve bacterial clearance and survival.Cutaneous burn injury and infection cause significant adaptive immune dysfunction. IL-15 SA does not augment host

  15. Effect of Malva sylvestris cream on burn injury and wounds in rats

    Directory of Open Access Journals (Sweden)

    Ebrahim Nasiri

    2015-06-01

    Full Text Available Objectives: Burn injury is one of the most health-threatening problems in the world. Malva sylvestris (M. sylvestris flowershave a high mucilage content and are used as a remedy for cut wound and dermal infected wounds in Iranian folklore Medicine. The purpose of this study was to investigate the effect of M. sylvestris cream on the second degree burn injury in rats. Materials and Methods: Five groups of 10 rats per group were burned with hot metal plate. Animals were administrated divided as control, normal saline, standard silver sulfadiazine 1% (SSD, 5% M. sylvestris, and 10% M. sylvestris into separate groups. Wound area, percentage of wound contraction, and histological and bacteriological assessments were evaluated. Results: Wound sizes were not significantly different among groups on 1st and 3rd days after burn injury, while they were significantly different among groups after 7th day post-burn injury. The average areas of wounds on the 15th day were 7.5±2.9, 6.7±2, 10.5±1.6, 4.7±2, and 4.5±2 cm2 for base cream, normal saline, SSD, 5% M. sylvestris, and 10% M. sylvestris, respectively. The results of histology exhibited well-formed horizontally-oriented collagen fibers in MS topical treatment groups. Microorganisms existed in the SSD group were most probably Staphilococcus epidermitis and for NS group were staphylococcus saprophiteccus. Conclusion: M. sylvestris cream improved histological changes of tissue components in the process of healing when compared with SSD cream. Therefore, it can be used as a topical treatment agent for burn wound.

  16. In vivo imaging of human burn injuries with polarization-sensitive optical coherence tomography

    Science.gov (United States)

    Kim, Ki Hean; Pierce, Mark C.; Maguluri, Gopi; Park, B. Hyle; Yoon, Sang June; Lydon, Martha; Sheridan, Robert; de Boer, Johannes F.

    2012-06-01

    The accurate determination of burn depth is critical in the clinical management of burn wounds. Polarization-sensitive optical coherence tomography (PS-OCT) has been proposed as a potentially non-invasive method for determining burn depth by measuring thermally induced changes in the structure and birefringence of skin, and has been investigated in pre-clinical burn studies with animal models and ex vivo human skin. In this study, we applied PS-OCT to the in-vivo imaging of two pediatric burn patients. Deep and superficial burned skins along with contralateral controls were imaged in 3D. The imaging size was 8 mm×6 mm×2 mm in width, length, and depth in the air respectively, and the imaging time was approximately 6 s per volume. Superficially burned skins exhibited the same layered structure as the contralateral controls, but more visible vasculature and reduced birefringence compared to the contralateral controls. In contrast, a deeply burned skin showed loss of the layered structure, almost absent vasculature, and smaller birefringence compared to superficial burns. This study suggested the vasculature and birefringence as parameters for characterizing burn wounds.

  17. The effectiveness of using pictures in teaching young children about burn injury accidents.

    Science.gov (United States)

    Liu, Hsueh-Fen; Lin, Fang-Suey; Chang, Chien-Ju

    2015-11-01

    This study utilized the "story grammar" approach (Stein and Glenn, 1979) to analyze the within-corpus differences in recounting of sixty 6- and 7-year-old children, specifically whether illustrations (5-factor accident sequence) were or were not resorted to as a means to assist their narration of a home accident in which a child received a burn injury from hot soup. Our investigation revealed that the message presentation strategy "combining oral and pictures" better helped young children to memorize the story content (sequence of events leading to the burn injury) than "oral only." Specifically, the content of "the dangerous objects that caused the injury", "the unsafe actions that people involved took", and "how the people involved felt about the severity of the accident" differed significantly between the two groups. PMID:26154205

  18. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2014-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and mortality other outcomes post-burn. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure (MOF), and mortality were recorded. A cut-off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical significance is set at (p<0.05). ROC analysis identified a cut-off level of 234 pg/ml for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cut off and stratified into high (H) (n=133) and low (L) (n=335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area (TBSA) burned and incidence of MOF (p<0.001). In the H group IL-8 levels were able to predict sepsis (p<0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute phase responses compared to the L group (p<0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients. PMID:25514427

  19. Lateral lower face and neck contouring following burn injury.

    Directory of Open Access Journals (Sweden)

    Sadrollah Motamed

    2015-04-01

    Full Text Available The neck is normally a concave and highly mobile structure. Facial and cervical skin is prone to burn scar contracture because of its thin nature. The goal of treatment is to reconstruct this region to achieve a good aesthetic outcome and also normal neck and chin mobilization. This study was conducted to compare the effect of one row of suture and three rows of suture in critical points of the neck to recreate cervicomandibular angle for better contouring of the neck. A cross-sectional study was performed from July 2006 until August 2010. A total of 65 patients underwent lower lateral face and neck burn scar contracture reconstruction. The mean age of participants was 25.5 years old. After designing a local flap, in 31 patients we applied one row of suture. In 34 patients, we used three rows of suture on each side of the neck incorporation with  the recipient bed and the flap dermis or capsule to recreate a natural lower lateral face and neck contour (P<0.001. The standard deviation in hospitalization was 7 ± 2 days for group A and 6 ± 1 days for group B. In a two years follow-up, no blunting of cervicomandibular angle occurred and three rows of suture were superior according to present findings.

  20. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    Directory of Open Access Journals (Sweden)

    Disseldorp Laurien M

    2012-12-01

    Full Text Available Abstract Background Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children and adolescents after burn injury is limited and pertains only to children with major burns. The current multidimensional study aims to determine the level of physical fitness, the level of physical activity, health-related quality of life and perceived fatigue in children after a burn injury. Furthermore, interrelations between those levels will be explored, as well as associations with burn characteristics. Methods/design Children and adolescents in the age range of 6 up to and including 18 years are invited to participate in this cross-sectional descriptive study if they have been admitted to one of the three Dutch burn centers between 6 months and 5 years ago with a burn injury involving at least 10% of the total body surface area and/or were hospitalized ≥ 6 weeks. Physical fitness assessments will take place in a mobile exercise lab. Quantitative measures of cardiorespiratory endurance, muscular strength, body composition and flexibility will be obtained. Outcomes will be compared with Dutch reference values. Physical activity, health-related quality of life and fatigue will be assessed using accelerometry and age-specific questionnaires. Discussion The findings of the current study will contribute to a better understanding of the long-term consequences of burn injury in children and adolescents after burns. The results can guide rehabilitation to facilitate a timely and optimal physical recovery. Trial registration The study is registered in

  1. Analysis of factorial time-course microarrays with application to a clinical study of burn injury

    Science.gov (United States)

    Zhou, Baiyu; Xu, Weihong; Herndon, David; Tompkins, Ronald; Davis, Ronald; Xiao, Wenzhong; Wong, Wing Hung; Toner, Mehmet; Warren, H. Shaw; Schoenfeld, David A.; Rahme, Laurence; McDonald-Smith, Grace P.; Hayden, Douglas; Mason, Philip; Fagan, Shawn; Yu, Yong-Ming; Cobb, J. Perren; Remick, Daniel G.; Mannick, John A.; Lederer, James A.; Gamelli, Richard L.; Silver, Geoffrey M.; West, Michael A.; Shapiro, Michael B.; Smith, Richard; Camp, David G.; Qian, Weijun; Storey, John; Mindrinos, Michael; Tibshirani, Rob; Lowry, Stephen; Calvano, Steven; Chaudry, Irshad; West, Michael A.; Cohen, Mitchell; Moore, Ernest E.; Johnson, Jeffrey; Moldawer, Lyle L.; Baker, Henry V.; Efron, Philip A.; Balis, Ulysses G.J.; Billiar, Timothy R.; Ochoa, Juan B.; Sperry, Jason L.; Miller-Graziano, Carol L.; De, Asit K.; Bankey, Paul E.; Finnerty, Celeste C.; Jeschke, Marc G.; Minei, Joseph P.; Arnoldo, Brett D.; Hunt, John L.; Horton, Jureta; Cobb, J. Perren; Brownstein, Bernard; Freeman, Bradley; Maier, Ronald V.; Nathens, Avery B.; Cuschieri, Joseph; Gibran, Nicole; Klein, Matthew; O’Keefe, Grant

    2010-01-01

    Time-course microarray experiments are capable of capturing dynamic gene expression profiles. It is important to study how these dynamic profiles depend on the multiple factors that characterize the experimental condition under which the time course is observed. Analytic methods are needed to simultaneously handle the time course and factorial structure in the data. We developed a method to evaluate factor effects by pooling information across the time course while accounting for multiple testing and nonnormality of the microarray data. The method effectively extracts gene-specific response features and models their dependency on the experimental factors. Both longitudinal and cross-sectional time-course data can be handled by our approach. The method was used to analyze the impact of age on the temporal gene response to burn injury in a large-scale clinical study. Our analysis reveals that 21% of the genes responsive to burn are age-specific, among which expressions of mitochondria and immunoglobulin genes are differentially perturbed in pediatric and adult patients by burn injury. These new findings in the body’s response to burn injury between children and adults support further investigations of therapeutic options targeting specific age groups. The methodology proposed here has been implemented in R package “TANOVA” and submitted to the Comprehensive R Archive Network at http://www.r-project.org/. It is also available for download at http://gluegrant1.stanford.edu/TANOVA/. PMID:20479259

  2. Epidemiology of burn injuries in South-Eastern Iran: A retrospective study

    International Nuclear Information System (INIS)

    Objective: To explore the epidemiology of burn injuries in Zahedan, Southeastern Iran. Methods: A retrospective review of 730 medical records, of burnt patients, for a period of two years was done. Pre-designed data recording forms were used to collect data. The SPSS-15 was used to analyze data. Results: Overall, 713 medical records were analyzed: two-thirds (62.0%) were fire-related and one-third related to scalds (33.1%). Intentional self-harm injuries accounted for 14.3% of all admissions. A significant difference existed between patients' age or sex and the causes of burns (P<0.001). Burns more than 60% closely correlated with death rate and hospital stay (P<0.001). Conclusion: Lack of the necessary, socio-economic infrastructure, language and cultural barriers, low level of literacy, flammability of women's clothes and unsafe application/design of stove and heaters are likely to contribute to the high frequency of burn injuries in this area. (author)

  3. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    Science.gov (United States)

    Leonard, Scott W; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G; Finnerty, Celeste C; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status. Objective: To test the hypothesis that thermal injury depletes body stores of vitamin E, α-tocopherol concentrations were measured in adipose tissue samples. Design: Pediatric patients (n = 8) were followed up to 1 y after burn injury. Surgically obtained samples were collected at various intervals and stored at −80°C in a biorepository. α- and γ-Tocopherols, cholesterol, and triglycerides were measured in the same tissue aliquot. Results: During the first week after injury, adipose tissue α-tocopherol concentrations were within the expected normal range of 199 ± 40 nmol/g adipose tissue but were substantially lower at weeks 2 and 3 (133 ± 13 and 109 ± 8 nmol/g adipose tissue, respectively). Individual rates of decrease, estimated by linear regression, showed that adipose tissue α-tocopherol decreased by an average of 6.1 ± 0.6 nmol/g daily. During the first month after injury, adipose tissue triglyceride concentrations also decreased, whereas no changes in cholesterol concentrations occurred. Conclusions: These data emphasize that the burn injury experienced by these pediatric patients altered their metabolism such that vitamin E status diminished during the month after injury. Further studies are needed to evaluate the mechanism and consequences of the observed vitamin E depletion. This trial was registered at clinicaltrials.gov as NCT00675714. PMID:20881067

  4. Fabrication and evaluation of auto-stripped tri-layer wound dressing for extensive burn injury

    International Nuclear Information System (INIS)

    In the study, we are going to develop a tri-layer membrane as the artificial skin for extensive burn injury. The first layer is a three-dimensional tri-copolymer sponge of gelatin/hyaluronan/chodroitin-6-sulfate with 70% in porosity and 20-100 μm in pore size. The layer is constructed as a dermis analogous layer to stimulate capillaries penetration, to promote dermal fibroblast migration and to induce the secretion of extra-cellular matrix, which provides a better physiological environment for burn patient recovery. The second layer is as so called auto-stripped layer composed by poly-N-isopropyacrylamide (PNIPAAm). The layer will be automatically peeled off from the tri-copolymer layer once the wound site closed and recovered. The third layer is composed by polypropylene (PP) non-woven fabric, which provides an open structure for exudates drainage out that will reduce the risk of second infection. The tri-layer wound dressing has been successfully prepared by subsequently high-energy plasma treatment, γ-ray irradiation, UV light exposure, and lyophilized process. From the results of MTT, IL-8, IL-1α, IL-6, and TNF-α measurement, the developed material will not induce tissue inflammatory or immune response. The dermal fibroblasts showed initial contact with the material surface through the radial extension of filopodia followed by cytoplasmic webbing that could be examined by SEM. Dermal fibroblasts subsequently flattened for further proliferation and extra-cellular matrix secretion. Dermal analog layer provides a three-dimensional architecture for normal dermis regeneration. The layer can be completely biodegraded within 4 weeks post-operation. After served as a scaffold for the ingrowth of self-fibroblasts, a normal dermis like layer will be regenerated. The dressing will fall off automatically without any damage once the wound site healed completely

  5. Fabrication and evaluation of auto-stripped tri-layer wound dressing for extensive burn injury

    Energy Technology Data Exchange (ETDEWEB)

    Lin, F.-H. [Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan (China); Department of Biomedical Engineering, National Taiwan University Hospital, Taipei, Taiwan (China); Tsai, J.-C. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Chen, T.-M. [Department of Plastic Surgery, Tri-service Hospital, Taipei, Taiwan (China); Chen, K.-S. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Yang, J.-M. [Department of Chemical Engineering, Chang Gung University, Tao-Yuan, Taiwan (China); Kang, P.-L. [Cardiovascular Division, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (China)]. E-mail: plkang@vghks.gov.tw; Wu, T-H. [Institute of Nuclear Energy Research, ROCEA, Tao-Yuan, Taiwan (China)

    2007-04-15

    In the study, we are going to develop a tri-layer membrane as the artificial skin for extensive burn injury. The first layer is a three-dimensional tri-copolymer sponge of gelatin/hyaluronan/chodroitin-6-sulfate with 70% in porosity and 20-100 {mu}m in pore size. The layer is constructed as a dermis analogous layer to stimulate capillaries penetration, to promote dermal fibroblast migration and to induce the secretion of extra-cellular matrix, which provides a better physiological environment for burn patient recovery. The second layer is as so called auto-stripped layer composed by poly-N-isopropyacrylamide (PNIPAAm). The layer will be automatically peeled off from the tri-copolymer layer once the wound site closed and recovered. The third layer is composed by polypropylene (PP) non-woven fabric, which provides an open structure for exudates drainage out that will reduce the risk of second infection. The tri-layer wound dressing has been successfully prepared by subsequently high-energy plasma treatment, {gamma}-ray irradiation, UV light exposure, and lyophilized process. From the results of MTT, IL-8, IL-1{alpha}, IL-6, and TNF-{alpha} measurement, the developed material will not induce tissue inflammatory or immune response. The dermal fibroblasts showed initial contact with the material surface through the radial extension of filopodia followed by cytoplasmic webbing that could be examined by SEM. Dermal fibroblasts subsequently flattened for further proliferation and extra-cellular matrix secretion. Dermal analog layer provides a three-dimensional architecture for normal dermis regeneration. The layer can be completely biodegraded within 4 weeks post-operation. After served as a scaffold for the ingrowth of self-fibroblasts, a normal dermis like layer will be regenerated. The dressing will fall off automatically without any damage once the wound site healed completely.

  6. Effects of early escharectomy on rats with combined radiation-burn injury

    International Nuclear Information System (INIS)

    Objective: To provide evidence for beneficial effect of clinical therapy with early escharectomy on survival and wound healing in rats combined radiation-burn injury. Methods: Rats were exposed to 5 Gy whole-body γ-ray irradiation from a 60Co source and to thermal-radiation burn (10% TBSA, full thickness burn) successively by a 5 kW bromo-tungsten lamp. Then the animals were given anti-shock and anti-infection remedies. Early escharectomy and stitch (EES) at 24 h after injury, eschar-protecting treatment, or other treatment modalities were carried out. The 60-day survival rate, the duration of wound healing and the changes of the body weight of animals were observed. Results: The 60-day survival rate of EES group reached 78%, being higher than that of the no-escharectomy group (40%, P < 0.05) and even higher than that of the escharectomy with non-stitch group (15%, P < 0.01) and that of the control group (10%, P < 0.01). Besides, in the EES group, the wound showed no sign of infection and healed well, and the body weights recovered faster. Conclusions: EES is effective and available on this model of combined injuries. It is appropriate for operation at 24-48 h after injury

  7. Unusual presentation of firework injury causing intraoral burns

    Directory of Open Access Journals (Sweden)

    Patel Chintan

    2005-01-01

    Full Text Available Fireworks are commonly used in celebrate festive occasions. We present a case of an unusual presentation of intraoral firework injury, which is a very rare case. A fifteen year old boy kept four explosive papercaps wrapped in a small polythene bags in between his left molars and crushed them. This resulted in a contused lacerated wound over the left buccal mucosa. Patient was treated conservatively with maintenance of intraoral hygiene, antibiotics, proteolytic enzymes and analgesics. It took 18 days for complete healing of the wound.

  8. The effect of levamisole on mortality rate among patients with severe burn injuries

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fatemi

    2013-01-01

    Full Text Available Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years was 33.29 ± 11.39 years (Mean ± SD, and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8% patients in the control group and 50 (58.8% patients in the treatment group (P = 0.8. Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.

  9. Outcomes in Adult Survivors of Childhood Burn Injuries as Compared with Matched Controls.

    Science.gov (United States)

    Stone, James; Gawaziuk, Justin P; Khan, Sazzadul; Chateau, Dan; Bolton, James M; Sareen, Jitender; Enns, Jessica; Doupe, Malcolm; Brownell, Marni; Logsetty, Sarvesh

    2016-01-01

    Limited research exists examining long-term mental and physical health outcomes in adult survivors of pediatric burns. The authors examine the postinjury lifetime prevalence of common mental and physical disorders in a large pediatric burn cohort and compare the results with matched controls. Seven hundred and forty five survivors of childhood burns identified in the Burn Registry (1% between April 1, 1988 and March 31, 2010) were matched 1:5 to the general population based on age at time of injury (index date), sex, and geographic residence. Postinjury rate ratio (RR) was used to compare burn cases and control cohorts for common mental and physical illnesses through physician billings, and hospital claims. RR was adjusted for sex, rural residence, and income. Compared with matched controls, postburn cases had significantly higher RR of all mental disorders, which remained significant (P abuse RR = 2.3 [CL: 1.7-3.2], suicide attempt RR = 4.3 [CL: 1.6-12.1], or any mental disorder RR = 1.5 [CL: 1.3-1.8]). The relative rate of some physical illnesses was also significantly increased in burn survivors: arthritis RR = 1.2 (CL: 1.1-1.4), fractures RR = 1.4 (CL: 1.2-1.6), total respiratory morbidity RR = 1.1 (CL: 1.02-1.3), and any physical illness RR = 1.2 (CL: 1.1-1.3). Adult survivors of childhood burn injury have significantly increased rates of postburn mental and physical illnesses. Screening and appropriate management of these illnesses is essential when caring for this population. PMID:26594866

  10. Determination of the Pre-Hospital Practices Performed for Children with Burn Injuries

    Directory of Open Access Journals (Sweden)

    Mehtap Kavurmaci

    2016-04-01

    Full Text Available Aim: The objective of this study was to determine the first aid practices performed and, effecting factors in burn injuries in before hospital admission. Material and Method: The study was conducted in burn centers of two hospitals in the Erzurum, between December 2013 and August 2014. The population was consisted of inpatient children aged 0-12 years who were treated in burn centers of related hospitals and their mothers at the date of the study. The study was carried out with a total of 121 children and their mothers who met the research inclusion criteria. Questionnaire data was used to collect data. In data analysis, percentage distributions, means and chi-square test were used. Results: It was found that, children%u2019 mothers applicate the cold water first when the burns ocur (57.9%, secondly only applying cold water (27.3%, then the mothers took off their children to hospital not to any application (75.2%, burn wound on the olive oil riding (10.7%, burn wound yogurt riding (8.3%. Discussion: As a result, it was determined that children%u2019 mothers don%u2019t have an adequate level of first-aid knowledge, and younger mothers with low levels of education living in rural areas perform incorrect first aid practices.

  11. Safe! Sports, Campers & Reducing Sports Injuries.

    Science.gov (United States)

    Thomson, Beth J.

    1989-01-01

    Acceptance of adult roles by children increases "adult injuries," notably broken bones from sports. Suggests camp administrators be familiar with clientele, particular sports, and the kinds of injuries that generally result in each. Discusses children's age, types of sports, and other factors that come into play when anticipating and treating…

  12. Comparison of Healing Effect of Aloe Vera Extract and Silver Sulfadiazine in Burn Injuries in Experimental Rat Model

    OpenAIRE

    Akhoondinasab, Mohammad Reza; Akhoondinasab, Motahhare; Saberi, Mohsen

    2014-01-01

    BACKGROUND Wound healing is widely discussed in the medical literature. This study compared the healing effect of aloe vera extract and silver sulfadiazine in burn injuries in experimental rat model. METHODS Sixteen rats were randomly assigned to one of two groups, each group 8 rats. A deep second-degree burn on the lower back and 3rd degree burn on upper back of each rat were created with a standard burning procedure. Burns were dressed daily with aloe vera extract in group 2 and silver sulf...

  13. Early markers of renal injury in predicting outcome in thermal burn patients

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) is a well known complication of severe burn and is an important factor that can increase mortality. To determine the predictors of acute renal failure that occur in major burns, we studied 40 patients with moderate to severe thermal burn injury - second to third degree with > 20% of total body surface area. All patients were subjected to routine investigations including: Serum creatinine, blood urea nitrogen, fractional excretion of sodium, uri-nary malondialdehyde and microalbuminuria on day 0, 3, 7, 14 and 21 of hospitalization. Nine patients (22.5 %) developed acute renal failure; 4 patients required supportive dialysis. The group that developed ARF showed an increase of markers of glomerular damage with appearance of microalbuminuria on day 0 that reached 3 - 4 folds above its normal level on day 14 and remained constant with elevated serum creatinine and burn size in the 3 rd week of ARF, and progressed to overt proteinuria in 3 cases. Urinary malondialdehyde increased 3 folds above normal values before developing acute renal failure, and gradually increased on day 14, which coincided with the increased of microalbuminuria. Two cases (22.2%) in the ARF group who developed septicemia and required dialysis died on the 32nd and 36th days post-burn. Burn size and occurrence of septicemia were the only predictors of acute renal failure using multiple regression analysis (P value < 0.001 and < 0.0371, respectively). We conclude that acute renal failure complicates burn patients and is related to the size and depth of burn and occurrence of septicemia. Microalbuminuria and urinary malondialdehyde are useful markers for prediction of renal outcome in such group of patients. (author)

  14. Bone Marrow Mesenchymal Stromal Cells Attenuate Organ Injury Induced by LPS and Burn

    OpenAIRE

    Yagi, Hiroshi; Soto-Gutierrez, Alejandro; Kitagawa, Yuko; Tilles, Arno W.; Tompkins, Ronald G.; Yarmush, Martin L

    2010-01-01

    Bone marrow mesenchymal stromal cells (MSCs) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. A therapeutic modality for systemic inflammation and its consequences is not available yet. Thus, this work investigates the therapeutic effects of MSCs in injury-models induced by Lipopolysaccharide (LPS) or burn. Gene expression was analyzed in MSCs when exposed to inflammatory serum from injured animals and it showed remarkable alteration...

  15. Bone Loss in the Acute Stage Following Burn Injury - Original Investigation

    Directory of Open Access Journals (Sweden)

    Berrin Leblebici

    2007-06-01

    Full Text Available Aim: The purpose of this study was to determine whether a bone loss occurs during acute period following burn injury or not, and to investigate the effects of various parameters on it. Materials and Methods: This study was conducted on 19 patients, ages between 20 and 50, who had a burn injury with more than %20 of Total Body Surface Area (TBSA. We recorded the patients’ burn cause, localization, percantage, ambulation and functional status. At the end of the first month, we measured bone mıneral densıty of total L1-L4 vertebrae, left distal forearm, left total femur, in all patients. A Z score less than –1 was accepted to be the indicator of bone loss. Results: The mean age of the patients (14 male and 5 female was 33.09±11.61. We found a Z score less then -1 in 68.4% of left distal forearm, 21.1% of left total femur and 36.8% of total L1-L4 vertabrae measurements. There were no significant correlations between TBSA, Functional Ambulatıon Scale and Functional Independence Measure, and Z scores. Conclusion: There is a reduction in Bone Mineral Density in patıents wıth moderate/severe burn ınjuries in the acute period which is not correlated wıth neither TBSA nor functional status. (From the World of Osteoporosis 2007;13:33-6

  16. Factors Associated With Length of Stay and Hospital Charges among Pediatric Burn Injury in Kermanshah, West of Iran

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    Satar Rezaei

    2015-01-01

    This study highlights that the independent predictors affecting hospital costs and LOS associated with pediatric burn injury in Kermanshah. Also, our study indicates the BBS was the main factors affecting hospital costs and LOS for the study population. 

  17. Burns

    Science.gov (United States)

    ... touching the stove This list is not all-inclusive. You can also burn your airways if you ... extinguishers in key locations at home, work, and school. Remove electrical cords from floors and keep them ...

  18. Measuring coping behavior in patients with major burn injuries: a psychometric evaluation of the BCOPE.

    Science.gov (United States)

    Amoyal, Nicole R; Mason, Shawn T; Gould, Neda F; Corry, Nida; Mahfouz, Soad; Barkey, Adam; Fauerbach, James A

    2011-01-01

    Burn injuries involve significant physiological, psychological, and social challenges with which individuals must cope. Although the brief COPE (BCOPE) is frequently used, knowledge of its factor structure and construct validity is limited, thus limiting confidence with interpreting results. This study assessed psychometric properties of the BCOPE in hospitalized patients with burn injury. Participants had a major burn injury (n = 362). Measures assessed coping behavior and physical, psychological, and social functioning. Exploratory factorial analysis was conducted to evaluate patterns of coping strategies. To assess construct validity, the BCOPE scale scores were correlated with the distress measures across time points. Exploratory factorial analysis revealed seven factors accounting for 51% of total variance. The pattern matrix indicated four items loaded onto factor 1 (active coping = 0.47-0.80) and four onto factor 2 (avoidant coping = 0.59-0.73). The remaining factors were consistent with original scale assignments reported by Carver (Int J Behav Med 1997;4:92-100). Construct validity of BCOPE scales (active and avoidant) was demonstrated by their association with the Davidson trauma scale, short form-12, and satisfaction with appearance scale. The results indicate that the BCOPE is valid, reliable, and can be meaningfully interpreted. Research using these factors may improve knowledge about interrelationships among stress, coping, and outcome, thus building the evidence base for managing distress in this population. PMID:21562462

  19. Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia

    OpenAIRE

    Duke, Janine M; Bauer, Jacqui; Fear, Mark W.; Rea, Suzanne; Wood, Fiona M; Boyd, James

    2014-01-01

    Objective To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury. Design Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia. Participants Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Infor...

  20. Impact of Oxandrolone Treatment on Acute Outcomes After Severe Burn Injury

    Science.gov (United States)

    Pham, Tam N.; Klein, Matthew B.; Gibran, Nicole S.; Arnoldo, Brett D.; Gamelli, Richard L.; Silver, Geoffrey M.; Jeschke, Marc G.; Finnerty, Celeste C.; Tompkins, Ronald G.; Herndon, David N.

    2013-01-01

    Pharmacologic modulation of hypermetabolism clearly benefits children with major burns, however, its role in adult burns remains to be defined. Oxandrolone appears to be a promising anabolic agent although few outcome data are as yet available. We examined whether early oxandrolone treatment in severely burned adults was associated with improved outcomes during acute hospitalization. We evaluated for potential associations between oxandrolone treatment and outcomes in a large cohort of severely burned adults in the context of a multicenter observational study. Patients were dichotomized with respect to oxandrolone treatment, defined as administration within 7 days after admission, with duration of at least 7 days. Acute hospitalization outcomes were compared with univariate and multivariate analyses. One hundred seventeen patients were included in this analysis. Mean patient age was 42.6 years (range, 18–86); 77% were male, with an average TBSA of 44.1%. Baseline and injury characteristics were similar among treatment and nontreatment cohorts. Oxandrolone treatment (N =59) did not impact length of stay but was associated with a lower mortality rate (P = .01) by univariate analysis. Oxandrolone treatment was independently associated with higher survival by adjusted analyses (P = .02). Examination of early oxandrolone treatment in this cohort of severely burned adults suggests that this therapy is safe and may be associated with improved survival. Further studies are necessary to define the exact mechanisms by which oxandrolone is beneficial during inpatient treatment. PMID:18849836

  1. School Bus Accidents: Reducing Incidents and Injuries

    Science.gov (United States)

    Mahoney, Daniel

    2009-01-01

    The number of children injured in nonfatal school bus accidents annually is more than double the number previously estimated. In Ohio alone, approximately 20,800 children younger than 18 were occupants of school buses that were involved in crashes in 2003 and 2004 (McGeehan 2007). Among those children, most had minor or no injuries. However, there…

  2. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  3. Post-traumatic stress disorder in patients with acute burn injury

    International Nuclear Information System (INIS)

    Objective: To determine the risk of PTSD in patients with acute burn incidents. Method: This was an observational prospective cross-sectional study conducted in admitted patients in Burns Ward of Civil Hospital, Karachi during a period of 6 months from January 1 to June 30, 2011. Data was collected through questionnaire having socio demographic variables and the Impact of Event-Scale (IES-R) was used to determine the risk of PTSD. Results: Out of 145 patients, 12 (77.3%) were at risk of PTSD with 75 (66.9%) males and 37 (33%) females. Out of these 112 cases, 50% belonged to age group 16-29 years. All burn patients with more than 60% total body surface area (TBSA) involved in injury were at risk. Conclusion: The study reports an astronomic number of burns patients with PTSD risk. PTSD drastically affects the quality of life. The earlier this disorder is diagnosed and assessed; better chances are there for enhanced treatment and better recovery. (author)

  4. Epidemiology of outpatient burns in Iran: an update

    OpenAIRE

    Karimi, H.; Motevalian, S.A.; M. Momeni

    2014-01-01

    Burn injury remains a serious and devastating issue faced by developing countries. It is also true, however, that the developed world still tackles many of the challenges caused by burns. In order to reduce this problem through preventive programs, the characteristics of this type of injury must be studied and well documented in each setting. Our study aims to show the epidemiology, demographic distribution and clinical outcomes of burns patients referred to Motahari Burn Hospital, the burn c...

  5. Assessment of electrical burn injury using structured illumination in an in-vivo electrical injury model

    Science.gov (United States)

    Nguyen, Thu T. A.; Basiri, Ali; Shupp, J. W.; Moffatt, L. T.; Jordan, M. H.; Jeng, J. C.; Leto, E.; Ramella-Roman, J. C.

    2011-03-01

    Electrical injury is a devastating and hard to treat clinical lesion. Fully understanding the pathophysiology of electrical trauma is still a challenge for clinicians and scientists. Further elucidating the natural history of this form of tissue injury could be helpful in improving limb salvage and offering stage-appropriate therapy. Multi-spectral imaging technique is a non-invasive technology that can be used to determine optical properties of tissues in and adjacent to injury. Images at different wavelengths can provide essential information related to the pathophysiological condition of the tissue. To promote the applicability of this technique in medical diagnosis, we built a complete experimental model of electrical injury. In this model, electrical injuries were created by a reliable high-tension shock system at preset voltage or current. A thermal camera recorded the change of skin temperature during the electrical shock. Then, a high-resolution spectral imaging system based on structured illumination was used to capture images for post analysis to extrapolate optical properties of the tissue. To test accuracy, this imaging system was calibrated by using a set of epoxy phantoms with known optical properties. In this paper, the results of experiments conducted on rats and discussions on the systemic changes in tissue optical properties before and after electrical shock are presented.

  6. A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India

    Directory of Open Access Journals (Sweden)

    Gupta Ashok

    2011-01-01

    Full Text Available Aim : To analyze the causes, demographic and socio-cultural aspects, and the magnitude of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to burns ICU of tertiary care hospital. Materials and Methods : A total of 892 burn patients admitted over a period of 6 years from January 2002 to December 2007 at tertiary care hospital in Punjab, India, were analyzed. Results : 54% patients were males. A majority of the patients, 704(79%, were in the age group of 15-45 years. Six hundred and thirty-four patients (72% sustained flame burns, while 17% and 7% sustained electrical and scald burns, respectively. A total of 470(53% patients sustained major two to three degree flame burns involving more than 45% of total body surface area (TBSA. The mortality rate was 40%, i.e. 357 patients died of burns and its related problems, in our study. Six hundred and thirty-nine patients (72% sustained burns in closed space of which 331 patients (52% sustained burns in kitchen. Seven hundred and seventy-nine patients sustained accidental burns. Burn victims were mainly Hindus and Sikhs. The mean hospital stay varied depending upon the percentage of burns. On an average, a patient with >45% TBSA burns received 15 whole blood transfusions. Split skin grafting was done in 416 patients. Most common complication encountered during their hospital stay was wound infection which was seen in 671 patients, followed by ARDS in 221 patients. The most common organisms causing wound infection were Pseudomonas and Acinetobacter. Conclusion : Developing country like India need an aggressive public education program so that people become more literate about various etiological factors causing burns and means of preventing them. Also needed are burn care hospitals which are easily accessible and affordable.

  7. A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care.

    Directory of Open Access Journals (Sweden)

    Lee A Wallis

    Full Text Available Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back.The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care.In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be

  8. Plasma Proteome Response to Severe Burn Injury Revealed by 18O-Labeled “Universal” Reference-based Quantitative Proteomics

    OpenAIRE

    Qian, Wei-Jun; Petritis, Brianne O.; Kaushal, Amit; Finnerty, Celeste C.; Jeschke, Marc G.; Monroe, Matthew E.; Moore, Ronald J.; Schepmoes, Athena A.; Xiao, Wenzhong; Moldawer, Lyle L; Davis, Ronald W; Tompkins, Ronald G.; Herndon, David N; Camp, David G.; Smith, Richard D.

    2010-01-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the ...

  9. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    Science.gov (United States)

    Gauglitz, Gerd G; Finnerty, Celeste C; Herndon, David N; Mlcak, Ronald P; Jeschke, Marc G

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different serum cytokine profile compared with burn patients with inhalation injury who survived. Early identification followed by appropriate management of these high-risk patients may lead to improved clinical outcome. Methods Thirteen severely burned children with inhalation injury who did not survive and 15 severely burned pediatric patients with inhalation injury who survived were enrolled in the study. Blood was collected within 24 hours of admission and 5 to 7 days later. Cytokine levels were profiled using multiplex antibody coated beads. Inhalation injury was diagnosed by bronchoscopy during the initial surgery. The number of days on the ventilator, peak inspiratory pressure rates, arterial oxygen tension (PaO2)/fraction of inspired oxygen (FiO2) ratio and incidence of acute respiratory distress syndrome were recorded for those patients. Results Significantly altered levels of IL-4, IL-6, IL-7, IL-10, and IL-13 were detected within the first 7 days after admission in serum from burn pediatric patients with concomitant inhalation injury who did not survive when compared with similar patients who did (P < 0.05). Alterations in these cytokines were associated with increased incidence of acute respiratory distress syndrome, number of days under ventilation, increased peak inspiratory pressure, and lower PaO2/FiO2 ratio in this patient population. Multiple logistic regression analysis revealed that patients with increased IL-6 and IL-10 as well as decreased IL-7 serum levels had a

  10. Self-perceptions of young adults who survived severe childhood burn injury.

    Science.gov (United States)

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    significantly lower self-concept scores on the TSCS2 physical scale are consistent with the physical disfigurement and handicaps common with major burn injuries, and a strong indication of this group's perception of the first impression made when interacting with others. The survivors seem to feel worthwhile within the contexts of family and friends. Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare the burn survivors, the TSCS2 does help in gaining insight into the self-esteem issues of the burn survivor population. PMID:23202876

  11. Antithrombin attenuates myocardial dysfunction and reverses systemic fluid accumulation following burn and smoke inhalation injury: a randomized, controlled, experimental study

    OpenAIRE

    Rehberg, S; Yamamoto, Y; Bartha, E; Sousse, L.E. (Linda); Jonkam, C. (Collette); Zhu, Y; Traber, L.D. (Lillian); Cox, R. A.; Traber, D.L. (Daniel); Enkhbaatar, P

    2013-01-01

    Introduction: We hypothesized that maintaining physiological plasma levels of antithrombin attenuates myocardial dysfunction and inflammation as well as vascular leakage associated with burn and smoke inhalation injury. Therefore, the present prospective, randomized experiment was conducted using an established ovine model. Methods: Following 40% of total body surface area, third degree flame burn and 4 × 12 breaths of cold cotton smoke, chronically instrumented sheep were randomly assigned t...

  12. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  13. Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review

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    CESAR PEDREROS P

    2007-06-01

    Full Text Available Cada año casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos años. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y son temas desconocidos para la mayoría de los médicos. En el contexto de la próxima incorporación de este tipo de dolencias en el plan de garantías explícitas en la salud chilena hemos realizado una actualización del temaEvery year almost three thousand people get burned in Chile. In this group, about 40% of the critical burned patients also suffer inhalation injury. This number is expected to grow bigger among the adult population in the next few years. Inhalation injury significantly increases mortality in burned patients. The prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of Chilean medical schools. Therefore, this subject is pooly known by most of our physicians. Because this disease will be included in the explicit warranties health plan of the public health care system in Chile, we decide to write this review about this pathological condition

  14. Vitamin C in Burn Resuscitation.

    Science.gov (United States)

    Rizzo, Julie A; Rowan, Matthew P; Driscoll, Ian R; Chung, Kevin K; Friedman, Bruce C

    2016-10-01

    The inflammatory state after burn injury is characterized by an increase in capillary permeability that results in protein and fluid leakage into the interstitial space, increasing resuscitative requirements. Although the mechanisms underlying increased capillary permeability are complex, damage from reactive oxygen species plays a major role and has been successfully attenuated with antioxidant therapy in several disease processes. However, the utility of antioxidants in burn treatment remains unclear. Vitamin C is a promising antioxidant candidate that has been examined in burn resuscitation studies and shows efficacy in reducing the fluid requirements in the acute phase after burn injury. PMID:27600125

  15. The Role of the Nurse in the Rehabilitation of Patients with Radical Changes in Body Image Due to Burn Injuries

    OpenAIRE

    Aacovou, I.

    2005-01-01

    Burn injuries are among the most serious causes of radical changes in body image. The subject of body image and self-image is essential in rehabilitation, and the nurse must be aware of the issues related to these concepts and take them seriously into account in drafting out the nursing programme. This paper defines certain key words related to body image and discusses the social context of body image. Burn injuries are considered in relation to the way each of these affects the patient's bod...

  16. About the tactics of treatment and visual rehabilitation in case of an acute severe alkaline burn injury of the eye. A case report

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    V.F. Chernysh

    2013-04-01

    Full Text Available ABSTRACT Purpose. To acquaint ophthalmologists with tactics of treatment of a victim with an acute severe chemical burn injury of the eye i n one of follow-up cases fr om practice. Material and methods. The female patient of 31 years old had a severe alkaline burn injury with total limbal stem cell deficiency in the right eye. до (до After an emergency aid an ischemia of a limbus zone, a total corneal erosion and its moderate edema, a deepithelization of conjunctiva up to the fornices were observed. Visual acuity was 0.3 (before the burn it was 1.0. At 8 days after the burn the covering of ocular surface structures without epithelium was performed using a fresh amnion transplant which edges were sutured closely to the edges of intact bulbar conjunctiva. The total epithelization of the ocular surface (including the cornea was noted at 39 days after the operation. Visual acuity was 0.2. One year later the visual acuity was 0.07 and the total fibrovascular pannus with the effects of corneal epitheliopathy was detected. The сonjunctival limbal autograft was carried out. Six months later the visual acuity w as 0.9. Conclusion. During the early periods of ocular burn disease with the total limbal stem cell deficiency, the covering of the ocular surface using amnion in a variant of conjunctival plasty reduced the healing time, stabilized the condition of the corneal stroma after the burn, prevented the corneal opacity and an inevitable vascular in-growth creating favorable conditions for the limbal stem cell transplantation.

  17. Beneficial Effects of Concomitant Neuronal and Inducible Nitric Oxide Synthase Inhibition in Ovine Burn and Inhalation Injury

    OpenAIRE

    Lange, Matthias; Hamahata, Atsumori; Enkhbaatar, Perenlei; Cox, Robert A.; Nakano, Yoshimitsu; Westphal, Martin; Traber, Lillian D.; Herndon, David N.; Traber, Daniel L.

    2011-01-01

    Different isoforms of nitric oxide synthase are critically involved in the development of pulmonary failure secondary to acute lung injury. Here we tested the hypothesis that simultaneous blockade of inducible and neuronal nitric oxide synthase effectively prevents the pulmonary lesions in an ovine model of acute respiratory distress syndrome (ARDS) induced by combined burn and smoke inhalation injury. Chronically instrumented sheep were allocated to a sham-injured group (n = 6), an injured a...

  18. Burn injury triggered dysfunction in dendritic cell response to TLR9 activation and resulted in skewed T cell functions.

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    Haitao Shen

    Full Text Available Severe trauma such as burn injury is often associated with a systemic inflammatory syndrome characterized by a hyperactive innate immune response and suppressed adaptive immune function. Dendritic cells (DCs, which sense pathogens via their Toll-like receptors (TLRs, play a pivotal role in protecting the host against infections. The effect of burn injury on TLR-mediated DC function is a debated topic and the mechanism controlling the purported immunosuppressive response remains to be elucidated. Here we examined the effects of burn injury on splenic conventional DC (cDC and plasmacytoid DC (pDC responses to TLR9 activation. We demonstrate that, following burn trauma, splenic cDCs' cytokine production profile in response to TLR9 activation became anti-inflammatory dominant, with high production of IL-10 (>50% increase and low production of IL-6, TNF-α and IL-12p70 (∼25-60% reduction. CD4+ T cells activated by these cDCs were defective in producing Th1 and Th17 cytokines. Furthermore, burn injury had a more accentuated effect on pDCs than on cDCs. Following TLR9 activation, pDCs displayed an immature phenotype with an impaired ability to secrete pro-inflammatory cytokines (IFN-α, IL-6 and TNF-α and to activate T cell proliferation. Moreover, cDCs and pDCs from burn-injured mice had low transcript levels of TLR9 and several key molecules of the TLR signaling pathway. Although hyperactive innate immune response has been associated with severe injury, our data show to the contrary that DCs, as a key player in the innate immune system, had impaired TLR9 reactivity, an anti-inflammatory phenotype, and a dysfunctional T cell-priming ability. We conclude that burn injury induced impairments in DC immunobiology resulting in suppression of adaptive immune response. Targeted DC immunotherapies to promote their ability in triggering T cell immunity may represent a strategy to improve immune defenses against infection following burn injury.

  19. T cell IFN-γ suppression following alcohol and burn injury is independent of miRNA155.

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    Xiaoling Li

    Full Text Available miRNA155 has been implicated in normal T cell function and their differentiations into the Th1 subtype. We have shown that acute alcohol (ethanol intoxication combined with burn injury suppresses T cell IFN-γ release. Herein, we examined whether the decrease in IFN-γ is resulted from altered expression of miRNA155 and transcription factors--NFAT, Tbx21, Jun and Fos--in T cells following ethanol and burn injury. Mice received ethanol (∼3 g/Kg 4 hours prior to ∼12.5% total body surface area sham or burn injury and were sacrificed one day after injury. Splenic T cells were harvested and cultured with anti-CD3 (2 µg/ml in the presence or absence of rIL-12 (10 ng/ml or PMA (10 ng/ml plus ionomycin (50 ng/ml for 48 hours. We observed a significant decrease in miRNA155, NFAT, Tbx21, Jun and Fos expression as well as IFN-γ release in T cells cultured with anti-CD3 following ethanol and burn injury compared with shams. The co-treatment of T cells with rIL-12 prevented the decrease in IFN-γ and NFAT, Tbx21, Jun and Fos, but not miRNA155. In contrast, the co-treatment with PMA plus ionomycin normalized the expression of NFAT. It did not prevent the decrease in IFN-γ, Tbx21, Jun, Fos and miRNA155. Finally, results obtained in miRNA155-/- mice did not show any change in T cell release of IFN-γ or expression of nuclear factors compared to wildtype mice. Together, these findings suggest that while ethanol and burn injury decreases the expression of miRNA155, it may not be involved in decreased IFN-γ under those conditions.

  20. Acute kidney injury is common, parallels organ dysfunction or failure, and carries appreciable mortality in patients with major burns: a prospective exploratory cohort study

    OpenAIRE

    Steinvall, Ingrid; Bak, Zoltan; Sjöberg, Folke

    2008-01-01

    Introduction: The purpose of this study was to determine the incidence, time course, and outcome of acute kidney injury after major burns and to evaluate the impact of possible predisposing factors ( age, gender, and depth and extent of injury) and the relation to other dysfunctioning organs and sepsis. Method: We performed an explorative cohort study on patients with a TBSA% (percentage burned of total body surface area) of 20% or more who were admitted to a national burn centre. Acute kidne...

  1. Astaxanthin Attenuates Early Acute Kidney Injury Following Severe Burns in Rats by Ameliorating Oxidative Stress and Mitochondrial-Related Apoptosis

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    Song-Xue Guo

    2015-04-01

    Full Text Available Early acute kidney injury (AKI is a devastating complication in critical burn patients, and it is associated with severe morbidity and mortality. The mechanism of AKI is multifactorial. Astaxanthin (ATX is a natural compound that is widely distributed in marine organisms; it is a strong antioxidant and exhibits other biological effects that have been well studied in various traumatic injuries and diseases. Hence, we attempted to explore the potential protection of ATX against early post burn AKI and its possible mechanisms of action. The classic severe burn rat model was utilized for the histological and biochemical assessments of the therapeutic value and mechanisms of action of ATX. Upon ATX treatment, renal tubular injury and the levels of serum creatinine and neutrophil gelatinase-associated lipocalin were improved. Furthermore, relief of oxidative stress and tubular apoptosis in rat kidneys post burn was also observed. Additionally, ATX administration increased Akt and Bad phosphorylation and further down-regulated the expression of other downstream pro-apoptotic proteins (cytochrome c and caspase-3/9; these effects were reversed by the PI3K inhibitor LY294002. Moreover, the protective effect of ATX presents a dose-dependent enhancement. The data above suggested that ATX protects against early AKI following severe burns in rats, which was attributed to its ability to ameliorate oxidative stress and inhibit apoptosis by modulating the mitochondrial-apoptotic pathway, regarded as the Akt/Bad/Caspases signalling cascade.

  2. Effect of auto-skin grafting on bacterial infection of wound in rats inflicted with combined radiation-burn injury

    International Nuclear Information System (INIS)

    Rats were exposed to 6 Gy whole body γ-ray irradiation from a 60Co source followed by light radiation burn (15% TBSA, full thickness burn) from a 5 kw bromo-tungsten lamp. The effect of auto-skin grafting on invasive bacterial infection of wound in the rats with combined radiation-burn injury was studied, In the control group inflicted with combined radiation-burn injury but without skin grafting, bacteria were found on and in the eschars at 24th hour after injury, and in the subeschar tissue on 3rd day. Tremendous bacterial multiplication occurred from 7th to 15th day, and the amount of bacteria in the internal organs increased along with the increase of subeschar infection. At the same time, no bacterial infection was found in internal organs in auto-skin grafted group at 24th hour after injury. The results show that skin grafting can decrease or prevent bacterial infection in both subeschar tissue and internal organs

  3. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

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    Tanash HA

    2015-11-01

    Full Text Available Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackground: Long-term oxygen therapy (LTOT improves the survival time in hypoxemic chronic obstructive pulmonary disease. Despite warnings about potential dangers, a considerable number of patients continue to smoke while on LTOT. The incidence of burn injuries related to LTOT is unknown. The aim of this study was to estimate the rate of burn injury requiring health care contact during LTOT.Methods: Prospective, population-based, consecutive cohort study of people starting LTOT from any cause between January 1, 1992 and December 31, 2009 in the Swedish National Register of Respiratory Failure (Swedevox.Results: In total, 12,497 patients (53% women were included. The mean (standard deviation age was 72±9 years. The main reasons for starting LTOT were chronic obstructive pulmonary disease (75% and pulmonary fibrosis (15%. Only 269 (2% were active smokers when LTOT was initiated. The median follow-up time to event was 1.5 years (interquartile range, 0.55–3.1. In total, 17 patients had a diagnosed burn injury during 27,890 person-years of LTOT. The rate of burn injury was 61 (95% confidence interval, 36–98 per 100,000 person-years. There was no statistically significant difference in the rate of burn injury between ever-smokers and never-smokers, or between men and women.Conclusion: The rate of burn injuries in patients on LTOT seems to be low in Sweden. The strict requirements in Sweden for smoking cessation before LTOT initiation may contribute to this finding.Keywords: respiratory failure, oxygen, fire

  4. Gradual reintroduction of oxygen reduces reperfusion injury in cat stomach

    International Nuclear Information System (INIS)

    Recent studies have shown that oxygen-derived free radicals are responsible for a major portion of ischemia-reperfusion injury in the stomach. The oxygen radicals are produced during perfusion when oxygen delivery to the tissue increases. In the present study the authors investigate the effect on mucosal injury of regulating the rate of reintroduction of oxygen to the stomach after ischemia. Local gastric ischemia was achieved by reducing celiac artery pressure to 30 mmHg for 1 h. Ischemic injury was assessed by measuring the loss of 51Cr-labeled red blood cells across the gastric mucosa. Mucosal blood loss was negligible before and during the ischemia period but increased during reperfusion. When blood flow to the stomach was gradually returned to normal after ischemia, the mucosal blood loss was reduced. If the stomach was vascularly perfused with low Po2 blood for 1 h after ischemia before being returned to normal arterial perfusion, the mucosal blood loss was also reduced. When the stomach was made hypoxemic for 1 h rather than ischemic by perfusing the vasculature with low Po2 blood then reperfused with normoxic blood, there was very little mucosal bleeding. The data indicate that gastric mucosal bleeding after ischemia is reduced if the tissue is returned slowly to a normal Po2. These findings support the concept that reperfusion injury is due largely to the production of oxygen radicals. The low level of injury produced by hypoxemia indicates that hypoxia per se makes only a minor contribution to reperfusion injury in the stomach

  5. Necrostatin-1 Reduces Neurovascular Injury after Intracerebral Hemorrhage

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    Melanie D. King

    2014-01-01

    Full Text Available Intracerebral hemorrhage (ICH is the most common form of hemorrhagic stroke, accounting for 15% of all strokes. ICH has the highest acute mortality and the worst long-term prognosis of all stroke subtypes. Unfortunately, the dearth of clinically effective treatment options makes ICH the least treatable form of stroke, emphasizing the need for novel therapeutic targets. Recent work by our laboratory identified a novel role for the necroptosis inhibitor, necrostatin-1, in limiting neurovascular injury in tissue culture models of hemorrhagic injury. In the present study, we tested the hypothesis that necrostatin-1 reduces neurovascular injury after collagenase-induced ICH in mice. Necrostatin-1 significantly reduced hematoma volume by 54% at 72 h after-ICH, as compared to either sham-injured mice or mice administered an inactive, structural analogue of necrostatin-1. Necrostatin-1 also limited cell death by 48%, reduced blood-brain barrier opening by 51%, attenuated edema development to sham levels, and improved neurobehavioral outcomes after ICH. These data suggest a potential clinical utility for necrostatin-1 and/or novel necroptosis inhibitors as an adjunct therapy to reduce neurological injury and improve patient outcomes after ICH.

  6. Application effects of dexmedetomidine combined with sevoflurane for anesthesia in short operations in children with burn injury

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    Jin-xin WANG

    2016-04-01

    Full Text Available Objective  To evaluate the effectiveness and safety of dexmedetomidine combined with sevoflurane for anesthesia in short operations in pediatric burn patients. Methods  Forty hospitalized children undergoing short operation for burn injury were allocated to sevoflurane group (S group or sevoflurane combined dexmedetomidine group (group D(20 patients each. Children in group D inhaled 8% sevoflurane in the beginning until loss of eyelash reflex, and then the density of sevoflurane was reduced to 3% for maintenance, 5μg/(kg.h of dexmedetomidine was pumped for 10 mins, then the density was reduced to 0.5μg/(kg.h. Then operation was started herewith till to the end. Children in group S received sevoflurane anethesia alone, and dexmedetomidine was replaced by the same volume of physiological saline. Additional 3mg/kg propofol was injected when anesthesia was inadequate. During the procedure, HR, MAP, SpO2 and Ramsay scale were recorded at baseline (T1, loss of eyelash reflex (T2, 5min after the start of operation (T4, 10min (T5 and the end of operation (T6. The operation time, anethesia time, propofol consumption, case of respiratory depression and pediatric anesthesia emergence delirium scale (PAED in pediatric anesthesia care unit (PACU were recorded. Results  There was no significant difference in operation time between the two groups. Intraoperative SpO2 was higher in group D than in group S (P<0.05, respiratory inhibition occurred in 4 cases of group D and 10 cases of group S (P<0.05. Propofol consumption was less and the operation time was longer in group D than in group S (P<0.05. At T3-T6, the MAP and HR were lower, but the Ramsay scale was higher in group D than in group S (P<0.05. In PACU, PAED scale was lower in group D than in group S (P<0.05. Conclusions  Dexmedetomidine combined with sevoflurane for anesthesia for short burn surgery in children not only stabilize hemodynamic parameters but also reduce the impact to respiration

  7. Erythrocyte Aggregation due to Surface Nanobubble Interactions During the Onset of Thermal Burn Injury

    Science.gov (United States)

    Seidner, Harrison S.

    Red Blood Cell (RBC) aggregation is an important hemorheological phenomenon especially in microcirculation. In healthy individuals, RBCs are known to aggregate and gravitate toward the faster flow in the center of vessels to increase their throughput for more efficient oxygen delivery. Their aggregation is known to occur during a variety of environmental, pathological, and physiological conditions and is reversible when aggregates are subject to the relatively high shear forces in the circulation. The likelihood that aggregates will monodisperse in flow is dependent on the conditions during which they form. In situations where such aggregates are not sheared to monodispersion their presence can impact the perfusion of microvascular networks. More specifically, aggregates subject to the low shear rates in the zone of stasis near regions of thermal burn injury are capable of occluding vessels in the microcirculation and inhibiting the delivery of oxygen and nutrients to tissue downstream. The basic mechanism leading to erythrocyte aggregation at the onset of thermal injury is unknown. This dissertation investigates parameters involved in erythrocyte aggregation, methods of measuring and testing erythrocyte aggregation, and incorporates modeling based on first principles ultimately to propose a mechanism of this phenomenon.

  8. Abdominal fat reducing outcome of exercise training: fat burning or hydrocarbon source redistribution?

    Science.gov (United States)

    Kuo, Chia-Hua; Harris, M Brennan

    2016-07-01

    Fat burning, defined by fatty acid oxidation into carbon dioxide, is the most described hypothesis to explain the actual abdominal fat reducing outcome of exercise training. This hypothesis is strengthened by evidence of increased whole-body lipolysis during exercise. As a result, aerobic training is widely recommended for obesity management. This intuition raises several paradoxes: first, both aerobic and resistance exercise training do not actually elevate 24 h fat oxidation, according to data from chamber-based indirect calorimetry. Second, anaerobic high-intensity intermittent training produces greater abdominal fat reduction than continuous aerobic training at similar amounts of energy expenditure. Third, significant body fat reduction in athletes occurs when oxygen supply decreases to inhibit fat burning during altitude-induced hypoxia exposure at the same training volume. Lack of oxygen increases post-meal blood distribution to human skeletal muscle, suggesting that shifting the postprandial hydrocarbons towards skeletal muscle away from adipose tissue might be more important than fat burning in decreasing abdominal fat. Creating a negative energy balance in fat cells due to competition of skeletal muscle for circulating hydrocarbon sources may be a better model to explain the abdominal fat reducing outcome of exercise than the fat-burning model. PMID:27152424

  9. Role of the PPAR-α agonist fenofibrate in severe pediatric burn injury

    Science.gov (United States)

    Elijah, Itoro E.; Børsheim, Elisabet; Maybauer, Dirk M.; Finnerty, Celeste C.; Herndon, David N.; Maybauer, Marc O.

    2013-01-01

    Fenofibrate is a peroxisome proliferator activated receptor alpha agonist that contains both pro and anti-inflammatory properties, and has been used in the treatment of dyslipidemia and diabetes for decades. Its receptors are expressed in the liver, skeletal muscle, cardiac, enteric, and renal cells, which allow it to provide systemic regulation of lipoprotein metabolism, fatty acid oxidation, and fatty acid transport. Hyperglycemia is a common complication found in the burn population because hepatic glucose production and catecholamine-mediated hepatic glycogenolysis are augmented. Insulin resistance occurs often in these patients and is associated with poor outcomes. In the pediatric burn population, fenofibrate has been found to ameliorate or decrease the number of hypoglycemic episodes when compared to management with insulin alone. Its mechanism of action is thought to involve an improvement in insulin signaling in skeletal muscle, as well as improvements in mitochondrial function, glucose oxidation, and insulin sensitivity. The long term use of fenofibrate in severely burned patients may improve hyperglycemia and insulin resistance, as well as improve wound healing, and reduce apoptosis, and oxidative stress. PMID:22226866

  10. Nanolayered siRNA delivery platforms for local silencing of CTGF reduce cutaneous scar contraction in third-degree burns.

    Science.gov (United States)

    Castleberry, Steven A; Golberg, Alexander; Sharkh, Malak Abu; Khan, Saiqa; Almquist, Benjamin D; Austen, William G; Yarmush, Martin L; Hammond, Paula T

    2016-07-01

    Wound healing is an incredibly complex biological process that often results in thickened collagen-enriched healed tissue called scar. Cutaneous scars lack many functional structures of the skin such as hair follicles, sweat glands, and papillae. The absence of these structures contributes to a number of the long-term morbidities of wound healing, including loss of function for tissues, increased risk of re-injury, and aesthetic complications. Scar formation is a pervasive factor in our daily lives; however, in the case of serious traumatic injury, scars can create long-lasting complications due to contraction and poor tissue remodeling. Within this report we target the expression of connective tissue growth factor (CTGF), a key mediator of TGFβ pro-fibrotic response in cutaneous wound healing, with controlled local delivery of RNA interference. Through this work we describe both a thorough in vitro analysis of nanolayer coated sutures for the controlled delivery of siRNA and its application to improve scar outcomes in a third-degree burn induced scar model in rats. We demonstrate that the knockdown of CTGF significantly altered the local expression of αSMA, TIMP1, and Col1a1, which are known to play roles in scar formation. The knockdown of CTGF within the healing burn wounds resulted in improved tissue remodeling, reduced scar contraction, and the regeneration of papillary structures within the healing tissue. This work adds support to a number of previous reports that indicate CTGF as a potential therapeutic target for fibrosis. Additionally, we believe that the controlled local delivery of siRNA from ultrathin polymer coatings described within this work is a promising approach in RNA interference that could be applied in developing improved cancer therapies, regenerative medicine, and fundamental scientific research. PMID:27108403

  11. The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study.

    Science.gov (United States)

    Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer

    2013-09-01

    Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg. PMID:23313241

  12. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury.

    Science.gov (United States)

    Ito, Keisuke; Saito, Akihiro; Fujie, Toshinori; Nishiwaki, Keisuke; Miyazaki, Hiromi; Kinoshita, Manabu; Saitoh, Daizoh; Ohtsubo, Shinya; Takeoka, Shinji

    2015-09-01

    Partial-thickness burn injury has the potential for reepithelialization and heals within 3weeks. If the wound is infected by bacteria before reepithelization, however, the depth of disruption increases and the lesion easily progresses to the full-thickness dermal layers. In the treatment of partial-thickness burn injury, it is important to prevent the wound area from bacterial infection with an antimicrobial dressing. Here, we have tested the antimicrobial properties of polymeric ultra-thin films composed of poly(lactic acid) (termed "PLA nanosheets"), which have high flexibility, adhesive strength and transparency, and silver sulfadiazine (AgSD), which exhibits antimicrobial efficacy. The AgSD-loaded nanosheet released Ag(+) for more than 3days, and exerted antimicrobial efficacy against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro Kirby-Bauer test. By contrast, a cell viability assay indicated that the dose of AgSD used in the PLA nanosheets did not show significant cytotoxicity toward fibroblasts. In vivo evaluation using a mouse model of infection in a partial-thickness burn wound demonstrated that the nanosheet significantly reduced the number of MRSA bacteria on the lesion (more than 10(5)-fold) and suppressed the inflammatory reaction, thereby preventing a protracted wound healing process. PMID:26079191

  13. Third-Degree Hindpaw Burn Injury Induced Apoptosis of Lumbar Spinal Cord Ventral Horn Motor Neurons and Sciatic Nerve and Muscle Atrophy in Rats

    Directory of Open Access Journals (Sweden)

    Sheng-Hua Wu

    2015-01-01

    Full Text Available Background. Severe burns result in hypercatabolic state and concomitant muscle atrophy that persists for several months, thereby limiting patient recovery. However, the effects of burns on the corresponding spinal dermatome remain unknown. This study aimed to investigate whether burns induce apoptosis of spinal cord ventral horn motor neurons (VHMNs and consequently cause skeletal muscle wasting. Methods. Third-degree hindpaw burn injury with 1% total body surface area (TBSA rats were euthanized 4 and 8 weeks after burn injury. The apoptosis profiles in the ventral horns of the lumbar spinal cords, sciatic nerves, and gastrocnemius muscles were examined. The Schwann cells in the sciatic nerve were marked with S100. The gastrocnemius muscles were harvested to measure the denervation atrophy. Result. The VHMNs apoptosis in the spinal cord was observed after inducing third-degree burns in the hindpaw. The S100 and TUNEL double-positive cells in the sciatic nerve increased significantly after the burn injury. Gastrocnemius muscle apoptosis and denervation atrophy area increased significantly after the burn injury. Conclusion. Local hindpaw burn induces apoptosis in VHMNs and Schwann cells in sciatic nerve, which causes corresponding gastrocnemius muscle denervation atrophy. Our results provided an animal model to evaluate burn-induced muscle wasting, and elucidate the underlying mechanisms.

  14. Prediction of Mortality in Pediatric Burn Injuries: R-Baux Score to Be Applied in Children (Pediatrics-Baux Score

    Directory of Open Access Journals (Sweden)

    Hamid Karimi

    2013-04-01

    Full Text Available Objective: R-Baux score has obtained an acceptable validity and accuracy in predicting burn-related mortality. However, its usage and efficacy among pediatric burn patients has not been well documented. The aim of this study was to employ Pediatrics-Baux (P-Buax score as modified version of R-Baux score in these patients to determine how it could be applicable in this population.Methods: Through a prospective study, 870 pediatric burn patients were enrolled. P-Baux and R-Baux scores were calculated for each patient and they were categorized to different groups according to these scores. Mortality and further death probability were measured for each subject and then analyzed by logistic regression model to reveal how they change in relation with age in pediatric burn patients.Findings: R-Baux score for 95% probability of death revealed a mean of 73 among patients of this study. Also P-Baux score was measured in these patients with inhalation injury which showed to be 55 for 95% probability of death. Results showed that age had a positive prognostic value in contrast to the negative prognostic value of Total Body Surface Area (TBSA and inhalation injury.Conclusion: Our analysis showed that in children under the age of 15 years, age has a positive prognostic value while TBSA and inhalation injuries had negative prognostic values in relation to mortality. Hence, in contrast to the adult population, burn injury related mortality may be predicted by modified R-Baux score as (TBSA - age + [18×R] which could be named as P-Baux score.

  15. Guideline for diagnosis, prophylaxis and treatment of invasive fungal infection post burn injury in China 2013

    Directory of Open Access Journals (Sweden)

    Gaoxing Luo

    2014-04-01

    Full Text Available Invasive fungal infection is one of the major complication of severe burns which can induce local or systemic inflammatory response and cause serious substantial damage to the patient. The incidence of fungal infection for burn victims is increasing dramatically during recent years. This guideline, organized by Chinese Society of Burn Surgeons, aims to standardize the diagnosis, prevention and treatment of burn invasive fungal infection. It can be used as one of the tools for treatment of major burn patients.

  16. Time-Dependent and Organ-Specific Changes in Mitochondrial Function, Mitochondrial DNA Integrity, Oxidative Stress and Mononuclear Cell Infiltration in a Mouse Model of Burn Injury.

    Directory of Open Access Journals (Sweden)

    Bartosz Szczesny

    Full Text Available Severe thermal injury induces a pathophysiological response that affects most of the organs within the body; liver, heart, lung, skeletal muscle among others, with inflammation and hyper-metabolism as a hallmark of the post-burn damage. Oxidative stress has been implicated as a key component in development of inflammatory and metabolic responses induced by burn. The goal of the current study was to evaluate several critical mitochondrial functions in a mouse model of severe burn injury. Mitochondrial bioenergetics, measured by Extracellular Flux Analyzer, showed a time dependent, post-burn decrease in basal respiration and ATP-turnover but enhanced maximal respiratory capacity in mitochondria isolated from the liver and lung of animals subjected to burn injury. Moreover, we detected a tissue-specific degree of DNA damage, particularly of the mitochondrial DNA, with the most profound effect detected in lungs and hearts of mice subjected to burn injury. Increased mitochondrial biogenesis in lung tissue in response to burn injury was also observed. Burn injury also induced time dependent increases in oxidative stress (measured by amount of malondialdehyde and neutrophil infiltration (measured by myeloperoxidase activity, particularly in lung and heart. Tissue mononuclear cell infiltration was also confirmed by immunohistochemistry. The amount of poly(ADP-ribose polymers decreased in the liver, but increased in the heart in later time points after burn. All of these biochemical changes were also associated with histological alterations in all three organs studied. Finally, we detected a significant increase in mitochondrial DNA fragments circulating in the blood immediately post-burn. There was no evidence of systemic bacteremia, or the presence of bacterial DNA fragments at any time after burn injury. The majority of the measured parameters demonstrated a sustained elevation even at 20-40 days post injury suggesting a long-lasting effect of thermal

  17. Risk factors for frequent work-related burn and cut injuries and low back pain among commercial kitchen workers in Japan.

    Science.gov (United States)

    Tomita, Shigeru; Muto, Takashi; Matsuzuki, Hiroe; Haruyama, Yasuo; Ito, Akiyoshi; Muto, Shigeki; Haratani, Takashi; Seo, Akihiko; Ayabe, Makoto; Katamoto, Shizuo

    2013-01-01

    This study investigated risk factors for frequent work-related burn and cut injuries and low back pain (LBP) among kitchen workers including personal, work-related and environmental factors. Subjects were 991 kitchen workers in 103 schools, 17 hospitals and nursing homes, and 6 restaurants in central Japan. A cross-sectional survey was carried out using a structured self-administered questionnaire. Logistic regression models were used to examine associations between frequent injuries/LBP and risk factors. The effective response rate was 75.1% (n=744), the mean age was 40.7 (SD 11.7) and 77.2% were female. Burn injury was associated with a smaller kitchen (OR 1.94; 95%CI, 1.13-3.33), and gas kitchens rather than electric kitchens (OR 2.30; 95%CI, 1.17-4.52). LBP was associated with female gender (OR 2.46; 95%CI, 1.37-4.43), high body height (>160 cm) (OR 2.03; 95%CI, 1.22-3.36), and large number of meals produced per person (≥ 150 meals) (OR 1.83; 95%CI, 1.12-3.00). The results of this study suggest that securing adequate work space and introducing electric kitchen systems may reduce the risk to kitchen workers, as well as the importance of adequate height of cooking equipment and selecting an appropriate volume of meals to produce per person to prevent LBP in kitchen workers. PMID:23385436

  18. The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire

    Science.gov (United States)

    Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

    2016-01-01

    Background Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. Methods International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. Results During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Key findings Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR ‘highly valuable’ for prioritising, developing and monitoring burn prevention programmes. Conclusions The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. PMID:27044496

  19. Pathological changes after bone marrow and skin allograft transplantation in rats inflicted with severe combined radiation-burn injury

    International Nuclear Information System (INIS)

    Bone marrow and skin allografts from the same donor were transplanted to rats inflicted with 8 Gy γ-radiation combined with third degree burns of 15% body surface area within 6 hr post injury. Pathological changes of hematopoietic tissues and skin allografts were studied. All injured controls died within 7 days post injury without bone marrow regeneration; 50% of treated rats survived with living skin allografts on 50th day post injury. On days 100 and 480 post operation, grafted skin still survived well on recipients with normal ultrastructure. Epidermic cells of skin allografts proliferated on day 5, developed and repaired on day 10. Histological structure of the skin returned to normal on day 30 post operation. The regeneration of bone marrow appeared on 5th day, increased markedly on day 10, and almost completed on day 15 after bone marrow transplantation. However, the regeneration of lymphocytes in cortex of spleen and lymph nodes did not appear until day 15 of BMT. The results show that bone marrow and skin allograft transplantation at early time post injury in most severe combined radiation-burn injury have tremendous beneficial effects, and the skin allograft can survive for a long time

  20. Inhibition of long myosin light-chain kinase activation alleviates intestinal damage after binge ethanol exposure and burn injury

    OpenAIRE

    Zahs, Anita; Bird, Melanie D.; Ramirez, Luis; Turner, Jerrold R; Choudhry, Mashkoor A.; Kovacs, Elizabeth J

    2012-01-01

    Laboratory evidence suggests that intestinal permeability is elevated following either binge ethanol exposure or burn injury alone, and this barrier dysfunction is further perturbed when these insults are combined. We and others have previously reported a rise in both systemic and local proinflammatory cytokine production in mice after the combined insult. Knowing that long myosin light-chain kinase (MLCK) is important for epithelial barrier maintenance and can be activated by proinflammatory...

  1. Management of severe burn injuries with topical heparin: the first evidence-based study in Ghana

    OpenAIRE

    Agbenorku, Pius; Fugar, Setri; Akpaloo, Joseph; Hoyte-Williams, Paa E; Alhassan, Zainab; Agyei, Fareeda

    2013-01-01

    Conventional therapy for burns has always produced a nightmarish illness for patients. The lack of the ability to prevent contractures often produces dysfunctional limbs and the ugly scars resulting from severe burns are an ongoing reminder of this lengthy painful illness. This study is to determine the effectiveness of topical heparin in burns management among some patients at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Patients for this ...

  2. Response to: Practice of first aid in burn related injuries in a developing country.

    Science.gov (United States)

    Baker, Benjamin; Amin, Kavit; Khor, Wee Sim; Khwaja, Nadeem

    2015-12-01

    Traditional remedies for burns first aid are rarely compliant with current best practice. Greater Manchester is one of the most ethnically diverse regions in the UK. Our burns centre has noted the prevalent use of traditional remedies over recognised first aid prior to presentation. We review traditional burns remedies and highlight the importance of burns first aid education that is accessible to migrant communities. PMID:26428366

  3. The Immune Response to Skin Trauma Is Dependent on the Etiology of Injury in a Mouse Model of Burn and Excision.

    Science.gov (United States)

    Valvis, Samantha M; Waithman, Jason; Wood, Fiona M; Fear, Mark W; Fear, Vanessa S

    2015-08-01

    Skin trauma has many different causes including incision, blunt force, and burn. All of these traumas trigger an immune response. However, it is currently unclear whether the immune response is specific to the etiology of the injury. This study was established to determine whether the immune response to excision and burn injury of equivalent extent was the same. Using a mouse model of a full-thickness 19 mm diameter excision or 19 mm diameter full-thickness burn injury, we examined the innate immune response at the level of serum cytokine induction, whole-blood lymphocyte populations, dendritic cell function/phenotype, and the ensuing adaptive immune responses of CD4 and CD8 T-cell populations. Strikingly, both the innate and adaptive immune system responses differed between the burn and excision injuries. Acute cytokine induction was faster and different in profile to that of excision injury, leading to changes in systemic monocyte and neutrophil levels. Differences in the immune profile between burn and excision were also noted up to day 84 post injury, suggesting that the etiology of injury leads to sustained changes in the response. This may in part underlie clinical observations of differences in patient morbidity and mortality in response to different skin injury types. PMID:25826422

  4. Mesenchymal stem cells reduce the irradiation induced lung injury

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of mesenchymal stem cells (MSCs) derived from mouse bone and embryo dorsal aorta (DA) area in the treatment of irradiation induced lung injury of mouse model. Methods: The mice were divided into four groups as normal control group, irradiation group,bone MSCs treatment group and DA MSCs treatment group. Immunohistochemical Analysis of lung tissue was observed after 9 months of treatment. Results: Fibrosis and alveolar infiltration were scored in each group. The score for fibrosis and alveolar is 0. 17 in normal control group, 2 in irradiation group, 1 in bone MSCs treat group and 1.38 in DA MSCs treat group. Conclusion: The extent of irradiation Induced Lung Injury could be reduced thorough the treatment of MSCs derived from mouse bone and embryos dorsal aorta ( DA ) area. (authors)

  5. Epidemiology of U.K. military burns.

    Science.gov (United States)

    Foster, Mark Anthony; Moledina, Jamil; Jeffery, Steve L A

    2011-01-01

    The authors review the etiology of U.K. military burns in light of increasing hybrid warfare. Analysis of the nature of these injured personnel will provide commanders with the evidence to plan for on-going and future operations. Case notes of all U.K. Armed Forces burn injured patients who were evacuated to the Royal Centre for Defence Medicine were reviewed. Demographics, burn severity, pattern, and mortality details were included. There were 134 U.K. military personnel with burns requiring return to the United Kingdom during 2001-2007. The median age was 27 (20-62) years. Overall, 60% of burns seen were "accidental." Burning waste, misuse or disrespect of fuel, and scalds were the most prevalent noncombat burns. Areas commonly burned were the face, legs, and hands. During 2006-2007 in the two major conflicts, more than 59% (n = 36) of the burned patients evacuated to the United Kingdom were injured during combat. Burns sustained in combat represent 5.8% of all combat casualties and were commonly associated with other injuries. Improvised explosive device, minestrike, and rocket-propelled grenade were common causes. The mean TBSA affected for both groups was 5% (1-70). The majority of combat burn injuries have been small in size. Greater provision of flame retardant equipment and clothing may reduce the extent and number of combat burns in the future. The numbers of noncombat burns are being reduced by good military discipline. PMID:21422938

  6. Optimization of the Anterior Cruciate Ligament Injury Prevention Paradigm : Novel Feedback Techniques to Enhance Motor Learning and Reduce Injury Risk

    NARCIS (Netherlands)

    Benjaminse, Anne; Gokeler, Alli; Dowling, Ariel V.; Faigenbaum, Avery; Ford, Kevin R.; Hewett, Timothy E.; Onate, James A.; Otten, Bert; Myer, Gregory D.

    2015-01-01

    SYNOPSIS: Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence-is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current

  7. Axially homogeneous thorium fuel designs for transuranic burning in reduced-moderation BWRs

    International Nuclear Information System (INIS)

    Reduced-moderation Boiling Water Reactors (RBWRs) can allow sustained burning of transuranics (TRU), such that full actinide recycle can be achieved. However, the void coefficient (VC) tends to become positive with reduced moderation and high TRU loading, which can severely limit the design feasibility and performance. This motivates use of thorium (Th) as an alternative feed to uranium (U), as this tends to result in a more negative VC. Using coupled neutronic-thermal-hydraulic core calculations, Th-fuelled RBWRs are shown to be capable of achieving high discharge burn-ups, while incinerating an external supply of TRU. This gives them some flexibility to incinerate TRU with different isotope vectors. Spatial separation of Th-TRU and Th-U3 into regions of the order of a few thermal neutron diffusion lengths greatly improves neutronic performance. This can be accomplished radially or axially, but radial separation results in significantly easier fuel fabrication. A companion paper considers axially heterogeneous fuel designs, which are not found to deliver improved performance. A radially heterogeneous RBWR core design, can achieve 135 kg/GWthyr waste incineration rate, and at least 70–80 GWd/t discharge burn-up, depending on the TRU cooling time, and whether a single pass through a conventional PWR is used as an initial step before full recycle in an RBWR. Alternatively, a micro-heterogeneous assembly design with Th-Pu and Th-U3-MA pins can reduce fuel fabrication costs, although this limits the TRU incineration rate to ∼100 kg/GWthyr. ∼200 cm and ∼120 cm core heights are considered, with the former being generally preferred due to the possibility to match both the rating and pressure vessel size of an ABWR. (author)

  8. Burns: an update on current pharmacotherapy

    Science.gov (United States)

    Rojas, Yesinia; Finnerty, Celeste C.; Radhakrishnan, Ravi S.; Herndon, David N.

    2013-01-01

    Introduction The world-wide occurrence of burn injuries remains high despite efforts to reduce injury incidence through public awareness campaigns and improvements in living conditions. In 2004, almost 11 million people experienced burns severe enough to warrant medical treatment. Advances over the past several decades in aggressive resuscitation, nutrition, excision, and grafting have reduced morbidity and mortality. Incorporation of pharmacotherapeutics into treatment regimens may further reduce complications of severe burn injuries. Areas covered Severe burn injuries, as well as other forms of stress and trauma, trigger a hypermetabolic response that, if left untreated, impedes recovery. In the past two decades, use of anabolic agents, beta adrenergic receptor antagonists, and anti-hyperglycemic agents has successfully counteracted post-burn morbidities including catabolism, the catecholamine-mediated response, and insulin resistance. Here we review the most up-to-date information on currently used pharmacotherapies in the treatment of these sequelae of severe burns and the insights that have expanded our understanding of the pathophysiology of severe burns. Expert opinion Existing drugs offer promising advances in the care of burn injuries. Continued gains in our understanding of the molecular mechanisms driving the hypermetabolic response will enable the application of additional existing drugs to be broadened to further attenuate the hypermetabolic response. PMID:23121414

  9. 烧伤后早期心肌损害与防治%Myocardial injury after burn at early stage and its treatment

    Institute of Scientific and Technical Information of China (English)

    黄跃生

    2008-01-01

    Isehemia/hypoxia is one of the key clinical issues following severe burns, and isehemic/hypoxic damage of tissues and organs is still hard to be prevented or minimized by various fluid resuscitation regimens . To those who suffered severe bums, even though fluid replacement therapy is delivered promptly, isehemic/hypoxie damage of organs is still inevitable. Previously, blood flow in vital organs such as heart was eonsidered not to be reduced because of blood redistribution under the circumstance of stress. The postbum cardiac dysfunction has been mainly attributed to the reduced blood flow returned to the heart due to decreased blood volume caused by increased capillary permeability. Therefore, postbum cardiac dysfunction has been considered to be the result of burn shock. During the past two decades, we have performed serial studies on severe burns, and found that isehemie/hypoxie myocardial damage and functional impairment of myocardium due to activation of reninangio tensin system existing in the heart itself occur immediately after severe bums even before significant reduction in blood volume secondary to an increase of capillary permeability . Such prompt myocardial damage leads to cardiac deficiency, and it is also a precipitating factor for bum shock and isehemic/hypoxie injury of systemic tissues and organs. Therefore, we called it " shock heart" in our reports. The cellular and molecular mechanisms leading to myocardial damage were systematically investigated. Strategies for prevention of early postburn myocardial damage and dysfunction, and a new effective burn shock resuscitation regimen "volume replacement" plus "dynamic support" (cardiac support and myocardial protection) have been proposed based on our previous studies.

  10. Impact of Oxandrolone Treatment on Acute Outcomes After Severe Burn Injury

    OpenAIRE

    Pham, Tam N.; Klein, Matthew B.; Gibran, Nicole S.; Arnoldo, Brett D.; Gamelli, Richard L.; Silver, Geoffrey M.; Jeschke, Marc G.; Finnerty, Celeste C.; Tompkins, Ronald G.; Herndon, David N

    2008-01-01

    Pharmacologic modulation of hypermetabolism clearly benefits children with major burns, however, its role in adult burns remains to be defined. Oxandrolone appears to be a promising anabolic agent although few outcome data are as yet available. We examined whether early oxandrolone treatment in severely burned adults was associated with improved outcomes during acute hospitalization. We evaluated for potential associations between oxandrolone treatment and outcomes in a large cohort of severe...

  11. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    OpenAIRE

    Nilgün Aksoy; Senay Arli; Ozlem Yigit

    2014-01-01

    Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ r...

  12. Melatonin reduces acute lung injury in endotoxemic rats

    Institute of Scientific and Technical Information of China (English)

    SHANG You; XU San-peng; WU Yan; JIANG Yuan-xu; WU Zhou-yang; YUAN Shi-ying; YAO Shang-long

    2009-01-01

    Background Treatment with melatonin significantly reduces lung injury induced by bleomycin, paraquat and ischemia reperfusion. In the present study, we investigated the possible protective roles of melatonin in pulmonary inflammation and lung injury during acute endotoxemia.Methods Thirty-two male Sprague-Dawley rats were randomly assigned to four groups: vehicle + saline group, melatonin + saline group, vehicle + lipopolysaccharide group, melatonin + lipopolysaccharide group. The rats were treated with melatonin (10 mg/kg, intraperitoneal injection (I.p.)) or vehicle (1% ethanol saline), 30 minutes prior to lipopolysaccharide administration (6 mg/kg, intravenous injection). Four hours after lipopolysaccharide injection, samples of pulmonary tissue were collected. Blood gas analysis was carried out. Optical microscopy was performed to examine pathological changes in lungs and lung injury score was assessed. Wet/dry ratios (W/D), myeloperoxidase activity, malondialdehyde concentrations and tumor necrosis factor-alpha (TNF-a) and interleukin-10 (IL-10) levels in lungs were measured. The pulmonary expression of nuclear factor-kappa B (NF-KB) p65 was evaluated by Western blotting. Results PaO2 in the vehicle + lipopolysaccharide group decreased compared with that in the vehicle + saline group. This decrease was significantly reduced in the melatonin + lipopolysaccharide group. The lung tissues from the saline + lipopolysaccharide group were significantly damaged, which were less pronounced in the melatonin + lipopolysaccharide group. The W/D ratio increased significantly in the vehicle + lipopolysaccharide group (6.1±0.18) as compared with that in the vehicle + saline group (3.611±0.3) (P <0.01), which was significantly reduced in the melatonin + lipopolysaccharide group (4.8±0.25) (P <0.01). Myeloperoxidase activity and malondialdehyde levels increased significantly in the vehicle + lipopolysaccharide group compared with that in the vehicle + saline group, which

  13. Functionally Selective AT(1) Receptor Activation Reduces Ischemia Reperfusion Injury

    DEFF Research Database (Denmark)

    Hostrup, Anders; Christensen, Gitte Lund; Bentzen, Bo Hjort; Liang, Bo; Aplin, Mark; Grunnet, Morten; Hansen, Jakob Lerche; Jespersen, Thomas

    2012-01-01

    physiological functions of AngII. The AT(1)R mediates its effects through both G protein-dependent and independent signaling, which can be separated by functionally selective agonists. In the present study we investigate the effect of AngII and the ß-arrestin biased agonist [SII]AngII on ischemia......-reperfusion injury in rat hearts. Isolated hearts mounted in a Langendorff perfused rat heart preparations showed that preconditioning with [SII]AngII reduced the infarct size induced by global ischemia from 46±8.4% to 22±3.4%. In contrast, neither preconditioning with AngII nor postconditioning with AngII or [SII...

  14. Plasma Proteome Response to Severe Burn Injury Revealed by 18O-Labeled “Universal” Reference-based Quantitative Proteomics

    Science.gov (United States)

    Qian, Wei-Jun; Petritis, Brianne O.; Kaushal, Amit; Finnerty, Celeste C; Jeschke, Marc G; Monroe, Matthew E.; Moore, Ronald J.; Schepmoes, Athena A.; Xiao, Wenzhong; Moldawer, Lyle L.; Davis, Ronald W.; Tompkins, Ronald G.; Herndon, David N.; Camp, David G.; Smith, Richard D.

    2010-01-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the 12 most abundant plasma proteins with cysteinyl-peptide enrichment-based fractionation prior to LC-MS analyses of individual patient samples. Incorporation of an 18O-labeled “universal” reference among the sample sets enabled precise relative quantification across samples. In total, 313 plasma proteins confidently identified with two or more unique peptides were quantified. Following statistical analysis, 110 proteins exhibited significant abundance changes in response to the burn injury. The observed changes in protein concentrations suggest significant inflammatory and hypermetabolic response to the injury, which is supported by the fact that many of the identified proteins are associated with acute phase response signaling, the complement system, and coagulation system pathways. The regulation of ~35 proteins observed in this study is in agreement with previous results reported for inflammatory or burn response, but approximately 50 potentially novel proteins previously not known to be associated with burn response or inflammation are also found. Elucidating proteins involved in the response to severe burn injury may reveal novel targets for therapeutic interventions, as well as potential predictive biomarkers for patient outcomes such as multiple organ failure. PMID:20698492

  15. Axially heterogeneous thorium fuel designs for transuranic burning in reduced-moderation BWRs

    International Nuclear Information System (INIS)

    Reduced-moderation Boiling Water Reactors (RBWRs) can allow sustained burning of transuranics (TRU), such that full actinide recycle can be achieved. However, the void coefficient (VC) tends to become positive with reduced moderation and high TRU loading, which can severely limit the design feasibility and performance. This motivates use of thorium (Th) as an alternative feed to uranium (U), as this tends to result in a more negative VC, leading to much improved neutronic performance. While axially homogeneous fuel design is preferable for ease of fuel fabrication, it is valuable to evaluate axially heterogeneous fuel designs to see if improved neutronic performance can be realised, which could lead to a reduction in fuel reprocessing and fabrication throughput. Multi-recycled Th-TRU fuel contains Th, U, Pu and MAs, leading to a wide range of possible fuel designs. Axially heterogeneous designs are considered using 3D pincell calculations using the Monte Carlo code Serpent. Radially heterogeneous assembly designs are considered in a companion paper. Spatial separation of Th-TRU and Th-U3 into regions of the order of a few thermal neutron diffusion lengths greatly improves neutronic performance. This can be accomplished radially or axially, but radial separation results in significantly easier fuel fabrication. Axial seed-blanket heterogeneity improves neutron economy at the expense of high power peaking, such that the radially heterogeneous assembly design is preferred. Separation of Th-TRU and Th-U3 into larger regions is not effective, due to increased power density in the Th-TRU region with voiding and with burn-up, leading to a more positive VC. It is therefore concluded that there is no motivation to pursue axially heterogeneous Th-TRU RBWR burner designs. (author)

  16. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment

    Science.gov (United States)

    Oláh, Gábor; Finnerty, Celeste; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David; Szabó, Csaba

    2011-01-01

    Summary Activation of the nuclear enzyme poly (ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibition. The aim of the current study was to measure the activation of PARP in human skeletal muscle biopsies at various stages of severe pediatric burn injury and to identify the cell types where this activation may occur. Another aim of the study was to test the effect of propranolol (an effective treatment of patients with burns), on the activation of PARP in skeletal muscle biopsies. PARP activation was measured by Western blotting for its product, poly(ADP-ribose) (PAR). The localization of PARP activation was determined by PAR immunohistochemistry. The results showed that PARP becomes activated in the skeletal muscle tissue after burns, with the peak of the activation occurring in the middle stage of the disease (13–18 days after burns). Even at the late stage of the disease (69–369 days post-burn) an elevated degree of PARP activation persisted in some of the patients. Immunohistochemical studies localized the staining of PAR primarily to vascular endothelial cells, and occasionally to resident mononuclear cells. There was a marked suppression of PARP activation in the skeletal muscle biopsies of patients who received propranolol treatment. We conclude that human burn injury is associated with the activation of PARP. We hypothesize that this response may contribute to the inflammatory responses and cell dysfunction in burns. Some of the clinical benefit of propranolol in burns may be related to its inhibitory effect on PARP activation. PMID:21368715

  17. Acute changes in oxygen consumption and body temperature after burn injury.

    OpenAIRE

    Childs, C.; Little, R. A.

    1994-01-01

    This study describes the pattern of oxygen consumption (VO2), rectal temperature (Tr), and acral skin temperature (Tac) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VO2 and carbon dioxide production (VCO2)) were made using an open circuit, flow through system of indirect calorimetry. Tr and Tac were monitored continuously. Sixteen patients were studied during the first 18 hours after being burned. Three phases...

  18. Trimetazidine effect on burn-induced intestinal mucosal injury and kidney damage in rats

    OpenAIRE

    Yalcin, Arzu Didem; Bisgin, Atil; Erbay, Riza Hakan; Oguz, Oguzhan; Demir, Suleyman; Yilmaz, Mustafa; Gumuslu, Saadet

    2012-01-01

    Background: Trimetazidine (TMZ) has been used in cardiology practice for protection from ischemiareperfusion injury. But its effects on intestinal mucosa are not well known. Our aim was to investigate the protective effect of TMZ on intestinal mucosa and on damaged kidney due to thermal injury in rats. Material and methods: Total of 30 male Sprague-Dawley rats were used in the study of intestinal mucosa damage and 24 female Sprague-Dawley rats in renal injury model. Back regions were shaved a...

  19. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment

    OpenAIRE

    Oláh, Gábor; Finnerty, Celeste; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David; Szabó, Csaba

    2011-01-01

    Activation of the nuclear enzyme poly (ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibiti...

  20. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics

    Science.gov (United States)

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Ferrando, Arny A.; Elijah, Itoro E.; Mlcak, Ronald P.; Finnerty, Celeste C.; Wolfe, Robert R.; Herndon, David N.

    2011-01-01

    Purpose This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Methods: Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-2H5]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Results Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p < 0.05). Muscle protein fractional synthesis rate (FSR) was higher in children (adult vs. children, 0.11 ± 0.05 vs. 0.16 ± 0.10 %/h, p < 0.05). Leg muscle protein breakdown was not different between the groups (adult vs. children, 179 ± 115 vs. 184 ± 124 nmol Phe/ min/100 ml leg volume, p < 0.05; synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. Conclusion In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children. PMID:21647721

  1. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Nilgün Aksoy

    2014-08-01

    Full Text Available Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ referred to the emergency department (ED of Akdeniz hospital, Turkey, 2008. Demographic data, the season, place, reason, anatomical sites, total body surface area, degrees, proceeding treatment, and admission time were recorded. Multinomial logistic regression was used to compare frequencies’ differences among single categorized variables. Stepwise logistic regression was applied to develop a predictive model for hospitalization. P<0.05 was defined as a significant level. Results: Two hundred thirty patients were enrolled (53.9% female. The mean of patients' ages was 25.3 ± 22.3 years. The most prevalence of burn were in the 0-6 age group and most of which was hot liquid scalding (71.3%. The most affected parts of the body were the left and right upper extremities. With increasing the severity of triage level (OR=2.2; 95% CI: 1.02-4.66; p=0.046, intentional burn (OR=4.7; 95% CI: 1.03-21.8; p=0.047, referring from other hospitals or clinics (OR=3.4; 95% CI: 1.7-6.6; p=0.001, and percentage of burn (OR=18.1; 95% CI: 5.42-62.6; p<0.001 were independent predictive factor for hospitalization. In addition, odds of hospitalization was lower in patients older than 15 years (OR=0.7; 95% CI: 0.5-0.91; p=0.035. Conclusion: This study revealed the most frequent burns are encountered in the age group of 0-6 years, percentage of <10%, second degree, upper extremities, indoor, and scalding from hot liquids. Increasing ESI severity, intentional burn, referring from

  2. About the tactics of treatment and visual rehabilitation in case of an acute severe alkaline burn injury of the eye. A case report

    OpenAIRE

    V.F. Chernysh; E.V. Boyko

    2013-01-01

    ABSTRACT Purpose. To acquaint ophthalmologists with tactics of treatment of a victim with an acute severe chemical burn injury of the eye i n one of follow-up cases fr om practice. Material and methods. The female patient of 31 years old had a severe alkaline burn injury with total limbal stem cell deficiency in the right eye. до (до After an emergency aid an ischemia of a limbus zone, a total corneal erosion and its moderate edema, a deepithelization of conjunctiva...

  3. Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Krarup, Annabel Lee; Nielsen, L M; Reimert, C M; Pedersen, A N; Dybkjaer, E; Partoft, S; Alsbjørn, B

    1999-01-01

    Adverse effects of perioperative blood transfusion appear to be storage-time-dependent and may be related to extracellular accumulation of bioactive substances in blood products. In this study the clinical effects of leukofiltered and non-filtered blood products in patients undergoing surgery for...... burn trauma are investigated. 24 consecutive patients were randomly selected to receive transfusion with non-filtered blood components (group A, n = 12) or similar products, which were prestorage leukofiltered (group B, n = 12). The burn injury was scored using the Bull and Fischer index of age and...... 30 min after skin incision until the grafts were secured by wrapping. Samples were also taken 8 h after skin incision and in the morning of postoperative days 1-5. The amount of blood products transfused from admission until day 5 postoperatively was recorded. All patients were followed until...

  4. Burn injury reveals altered phenotype in mannan-binding lectin-deficient mice

    DEFF Research Database (Denmark)

    Møller-Kristensen, Mette; Hamblin, MR; Thiel, Steffen; Jensenius, Jens Christian; Takahashi, K

    2007-01-01

    lectin complement pathway and acts as an opsonin. Recent studies suggest that MBL also modulates inflammatory responses. We report that local responses after burn in MBL null mice differ from those found in wild-type (WT) mice in the following important biological markers: spontaneous eschar separation......, thinned epidermis and dermis, upregulation of soluble factors including cytokines, chemokines, cell adhesion molecules, a growth factor-binding protein, and matrix metalloproteinases. Mice lacking C1q, C4, or C3 did not show the lack of eschar separation seen in MBL null-burn phenotype. These findings...

  5. 放烧复合伤的治疗研究%Studies on the treatment of combined radiation-burn injury

    Institute of Scientific and Technical Information of China (English)

    程天民; 冉新泽

    2008-01-01

    Combined radiation-bum injuries mainly occur under the circumstances of nuclear explosion, nuclear accident, nuclear terrorism, depleted uranium attack, as well as secondary injuries following attack on nuclear installation. Combination of burn and radiation injuries bring along more serious whole body damage, more complicated pathological mechanism and much more difficult management. Research progress on the pathological mechanism and medical management of several key links of combined injury were discussed in this paper.①En-hancement of early first aid and prevention of early death of wounded. ②Damage and restoration of hemopoetic function.③Disturbance of immune function and prevention and treatment of infection (mainly on the intestinla mucosa immunity and enter-ological infection).④Management of burn wound.⑤The uole of several important measures in the comprehensive treatment.

  6. Epidemiology of ventilator-associated tracheobronchitis and vantilator-associated pneumonia in patients with inhalation injury at the Burn Centre in Brno (Czech Republic)

    OpenAIRE

    Lipovy, B; Rihová, H.; Gregorova, N; Hanslianova, M.; Zaloudikova, Z.; Kaloudova, Y.; Brychta, P.

    2011-01-01

    Aim. The aim of this work is to determine the incidence of ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP) and to define the define the most important respiratory pathogens in patients with inhalation injury. Introduction. Infectious complications in severely burned patients present serious problems. Patients with inhalation injuries are exposed to greater risk owing to the possible development of infectious complications in the lower respiratory tract....

  7. The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury

    OpenAIRE

    Spyropoulou, G.A.; Iconomou, T.; Tsagarakis, M.; Tsoutsos, D.

    2005-01-01

    The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest ra...

  8. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    Directory of Open Access Journals (Sweden)

    GregoryAElder

    2012-12-01

    Full Text Available Blast-induced traumatic brain injury (TBI has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI. The β-amyloid (Aβ peptide associated with the development of Alzheimer’s disease (AD is elevated acutely following TBI in humans as well as in experimental animal models of nbTBI. We examined levels of brain Aβ following experimental blast injury using enzyme-linked immunosorbent assays for Aβ 40 and 42. In both rat and mouse models of blast injury, rather than being increased, endogenous rodent brain Aβ levels were decreased acutely following injury. Levels of the amyloid precursor protein (APP were increased following blast exposure although there was no evidence of axonal pathology based on APP immunohistochemical staining. Unlike the findings in nbTBI animal models, levels of the β-secretase, BACE-1, and the γ-secretase component presenilin-1 were unchanged following blast exposure. These studies have implications for understanding the nature of blast injury to the brain. They also suggest that strategies aimed at lowering Aβ production may not be effective for treating acute blast injury to the brain.

  9. Reducing health impacts of biomass burning for cooking. The need for cookstove performance testing

    Energy Technology Data Exchange (ETDEWEB)

    Abeliotis, K. [Department of Home Economics and Ecology, Harokopio University, Athens (Greece); Pakula, C. [Institute of Agricultural Engineering, Section Household and Appliance Technology, Rheinische Friedrich-Wilhelms University, Bonn (Germany)

    2013-08-15

    Biomass is a renewable energy source that is routinely used for cooking in the developing world, especially in rural areas. The World Health Organization estimates that about 2.5 billion people globally rely on biomass, such as wood, agricultural waste and animal dung to meet their energy needs for cooking utilising traditional low-efficiency cookstoves. However, certain human health risks are associated with the inhalation of off-gases resulting from the indoor use of biomass for cooking, especially for women and children who spend more of their time at home. On the other hand, use of energy-efficient cookstoves is considered to reduce those risks. Thus, qualitative and quantitative measurements of cookstove performance are necessary in order to make different stoves and different cooking processes comparable. The aim of this paper is the presentation of the current situation regarding biomass use for cooking with emphasis placed on the developing world, the brief of the adverse health impacts of biomass burning based on the review of literature, the presentation of the merits of improved efficiency cookstoves and to highlight the need for stove performance tests. The demand of different types of biomass is not likely to change in the near future in the developing world since biomass is readily available and cheap. Thus, the efforts to improve household air quality must concentrate on improving cookstoves efficiency and ventilation of the flue gases outdoors. Programmes for the improvement of the cookstoves efficiency in the developing world should be part of the development agenda.

  10. Is a Cognitive-Behavioural Biofeedback Intervention Useful to Reduce Injury Risk in Junior Football Players?

    OpenAIRE

    Arne Edvardsson; Andreas Ivarsson; Urban Johnson

    2012-01-01

    Athletes participating in sport are exposed to a relatively high injury risk. Previous research has suggested that it could be possible to reduce sports injuries through psychological skills training. The purpose of this study was to examine the extent to which a cognitive behavioural biofeedback intervention could reduce the number of sports injuries in a sample of players in Swedish elite football high schools. Participants from four elite football high schools (16-19 years old) were divide...

  11. A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students.

    Science.gov (United States)

    Goossens, L; Cardon, G; Witvrouw, E; Steyaert, A; De Clercq, D

    2016-01-01

    Physical Education Teacher Education (PETE) students are at considerable risk for non-contact sports injuries of the lower extremities. Multifactorial injury prevention interventions including exercises have been successful in sports populations, but no such study has ever been performed in PETE students. This study investigated the efficacy of a multifactorial injury prevention intervention on injury incidence reduction in PETE students. PETE students in the intervention group (n = 154) and in the control group (n = 189) registered sports injuries prospectively. The intervention lasted one academic year and consisted of an injury awareness programme and preventive strategies, implemented by the PETE sports lecturers. Differences in injury incidence between the intervention and control group were tested by Poisson regression Wald tests. There was a trend towards significantly lower incidence rate (2.18 vs. 2.73; p = 0.061) in the intervention group compared with the control group. Students in the intervention group had significantly less acute, first-time and extracurricular injuries. The largest reduction was observed for injuries during unsupervised practice sessions. A multifactorial injury prevention intervention embedded into a regular PETE programme is a promising and feasible strategy to prevent injuries in PETE students. Further research is needed to investigate whether the results may be generalised to other PETE programmes. PMID:25768808

  12. Reduced gastric acid production in burn shock period and its significance in the prevention and treatment of acute gastric mucosal lesions.

    Science.gov (United States)

    Zhu, Li; Yang, Zhong-Cheng; Li, Ao; Cheng, De-Chang

    2000-02-01

    AIM:To investigate the changes of gastric acid production and its mechanism in shock period of severe burn in rats.METHODS:A rat model with 30% TBSA full thickness burn injury was employed and the gastric acid production,together with gastric mucosal blood flow (GMBF) and energy charge (EC) were measured serially within 48h postburn.RESULTS:The gastric acid production in the acute shock period was markedly inhibited after severe burn injury.At the 3rd h postburn,the gastric juice volume, total acidity and acid output were already significantly decreased (P anti-acid drugs during burn shock period was unreasonable in some respects. Therefore, taking effective measures to improve gastric mucosal blood perfusion as early as possible postburn might be more preferable for the AGML prevention and treatment. PMID:11819529

  13. Management of acute burns and burn shock resuscitation.

    Science.gov (United States)

    Faldmo, L; Kravitz, M

    1993-05-01

    Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications. PMID:8489882

  14. Role of the PPAR-α agonist fenofibrate in severe pediatric burn injury

    OpenAIRE

    Elijah, Itoro E.; Børsheim, Elisabet; Maybauer, Dirk M.; Finnerty, Celeste C.; Herndon, David N; Maybauer, Marc O.

    2012-01-01

    Fenofibrate is a peroxisome proliferator activated receptor alpha agonist that contains both pro and anti-inflammatory properties, and has been used in the treatment of dyslipidemia and diabetes for decades. Its receptors are expressed in the liver, skeletal muscle, cardiac, enteric, and renal cells, which allow it to provide systemic regulation of lipoprotein metabolism, fatty acid oxidation, and fatty acid transport. Hyperglycemia is a common complication found in the burn population becaus...

  15. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    Jeschke, Marc

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased lite...

  16. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    AD Rogers; MG, Jeschke

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literatu...

  17. [I Am an Occupational Therapist. I Will Accompany You Through the Process of Burn Rehabilitation].

    Science.gov (United States)

    Chen, Sheng-Sung

    2016-02-01

    Burn injuries nearly always occur by accident. Burn injuries that cover large areas of the body typically cause hypertrophic scarring and joint contractures that affect the ability of the burn patient to handle normal activities of daily living. Occupational therapists begin the related interventions as early as possible, and patients require rehabilitation continuously until scar maturation. The present article provides an overview of the approach that occupational therapists should take in treating burn patients. Key elements of this approach include creating a burn rehabilitation program and helping patients achieve independence in their activities of daily living by applying individual assistive devices. The goal of this program is to allow burn patients to return to the workplace and to a normal life. We hope that this article makes more specialists aware of the proper approach to occupational therapy for burn patients and reduces the incidence of post-burn-injury sequelae. PMID:26813062

  18. Repair effect of transplantation of bone marrow mesenchymal stem cells on liver injury in severe burned rats and its mechanism

    International Nuclear Information System (INIS)

    Objective: To investigate the repair effect of transplantation of bone marrow mesenchymal stem cells (BMSCs) on liver injury in severe burned rats, and to clarify its mechanism. Methods: The BMSCs of rats were isolated, cultured, amplified, identified, and labeled in vitro. 30 Wistar rats were randomly divided into normal control group (n=10), model group (n=10) and cell therapy group (n=10). The burned rat model was established. The BMSCs labeled by chlormethyl-benzamidodialkylcarbocyanine (CM-Dil) were transplanted into the rats in cell therapy group by retro-orbital intravenous injection and the saline was injected into the rats in model group. The general status of all rats were observed. The liver tissues of rats were obtained 2 weeks after transplantation, and the pathohistological changes were observed and the pathohistological scores were detected; the apoptotic rate of liver cells was detected by TUNEL method; the engraftment of BMSCs in liver tissues of the rats was observed under laser scanning confocal microscope. Results: 2 weeks after transplantation, the rats in model group were obviously malaise dispirited and the rats in cell therapy group showed obviously better, and the body weight of the rats in cell therapy group was higher than that in model group (P<0.05). The pathohistological results showed the normal liver lobules of the rats in model group disappeared, and the liver cords disordered, and some liver sinusoids dilated and congested, lymphocytes infiltrated with occasional focal aggregating, and cell edema was found, cytoplasm loose and steatosis were seen in liver tissue. However, the pathohistological changes of liver tissue of the rats in cell therapy group were significantly better than those in model group. The pathohistological score of the rats in cell therapy group was significantly lower than that in model group (P<0.05). The TUNEL staining results showed that there were lots of apoptotic liver cells in liver tissue of the rats in

  19. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    OpenAIRE

    GregoryAElder; MiguelA.Gama Sosa; RitaDe Gasperi; MichaelCShaughness; StevenTDeKosky; SamGandy; MadhusoodanaPNambiar; JohnWSteele

    2012-01-01

    Blast-induced traumatic brain injury (TBI) has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI). The β-amyloid (Aβ) peptide associated with the development of Alzheimer’s disease (AD) is elevated acutely following TBI in humans as well as in ...

  20. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species

    OpenAIRE

    De Gasperi, Rita; Gama Sosa, Miguel A; Kim, Soong Ho; Steele, John W.; Shaughness, Michael C; Maudlin-Jeronimo, Eric; Hall, Aaron A.; DeKosky, Steven T.; McCarron, Richard M; Nambiar, Madhusoodana P.; Gandy, Sam; Ahlers, Stephen T.; Elder, Gregory A.

    2012-01-01

    Blast-induced traumatic brain injury (TBI) has been a major cause of morbidity and mortality in the conflicts in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. In particular, it is unclear whether blast injures the brain through mechanisms similar to those found in non-blast closed impact injuries (nbTBI). The β-amyloid (Aβ) peptide associated with the development of Alzheimer’s disease is elevated acutely following TBI in humans as well as in exper...

  1. Does mixing acute medical admissions with burn patients increase infective complications from paediatric thermal injuries?

    OpenAIRE

    Shaban, Fadlo; Stewart, Ken; Kalima, Pota

    2010-01-01

    In the winter of 2005–2006, the management at our children's hospital elected to admit ‘overspill’ acute medical admissions to the ward used for plastic surgery and burns for logistical reasons. This study was conducted to assess the effects of that change on the incidence of infective complications in thermally-injured patients. Seventy-three patients were studied, 23 in the sample winter and 50 in the two preceding control winters. The data gathered included days on IV fluids and antibiotic...

  2. The patient–body relationship and the "lived experience" of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment

    Directory of Open Access Journals (Sweden)

    McLean LM

    2015-08-01

    Full Text Available Loyola M McLean,1–3 Vanessa Rogers,3–4 Rachel Kornhaber,5–7 Marie-Therese Proctor,8 Julia Kwiet,3–4 Jeffrey Streimer,3–4 John Vanderord6 1Brain and Mind Centre and Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 2Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, University of Sydney and Western Sydney Local Health District, Parramatta, NSW, Australia; 3Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia; 4Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 5School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW, Australia; 6Severe Burns Injury Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia; 7School of Nursing, University of Adelaide, SA, Australia; 8Graduate School of Counselling, Excelsia College, Sydney, NSW, Australia Background: Throughout development and into adulthood, a person's face is the central focus for interpersonal communication, providing an important insight into one's identity, age, sociocultural background, and emotional state. The face facilitates important social, including nonverbal, communication. Therefore, sustaining a severe burn, and in particular a facial burn, is a devastating and traumatizing injury. Burn survivors may encounter unique psychosocial problems and experience higher rates of psychosocial maladjustment, although there may be a number of potentially mediating factors. Objectives: The purpose of this phenomenological study was to examine the early recovery experience of patients with a facial burn. In particular, this study focused on how the injury impacted on the participants’ relationship with their own body and the challenges of early psychosocial adjustment within the first 4 months of sustaining the injury. Methods: In 2011, six adult participants encompassing two females and four males

  3. Reducing the Risk of ACL Injury in Female Athletes

    Science.gov (United States)

    McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen

    2010-01-01

    The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical,…

  4. Late exercise reduces neuroinflammation and cognitive dysfunction after traumatic brain injury

    OpenAIRE

    Piao, Chun-Shu; Stoica, Bogdan A.; Wu, Junfang; Sabirzhanov, Boris; Zhao, Zaorui; Cabatbat, Rainier; Loane, David J.; Faden, Alan I.

    2013-01-01

    Delayed secondary biochemical and cellular changes after traumatic brain injury continue for months to years, and are associated with chronic neuroinflammation and progressive neurodegeneration. Physical activity can reduce inflammation and facilitate recovery after brain injury. Here, we investigated the time-dependent effects, and underlying mechanisms of post-traumatic exercise initiation on outcome after moderate traumatic brain injury using a well-characterized mouse controlled cortical ...

  5. Evaluating the superiority of honey over silver sulphadiazine dressing in shortening healing duration of burn injury: an evidence-based case report

    Directory of Open Access Journals (Sweden)

    Sandy S. Sopandi

    2013-12-01

    Full Text Available Background: Burn injury is a global health problem associated with major morbidity and mortality. Honey has long been used in wound management due to its ability to accelerate healing rates and prevent infection. This study is conducted to evaluate the efficacy of honey dressing in shortening healing duration of burn injury compared to silver sulphadiazine (SSD.Methods: A PubMed and Proquest database search was conducted to identify relevant studies. The studies were then appraised and ranked based on their validity, importance, and level of evidence.Results: The two studies appraised in this paper supported the supremacy of honey against SSD in shortening healing duration. However, the individual quality of studies involved was low.Conclusion: Honey is an alternative treatment in shortening burn wound healing duration. Further studies are needed to support clinical application of this conclusion. (Med J Indones. 2013;22:243-7. doi: 10.13181/mji.v22i4.608 Keywords: Burn injury, healing duration, honey, silver sulfadiazine

  6. Laboratory-based evaluation of MDR strains of Pseudomonas in patients with acute burn injuries

    Science.gov (United States)

    Zhang, Hong-Tu; Liu, Hui

    2015-01-01

    Localization of burn was variable: head and face in 76 patients (29%), trunk in 58 (49%), upper limb in 37 (52%), lower limbs in 44 (41%), hands in 16 (15%), perinea area in 26 (5.5%) and whole body except perinea area in 10 (9%) patients. Inhalation syndrome was present in 56 (44%) patients. Ninety patients (82%) had indwelling venous catheters, 83 (75.5%) patients’ arterial catheter and 86 (78%) patients’ urinary catheters. By multivariate analysis: age ≤4 years, Garcés 4, colistin use in documented multiresistant infections, and mechanical ventilation were independent variables related with mortality and graft requirement was a protective factor for mortality. Despite advances in care, gram negative bacterial infections and infection with Pseudomonas aeruginosa remain the most common cause of bacteria related mortality early in the hospital course. Viral infections are also associated with mortality and numbers have remained stable when compared to data from prior years. PMID:26629178

  7. Could Cord Blood Cell Therapy Reduce Preterm Brain Injury?

    OpenAIRE

    Li, Jingang; McDonald, Courtney A.; Fahey, Michael C.; Jenkin, Graham; Miller, Suzanne L.

    2014-01-01

    Major advances in neonatal care have led to significant improvements in survival rates for preterm infants, but this occurs at a cost, with a strong causal link between preterm birth and neurological deficits, including cerebral palsy (CP). Indeed, in high-income countries, up to 50% of children with CP were born preterm. The pathways that link preterm birth and brain injury are complex and multifactorial, but it is clear that preterm birth is strongly associated with damage to the white matt...

  8. Treatment with gelsolin reduces brain inflammation and apoptotic signaling in mice following thermal injury

    Directory of Open Access Journals (Sweden)

    Sheng Zhi-Yong

    2011-09-01

    Full Text Available Abstract Background Burn survivors develop long-term cognitive impairment with increased inflammation and apoptosis in the brain. Gelsolin, an actin-binding protein with capping and severing activities, plays a crucial role in the septic response. We investigated if gelsolin infusion could attenuate neural damage in burned mice. Methods Mice with 15% total body surface area burns were injected intravenously with bovine serum albumin as placebo (2 mg/kg, or with low (2 mg/kg or high doses (20 mg/kg of gelsolin. Samples were harvested at 8, 24, 48 and 72 hours postburn. The immune function of splenic T cells was analyzed. Cerebral pathology was examined by hematoxylin/eosin staining, while activated glial cells and infiltrating leukocytes were detected by immunohistochemistry. Cerebral cytokine mRNAs were further assessed by quantitative real-time PCR, while apoptosis was evaluated by caspase-3. Neural damage was determined using enzyme-linked immunosorbent assay of neuron-specific enolase (NSE and soluble protein-100 (S-100. Finally, cerebral phospho-ERK expression was measured by western blot. Results Gelsolin significantly improved the outcomes of mice following major burns in a dose-dependent manner. The survival rate was improved by high dose gelsolin treatment compared with the placebo group (56.67% vs. 30%. Although there was no significant improvement in outcome in mice receiving low dose gelsolin (30%, survival time was prolonged against the placebo control (43.1 ± 4.5 h vs. 35.5 ± 5.0 h; P Conclusion Exogenous gelsolin infusion improves survival of mice following major burn injury by partially attenuating inflammation and apoptosis in brain, and by enhancing peripheral T lymphocyte function as well. These data suggest a novel and effective strategy to combat excessive neuroinflammation and to preserve cognition in the setting of major burns.

  9. Tadalafil significantly reduces ischemia reperfusion injury in skin island flaps

    Directory of Open Access Journals (Sweden)

    Oguz Kayiran

    2013-01-01

    Full Text Available Introduction: Numerous pharmacological agents have been used to enhance the viability of flaps. Ischemia reperfusion (I/R injury is an unwanted, sometimes devastating complication in reconstructive microsurgery. Tadalafil, a specific inhibitor of phosphodiesterase type 5 is mainly used for erectile dysfunction, and acts on vascular smooth muscles, platelets and leukocytes. Herein, the protective and therapeutical effect of tadalafil in I/R injury in rat skin flap model is evaluated. Materials and Methods: Sixty epigastric island flaps were used to create I/R model in 60 Wistar rats (non-ischemic group, ischemic group, medication group. Biochemical markers including total nitrite, malondialdehyde (MDA and myeloperoxidase (MPO were analysed. Necrosis rates were calculated and histopathologic evaluation was carried out. Results: MDA, MPO and total nitrite values were found elevated in the ischemic group, however there was an evident drop in the medication group. Histological results revealed that early inflammatory findings (oedema, neutrophil infiltration, necrosis rate were observed lower with tadalafil administration. Moreover, statistical significance (P < 0.05 was recorded. Conclusions: We conclude that tadalafil has beneficial effects on epigastric island flaps against I/R injury.

  10. The Effect of Different Topical Agents (Silver Sulfadiazine, Povidone-Iodine, and Sodium Chloride 0.9%) on Burn Injuries in Rats

    OpenAIRE

    Emir Burak Yüksel; Alpagan Mustafa Yıldırım; Ali Bal; Tuncay Kuloglu

    2014-01-01

    It was aimed to comparatively evaluate the effects of dressing methods with silver sulfadiazine, povidone-iodine, and saline which have a common use in routine practices for burn injuries. Twenty-eight Sprague Dawley adult female rats were used in this study. All the rats were divided into 4 groups: the control group, the povidone-iodine group, the saline group, and the silver sulfadiazine group. On each rat, a second degree burn which covered less than 10% of the body surface area was create...

  11. ISBI Practice Guidelines for Burn Care.

    Science.gov (United States)

    Isbi Practice Guidelines Committee

    2016-08-01

    Practice guidelines (PGs) are recommendations for diagnosis and treatment of diseases and injuries, and are designed to define optimal evaluation and management. The first PGs for burn care addressed the issues encountered in developed countries, lacking consideration for circumstances in resource-limited settings (RLS). Thus, the mission of the 2014-2016 committee established by the International Society for Burn Injury (ISBI) was to create PGs for burn care to improve the care of burn patients in both RLS and resource-abundant settings. An important component of this effort is to communicate a consensus opinion on recommendations for burn care for different aspects of burn management. An additional goal is to reduce costs by outlining effective and efficient recommendations for management of medical problems specific to burn care. These recommendations are supported by the best research evidence, as well as by expert opinion. Although our vision was the creation of clinical guidelines that could be applicable in RLS, the ISBI PGs for Burn Care have been written to address the needs of burn specialists everywhere in the world. PMID:27542292

  12. The media glorifying burns: a hindrance to burn prevention.

    Science.gov (United States)

    Greenhalgh, David G; Palmieri, Tina L

    2003-01-01

    The media have a profound influence on the actions of children and adults. Burns and burn prevention tend to be ignored or even mocked. The purpose of this presentation is to reveal the callousness of the media in its dealings with burns and burn prevention. Printed materials with a relationship to burns, risk of burning, or disrespect for the consequences of burns were collected. The materials were tabulated into four categories: comics, advertisements (ads), articles that made light of burns, and television shows that portrayed behavior that would risk burn injury. Most burn-related materials were found in comics or advertisements. Several comics made light of high-risk behavior with flames, scald injury, contact injury, or burns. In addition, several advertisements showed people on fire or actions that could easily lead to burns. Several articles and televisions shows portrayed high-risk behavior that, in some instances, led to copycat injuries. Flames are frequently used to sell items that target adolescent boys or young men. The high incidence injuries that frequent this population parallel the high-risk behaviors portrayed by the media. The media portrays flames and high-risk behavior for burn injury as being cool, funny, and without consequence. The use of flames on clothing and recreational equipment (skateboards, hot rods) particularly targets the high-risk adolescent male. The burn community should make the media aware of the harm it causes with its callous depiction and glorification of burns. PMID:12792237

  13. Effectiveness of an outside-the-boot ankle brace in reducing parachuting related ankle injuries

    OpenAIRE

    Schmidt, M.; Sulsky, S; Amoroso, P.

    2005-01-01

    Objectives: To examine the efficacy of an outside-the-boot parachute ankle brace (PAB) in reducing risk of ankle injury to army paratrooper trainees and to identify inadvertent risks associated with PAB use.

  14. An overview of war-related thermal injuries.

    Science.gov (United States)

    Roeder, Rosiane Alfinito; Schulman, Carl I

    2010-07-01

    Thermal injuries have always been a source of morbidity and mortality in times of war. Historically, they constitute 5% to 20% of all injuries and approximately 4% mortality. Although burn patients constitute a small number of casualties, they consume a disproportionate amount of resources and require specialized care. The current conflicts in the Middle East report similar numbers for thermal injuries despite improvement in predeployment education to reduce noncombat-related burns, flame retardant military clothing, and decline of war patterns usually associated with increased thermal injuries. However, the increased use of improvised explosive devices and vehicle-borne improvised explosive devices presents a new source of potential thermal injury. Indeed, the burden of explosion-related burns has increased as has its associated Injury Severity Score. As has been the case in previous conflicts, most burns are hand and head burns. Although usually not life threatening, burns to hands and face lead to significant physical and psychologic morbidities. In this paper, we will review the currently available literature on war-related thermal injuries in Operation Iraqi and Operation Enduring Freedom. We will describe the epidemiology of burn injuries, prewar preparation to prevent and treat thermal injuries, and the assessment, triage, and final treatment of burn patients. In addition, we will discuss the associated physical and psychologic morbidities and, finally, the role of plastic surgeon in burn rehabilitation and reconstruction. PMID:20613571

  15. Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Carlos Roddgo Cámara; Francisco Javier Guzmán; Ernesto Alexis Barrera; Andrés Jesús Cabello; Armando Garcia; Nancy Esthela Fernández; Eloy Caballero; Jesus Ancer

    2008-01-01

    AIM:To investigate the effects of ketamine anesthesia on the motility alterations and tissue injury caused by ischemia/reperfusion in rats.METHODS:Thirty maIe Wistar rats weighing 200-250 g were used.Ischemia was induced by obstructing blood flow in 25% of the total small intestinal length(ileum)with a vascular clamp for 45 min,after which either 60 min or 24 h of reperfusion was allowed.Rats were either anesthetized with pento-barbital sodium(50 mg/kg)or ketamine(100 mg/kg).Control groups received sham surgery,After 60 min of reperfusion,the intestine was examined for mor-phological alterations,and after 24 h intestinal basic electrical rhythm(BER)frequency was calculated,and intestinal transit determined in all groups.RESULTS:The intestinal mucosa in rats that were anesthetized with ketamine showed moderate alterations such as epithelial lifting,while ulceration and hemorrhage was observed in rats that received pento-barbital sodium after 60 min of reperfusion.Quantitative analysis of structural damage using the Chiu scale showed significantly Iess injury in rats that received ketamine than in rats that did not(2.35±1.14 vs 4.58 ±0.50,P<0.0001).The distance traveled by a marker,expressed as percentage of total intestinal length,in rats that received pentobarbital sodium was 20% ± 2% in comparison with 25.9% ±1.64% in rats that received ketamine(P=0.017).BER was not statistically different between groups.CONCLUSION:Our results show that ketamine anesthesia is associated with diminished intestinal iniury and abolishes the intestinal transit delay induced by ischemia/reperfusion.(C)2008 The WJG Press.All rights reserved.

  16. Glucose administration after traumatic brain injury improves cerebral metabolism and reduces secondary neuronal injury

    OpenAIRE

    Moro, Nobuhiro; Ghavim, Sima; Harris, Neil G.; Hovda, David A.; Sutton, Richard L.

    2013-01-01

    Clinical studies have indicated an association between acute hyperglycemia and poor outcomes in patients with traumatic brain injury (TBI), although optimal blood glucose levels needed to maximize outcomes for these patients’ remains under investigation. Previous results from experimental animal models suggest that post-TBI hyperglycemia may be harmful, neutral, or beneficial. The current studies determined the effects of single or multiple episodes of acute hyperglycemia on cerebral glucose ...

  17. Germline ablation of dermatan-4O-sulfotransferase1 reduces regeneration after mouse spinal cord injury.

    Science.gov (United States)

    Rost, S; Akyüz, N; Martinovic, T; Huckhagel, T; Jakovcevski, I; Schachner, M

    2016-01-15

    Chondroitin/dermatan sulfate proteoglycans (CSPGs/DSPGs) are major components of the extracellular matrix. Their expression is generally upregulated after injuries to the adult mammalian central nervous system, which is known for its low ability to restore function after injury. Several studies support the view that CSPGs inhibit regeneration after injury, whereas the functions of DSPGs in injury paradigms are less certain. To characterize the functions of DSPGs in the presence of CSPGs, we studied young adult dermatan-4O-sulfotransferase1-deficient (Chst14(-/-)) mice, which express chondroitin sulfates (CSs), but not dermatan sulfates (DSs), to characterize the functional outcome after severe compression injury of the spinal cord. In comparison to their wild-type (Chst14(+/+)) littermates, regeneration was reduced in Chst14(-/-) mice. No differences between genotypes were seen in the size of spinal cords, numbers of microglia and astrocytes neither in intact nor injured spinal cords after injury. Monoaminergic innervation and re-innervation of the spinal cord caudal to the lesion site as well as expression levels of glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were similar in both genotypes, independent of whether they were injured and examined 6weeks after injury or not injured. These results suggest that, in contrast to CSPGs, DSPGs, being the products of Chst14 enzymatic activity, promote regeneration after injury of the adult mouse central nervous system. PMID:26586562

  18. Progress in reducing road-related deaths and injuries in Irish children.

    OpenAIRE

    Donnelly, Jean; Bimpeh, Y; Trace, F.; Waters, A; Nicholson, Alf J

    2012-01-01

    The aim was to study road-related injuries and fatalities in under 15 year olds in two time periods (1996-2000 and 2004-2008 inclusive) to assess whether progress has been made via cross-sectoral efforts to reduce this injury toll in Ireland. For pedestrian and car-related accidents, police assistance is required and at the time a detailed CT 68 form is completed by the attending officer and sent to the Road Safety Authority for analysis. Details re the severity of injury, light and road cond...

  19. Negative Pressure Wound Therapy Decreases Mortality in a Murine Model of Burn-Wound Sepsis Involving Pseudomonas aeruginosa Infection

    OpenAIRE

    Yang Liu; Qin Zhou; Yunchuan Wang; Zhengcai Liu; Maolong Dong; Yaojun Wang; Xiao Li; Dahai Hu

    2014-01-01

    BACKGROUND: The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. METHODS: Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected...

  20. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India

    OpenAIRE

    Daruwalla, N.; Belur, J.; Kumar, M.; Tiwari, V; Sarabahi, S.; Tilley, N.; Osrin, D

    2014-01-01

    Background Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause – accidental or non-accidental, suicidal or homicidal – is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. Methods We conduc...

  1. Friction Burns: Epidemiology and Prevention

    OpenAIRE

    Agrawal, A; Raibagkar, S.C.; Vora, H.J.

    2008-01-01

    This epidemiological study deals with 60 patients with friction burns between January 2004 and January 2006. The age group most affected was that between 21 and 30 years, with male predominance. Road traffic accidents were the commonest cause of friction burns (56 patients), and the lower limb was the most frequently affected part of the body. Patient management was performed according to the degree of the burn injury. It is suggested that most friction burn injuries are neglected on admissio...

  2. Exendin-4, a glucagon-like peptide-1 receptor agonist, reduces intimal thickening after vascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Hiromasa [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Nomiyama, Takashi, E-mail: tnomiyama@fukuoka-u.ac.jp [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Mita, Tomoya; Yasunari, Eisuke; Azuma, Kosuke; Komiya, Koji; Arakawa, Masayuki; Jin, Wen Long; Kanazawa, Akio [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Kawamori, Ryuzo [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Beta Cell Biology and Regeneration, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Fujitani, Yoshio; Hirose, Takahisa [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Watada, Hirotaka, E-mail: hwatada@juntendo.ac.jp [Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan); Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421 (Japan)

    2011-02-04

    Research highlights: {yields} Exendin-4 reduces neointimal formation after vascular injury in a mouse model. {yields} Exendin-4 dose not alter metabolic parameters in non-diabetic, non-obese mouse model. {yields} Exendin-4 reduces PDGF-induced cell proliferation in cultured SMCs. {yields} Exendin-4 may reduces neointimal formation after vascular injury at least in part through its direct action on SMCs. -- Abstract: Glucagon-like peptide-1 is a hormone secreted by L cells of the small intestine and stimulates glucose-dependent insulin response. Glucagon-like peptide-1 receptor agonists such as exendin-4 are currently used in type 2 diabetes, and considered to have beneficial effects on the cardiovascular system. To further elucidate the effect of glucagon-like peptide-1 receptor agonists on cardiovascular diseases, we investigated the effects of exendin-4 on intimal thickening after endothelial injury. Under continuous infusion of exendin-4 at 24 nmol/kg/day, C57BL/6 mice were subjected to endothelial denudation injury of the femoral artery. Treatment of mice with exendin-4 reduced neointimal formation at 4 weeks after arterial injury without altering body weight or various metabolic parameters. In addition, in vitro studies of isolated murine, rat and human aortic vascular smooth muscle cells showed the expression of GLP-1 receptor. The addition of 10 nM exendin-4 to cultured smooth muscle cells significantly reduced their proliferation induced by platelet-derived growth factor. Our results suggested that exendin-4 reduced intimal thickening after vascular injury at least in part by the suppression of platelet-derived growth factor-induced smooth muscle cells proliferation.

  3. Occupational health nursing interventions to reduce third-party liability in workplace injuries.

    Science.gov (United States)

    Delk, Kayla L

    2012-03-01

    This article explores general principles of workers' compensation law and the ability to sue third parties for employee injuries by using case law and the treatise Larson's Workers' Compensation Law. This overview provides occupational health nurses with a background on workers' compensation law, who is liable for employee injuries, and how recovery from third parties is distributed between the employer or insurer and the employee. The author then explores interventions that occupational health nurses can implement to reduce employee injury and employer costs for providing workers' compensation. The goal of this article is to stimulate occupational health nurses' critical-thinking and problem-solving skills so they may identify risks and implement cost-effective solutions that will prevent injuries to employees. PMID:22387245

  4. Reducing burn-in voltage loss in polymer solar cells by increasing the polymer crystallinity

    KAUST Repository

    Heumueller, Thomas

    2014-08-01

    In order to commercialize polymer solar cells, the fast initial performance losses present in many high efficiency materials will have to be managed. This burn-in degradation is caused by light-induced traps and its characteristics depend on which polymer is used. We show that the light-induced traps are in the bulk of the active layer and we find a direct correlation between their presence and the open-circuit voltage loss in devices made with amorphous polymers. Solar cells made with crystalline polymers do not show characteristic open circuit voltage losses, even though light-induced traps are also present in these devices. This indicates that crystalline materials are more resistant against the influence of traps on device performance. Recent work on crystalline materials has shown there is an energetic driving force for charge carriers to leave amorphous, mixed regions of bulk heterojunctions, and charges are dominantly transported in pure, ordered phases. This energetic landscape allows efficient charge generation as well as extraction and also may benefit the stability against light-induced traps. This journal is © the Partner Organisations 2014.

  5. Marine Compound Xyloketal B Reduces Neonatal Hypoxic-Ischemic Brain Injury

    Directory of Open Access Journals (Sweden)

    Ai-Jiao Xiao

    2014-12-01

    Full Text Available Neonatal hypoxic-ischemic encephalopathy causes neurodegeneration and brain injury, leading to sensorimotor dysfunction. Xyloketal B is a novel marine compound isolated from a mangrove fungus Xylaria species (no. 2508 with unique antioxidant effects. In this study, we investigated the effects and mechanism of xyloketal B on oxygen-glucose deprivation-induced neuronal cell death in mouse primary cortical culture and on hypoxic-ischemic brain injury in neonatal mice in vivo. We found that xyloketal B reduced anoxia-induced neuronal cell death in vitro, as well as infarct volume in neonatal hypoxic-ischemic brain injury model in vivo. Furthermore, xyloketal B improved functional behavioral recovery of the animals following hypoxic-ischemic insult. In addition, xyloketal B significantly decreased calcium entry, reduced the number of TUNEL-positive cells, reduced the levels of cleaved caspase-3 and Bax proteins, and increased the level of Bcl-2 protein after the hypoxic-ischemic injury. Our findings indicate that xyloketal B is effective in models of hypoxia-ischemia and thus has potential as a treatment for hypoxic-ischemic brain injury.

  6. Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling.

    Science.gov (United States)

    Carrivick, Philip J W; Lee, Andy H; Yau, Kelvin K W; Stevenson, Mark R

    2005-06-22

    Manual handling is the greatest contributor to non-fatal injury and disease in the workplace, commonly accounting for one-third of national injury counts. Interventional strategies that have focused on selecting or modifying the worker have been ineffective in reducing injury risk. In recent times, participatory ergonomics has been widely adopted as a process to reduce the risk of injury from manual handling but it is not well validated as an intervention. This study evaluated the effectiveness of a participatory ergonomics risk assessment approach in reducing the rate and severity of injuries from manual and non-manual handling sustained by a cohort of 137 cleaners within a hospital setting. The date of injury and the workers' compensation claim cost and hours lost from work were obtained for each injury incurred during the 4-year pre-intervention and 3-year intervention period. The age, gender and hours worked were ascertained for every cleaner whether injured or not. Using generalized linear mixed modelling analysis, reductions of rate of injury by two-thirds, workers' compensation claim costs by 62% and hours lost by 35% for manual handling injuries were found to be associated with the intervention period. Although the cleaners experienced a significant intervention period reduction in non-manual handling injury rate, the corresponding changes in severity of injury were not significant. The success of the intervention supports the adoption of a participatory ergonomics approach in reducing the rate and consequence of injuries in the workplace. PMID:16147411

  7. Current situation and prospect of measures of rehabilitation after burn injury%烧伤康复治疗技术现状与展望

    Institute of Scientific and Technical Information of China (English)

    胡大海; 易南

    2014-01-01

    In the wound healing process after a deep burn injury,improper treatment in the early stage and lack of functional rehabilitation measures in the late stage usually lead tohyperplastic scar,joint contracture,synarthrophysis,and other deformities.All of them may result in cosmetic and functional impairments,loss of work ability,poor life quality,and even psychopathy of the patients.Thus,the improvement in rehabilitation methods and the maximal recovery of appearance and functions have drawn intense attention.This article mainly discusses the prevention,systematic treatment principles and methods for the hyperplastic scar and scar contracture,as well as the problems need to be solved in burn rehabilitation,based on the introduction of the new advancement in the rehabilitation techniques.

  8. Pyridoxamine reduces postinjury fibrosis and improves functional recovery after acute kidney injury.

    Science.gov (United States)

    Skrypnyk, Nataliya I; Voziyan, Paul; Yang, Haichun; de Caestecker, Christian R; Theberge, Marie-Claude; Drouin, Mathieu; Hudson, Billy; Harris, Raymond C; de Caestecker, Mark P

    2016-08-01

    Acute kidney injury (AKI) is a common and independent risk factor for death and chronic kidney disease (CKD). Despite promising preclinical data, there is no evidence that antioxidants reduce the severity of injury, increase recovery, or prevent CKD in patients with AKI. Pyridoxamine (PM) is a structural analog of vitamin B6 that interferes with oxidative macromolecular damage via a number of different mechanisms and is in a phase 3 clinical efficacy trial to delay CKD progression in patients with diabetic kidney disease. Because oxidative stress is implicated as one of the main drivers of renal injury after AKI, the ability of PM to interfere with multiple aspects of oxidative damage may be favorable for AKI treatment. In these studies we therefore evaluated PM treatment in a mouse model of AKI. Pretreatment with PM caused a dose-dependent reduction in acute tubular injury, long-term postinjury fibrosis, as well as improved functional recovery after ischemia-reperfusion AKI (IR-AKI). This was associated with a dose-dependent reduction in the oxidative stress marker isofuran-to-F2-isoprostane ratio, indicating that PM reduces renal oxidative damage post-AKI. PM also reduced postinjury fibrosis when administered 24 h after the initiating injury, but this was not associated with improvement in functional recovery after IR-AKI. This is the first report showing that treatment with PM reduces short- and long-term injury, fibrosis, and renal functional recovery after IR-AKI. These preclinical findings suggest that PM, which has a favorable clinical safety profile, holds therapeutic promise for AKI and, most importantly, for prevention of adverse long-term outcomes after AKI. PMID:27194713

  9. The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556

    Directory of Open Access Journals (Sweden)

    McRae Sarah E

    2005-03-01

    Full Text Available Abstract Background The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects 12. Intervention with Virtual Reality (VR games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. Methods This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. Results The average pain scores (from the Faces Scale for pharmacological analgesia only was, 4.1 (SD 2.9, while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8 Conclusion The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain.

  10. Patterns of scald injuries in children--has anything changed?

    LENUS (Irish Health Repository)

    Yates, J

    2011-10-01

    The objective was to study presentation patterns of scald injuries in children and suggest potential countermeasures to reduce these injuries. We retrospectively studied scald injuries in children attending an urban paediatric emergency department between January 1st and December 31st 2008. Data was extracted from our emergency department database using search terms \\'burn\\

  11. Progress in reducing road-related deaths and injuries in Irish children.

    Science.gov (United States)

    Donnelly, J; Bimpeh, Y; Trace, F; Waters, A; Nicholson, A J

    2012-04-01

    The aim was to study road-related injuries and fatalities in under 15 year olds in two time periods (1996-2000 and 2004-2008 inclusive) to assess whether progress has been made via cross-sectoral efforts to reduce this injury toll in Ireland. For pedestrian and car-related accidents, police assistance is required and at the time a detailed CT 68 form is completed by the attending officer and sent to the Road Safety Authority for analysis. Details re the severity of injury, light and road conditions and safety measures such as seat belt or car restraint use, seat position and helmet use if a cyclist were recorded. Injuries were sub-classified as fatalities, serious (detained in hospital, fractures, severe head injury, severe internal injuries or shock requiring treatment) or minor. All data for the two time periods was entered onto an SPSS database. A concerted national campaign re road safety media campaign allied to random breath testing, penalty points for driving offences, on the spot fines for speeding and far greater police enforcement took place between the two time frames and continues to this day. When looked at as most likely estimates of death ratios the results were found to be statistically significant with an overall p value of Cyclist fatalities saw the most significant fall (76%) with a dramatic reduction in cyclist injuries from 25 down to 6 (63%). The 13-15 year old age group had the highest mortality and morbidity in both cohorts. Documented restraint use was less than 70% in both cohorts. A national road safety campaign, greater police enforcement and a cultural change has seen road-related injuries in children drop very significantly (by 50%) over the two time periods and this campaign should continue. PMID:22708222

  12. Sphingosine-1-Phosphate reduces ischemia/reperfusion injury by phosphorylating the gap junction protein Connexin43

    DEFF Research Database (Denmark)

    Morel, Sandrine; Christoffersen, Christina; Axelsen, Lene N;

    2016-01-01

    recruitment seems only indirectly affected. Importantly, short-term S1P treatment at the onset of reperfusion was sufficient to reduce ischemia/reperfusion injury in isolated perfused hearts. Mechanistic in vitro and ex vivo studies revealed that 5 min of S1P treatment induced phosphorylation of the gap...

  13. 77 FR 12844 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Reducing...

    Science.gov (United States)

    2012-03-02

    ... among People with Intellectual Disabilities, FOA DD12-003, initial review.'' Contact Person for More... HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Reducing Health Disparities Among People With...

  14. Is a cognitive-behavioural biofeedback intervention useful to reduce injury risk in junior football players?

    Science.gov (United States)

    Edvardsson, Arne; Ivarsson, Andreas; Johnson, Urban

    2012-01-01

    Athletes participating in sport are exposed to a relatively high injury risk. Previous research has suggested that it could be possible to reduce sports injuries through psychological skills training. The purpose of this study was to examine the extent to which a cognitive behavioural biofeedback intervention could reduce the number of sports injuries in a sample of players in Swedish elite football high schools. Participants from four elite football high schools (16-19 years old) were divided into one experiment (n = 13) and one control group (n = 14). Participants were asked to complete three questionnaires to assess anxiety level (Sport Anxiety Scale), history of stressors (Life Event Scale for Collegiate Athletes) and coping skills (Athletic Coping Skills Inventory - 28) in a baseline measure. Mann-Whitney U-tests showed no significant differences in pre-intervention scores based on the questionnaires. The experimental group participated in a nine-week intervention period consisting of seven sessions, including: somatic relaxation, thought stopping, emotions/problem focused coping, goal setting, biofeedback training as well as keeping a critical incident diary. A Mann-Whitney U test showed no significant difference between the control and experimental group U (n1 = 13, n2 = 14) = 51.00, p = 0.054. However, considering the small sample, the statistical power (0.05 for present study), to detect effects was low. The results of the study are discussed from a psychological perspective and proposals for future research are given. Key pointsCognitive-behavioral training together with biofeedback training seems to be an effective strategy to decrease the occurrence of injuries.More intervention studies should be conducted applying existing biofeedback methodology, especially in the injury preventive area.Future research should develop a bio-psychological injury model aimed at predicting injury occurrence which describes the physiological stress responses and how they

  15. Burn mouse models

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus

    2014-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third-degree b......Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third...... with infected burn wound compared with the burn wound only group. The burn mouse model resembles the clinical situation and provides an opportunity to examine or develop new strategies like new antibiotics and immune therapy, in handling burn wound victims much....

  16. Curcumin reduces inflammatory reactions following transient cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Jing Zhao; Shanshan Yu; Lan Li; Xuemei Lin; Yong Zhao

    2011-01-01

    Inflammatory reactions are important pathophysiological mechanisms of ischemic brain injury. The present study analyzed the anti-inflammatory characteristics of curcumin via myeloperoxidase activity and nitric oxide content after 2-hour ischemia/24-hour reperfusion in Sprague Dawley rats. In addition, expressions of nuclear factor kappa B, tumor necrosis factor-α and interleukin-1β protein were measured. Curcumin significantly reduced myeloperoxidase and nitric oxide synthase activities and suppressed expressions of nuclear factor kappa B, tumor necrosis factor-a, and interleukin-1β in ischemia/reperfusion brain tissue. Results suggested that the neuroprotective effect of curcumin following cerebral ischemia/reperfusion injury could be associated with inhibition of inflammatory reactions.

  17. Edaravone protects endotoxin-induced liver injury by inhibiting apoptosis and reducing proinflammatory cytokines

    Energy Technology Data Exchange (ETDEWEB)

    Zong, L. [Second Military Medical University, Changhai Hospital, Department of Anesthesiology, Shanghai, China, Department of Anesthesiology, Changhai Hospital, Second Military Medical University, Shanghai (China); No. 82 Hospital of People' s Liberation Army, Department of Anesthesiology, Jiangsu, China, Department of Anesthesiology, No. 82 Hospital of People' s Liberation Army, Jiangsu (China); Yu, Q.H. [Second Military Medical University, Changhai Hospital, Department of Gastroenterology, Shanghai, China, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai (China); Du, Y.X. [No. 82 Hospital of People' s Liberation Army, Department of Anesthesiology, Jiangsu, China, Department of Anesthesiology, No. 82 Hospital of People' s Liberation Army, Jiangsu (China); Deng, X.M. [Second Military Medical University, Changhai Hospital, Department of Anesthesiology, Shanghai, China, Department of Anesthesiology, Changhai Hospital, Second Military Medical University, Shanghai (China)

    2014-03-03

    Studies have shown that edaravone may prevent liver injury. This study aimed to investigate the effects of edaravone on the liver injury induced by D-galactosamine (GalN) and lipopolysaccharide (LPS) in female BALB/c mice. Edaravone was injected into mice 30 min before and 4 h after GalN/LPS injection. The survival rate was determined within the first 24 h. Animals were killed 8 h after GalN/LPS injection, and liver injury was biochemically and histologically assessed. Hepatocyte apoptosis was measured by TUNEL staining; proinflammatory cytokines [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)] in the liver were assayed by ELISA; expression of caspase-8 and caspase-3 proteins was detected by Western blot assay; and caspase-3 activity was also determined. Results showed that GalN/LPS induced marked elevations in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Edaravone significantly inhibited elevation of serum AST and ALT, accompanied by an improvement in histological findings. Edaravone lowered the levels of TNF-α and IL-6 and reduced the number of TUNEL-positive cells. In addition, 24 h after edaravone treatment, caspase-3 activity and mortality were reduced. Edaravone may effectively ameliorate GalN/LPS-induced liver injury in mice by reducing proinflammatory cytokines and inhibiting apoptosis.

  18. Fms-like tyrosine kinase-3 ligand alters antigen-specific responses to infections after severe burn injury

    OpenAIRE

    Bohannon, Julia; Fang, Geping; Cui, Weihua; Sherwood, Edward; Toliver-Kinsky, Tracy

    2009-01-01

    Burn patients are susceptible to opportunistic infections due partly to decreased immune functions, especially Th1-driven antigen-specific responses, which are regulated by dendritic cells. The dendritic cell growth factor, fms-like tyrosine kinase-3 ligand (FL), has been shown to increase resistance to P. aeruginosa, in a dendritic cell-dependent manner, in a mouse model of burn wound infection. The specific mechanisms of protection are not known. This study tested the hypothesis that FL can...

  19. Progress in reducing road-related deaths and injuries in Irish children.

    LENUS (Irish Health Repository)

    Donnelly, J

    2012-04-01

    The aim was to study road-related injuries and fatalities in under 15 year olds in two time periods (1996-2000 and 2004-2008 inclusive) to assess whether progress has been made via cross-sectoral efforts to reduce this injury toll in Ireland. For pedestrian and car-related accidents, police assistance is required and at the time a detailed CT 68 form is completed by the attending officer and sent to the Road Safety Authority for analysis. Details re the severity of injury, light and road conditions and safety measures such as seat belt or car restraint use, seat position and helmet use if a cyclist were recorded. Injuries were sub-classified as fatalities, serious (detained in hospital, fractures, severe head injury, severe internal injuries or shock requiring treatment) or minor. All data for the two time periods was entered onto an SPSS database. A concerted national campaign re road safety media campaign allied to random breath testing, penalty points for driving offences, on the spot fines for speeding and far greater police enforcement took place between the two time frames and continues to this day. When looked at as most likely estimates of death ratios the results were found to be statistically significant with an overall p value of < 0.0001 CI [0.39, 0.69]. When broken down into specific age ranges all were significant apart from the 0-3 age range with a p value of 0.69 CI [0.26, 1.1]. The most significant changes were found in the 7-9 years, 10-12 and 13-15 year age ranges with p values of < 0.0001, 0.0002 and 0.0007 respectively. When results were compared between the two cohorts, car occupant fatalities between both groups dropped by 36%. Pedestrian injuries dropped from 1719 to 1232, pedestrian fatalities decreased by almost 50% as did serious pedestrian injuries from 261 down to 129. Cyclist fatalities saw the most significant fall (76%) with a dramatic reduction in cyclist injuries from 25 down to 6 (63%). The 13-15 year old age group had the highest

  20. Reducing particulate matter in the operation of firewood burning stoves taking into account the toxicological relevance

    International Nuclear Information System (INIS)

    One of the greatest challenges facing humanity is climate change. Correspondingly, inter alia, the German government has set a target by 2020, to reduce emissions of greenhouse gases to the 1990 level by 20%. For this purpose can and should an increased energetic use of biomass contribute. End of 2007, the bioenergy had a share of around three quarters of the renewable primary energy input. Of which more than 45% were used for the heat supply. A total of more than 90% of renewable heat have been provided from biomass. From the provided amount of heat come over 80% from the combustion of solid biofuels - so far almost exclusively wood products - in small and medium wood-fuelled combustion systems. To reduce carbon dioxide emissions the federal government is accelerating a further expansion of energetic use of biomass in the heating sector. This expansion of thermal use of biomass, however, for reasons of pollution control, should not rise simultaneously with the emissions of air pollutants such as carbon monoxide, nitrogen oxides or particulate matter.

  1. Strength Training Reduces Injury Rate in Elite Young Soccer Players During One Season.

    Science.gov (United States)

    Zouita, Sghair; Zouita, Amira B M; Kebsi, Wiem; Dupont, Grégory; Ben Abderrahman, Abderraouf; Ben Salah, Fatma Z; Zouhal, Hassane

    2016-05-01

    The purpose of this study was to examine the effect of strength training on physical fitness parameters and injuries occurrence in young elite soccer players. Fifty-two elite young soccer players (13-14 years) were divided on a randomized order into experimental group (EG, n = 26) and control group (CG, n = 26). For EG, 2 to 3 sessions of strength training (90 minutes) were introduced weekly in their training program for 12 weeks (4 × 3 weeks separated by 1-week recovery). Sprint tests (10-20-30 m), T-test time, and jumping tests were measured at the start (T0), at the middle (T1), and at the end of the experiment period (T2). The injury rate was recorded by the medical and fitness training staff throughout the soccer season. Compared to CG, EG performed significantly better in sprint running and T-test time at T2 (p soccer season. The rate was higher in CG (13 injuries) than in training group (4 injuries). This study showed that strength training accurately and efficiently scheduled in youth soccer players, induced performance improvement, and reduced the rate of injuries. PMID:26918277

  2. Transmutation, Burn-Up and Fuel Fabrication Trade-Offs in Reduced-Moderation Water Reactor Thorium Fuel Cycles - 13502

    Energy Technology Data Exchange (ETDEWEB)

    Lindley, Benjamin A.; Parks, Geoffrey T. [University of Cambridge, Cambridge (United Kingdom); Franceschini, Fausto [Westinghouse Electric Company LLC, Cranberry Township, PA (United States)

    2013-07-01

    Multiple recycle of long-lived actinides has the potential to greatly reduce the required storage time for spent nuclear fuel or high level nuclear waste. This is generally thought to require fast reactors as most transuranic (TRU) isotopes have low fission probabilities in thermal reactors. Reduced-moderation LWRs are a potential alternative to fast reactors with reduced time to deployment as they are based on commercially mature LWR technology. Thorium (Th) fuel is neutronically advantageous for TRU multiple recycle in LWRs due to a large improvement in the void coefficient. If Th fuel is used in reduced-moderation LWRs, it appears neutronically feasible to achieve full actinide recycle while burning an external supply of TRU, with related potential improvements in waste management and fuel utilization. In this paper, the fuel cycle of TRU-bearing Th fuel is analysed for reduced-moderation PWRs and BWRs (RMPWRs and RBWRs). RMPWRs have the advantage of relatively rapid implementation and intrinsically low conversion ratios. However, it is challenging to simultaneously satisfy operational and fuel cycle constraints. An RBWR may potentially take longer to implement than an RMPWR due to more extensive changes from current BWR technology. However, the harder neutron spectrum can lead to favourable fuel cycle performance. A two-stage fuel cycle, where the first pass is Th-Pu MOX, is a technically reasonable implementation of either concept. The first stage of the fuel cycle can therefore be implemented at relatively low cost as a Pu disposal option, with a further policy option of full recycle in the medium term. (authors)

  3. Transmutation, Burn-Up and Fuel Fabrication Trade-Offs in Reduced-Moderation Water Reactor Thorium Fuel Cycles - 13502

    International Nuclear Information System (INIS)

    Multiple recycle of long-lived actinides has the potential to greatly reduce the required storage time for spent nuclear fuel or high level nuclear waste. This is generally thought to require fast reactors as most transuranic (TRU) isotopes have low fission probabilities in thermal reactors. Reduced-moderation LWRs are a potential alternative to fast reactors with reduced time to deployment as they are based on commercially mature LWR technology. Thorium (Th) fuel is neutronically advantageous for TRU multiple recycle in LWRs due to a large improvement in the void coefficient. If Th fuel is used in reduced-moderation LWRs, it appears neutronically feasible to achieve full actinide recycle while burning an external supply of TRU, with related potential improvements in waste management and fuel utilization. In this paper, the fuel cycle of TRU-bearing Th fuel is analysed for reduced-moderation PWRs and BWRs (RMPWRs and RBWRs). RMPWRs have the advantage of relatively rapid implementation and intrinsically low conversion ratios. However, it is challenging to simultaneously satisfy operational and fuel cycle constraints. An RBWR may potentially take longer to implement than an RMPWR due to more extensive changes from current BWR technology. However, the harder neutron spectrum can lead to favourable fuel cycle performance. A two-stage fuel cycle, where the first pass is Th-Pu MOX, is a technically reasonable implementation of either concept. The first stage of the fuel cycle can therefore be implemented at relatively low cost as a Pu disposal option, with a further policy option of full recycle in the medium term. (authors)

  4. Inhalation Injuries

    Science.gov (United States)

    ... increase mortality 30% to 40% when patients with cutaneous burns and inhalation injury are compared with patients ... nasal hairs • Facial burnsBurns around the mouth • Mineral spirits – 104º F – paint thinner, brush cleaner. • Redness, ...

  5. Epoetin Alpha and Epoetin Zeta: A Comparative Study on Stimulation of Angiogenesis and Wound Repair in an Experimental Model of Burn Injury

    Directory of Open Access Journals (Sweden)

    Natasha Irrera

    2015-01-01

    Full Text Available Deep second-degree burns are characterized by delayed formation of granulation tissue and impaired angiogenesis. Erythropoietin (EPO is able to stimulate angiogenesis and mitosis, activating vascularization and cell cycle. The aim of our study was to investigate whether two biosimilar recombinant human erythropoietins, EPO-α and EPO-Z, may promote these processes in an experimental model of burn injury. A total of 84 mice were used and a scald burn was produced on the back after shaving, in 80°C water for 10 seconds. Mice were then randomized to receive EPO-α (400 units/kg/day/sc or EPO-Z (400 units/kg/day/sc or their vehicle (100 μL/day/sc 0.9% NaCl solution. After 12 days, both EPO-α and EPO-Z increased VEGF protein expression. EPO-α caused an increased cyclin D1/CDK6 and cyclin E/CDK2 expression compared with vehicle and EPO-Z (p<0.001. Our study showed that EPO-α and EPO-Z accelerated wound closure and angiogenesis; however EPO-α resulted more effectively in achieving complete skin regeneration. Our data suggest that EPO-α and EPO-Z are not biosimilars for the wound healing effects. The higher efficacy of EPO-α might be likely due to its different conformational structure leading to a more efficient cell proliferation and skin remodelling.

  6. Does improvised waterbed reduce the incidence of pressure ulcers in patients with spinal injury?

    Directory of Open Access Journals (Sweden)

    Jude-Kennedy C Emejulu

    2015-01-01

    Full Text Available Background: Pressure ulcers are lesions caused by unrelieved pressure over bony prominences, resulting in damage to underlying tissues. The etiology is multifactorial including prolonged immobility. They usually complicate spinal cord injuries with long periods of bed confinement. The use of bed replacements markedly reduces the incidence of pressure ulcers, but the unaffordability of these replacements in low-income countries has necessitated the need to explore cheaper alternatives. Aim and Objective: The aim of this study was to ascertain whether the use of our cheap and locally improvised waterbeds would reduce the incidence of pressure ulcers in patients on prolonged bed confinement due to spinal injury. Methodology: Over a 16-month period, 51 patients (age range 1-80 years with spinal injuries were managed conservatively in our service using improvised waterbeds in 21 (41.2%, while using the regular hospital bed/foam in 30 (58.8%. Biodata, the time interval between injury and presentation to the hospital, nature of the injury, use of improvised waterbed and development of pressure ulcer, were collected, collated, and analyzed. Statistical significance was calculated with the Chi-square test. Results: Most were males (98%, in the age range of 21-30 years (25.5%, and due to fall from heights (35.3%. Of 21 patients who were managed on improvised waterbeds, 6 (28.6% had pressure ulcers, and of the 30 who did not use the waterbed, 17 (56.7% developed ulcers. The c2 = 3.9381, while P = 0.0472. This difference was statistically significant. Conclusion: The improvised waterbed, which is much cheaper than the standard waterbed, was observed to have significantly reduced the incidence of pressure ulcers among our patients. Nonetheless, further studies would still be needed to confirm this observation.

  7. Clinical profile of burn injured patients

    OpenAIRE

    Efstathiou, Flora; Svardagalou, Paraskevi

    2016-01-01

    Abstract Introduction: Burn injury is a severe systemic disease with social implications. Aim: The recording of patient’s clinical profile with burn injury worldwide and in Greece, the outcome and impact of the injury on the patient’s mental health and social, professional and family life. Methods: There were collected surveys and reports concerned burn victims, men and women, teenagers and adults of all types and severities of burns in the world and in Greece. The inf...

  8. Effect of Antioxidants on the Incidence of Wound Infection in Burn Patients

    OpenAIRE

    Sahib, A.S.; Al-Jawad, F.H.; Alkaisy, A.A.

    2010-01-01

    Background. Thermal injury causes the destruction of the physical skin barrier that normally protects the body from invasion by micro-organisms and induces an immunocompromised state that predisposes burn patients to infection, sepsis, and multiple organ failure. Reactive oxygen species contribute to burn-mediated immune suppression, and as the use of antioxidants has a positive effect on immune function, this may reduce the incidence of wound infection and related complications in burn patie...

  9. E P I DEMIOLOGY OF PAEDIATRIC BURNS: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jangpreet Singh

    2015-04-01

    Full Text Available BACKGROUND: Burn injuries are a major cause of morbidity and mortality in children. These are the third most common injury causing death in children, following motor vehicle accidents and drowning accidents. AIM: To study the Epidemiological parameters for assessment of morbidity & mortality rate in pediatric burns and to form effective preventive strategy. MATERIAL AND METHODS: The study was done at the Department of Surgery, PIMS, Jalandhar. Total 50 patients (n=50 up to age of 12 years, were included in the study retrospectively. Data regarding age, sex, demographic distribution, seasonal variation, Total body surface area (TBSA involved, type and place of burn injury, parent’s occupation, family size and mortality rate were noted and analysed. RESULT S: Total 50 patients (n =50 of which 32 were males and 18 females were included in the study. Mean age of burn injuries was 3.6 years. Scalds burns were the most common cause of burns followed by thermal burns. It involved mostly upper limbs (67%, anterio r trunk (56%, lower limbs (53%, face (4%, and posterior trunk including buttocks (16% . The time lapse from injury to presentation to hospital ranged from 1 hour to 3 weeks. Total body surface area burnt was ranged from 2 – 60%. Mean hospital duration was 12 . 4 days. Complications ranged from wound sepsis in 11 patients (22%, contractures of fingers in 3 patients ( 6 % and hypertrophic scarring in 8 patients (16% . After healing of wounds, patients were advised pressure garments and oil massage and night splint age regularly for six months. CONCLUSION: Children constitute a vulnerable group of burns. Most injuries occur in the home setting where effective control measures can be adopted. Advances have also made in resuscitation, intensive care, antimicrobi als, vascular access, nutritional support, and skin banking. Splintage, physiotherapy, massage and pressure garments also help in reducing the morbidity and overall long term burden over

  10. Antithrombin in the treatment of burn trauma.

    Science.gov (United States)

    Kowal-Vern, Areta; Orkin, Bruce A

    2016-02-01

    Antithrombin (AT) is a natural anticoagulant with anti-inflammatory properties that has demonstrated value in sepsis, disseminated intravascular coagulation and in burn and inhalation injury. With high doses, AT may decrease blood loss during eschar excision, reducing blood transfusion requirements. There are no human randomized, placebo-controlled studies, which have tested the true benefit of this agent in these conditions. Two main forms of AT are either plasma-derived AT (phAT) and recombinant AT (rhAT). Major ovine studies in burn and smoke inhalation injury have utilized rhAT. There have been no studies which have either translated the basic rhAT research in burn trauma, or determined the tolerance and pharmacokinetics of rhAT concentrate infusions in burn patients. Advantages of rhAT infusions are no risk of blood borne diseases and lower cost. However, the majority of human burn patient studies have been conducted utilizing phAT. Recent Japanese clinical trials have started using phAT in abdominal sepsis successfully. This review examines the properties of both phAT and rhAT, and analyzes studies in which they have been utilized. We believe that it is time to embark on a randomized placebo-controlled multi-center trial to establish the role of AT in both civilian and military patients with burn trauma. PMID:26855890

  11. Src blockade stabilizes a Flk/cadherin complex, reducing edema and tissue injury following myocardial infarction

    OpenAIRE

    Weis, Sara; Shintani, Satoshi; Weber, Alberto; Kirchmair, Rudolf; Wood, Malcolm; Cravens, Adrianna; McSharry, Heather; Iwakura, Atsushi; Yoon, Young-Sup; Himes, Nathan; Burstein, Deborah; Doukas, John; Soll, Richard; Losordo, Douglas; Cheresh, David

    2004-01-01

    Ischemia resulting from myocardial infarction (MI) promotes VEGF expression, leading to vascular permeability (VP) and edema, a process that we show here contributes to tissue injury throughout the ventricle. This permeability/edema can be assessed noninvasively by MRI and can be observed at the ultrastructural level as gaps between adjacent endothelial cells. Many of these gaps contain activated platelets adhering to exposed basement membrane, reducing vessel patency. Following MI, genetic o...

  12. CD47 Blockade Reduces Ischemia Reperfusion Injury and Improves Outcomes in a Rat Kidney Transplant Model

    Science.gov (United States)

    Lin, Yiing; Manning, Pamela T.; Jia, Jianluo; Gaut, Joseph P.; Xiao, Zhen-yu; Capoccia, Ben J.; Chen, Chun-Cheng; Hiebsch, Ronald R.; Upadhya, Gundumi; Mohanakumar, Thalachallour; Frazier, William A.; Chapman, William C.

    2016-01-01

    Background Ischemia/reperfusion injury (IRI) significantly contributes to delayed graft function and inflammation leading to graft loss. IRI is exacerbated by the thrombospondin-1/CD47 system through inhibition of nitric oxide signaling. We postulate that CD47 blockade and prevention of nitric oxide inhibition reduces IRI in organ transplantation. Methods We used a syngeneic rat renal transplantation model of IRI with bilaterally nephrectomized recipients to evaluate the effect of a CD47 monoclonal antibody (CD47mAb) on IRI. Donor kidneys were flushed with CD47mAb OX101 or an isotype-matched control immunoglobulin and stored at 4°C in UW solution for 6 hours prior to transplantation. Results CD47mAb perfusion of donor kidneys resulted in marked improvement in post-transplant survival, lower levels of serum creatinine, BUN, phosphorus and magnesium and less histologic evidence of injury. In contrast, control groups did not survive more than 5 days, had increased biochemical indicators of renal injury and exhibited severe pathological injury with tubular atrophy and necrosis. Recipients of CD47mAb-treated kidneys showed decreased levels of plasma biomarkers of renal injury including cystatin C, osteopontin, TIMP1, β2-microglobulin, VEGF-A and clusterin compared to the control group. Furthermore, laser Doppler assessment showed higher renal blood flow in the CD47mAb-treated kidneys. Conclusions These results provide strong evidence for the use of CD47 antibody-mediated blockade to reduce IRI and improve organ preservation for renal transplantation. PMID:24983310

  13. Animal Models in Burn Research

    OpenAIRE

    Abdullahi, A.; Amini-Nik, S.; Jeschke, M.G

    2014-01-01

    Burn injury is a severe form of trauma affecting more than two million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the...

  14. Inhibition of Phosphodiesterase-4 during Pneumococcal Pneumonia Reduces Inflammation and Lung Injury in Mice.

    Science.gov (United States)

    Tavares, Luciana P; Garcia, Cristiana C; Vago, Juliana P; Queiroz-Junior, Celso M; Galvão, Izabela; David, Bruna A; Rachid, Milene A; Silva, Patrícia M R; Russo, Remo C; Teixeira, Mauro M; Sousa, Lirlândia P

    2016-07-01

    Pneumococcal pneumonia is a leading cause of mortality worldwide. The inflammatory response to bacteria is necessary to control infection, but it may also contribute to tissue damage. Phosphodiesterase-4 inhibitors, such as rolipram (ROL), effectively reduce inflammation. Here, we examined the impact of ROL in a pneumococcal pneumonia murine model. Mice were infected intranasally with 10(5)-10(6) CFU of Streptococcus pneumoniae, treated with ROL in a prophylactic or therapeutic schedule in combination, or not, with the antibiotic ceftriaxone. Inflammation and bacteria counts were assessed, and ex vivo phagocytosis assays were performed. ROL treatment during S. pneumoniae infection decreased neutrophil recruitment into lungs and airways and reduced lung injury. Prophylactic ROL treatment also decreased cytokine levels in the airways. Although modulation of inflammation by ROL ameliorated pneumonia, bacteria burden was not reduced. On the other hand, antibiotic therapy reduced bacteria without reducing neutrophil infiltration, cytokine level, or lung injury. Combined ROL and ceftriaxone treatment decreased lethality rates and was more efficient in reducing inflammation, by increasing proresolving protein annexin A1 (AnxA1) expression, and bacterial burden by enhancing phagocytosis. Lack of AnxA1 increased inflammation and lethality induced by pneumococcal infection. These data show that immunomodulatory effects of phosphodiesterase-4 inhibitors are useful during severe pneumococcal pneumonia and suggest their potential benefit as adjunctive therapy during infectious diseases. PMID:26677751

  15. HAVE RECENT CHANGES TO THE RUGBY UNION LAWS OF SCRUMMAGE REDUCED SERIOUS CERVICAL SPINE INJURIES?

    Directory of Open Access Journals (Sweden)

    Terence F. McLoughlin

    2009-03-01

    Full Text Available All areas of play in rugby union are acknowledged to be potentially dangerous but it is in the scrum where the most frequent and serious spinal injuries occur (McIntosh & McCrory, 2005. This letter addresses the questions: what is it about the scrum which accounts for the alleged increased frequency of scrummage associated spinal cord injury (particular in the cervical region and what has the Rugby Football Union [RFU] done to minimise the chance of cervical cord damage by changes to the Laws? Scrums are used to restart play after infringement of Law 20.1. The team which is successful in winning the ball from the scrum can provide quality possession and space to their attacking backs (IRB, 2005.The three front row players are especially vulnerable to serious cervical spine injury. The majority of neck injuries are caused by heads not being properly aligned when opposing front row players make initial contact as the scrum is being formed. If the scrum collapses then excessive forward flexion/rotation of the cervical spine can occur and by wheeling the scrum this can result in increased abnormal lateral flexion/rotation. Added to these possible abnormal increases in directional movement of the cervical spine is the force generated at engagement. It has been calculated that in the front row a static weight of up to 1600kg is placed on each player's neck. Fracture dislocation (usually between C4/C6 of the spine can be the resulting injury which if the cord is involved can cause tetra paresis.In response to this evidence the IRB amended the law of scrummage which was put into effect 2007 in the hope of reducing the incidence of serious cervical spine injury. This is summarised as a 4 step Law of engagement which is: "crouch, touch, pause, engage". The distance between the front rows must now be less than arms length before making contact. Prior to the introduction of this Law with the stipulated distance apart before engagement, the front row

  16. Melatonin treatment reduces astrogliosis and apoptosis in rats with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Abdolreza Babaee

    2015-09-01

    Full Text Available Objective(s:Melatonin is known as an anti-inflammatory agent, and it has been proven to exert neuroprotection through inhibition of cell death (apoptosis in several models of brain injury.Secondary injury following the primary traumatic brain injury (TBI results in glial cells activation, especially astrocytes. In fact, astrocyte activation causes the production of pro-inflammatory cytokines that may lead to secondary injury. Since most TBI research studies have focused on injured neurons and paid little attention to glial cells, the aim of current study was to investigate the effects of melatonin against astrocytes activation (astrogliosis, as well as inhibition of apoptosis in brain tissue of male rats after TBI. Materials and Methods: The animals were randomly allocated into five groups: sham group, TBI+ vehicle group (1% ethanol in saline and TBI+ melatonin groups (5 mg/kg, 10 mg/kg and 20 mg/kg. All rats were intubated and then exposed to diffuse TBI, except for the sham group. Immunohistochemical methods were conducted using glial fibrillary acidic protein (GFAP marker and TUNEL assay to evaluate astrocyte reactivity and cell death, respectively. Results: The results showed that based on the number of GFAP positive astrocytes in brain cortex, astrogliosis was reduced significantly (P

  17. Ghrelin Therapy Improves Survival after Whole-Body Ionizing Irradiation or Combined with Burn or Wound: Amelioration of Leukocytopenia, Thrombocytopenia, Splenomegaly, and Bone Marrow Injury

    Science.gov (United States)

    Kiang, Juliann G.; Zhai, Min; Liao, Pei-Jyun; Elliott, Thomas B.; Gorbunov, Nikolai V.

    2014-01-01

    Exposure to ionizing radiation alone (RI) or combined with traumatic tissue injury (CI) is a crucial life-threatening factor in nuclear and radiological events. In our laboratory, mice exposed to 60Co-γ-photon radiation (9.5 Gy, 0.4 Gy/min, bilateral) followed by 15% total-body-surface-area skin wounds (R-W CI) or burns (R-B CI) experienced an increment of ≥18% higher mortality over a 30-day observation period compared to RI alone. CI was accompanied by severe leukocytopenia, thrombocytopenia, erythropenia, and anemia. At the 30th day after injury, numbers of WBC and platelets still remained very low in surviving RI and CI mice. In contrast, their RBC, hemoglobin, and hematocrit were recovered towards preirradiation levels. Only RI induced splenomegaly. RI and CI resulted in bone-marrow cell depletion. In R-W CI mice, ghrelin (a hunger-stimulating peptide) therapy increased survival, mitigated body-weight loss, accelerated wound healing, and increased hematocrit. In R-B CI mice, ghrelin therapy increased survival and numbers of neutrophils, lymphocytes, and platelets and ameliorated bone-marrow cell depletion. In RI mice, this treatment increased survival, hemoglobin, and hematocrit and inhibited splenomegaly. Our novel results are the first to suggest that ghrelin therapy effectively improved survival by mitigating CI-induced leukocytopenia, thrombocytopenia, and bone-marrow injury or the RI-induced decreased hemoglobin and hematocrit. PMID:25374650

  18. Group I metabotropic glutamate receptors reduce excitotoxic injury and may facilitate neurogenesis

    DEFF Research Database (Denmark)

    Baskys, Andrius; Bayazitov, Ildar; Fang, Liwei;

    2005-01-01

    Group I metabotropic glutamate receptor (mGluR) agonist DHPG reduced nerve cell death caused by their exposure to NMDA ("neuroprotective effect") and attenuated NMDA receptor-mediated currents [Blaabjerg, M., Baskys, A., Zimmer, J., Vawter, M. P., 2003b. Changes in hippocampal gene expression aft......GluRs reduces nerve cell susceptibility to excitotoxic injury in a PLC-dependent manner; (2) this reduction is associated with a PLC-dependent depression of excitatory synaptic transmission; and (3) mGluR1 activation may facilitate neurogenesis....

  19. Burns: Treatment and Outcomes

    OpenAIRE

    Burd, Andrew

    2010-01-01

    Burns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft t...

  20. Treatment with polyamine oxidase inhibitor reduces microglial activation and limits vascular injury in ischemic retinopathy.

    Science.gov (United States)

    Patel, C; Xu, Z; Shosha, E; Xing, J; Lucas, R; Caldwell, R W; Caldwell, R B; Narayanan, S P

    2016-09-01

    Retinal vascular injury is a major cause of vision impairment in ischemic retinopathies. Insults such as hyperoxia, oxidative stress and inflammation contribute to this pathology. Previously, we showed that hyperoxia-induced retinal neurodegeneration is associated with increased polyamine oxidation. Here, we are studying the involvement of polyamine oxidases in hyperoxia-induced injury and death of retinal vascular endothelial cells. New-born C57BL6/J mice were exposed to hyperoxia (70% O2) from postnatal day (P) 7 to 12 and were treated with the polyamine oxidase inhibitor MDL 72527 or vehicle starting at P6. Mice were sacrificed after different durations of hyperoxia and their retinas were analyzed to determine the effects on vascular injury, microglial cell activation, and inflammatory cytokine profiling. The results of this analysis showed that MDL 72527 treatment significantly reduced hyperoxia-induced retinal vascular injury and enhanced vascular sprouting as compared with the vehicle controls. These protective effects were correlated with significant decreases in microglial activation as well as levels of inflammatory cytokines and chemokines. In order to model the effects of polyamine oxidation in causing microglial activation in vitro, studies were performed using rat brain microvascular endothelial cells treated with conditioned-medium from rat retinal microglia stimulated with hydrogen peroxide. Conditioned-medium from activated microglial cultures induced cell stress signals and cell death in microvascular endothelial cells. These studies demonstrate the involvement of polyamine oxidases in hyperoxia-induced retinal vascular injury and retinal inflammation in ischemic retinopathy, through mechanisms involving cross-talk between endothelial cells and resident retinal microglia. PMID:27239699

  1. IS A COGNITIVE-BEHAVIOURAL BIOFEEDBACK INTERVENTION USEFUL TO REDUCE INJURY RISK IN JUNIOR FOOTBALL PLAYERS?

    Directory of Open Access Journals (Sweden)

    Arne Edvardsson

    2012-06-01

    Full Text Available Athletes participating in sport are exposed to a relatively high injury risk. Previous research has suggested that it could be possible to reduce sports injuries through psychological skills training. The purpose of this study was to examine the extent to which a cognitive behavioural biofeedback intervention could reduce the number of sports injuries in a sample of players in Swedish elite football high schools. Participants from four elite football high schools (16-19 years old were divided into one experiment (n = 13 and one control group (n = 14. Participants were asked to complete three questionnaires to assess anxiety level (Sport Anxiety Scale, history of stressors (Life Event Scale for Collegiate Athletes and coping skills (Athletic Coping Skills Inventory - 28 in a baseline measure. Mann-Whitney U-tests showed no significant differences in pre-intervention scores based on the questionnaires. The experimental group participated in a nine-week intervention period consisting of seven sessions, including: somatic relaxation, thought stopping, emotions/problem focused coping, goal setting, biofeedback training as well as keeping a critical incident diary. A Mann-Whitney U test showed no significant difference between the control and experimental group U (n1 = 13, n2 = 14 = 51.00, p = 0.054. However, considering the small sample, the statistical power (0.05 for present study, to detect effects was low. The results of the study are discussed from a psychological perspective and proposals for future research are given

  2. Again, new, Afresh: Electric Injuries In Children

    OpenAIRE

    Almiş, Habip; Yakıncı, Cengiz; KAYHAN, Eda; Kaplan, Fatih; Karakurt, Cemşit

    2014-01-01

    OBJECTIVESIn this study, we planned to determine the factors affecting the mortality, and morbidity of electrical injuries.Electric injuries, is cause of high morbidity and mortality, major burns, leading to cardiac and orthopedic problems and trauma, in all age groups are at risk type.This study of children presenting with electric injuries to determine the demographic characteristics, can be taken to reduce mortality and morbidity measures were planned to be discussed.MATERIAL AND METHODSIn...

  3. Using a fire propagation model to assess the efficiency of prescribed burning in reducing the fire hazard

    OpenAIRE

    Cassagne, Nathalie; Pimont, François; Dupuy, Jean-Luc; Linn, Rodman R.; Marell, Anders; Oliveri, Chloe; Rigolot, Eric

    2011-01-01

    We examined how fire hazard was affected by prescribed burning and fuel recovery over the first six years following treatment. Eight common Mediterranean fuel complexes managed by means of prescribed burning in limestone Provence (South-Eastern France) were studied, illustrating forest and woodland, garrigue and grassland situations. The coupled atmosphere-wildfire behaviour model FIRETEC was used to simulate fire behaviour (ROS, intensity) in these complex vegetations. The temporal threshold...

  4. Reducing hospital infection rates in the burn unit by adherence to infection control measures: a six-year experience

    OpenAIRE

    Zülal ÖZKURT; Ülkü ALTOPARLAK; YILMAZ, Sibel İBA; EROL, Serpil; Kemalettin ÖZDEN; AKÇAY, Müfide Nuran

    2012-01-01

    To show the effect of infection control measures (ICMs) on nosocomial infections (NIs) in a burn unit. Materials and methods: This study was conducted retrospectively at a 15-bed pediatric and adult burn unit, and 1329 hospitalized patients from 2003 to 2008 were enrolled. Detection and surveillance of NIs was performed by the infection control team (ICT), actively and prospectively, and was patient and laboratory based. Pan-resistant P. aeruginosa strains were seen in the unit in 2003. A p...

  5. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    OpenAIRE

    Tanash, Hanan

    2015-01-01

    Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackg...

  6. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    OpenAIRE

    Tanash HA; Huss F; Ekström M

    2015-01-01

    Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackground: Long-term oxygen ...

  7. Nanoemulsion Therapy for Burn Wounds Is Effective as a Topical Antimicrobial Against Gram-Negative and Gram-Positive Bacteria.

    Science.gov (United States)

    Dolgachev, Vladislav A; Ciotti, Susan M; Eisma, Rone; Gracon, Stephen; Wilkinson, J Erby; Baker, James R; Hemmila, Mark R

    2016-01-01

    The aim of this study is to investigate the antimicrobial efficacy of two different nanoemulsion (NE) formulations against Gram-positive and Gram-negative bacteria in an in vivo rodent scald burn model. Male Sprague-Dawley rats were anesthetized and received a partial-thickness scald burn. Eight hours after burn injury, the wound was inoculated with 1 × 10(8) colony-forming units of Pseudomonas aeruginosa or Staphylococcus aureus. Treatment groups consisted of two different NE formulations (NB-201 and NB-402), NE vehicle, or saline. Topical application of the treatment was performed at 16 and 24 hours after burn injury. Animals were killed 32 hours after burn injury, and skin samples were obtained for quantitative wound culture and determination of dermal inflammation markers. In a separate set of experiments, burn wound progression was measured histologically after 72 hours of treatment. Both NE formulations (NB-201 and NB-402) significantly reduced burn wound infections with either P. aeruginosa or S. aureus and decreased median bacterial counts at least three logs when compared with animals with saline applications (p wound as measured by myeloperoxidase (MPO) assay and histopathology (p wound progression 72 hours after injury. Topically applied NB-201 and NB-402 are effective in decreasing Gram-positive and Gram-negative bacteria growth in burn wounds, reducing inflammation, and abrogating burn wound progression. PMID:26182074

  8. THREE INTERMITTENT SESSIONS OF CRYOTHERAPY REDUCE THE SECONDARY MUSCLE INJURY IN SKELETAL MUSCLE OF RAT

    Directory of Open Access Journals (Sweden)

    Nuno M. L. Oliveira

    2006-06-01

    Full Text Available Although cryotherapy associated to compression is recommended as immediate treatment after muscle injury, the effect of intermittent sessions of these procedures in the area of secondary muscle injury is not established. This study examined the effect of three sessions of cryotherapy (30 min of ice pack each 2h and muscle compression (sand pack in the muscle-injured area. Twenty-four Wistar rats (312 ± 20g were evaluated. In three groups, the middle belly of tibialis anterior (TA muscle was injured by a frozen iron bar and received one of the following treatments: a three sessions of cryotherapy; b three sessions of compression; c not treated. An uninjured group received sessions of cryotherapy. Frozen muscles were cross- sectioned (10 µm and stained for the measurement of injured and uninjured muscle area. Injured muscles submitted to cryotherapy showed the smallest injured area (29.83 ± 6.6%, compared to compressed (39.2 ± 2.8%, p= 0.003 and untreated muscles (41.74 ± 4.0%, p = 0.0008. No difference was found between injured compressed and injured untreated muscles. In conclusion, three intermittent sessions of cryotherapy applied immediately after muscle damage was able to reduce the secondary muscle injury, while only the muscle compression did not provide the same effectiveness

  9. Barley Sprouts Extract Attenuates Alcoholic Fatty Liver Injury in Mice by Reducing Inflammatory Response

    Science.gov (United States)

    Lee, Yun-Hee; Kim, Joung-Hee; Kim, Sou Hyun; Oh, Ji Youn; Seo, Woo Duck; Kim, Kyung-Mi; Jung, Jae-Chul; Jung, Young-Suk

    2016-01-01

    It has been reported that barley leaves possess beneficial properties such as antioxidant, hypolipidemic, antidepressant, and antidiabetic. Interestingly, barley sprouts contain a high content of saponarin, which showed both anti-inflammatory and antioxidant activities. In this study, we evaluated the effect of barley sprouts on alcohol-induced liver injury mediated by inflammation and oxidative stress. Raw barley sprouts were extracted, and quantitative and qualitative analyses of its components were performed. The mice were fed a liquid alcohol diet with or without barley sprouts for four weeks. Lipopolysaccharide (LPS)-stimulated RAW 264.7 cells were used to study the effect of barley sprouts on inflammation. Alcohol intake for four weeks caused liver injury, evidenced by an increase in serum alanine aminotransferase and aspartate aminotransferase activities and tumor necrosis factor (TNF)-α levels. The accumulation of lipid in the liver was also significantly induced, whereas the glutathione (GSH) level was reduced. Moreover, the inflammation-related gene expression was dramatically increased. All these alcohol-induced changes were effectively prevented by barley sprouts treatment. In particular, pretreatment with barley sprouts significantly blocked inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 expression in LPS-stimulated RAW 264.7. This study suggests that the protective effect of barley sprouts against alcohol-induced liver injury is potentially attributable to its inhibition of the inflammatory response induced by alcohol. PMID:27455313

  10. Resveratrol attenuates peripheral and brain inflammation and reduces ischemic brain injury in aged female mice.

    Science.gov (United States)

    Jeong, Sae Im; Shin, Jin A; Cho, Sunghee; Kim, Hye Won; Lee, Ji Yoon; Kang, Jihee Lee; Park, Eun-Mi

    2016-08-01

    Resveratrol is known to improve metabolic dysfunction associated with obesity. Visceral obesity is a sign of aging and is considered a risk factor for ischemic stroke. In this study, we investigated the effects of resveratrol on inflammation in visceral adipose tissue and the brain and its effects on ischemic brain injury in aged female mice. Mice treated with resveratrol (0.1 mg/kg, p.o.) for 10 days showed reduced levels of interleukin-1β and tumor necrosis factor-α, as well as a reduction in the size of adipocytes in visceral adipose tissue. Resveratrol also reduced interleukin-1β and tumor necrosis factor-α protein levels and immunoglobulin G extravasation in the brain. Mice treated with resveratrol demonstrated smaller infarct size, improved neurological function, and blunted peripheral inflammation at 3 days postischemic stroke. These results showed that resveratrol counteracted inflammation in visceral adipose tissue and in the brain and reduced stroke-induced brain injury and peripheral inflammation in aged female mice. Therefore, resveratrol administration can be a valuable strategy for the prevention of age-associated and disease-provoked inflammation in postmenopausal women. PMID:27318135

  11. Pattern and outcome of children admitted for burns in Benin City, mid-western Nigeria

    Directory of Open Access Journals (Sweden)

    Oludiran O

    2009-01-01

    Full Text Available Children are a vulnerable to burns, an injury, which is often preventable. A study of the profile of cases of children admitted for burns will provide background information to suggest locally doable preventive strategies as well as supply basic information for future reference. We studied the records of 62 children aged 0-16 years, admitted for burns, at the University of Benin Teaching Hospital, Benin City, between January 2002 and December 2006. There were 34 male and 28 female children. Children under three years constituted 56.5%. Whereas the leading cause of burns in all the children was flame burns from kerosene explosions (52%, scalds were responsible for 68.6% of cases in those under three. The extent of burn injury ranged from 6 to 50% and most of them presented late. 64.6% were discharged within three weeks. Wound sepsis and post burn contractures were the most frequently encountered complications (19.4% and 9.7% respectively. There were two deaths (3.2% related to sepsis. Particular attention to burn safety precautions in children (especially, in the> 3 years age group, safer storage and dispensing of combustible chemicals particularly petroleum products is advocated. Fire safety awareness, correct first aid measures and early presentation in the hospital will reduce morbidity and mortality. Early physiotherapy and splinting strategies will reduce contractures. There is the need locally for the establishment of specialized burn centres both to treat these children and to stimulate interest in burn management.

  12. Burns and military clothing.

    Science.gov (United States)

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

  13. Targeting Kv1.3 channels to reduce white matter pathology after traumatic brain injury.

    Science.gov (United States)

    Reeves, Thomas M; Trimmer, Patricia A; Colley, Beverly S; Phillips, Linda L

    2016-09-01

    Axonal injury is present in essentially all clinically significant cases of traumatic brain injury (TBI). While no effective treatment has been identified to date, experimental TBI models have shown promising axonal protection using immunosuppressants FK506 and Cyclosporine-A, with treatment benefits attributed to calcineurin inhibition or protection of mitochondrial function. However, growing evidence suggests neuroprotective efficacy of these compounds may also involve direct modulation of ion channels, and in particular Kv1.3. The present study tested whether blockade of Kv1.3 channels, using Clofazimine (CFZ), would alleviate TBI-induced white matter pathology in rodents. Postinjury CFZ administration prevented suppression of compound action potential (CAP) amplitude in the corpus callosum of adult rats following midline fluid percussion TBI, with injury and treatment effects primarily expressed in unmyelinated CAPs. Kv1.3 protein levels in callosal tissue extracts were significantly reduced postinjury, but this loss was prevented by CFZ treatment. In parallel, CFZ also attenuated the injury-induced elevation in pro-inflammatory cytokine IL1-β. The effects of CFZ on glial function were further studied using mixed microglia/astrocyte cell cultures derived from P3-5 mouse corpus callosum. Cultures of callosal glia challenged with lipopolysaccharide exhibited a dramatic increase in IL1-β levels, accompanied by reactive morphological changes in microglia, both of which were attenuated by CFZ treatment. These results support a cell specific role for Kv1.3 signaling in white matter pathology after TBI, and suggest a treatment approach based on the blockade of these channels. This therapeutic strategy may be especially efficacious for normalizing neuro-glial interactions affecting unmyelinated axons after TBI. PMID:27302680

  14. Salubrinal reduces oxidative stress, neuroinflammation and impulsive-like behavior in a rodent model of traumatic brain injury.

    Science.gov (United States)

    Logsdon, Aric F; Lucke-Wold, Brandon P; Nguyen, Linda; Matsumoto, Rae R; Turner, Ryan C; Rosen, Charles L; Huber, Jason D

    2016-07-15

    Traumatic brain injury (TBI) is the leading cause of trauma related morbidity in the developed world. TBI has been shown to trigger secondary injury cascades including endoplasmic reticulum (ER) stress, oxidative stress, and neuroinflammation. The link between secondary injury cascades and behavioral outcome following TBI is poorly understood warranting further investigation. Using our validated rodent blast TBI model, we examined the interaction of secondary injury cascades following single injury and how these interactions may contribute to impulsive-like behavior after a clinically relevant repetitive TBI paradigm. We targeted these secondary pathways acutely following single injury with the cellular stress modulator, salubrinal (SAL). We examined the neuroprotective effects of SAL administration on significantly reducing ER stress: janus-N-terminal kinase (JNK) phosphorylation and C/EBP homology protein (CHOP), oxidative stress: superoxide and carbonyls, and neuroinflammation: nuclear factor kappa beta (NFκB) activity, inducible nitric oxide synthase (iNOS) protein expression, and pro-inflammatory cytokines at 24h post-TBI. We then used the more clinically relevant repeat injury paradigm and observed elevated NFκB and iNOS activity. These injury cascades were associated with impulsive-like behavior measured on the elevated plus maze. SAL administration attenuated secondary iNOS activity at 72h following repetitive TBI, and most importantly prevented impulsive-like behavior. Overall, these results suggest a link between secondary injury cascades and impulsive-like behavior that can be modulated by SAL administration. PMID:27131989

  15. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    Dalal P

    2010-10-01

    Full Text Available Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

  16. Pediatric burn rehabilitation: Philosophy and strategies

    OpenAIRE

    Shohei Ohgi; Shouzhi Gu

    2013-01-01

    Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Sc...

  17. Methyl Jasmonate Reduces Chilling Injury and Maintains Postharvest Quality in Peaches

    Institute of Scientific and Technical Information of China (English)

    FENG Lei; ZHENG Yong-hua; ZHANG Yan-fen; WANG Feng; ZHANG Lan; LU Zhao-xin

    2003-01-01

    Zhaohui peaches (Prunus persica Batsch) were treated with 0 (CK), 1, 10 or 100 μmol L-1methyl jasmonate (MeJA) vapor at 20℃ for 24 h before stored at 0℃ for 35 d. The untreated fruits showed chilling injury (CI) symptoms after 4 wk of storage, as indicated by increased fruit firmness and reduced extractable juice, which is referred as leatheriness. Treatment with 1 and 10 μmol L-1 MeJA promoted normal ripening and softening, maintained higher levels of extractable juice, titratable acidity, pectinesterase (PE)and polygalacturonase (PG) activities, inhibited increases in fruit fresh weight loss, decay incidence, electrolyte leakage and MDA content, and improved color development, thereby preventing chilling injury symptoms development and maintaining edible quality. MeJA treatment also delayed the climacteric rise in respiratory rate, but promoted ethylene production during the later period of cold storage, suggesting that ethylene may involve in CI development of peaches. These results indicate that 1 and 10 μmol L-1 MeJA treatments could be used to reduce CI development and decay incidence in peaches.

  18. Sesamin Ameliorates High-Fat Diet–Induced Dyslipidemia and Kidney Injury by Reducing Oxidative Stress

    Science.gov (United States)

    Zhang, Ruijuan; Yu, Yan; Deng, Jianjun; Zhang, Chao; Zhang, Jinghua; Cheng, Yue; Luo, Xiaoqin; Han, Bei; Yang, Haixia

    2016-01-01

    The study explored the protective effect of sesamin against lipid-induced renal injury and hyperlipidemia in a rat model. An animal model of hyperlipidemia was established in Sprague-Dawley rats. Fifty-five adult Sprague-Dawley rats were divided into five groups. The control group was fed a standard diet, while the other four groups were fed a high-fat diet for 5 weeks to induce hyperlipidemia. Three groups received oral sesamin in doses of 40, 80, or 160 mg/(kg·day). Seven weeks later, the blood lipids, renal function, antioxidant enzyme activities, and hyperoxide levels in kidney tissues were measured. The renal pathological changes and expression levels of collagen type IV (Col-IV) and α-smooth muscle actin (α-SMA) were analyzed. The administration of sesamin improved the serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, apolipoprotein-B, oxidized-low-density lipoprotein, and serum creatinine levels in hyperlipidemic rats, while it increased the high-density lipoprotein cholesterol and apolipoprotein-A levels. Sesamin reduced the excretion of 24-h urinary protein and urinary albumin and downregulated α-SMA and Col-IV expression. Moreover, sesamin ameliorated the superoxide dismutase activity and reduced malondialdehyde levels in kidney tissue. Sesamin could mediate lipid metabolism and ameliorate renal injury caused by lipid metabolism disorders in a rat model of hyperlipidemia. PMID:27171111

  19. Sesamin Ameliorates High-Fat Diet–Induced Dyslipidemia and Kidney Injury by Reducing Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Ruijuan Zhang

    2016-05-01

    Full Text Available The study explored the protective effect of sesamin against lipid-induced renal injury and hyperlipidemia in a rat model. An animal model of hyperlipidemia was established in Sprague-Dawley rats. Fifty-five adult Sprague-Dawley rats were divided into five groups. The control group was fed a standard diet, while the other four groups were fed a high-fat diet for 5 weeks to induce hyperlipidemia. Three groups received oral sesamin in doses of 40, 80, or 160 mg/(kg·day. Seven weeks later, the blood lipids, renal function, antioxidant enzyme activities, and hyperoxide levels in kidney tissues were measured. The renal pathological changes and expression levels of collagen type IV (Col-IV and α-smooth muscle actin (α-SMA were analyzed. The administration of sesamin improved the serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, apolipoprotein-B, oxidized-low-density lipoprotein, and serum creatinine levels in hyperlipidemic rats, while it increased the high-density lipoprotein cholesterol and apolipoprotein-A levels. Sesamin reduced the excretion of 24-h urinary protein and urinary albumin and downregulated α-SMA and Col-IV expression. Moreover, sesamin ameliorated the superoxide dismutase activity and reduced malondialdehyde levels in kidney tissue. Sesamin could mediate lipid metabolism and ameliorate renal injury caused by lipid metabolism disorders in a rat model of hyperlipidemia.

  20. Sesamin Ameliorates High-Fat Diet-Induced Dyslipidemia and Kidney Injury by Reducing Oxidative Stress.

    Science.gov (United States)

    Zhang, Ruijuan; Yu, Yan; Deng, Jianjun; Zhang, Chao; Zhang, Jinghua; Cheng, Yue; Luo, Xiaoqin; Han, Bei; Yang, Haixia

    2016-01-01

    The study explored the protective effect of sesamin against lipid-induced renal injury and hyperlipidemia in a rat model. An animal model of hyperlipidemia was established in Sprague-Dawley rats. Fifty-five adult Sprague-Dawley rats were divided into five groups. The control group was fed a standard diet, while the other four groups were fed a high-fat diet for 5 weeks to induce hyperlipidemia. Three groups received oral sesamin in doses of 40, 80, or 160 mg/(kg·day). Seven weeks later, the blood lipids, renal function, antioxidant enzyme activities, and hyperoxide levels in kidney tissues were measured. The renal pathological changes and expression levels of collagen type IV (Col-IV) and α-smooth muscle actin (α-SMA) were analyzed. The administration of sesamin improved the serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, apolipoprotein-B, oxidized-low-density lipoprotein, and serum creatinine levels in hyperlipidemic rats, while it increased the high-density lipoprotein cholesterol and apolipoprotein-A levels. Sesamin reduced the excretion of 24-h urinary protein and urinary albumin and downregulated α-SMA and Col-IV expression. Moreover, sesamin ameliorated the superoxide dismutase activity and reduced malondialdehyde levels in kidney tissue. Sesamin could mediate lipid metabolism and ameliorate renal injury caused by lipid metabolism disorders in a rat model of hyperlipidemia. PMID:27171111

  1. Ischemic preconditioning reduces the severity of ischemia-reperfusion injury of peripheral nerve in rats

    Directory of Open Access Journals (Sweden)

    Kurutas Ergul

    2006-09-01

    Full Text Available Abstract Background and aim Allow for protection of briefly ischemic tissues against the harmful effects of subsequent prolonged ischemia is a phenomennon called as Ischemic Preconditioning (IP. IP has not been studied in ischemia-reperfusion (I/R model of peripheral nerve before. We aimed to study the effects of acute IP on I/R injury of peripheral nerve in rats. Method 70 adult male rats were randomly divided into 5 groups in part 1 experimentation and 3 groups in part 2 experimentation. A rat model of severe nerve ischemia which was produced by tying iliac arteries and all idenfiable anastomotic vessels with a silk suture (6-0 was used to study the effects of I/R and IP on nerve biochemistry. The suture technique used was a slip-knot technique for rapid release at time of reperfusion in the study. Cytoplasmic vacuolar degeneration was also histopathologically evaluated by light microscopic examination in sciatic nerves of rats at 7th day in part 2 study. Results 3 hours of Reperfusion resulted in an increase in nerve malondialdehyde levels when compared with ischemia and non-ischemia groups (p 0.05. There was also a significant decrease in vacoular degeneration of sciatic nerves in IP group than I/R group (p Conclusion IP reduces the severity of I/R injury in peripheral nerve as shown by reduced tissue MDA levels at 3 th hour of reperfusion and axonal vacoulization at 7 th postischemic day.

  2. Dexmedetomidine Postconditioning Reduces Brain Injury after Brain Hypoxia-Ischemia in Neonatal Rats.

    Science.gov (United States)

    Ren, Xiaoyan; Ma, Hong; Zuo, Zhiyi

    2016-06-01

    Perinatal asphyxia can lead to death and severe disability. Brain hypoxia-ischemia (HI) injury is the major pathophysiology contributing to death and severe disability after perinatal asphyxia. Here, seven-day old Sprague-Dawley rats were subjected to left brain HI. Dexmedetomidine was given intraperitoneally after the brain HI. Yohimbine or atipamezole, two α2 adrenergic receptor antagonists, were given 10 min before the dexmedetomidine injection. Neurological outcome was evaluated 7 or 28 days after the brain HI. Frontal cerebral cortex was harvested 6 h after the brain HI. Left brain HI reduced the left cerebral hemisphere weight assessed 7 days after the brain HI. This brain tissue loss was dose-dependently attenuated by dexmedetomidine. Dexmedetomidine applied within 1 h after the brain HI produced this effect. Dexmedetomidine attenuated the brain HI-induced brain tissue and cell loss as well as neurological and cognitive dysfunction assessed from 28 days after the brain HI. Dexmedetomidine postconditioning-induced neuroprotection was abolished by yohimbine or atipamezole. Brain HI increased tumor necrosis factor α and interleukin 1β in the brain tissues. This increase was attenuated by dexmedetomidine. Atipamezole inhibited this dexmedetomidine effect. Our results suggest that dexmedetomidine postconditioning reduces HI-induced brain injury in the neonatal rats. This effect may be mediated by α2 adrenergic receptor activation that inhibits inflammation in the ischemic brain tissues. PMID:26932203

  3. Bilateral Lower Limb Amputations in a Nigerian Child Following High-Voltage Electrical Burns Injury: A Case Report

    OpenAIRE

    Dim, EM; Amanari, OC; Nottidge, TE; Inyang, UC; Nwashindi, A

    2013-01-01

    Abstract The human body conducts electricity very well. Direct contact with electric current can be lethal. The passage of electric current through the body is capable of producing a wide spectrum of injuries, including serious damage to the heart, brain, skin and muscles. Naked high-voltage electric cables negligently abandoned in residential, commercial and industrial areas are a recipe for disaster. This is a case report of a 5-year girl child who had bilateral lower limb gangrene followin...

  4. How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns

    Science.gov (United States)

    Disseldorp, Laurien M.; Niemeijer, Anuschka S.; Van Baar, Margriet E.; Reinders-Messelink, Heleen A.; Mouton, Leonora J.; Nieuwenhuis, Marianne K.

    2013-01-01

    Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM[R]…

  5. Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Krarup, Annabel Lee;

    1999-01-01

    burn surface area. Histamine, interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were analysed in plasma or serum collected from all patients 30 min before skin incision, at skin incision and 5, 10 and 30 min and thereafter every...

  6. Inhalation Injury

    OpenAIRE

    Coşkun Araz; Arash Pirat

    2011-01-01

    Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three...

  7. Taurine improves functional and histological outcomes and reduces inflammation in traumatic brain injury.

    Science.gov (United States)

    Su, Y; Fan, W; Ma, Z; Wen, X; Wang, W; Wu, Q; Huang, H

    2014-04-25

    We investigated the effect of taurine on inflammatory cytokine expression, on astrocyte activity and cerebral edema and functional outcomes, following traumatic brain injury (TBI) in rats. 72 rats were randomly divided into sham, TBI and Taurine groups. Rats subjected to moderate lateral fluid percussion injury were injected intravenously with taurine (200mg/kg) or saline immediately after injury or daily for 7days. Functional outcome was evaluated using Modified Neurological Severity Score (mNSS). Glial fibrillary acidic protein (GFAP) of the brain was measured using immunofluorescence. Concentration of 23 cytokines and chemokines in the injured cortex at 1 and 7days after TBI was assessed by Luminex xMAP technology. The results showed that taurine significantly improved functional recovery except 1day, reduced accumulation of GFAP and water content in the penumbral region at 7days after TBI. Compared with the TBI group, taurine significantly suppressed growth-related oncogene (GRO/KC) and interleukin (IL)-1β levels while elevating the levels of regulated on activation, normal T cell expressed and secreted (RANTES) at 1day. And taurine markedly decreased the level of 17 cytokine: eotaxin, Granulocyte colony-stimulating factor (G-CSF), Granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-gamma (IFN-γ), IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, IL-17, leptin, monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF), and only increased the level of MIP-1α in a week. The results suggest that taurine effectively mitigates the severity of brain damage in TBI by attenuating the increase of astrocyte activity and edema as well as pro-inflammatory cytokines. PMID:24530657

  8. Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Kan XU; Qi-xin CHEN; Fang-cai LI; Wei-shan CHEN; Min LIN; Qiong-hua WET

    2009-01-01

    Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Spragne-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day l, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.

  9. Inositol-trisphosphate reduces alveolar apoptosis and pulmonary edema in neonatal lung injury.

    Science.gov (United States)

    Preuss, Stefanie; Stadelmann, Sabrina; Omam, Friede D; Scheiermann, Julia; Winoto-Morbach, Supandi; von Bismarck, Philipp; Knerlich-Lukoschus, Friederike; Lex, Dennis; Adam-Klages, Sabine; Wesch, Daniela; Held-Feindt, Janka; Uhlig, Stefan; Schütze, Stefan; Krause, Martin F

    2012-08-01

    D-myo-inositol-1,2,6-trisphosphate (IP3) is an isomer of the naturally occurring second messenger D-myo-inositol-1,4,5-trisphosphate, and exerts anti-inflammatory and antiedematous effects in the lung. Myo-inositol (Inos) is a component of IP3, and is thought to play an important role in the prevention of neonatal pulmonary diseases such as bronchopulmonary dysplasia and neonatal acute lung injury (nALI). Inflammatory lung diseases are characterized by augmented acid sphingomyelinase (aSMase) activity leading to ceramide production, a pathway that promotes increased vascular permeability, apoptosis, and surfactant alterations. A novel, clinically relevant triple-hit model of nALI was developed, consisting of repeated airway lavage, injurious ventilation, and lipopolysaccharide instillation into the airways, every 24 hours. Thirty-five piglets were randomized to one of four treatment protocols: control (no intervention), surfactant alone, surfactant + Inos, and surfactant + IP3. After 72 hours of mechanical ventilation, lungs were excised from the thorax for subsequent analyses. Clinically, oxygenation and ventilation improved, and extravascular lung water decreased significantly with the S + IP3 intervention. In pulmonary tissue, we observed decreased aSMase activity and ceramide concentrations, decreased caspase-8 concentrations, reduced alveolar epithelial apoptosis, the reduced expression of interleukin-6, transforming growth factor-β1, and amphiregulin (an epithelial growth factor), reduced migration of blood-borne cells and particularly of CD14(+)/18(+) cells (macrophages) into the airspaces, and lower surfactant surface tensions in S + IP3-treated but not in S + Inos-treated piglets. We conclude that the admixture of IP3 to surfactant, but not of Inos, improves gas exchange and edema in our nALI model by the suppression of the governing enzyme aSMase, and that this treatment deserves clinical evaluation. PMID:22403805

  10. Minocycline Transiently Reduces Microglia/Macrophage Activation but Exacerbates Cognitive Deficits Following Repetitive Traumatic Brain Injury in the Neonatal Rat.

    Science.gov (United States)

    Hanlon, Lauren A; Huh, Jimmy W; Raghupathi, Ramesh

    2016-03-01

    Elevated microglial/macrophage-associated biomarkers in the cerebrospinal fluid of infant victims of abusive head trauma (AHT) suggest that these cells play a role in the pathophysiology of the injury. In a model of AHT in 11-day-old rats, 3 impacts (24 hours apart) resulted in spatial learning and memory deficits and increased brain microglial/macrophage reactivity, traumatic axonal injury, neuronal degeneration, and cortical and white-matter atrophy. The antibiotic minocycline has been effective in decreasing injury-induced microglial/macrophage activation while simultaneously attenuating cellular and functional deficits in models of neonatal hypoxic ischemia, but the potential for this compound to rescue deficits after impact-based trauma to the immature brain remains unexplored. Acute minocycline administration in this model of AHT decreased microglial/macrophage reactivity in the corpus callosum of brain-injured animals at 3 days postinjury, but this effect was lost by 7 days postinjury. Additionally, minocycline treatment had no effect on traumatic axonal injury, neurodegeneration, tissue atrophy, or spatial learning deficits. Interestingly, minocycline-treated animals demonstrated exacerbated injury-induced spatial memory deficits. These results contrast with previous findings in other models of brain injury and suggest that minocycline is ineffective in reducing microglial/macrophage activation and ameliorating injury-induced deficits following repetitive neonatal traumatic brain injury. PMID:26825312

  11. Reducing knee and anterior cruciate ligament injuries among female athletes: a systematic review of neuromuscular training interventions.

    Science.gov (United States)

    Hewett, Timothy E; Myer, Gregory D; Ford, Kevin R

    2005-01-01

    There is evidence that neuromuscular training not only decreases the potential biomechanical risk factors for ACL injury, but also decreases knee and, specifically, ACL injury incidence in female athletes. Five of the six interventions in this systematic review demonstrated significant effects on overall knee or ACL injury rates. It appears that plyometric power, biomechanics and technique, strength, balance, and core stability training can induce neuromuscular changes and potential injury prevention effects in female athletes. However, it is unknown which of these components is most effective or whether the effects are combinatorial. Future research should assess the relative efficacy of these interventions alone and in combination to achieve the optimal effect in the most efficient manner possible. Selective combination of neuromuscular training components may provide additive effects, further reducing the risk of ACL injuries in female athletes. Additional research directions include the assessment of relative injury risk using mass neuromuscular screening, the development of more specific injury prevention protocols targeted toward high-risk athletes, and the determination of when these interventions should be implemented. It may be that prepubertal or early pubertal female athletes may have the potential to achieve optimal biomechanical changes and the greatest chance of injury-free sports participation throughout their careers. PMID:15742602

  12. Review of Burn Research for Year 2014.

    Science.gov (United States)

    Sen, Soman; Palmieri, Tina; Greenhalgh, David

    2015-01-01

    Management of burn injuries requires treatments and interventions from many disciplines. Worldwide, burn patients suffer from physical and psychological challenges that impact their lives socially and economically. In this review, we will highlight a handful of the numerous articles published in multiple areas of burn care. The areas of burn care addressed in the article are: epidemiology; burn resuscitation, critical care, and infection; nutrition and metabolism; pain and rehabilitation; prevention and firefighter safety; psychology; and reconstruction and wounds. PMID:26204384

  13. Xiayuxue decoction reduces renal injury by promoting macrophage apoptosis in hepatic cirrhotic rats.

    Science.gov (United States)

    Liu, C; Cai, J; Cheng, Z; Dai, X; Tao, L; Zhang, J; Xue, D

    2015-01-01

    Renal pathological changes in cirrhotic rat have not been extensively reported. The aim of this study was to investigate whether Xiayuxue decoction (XYXD) could attenuate renal injury induced by bile duct ligation (BDL), with special focus on the mechanisms promoting renal macrophage apoptosis. The rats were treated with BDL for 5 weeks and administered 0.36 g/kg XYXD intragastrically from day 1 of initiating BDL. Renal tissue was monitored by hematoxylin-eosin and Sirius red staining. Macrophage infiltration and proinflammatory cytokines such as tumor necrosis factor and chemokine ligand 2 were detected by quantitative polymerase chain reaction. Macrophage apoptosis was detected by double immunofluorescence staining. Blood urea nitrogen, creatinine, and glomerulus diameter increased significantly after a 5-week BDL treatment in XYXD (BDL-XYXD) rats. CD68 and pro-inflammatory cytokine mRNA increased in the kidneys of control (BDL-water) rats. Fluorescence microscopy analysis showed that XYXD promoted apoptosis in renal CD68+ macrophages. Collogen1 (Col 1), pro-fibrogenic cytokines, and α-smooth muscle actin in kidneys of BDL-water rats increased significantly compared to the sham group. XYXD inhibited Col 1 and pro-fibrotic factors in BDL-XYXD rats. Our results demonstrated that XYXD significantly reduced renal injury by, at least in part, promoting macrophage apoptosis in rats with damaged renal histopathology due to BDL-induced cirrhosis. PMID:26400305

  14. The problem of search safe and effective method in reducing injuries in bodybuilding stage of specialized basic training

    OpenAIRE

    Slavityak O.S.

    2014-01-01

    Purpose: To identify the most frequently used coaches and athletes in bodybuilding principles that can help to reduce the injuries of athletes while maintaining the progressivity results. Material : a survey participated 86 coaches and 120 athletes, bodybuilders from 5 to 8 years. Results : It was found that most of the coaches used in the course of employment principles generally accepted system of training. In such circumstances, the risk of injury to athletes is large enough. When using pr...

  15. Traffic calming policy can reduce inequalities in child pedestrian injuries: database study

    OpenAIRE

    Jones, S; Lyons, R.; John, A.; Palmer, S.

    2005-01-01

    Objectives: To determine whether area wide traffic calming distribution reflects known inequalities in child pedestrian injury rates. To determine whether traffic calming is associated with changes in childhood pedestrian injury rates.

  16. A novel safety mechanism to reduce the risk of inadvertent electrosurgical injury.

    Science.gov (United States)

    van Duren, Bernard Hendrik; van Boxel, Gijsbert Isaac; Hart, Alister; Newton, Nick

    2016-07-01

    Thousands of laparoscopic procedures requiring the use of electrosurgical devices are performed worldwide on a daily basis. The use of electrosurgery carries with it inherent risks related to the use of an energy source within the abdomen. Inadvertent tissue injury due to the use of electrosurgical devices is rare, but is associated with a high morbidity and mortality if undetected. This paper describes a novel, yet simple method using instrument markers and image processing algorithms to reduce the risk of unsafe activation of electrosurgical instruments during laparoscopy. The method was tested in a simulated environment and measured against the decision of an experienced laparoscopic surgeon. Results showed that the position of an instrument in a visual field could be accurately determined using an image processing algorithm to ascertain whether it was safe for activation in agreement with the decisions made by manual inspection. PMID:27097524

  17. Reducing the Indication for Ventilatory Support in the Severely Burned Patient: Results of a New Protocol Approach at a Regional Burn Center.

    Science.gov (United States)

    Gille, Jochen; Bauer, Nicole; Malcharek, Michael J; Dragu, Adrian; Sablotzki, Armin; Taha, Hischam; Czeslick, Elke

    2016-01-01

    Initial management of the severely injured routinely includes sedation and mechanical ventilatory support. However, nonjudiciously applied mechanical ventilatory support can itself lead to poorer patient outcomes. In an attempt to reduce this iatrogenic risk, a standardized, in-house, five-point protocol providing clinical guidance on the use and duration of ventilation was introduced and analyzed, and the impact on patient outcomes was assessed. In 2007, a protocol for early spontaneous breathing was introduced and established in clinical practice. This protocol included: 1) early extubation (≤6 hours after admission) in the absence of absolute ventilatory indication; 2) avoidance of "routine intubation" in spontaneously breathing patients; 3) early postoperative extubation, including patients requiring multiple surgical interventions; 4) intensive chest and respiratory physiotherapy with routine application of expectorants; and 5) early active mobilization. A retrospective clinical study compared patients (group A) over a 2-year period admitted under the new protocol with a historical patient group (group B). Patients in group A (n = 38) had fewer ventilator days over the time-course of treatment (3 [1; 5.8] vs 18.5 days [0.5; 20.5]; P = .0001) with a lower rate of tracheostomies (15.8 vs 54%; P = .0003). Patients on ventilation at admission in group A had shorter ventilation periods after admission (4.75 [4; 22.25] vs 378 hours [8.5; 681.5]; P = .0003), and 66.7% of these patients were extubated within 6 hours of admission (vs 9.1% in group B). No patients fulfilling the inclusion criteria required re- or emergency intubation. In the first 5 days of treatment, significantly lower Sequential Organ Failure Assessment scores were recorded in group A. There was also a trend for lower mortality rates (0 [0%] vs 6 [14%]), sepsis rates (24 [63.2%] vs 37 [88.1%]), and cumulative fluid balance on days 3 and 7 in group A. In contrast, group A demonstrated an elevated

  18. Epidemiology and Outcome of Chemical Burn Patients Admitted in Burn Unit of JNMC Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India: A 5-year Experience

    OpenAIRE

    Akhtar, Md Sohaib; Ahmad, Imran; Khurram, M. Fahud; Kanungo, Srikanta

    2015-01-01

    Aims and Objective: The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. Materials and Methods: A retrospective analysis was performed on all the patients with chemical burns admitted at author's center between November 2008 and December 2013. All the patients were evaluated in terms of age, sex, total body surface area, etiology, treatment given, morbidity, mo...

  19. [Major Burn Trauma Management and Nursing Care].

    Science.gov (United States)

    Lo, Shu-Fen

    2015-08-01

    Major burn injury is one of the most serious and often life-threatening forms of trauma. Burn patients not only suffer from the physical, psychological, social and spiritual impacts of their injury but also experience considerable changes in health-related quality of life. This paper presents a review of the literature on the implications of previous research and clinical care guidelines related to major burn injuries in order to help clinical practice nurses use evidence-based care guidelines to respond to initial injury assessments, better manage the complex systemic response to these injuries, and provide specialist wound care, emotional support, and rehabilitation services. PMID:26242439

  20. Epidemiological data, outcome, and costs of burn patients in Kermanshah

    OpenAIRE

    Karami Matin, B.; Karami Matin, R.; Ahmadi Joybari, T.; Ghahvehei, N.; M Haghi; M. Ahmadi; S. Rezaei

    2012-01-01

    Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned bod...

  1. Ankle Injuries: Reduce the Risk by Using a Soccer-Specific Warm-up Routine

    Science.gov (United States)

    Elliott, Steven; Ellis, Margery; Combs, Sue; Hunt Long, Lynn

    2015-01-01

    Injuries to the ankle are among the most common injuries for soccer players at any age. Soccer coaches should be aware of current research and best practices that suggest it is possible to decrease the incidence of soccer players' ankle injuries by providing an appropriate warm-up to utilize prior to practices and games. This article introduces…

  2. Inhalation Injury

    Directory of Open Access Journals (Sweden)

    Coşkun Araz

    2011-07-01

    Full Text Available Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three types of injury: thermal injury, which is mostly restricted to the upper airway; chemical injury, which affects tracheobronchial tree; and systemic toxicity owing to toxic gases such as carbon monoxide. Inhalation injury increases the burn injury associated morbidity and mortality by causing airway problems and respiratory failure during the early phase and by contributing to the development of pneumonia and atelectasis during the late phase. Additionally, systemic effects of toxic gases such as carbon monoxide may also adversely affect the early and long-term outcome in burn victims. The early diagnosis and therapy of these problems plays a key role in improving the outcome of burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 37-45

  3. Simvastatin reduces endotoxin-induced acute lung injury by decreasing neutrophil recruitment and radical formation.

    Directory of Open Access Journals (Sweden)

    Jochen Grommes

    Full Text Available INTRODUCTION: Treatment of acute lung injury (ALI remains an unsolved problem in intensive care medicine. As simvastatin exerts protective effects in inflammatory diseases we explored its effects on development of ALI and due to the importance of neutrophils in ALI also on neutrophil effector functions. METHODS: C57Bl/6 mice were exposed to aerosolized LPS (500 µg/ml for 30 min. The count of alveolar, interstitial, and intravasal neutrophils were assessed 4 h later by flow cytometry. Lung permeability changes were assessed by FITC-dextran clearance and albumin content in the BAL fluid. In vitro, we analyzed the effect of simvastatin on neutrophil adhesion, degranulation, apoptosis, and formation of reactive oxygen species. To monitor effects of simvastatin on bacterial clearance we performed phagocytosis and bacterial killing studies in vitro as well as sepsis experiments in mice. RESULTS: Simvastatin treatment before and after onset of ALI reduces neutrophil influx into the lung as well as lung permeability indicating the protective role of simvastatin in ALI. Moreover, simvastatin reduces the formation of ROS species and adhesion of neutrophils without affecting apoptosis, bacterial phagocytosis and bacterial clearance. CONCLUSION: Simvastatin reduces recruitment and activation of neutrophils hereby protecting from LPS-induced ALI. Our results imply a potential role for statins in the management of ALI.

  4. Prognosis and treatment of burns.

    OpenAIRE

    Mann, R; Heimbach, D

    1996-01-01

    Survival rates for burn patients in general have improved markedly over the past several decades. The development of topical antibiotic therapy for burn wounds, the institution of the practice of early excision and grafting, and major advances in intensive care management have all contributed to this success. In this review we address these 3 important advances in the modern treatment of burn injuries and provide a brief historical overview of these accomplishments and others, emphasizing spe...

  5. BACTERIOLOGICAL STUDY OF BURNS INFECTION

    OpenAIRE

    Shareen; Basavarajappa; Hanumanthappa

    2015-01-01

    A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1) OBJECTIVE : The present study was therefore undertaken to isolate and identify the a...

  6. Lactobacillus rhamnosus GG reduces hepatic TNFα production and inflammation in chronic alcohol-induced liver injury.

    Science.gov (United States)

    Wang, Yuhua; Liu, Yanlong; Kirpich, Irina; Ma, Zhenhua; Wang, Cuiling; Zhang, Min; Suttles, Jill; McClain, Craig; Feng, Wenke

    2013-09-01

    The therapeutic effects of probiotic treatment in alcoholic liver disease (ALD) have been studied in both patients and experimental animal models. Although the precise mechanisms of the pathogenesis of ALD are not fully understood, gut-derived endotoxin has been postulated to play a crucial role in hepatic inflammation. Previous studies have demonstrated that probiotic therapy reduces circulating endotoxin derived from intestinal gram-negative bacteria in ALD. In this study, we investigated the effects of probiotics on hepatic tumor necrosis factor-α (TNFα) production and inflammation in response to chronic alcohol ingestion. Mice were fed Lieber DeCarli liquid diet containing 5% alcohol for 8weeks, and Lactobacillus rhamnosus GG (LGG) was supplemented in the last 2 weeks. Eight-week alcohol feeding caused a significant increase in hepatic inflammation as shown by histological assessment and hepatic tissue myeloperoxidase activity assay. Two weeks of LGG supplementation reduced hepatic inflammation and liver injury and markedly reduced TNFα expression. Alcohol feeding increased hepatic mRNA expression of Toll-like receptors (TLRs) and CYP2E1 and decreased nuclear factor erythroid 2-related factor 2 expression. LGG supplementation attenuated these changes. Using human peripheral blood monocytes-derived macrophages, we also demonstrated that incubation with ethanol primes both lipopolysaccharide- and flagellin-induced TNFα production, and LGG culture supernatant reduced this induction in a dose-dependent manner. In addition, LGG treatment also significantly decreased alcohol-induced phosphorylation of p38 MAP kinase. In conclusion, probiotic LGG treatment reduced alcohol-induced hepatic inflammation by attenuation of TNFα production via inhibition of TLR4- and TLR5-mediated endotoxin activation. PMID:23618528

  7. Berberine Attenuates Myocardial Ischemia/Reperfusion Injury by Reducing Oxidative Stress and Inflammation Response: Role of Silent Information Regulator 1

    Directory of Open Access Journals (Sweden)

    Liming Yu

    2016-01-01

    Full Text Available Berberine (BBR exerts potential protective effect against myocardial ischemia/reperfusion (MI/R injury. Activation of silent information regulator 1 (SIRT1 signaling attenuates MI/R injury by reducing oxidative damage and inflammation response. This study investigated the antioxidative and anti-inflammatory effects of BBR treatment in MI/R condition and elucidated its potential mechanisms. Sprague-Dawley rats were treated with BBR in the absence or presence of the SIRT1 inhibitor sirtinol (Stnl and then subjected to MI/R injury. BBR conferred cardioprotective effects by improving postischemic cardiac function, decreasing infarct size, reducing apoptotic index, diminishing serum creatine kinase and lactate dehydrogenase levels, upregulating SIRT1, Bcl-2 expressions, and downregulating Bax and caspase-3 expressions. Stnl attenuated these effects by inhibiting SIRT1 signaling. BBR treatment also reduced myocardium superoxide generation, gp91phox expression, malondialdehyde (MDA level, and cardiac inflammatory markers and increased myocardium superoxide dismutase (SOD level. However, these effects were also inhibited by Stnl. Consistently, BBR conferred similar antioxidative and anti-inflammatory effects against simulated ischemia reperfusion injury in cultured H9C2 cardiomyocytes. SIRT1 siRNA administration also abolished these effects. In summary, our results demonstrate that BBR significantly improves post-MI/R cardiac function recovery and reduces infarct size against MI/R injury possibly due to its strong antioxidative and anti-inflammatory activity. Additionally, SIRT1 signaling plays a key role in this process.

  8. Rosiglitazone ameliorates diffuse axonal injury by reducing loss of tau and up-regulating caveolin-1 expression

    Directory of Open Access Journals (Sweden)

    Yong-lin Zhao

    2016-01-01

    Full Text Available Rosiglitazone up-regulates caveolin-1 levels and has neuroprotective effects in both chronic and acute brain injury. Therefore, we postulated that rosiglitazone may ameliorate diffuse axonal injury via its ability to up-regulate caveolin-1, inhibit expression of amyloid-beta precursor protein, and reduce the loss and abnormal phosphorylation of tau. In the present study, intraperitoneal injection of rosiglitazone significantly reduced the levels of amyloid-beta precursor protein and hyperphosphorylated tau (phosphorylated at Ser 404 (p-tau (S 404 , and it increased the expression of total tau and caveolin-1 in the rat cortex. Our results show that rosiglitazone inhibits the expression of amyloid-beta precursor protein and lowers p-tau (S 404 levels, and it reduces the loss of total tau, possibly by up-regulating caveolin-1. These actions of rosiglitazone may underlie its neuroprotective effects in the treatment of diffuse axonal injury.

  9. The problem of search safe and effective method in reducing injuries in bodybuilding stage of specialized basic training

    Directory of Open Access Journals (Sweden)

    Slavityak O.S.

    2014-11-01

    Full Text Available Purpose: To identify the most frequently used coaches and athletes in bodybuilding principles that can help to reduce the injuries of athletes while maintaining the progressivity results. Material : a survey participated 86 coaches and 120 athletes, bodybuilders from 5 to 8 years. Results : It was found that most of the coaches used in the course of employment principles generally accepted system of training. In such circumstances, the risk of injury to athletes is large enough. When using pre-exhaustion principle to increase the intensity of the training process increases the risk of overloading the body athletes. Conclusions : Athletes with a longer training experience (about 8 years, more likely to use the principle of prior exhaustion. In this case athletes try using this principle to reduce the operating parameters of volume load. This helps to reduce the level of injury and maintain positive dynamics performance.

  10. Rosiglitazone ameliorates diffuse axonal injury by reducing loss of tau and up-regulating caveolin-1 expression

    Science.gov (United States)

    Zhao, Yong-lin; Song, Jin-ning; Ma, Xu-dong; Zhang, Bin-fei; Li, Dan-dong; Pang, Hong-gang

    2016-01-01

    Rosiglitazone up-regulates caveolin-1 levels and has neuroprotective effects in both chronic and acute brain injury. Therefore, we postulated that rosiglitazone may ameliorate diffuse axonal injury via its ability to up-regulate caveolin-1, inhibit expression of amyloid-beta precursor protein, and reduce the loss and abnormal phosphorylation of tau. In the present study, intraperitoneal injection of rosiglitazone significantly reduced the levels of amyloid-beta precursor protein and hyperphosphorylated tau (phosphorylated at Ser404(p-tau (S404)), and it increased the expression of total tau and caveolin-1 in the rat cortex. Our results show that rosiglitazone inhibits the expression of amyloid-beta precursor protein and lowers p-tau (S404) levels, and it reduces the loss of total tau, possibly by up-regulating caveolin-1. These actions of rosiglitazone may underlie its neuroprotective effects in the treatment of diffuse axonal injury.

  11. Accumulative eschar after burn.

    Science.gov (United States)

    Ma, Fushun

    2016-02-01

    Eschar formation is a potential sequela of burn injuries. Definitive management may include escharectomy and eschar debridement. After eschar removal, the wound can be covered with a skin graft or reepithelialization. For prolonged refractory eschar on the fingertips, topical use of rb-bFGF after debridement can achieve an optimal outcome. PMID:26862412

  12. Accumulative eschar after burn

    OpenAIRE

    Ma, Fushun

    2015-01-01

    Key Clinical Message Eschar formation is a potential sequela of burn injuries. Definitive management may include escharectomy and eschar debridement. After eschar removal, the wound can be covered with a skin graft or reepithelialization. For prolonged refractory eschar on the fingertips, topical use of rb‐bFGF after debridement can achieve an optimal outcome.

  13. Building resilience in burns nurses: a descriptive phenomenological inquiry.

    Science.gov (United States)

    Kornhaber, Rachel Anne; Wilson, Anne

    2011-01-01

    The purpose of this qualitative study was to explore the concept of building resilience as a strategy for responding to adversity experienced by burns nurses. Nurses who care for patients with severe burn injury are often exposed to patients' pain and disfigurement, encountering emotional exhaustion, distress, reduced self-esteem, and desensitization to pain. Resilience has been identified as an essential characteristic for nurses in their work environment. Resilience assists nurses to bounce back and to cope in the face of adversity, sustaining them through difficult and challenging working environments. Nonetheless, there remains limited information that addresses the concept of building resilience in burns nurses. In 2009, seven burns nurses were recruited from a severe burn injury unit in New South Wales, Australia. A qualitative phenomenological methodology was used to construct themes depicting nurses' experiences. Participants were selected through purposeful sampling, and data were collected through in-depth individual semistructured interviews using open-ended questions. Data were analyzed with Colaizzi's phenomenological method of data analysis. The concept of building resilience as a strategy for coping with adversity was identified and organized into six categories: toughening up, natural selection, emotional toughness, coping with the challenges, regrouping and recharging, and emotional detachment. The findings clearly demonstrate that it is vital for burns nurses to build resilience to endure the emotional trauma of nursing patients with severe burn injury. Knowledge about building resilience could be incorporated into nursing education for both undergraduate and experienced nurses. Building resilience within the domain of burns nursing has the potential to retain nurses within the profession, having implications for staff development, orientation, and retention. PMID:21747335

  14. Coal-burning endemic fluorosis is associated with reduced activity in antioxidative enzymes and Cu/Zn-SOD gene expression.

    Science.gov (United States)

    Wang, Qi; Cui, Kang-ping; Xu, Yuan-yuan; Gao, Yan-ling; Zhao, Jing; Li, Da-sheng; Li, Xiao-lei; Huang, Hou-jin

    2014-02-01

    To study the effect of fluorine on the oxidative stress in coal-burning fluorosis, we investigated the environmental characteristics of coal-burning endemic fluorosis combined with fluorine content surveillance in air, water, food, briquette, and clay binder samples from Bijie region, Guizhou Province, southwest of China. The activities of antioxidant enzymes including copper/zinc superoxide dismutase (Cu/Zn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and level of lipid peroxidation such as malondialdehyde (MDA) were measured in serum samples obtained from subjects residing in the Bijie region. Expression of the Cu/Zn-SOD gene was assessed by quantitative reverse transcriptase PCR (qRT-PCR). Our results showed that people suffering from endemic fluorosis (the high and low exposure groups) had much higher MDA level. Their antioxidant enzyme activities and Cu/Zn-SOD gene expression levels were lower when compared to healthy people (the control group). Fluorosis can decrease the activities of antioxidant enzymes, which was associated with exposure level of fluorine. Down-regulation of Cu/Zn-SOD expression may play an important role in the aggravation of oxidative stress in endemic fluorosis. PMID:23567976

  15. Reducir la secuela en una quemadura doméstica Reducing the effect of a domestic burn

    Directory of Open Access Journals (Sweden)

    R. Fernando García González

    2008-03-01

    Full Text Available En la actualidad y en nuestro medio, las quemaduras domésticas son una de las lesiones más habituales, y en las que mejor podemos iniciar un programa de prevención progresivo. Las más comunes son las escaldaduras -debido al contacto accidental con líquidos o gases calientes- y las producidas por la acción directa de las llamas. Las consecuencias van desde el dolor, la deshidratación, las secuelas físicas con repercusiones psíquicas hasta, en ocasiones, la muerte. Ante un paciente con quemaduras es prioritario y esencial llevar a cabo una minuciosa y adecuada valoración inicial que incluya: grado de la lesión (profundidad, extensión (porcentaje de superficie corporal total quemada, zona anatómica afectada y estado general del paciente (edad, estado inmunológico, nutricional, respiratorio, circulatorio, etc., para así poder planificar los cuidados adecuados. En el presente trabajo describimos el caso de una mujer de 62 años que sufre quemaduras de primer grado y segundo grado superficial y profundo en cuello, ambas mamas y abdomen mientras manipulaba una olla a presión, con una extensión de un 6% de SCTA (Superficie Corporal Total Afectada. Se expone todo el proceso de valoración de la paciente y su correspondiente plan de cuidados, detallando los distintos tratamientos locales en función de la evolución de las lesiones, así como las medidas preventivas para minimizar las posibles complicaciones físicas y psíquicas derivadas de la aparición de cicatrices hipertróficas.Actually, in our environment, domestic burns are one of the more frequent lesions, and we can start a progressive prevention program in a better way on these ones. The more common of them are scalds -due to an accidental contact with hot liquids or gas- and those ones produced because of the direct action of flames. The consequences go from pain, dehydration, physical sequels with psychical repercussions to, sometimes, death. In the presence of a patient

  16. Hypoxia-induced neuroinflammatory white-matter injury reduced by minocycline in SHR/SP

    Science.gov (United States)

    Jalal, Fakhreya Y; Yang, Yi; Thompson, Jeffrey F; Roitbak, Tamara; Rosenberg, Gary A

    2015-01-01

    Hypertensive small vessel disease is a major cause of vascular cognitive impairment (VCI). Spontaneously hypertensive/stroke prone rats (SHR/SP) with unilateral carotid artery occlusion (UCAO) and a Japanese permissive diet (JPD) have white-matter (WM) damage similar to that seen in VCI. We hypothesized that WM injury was due to hypoxia-mediated, blood–brain barrier (BBB) disruption. Twelve-week-old SHR/SP had UCAO/JPD and were studied with immunohistochemistry, biochemistry, multimodal magnetic resonance imaging (MRI), and Morris water maze (MWM) testing. One week after UCAO/JPD, WM showed a significant increase in hypoxia inducible factor-1α (HIF-1α), which increased further by 3 weeks. Prolyl hydroxylase-2 (PHD2) expression decreased at 1 and 3 weeks. Infiltrating T cells and neutrophils appeared around endothelial cells from 1 to 3 weeks after UCAO/JPD, and matrix metalloproteinase-9 (MMP-9) colocalized with inflammatory cells. At 3 weeks, WM immunostained for IgG, indicating BBB leakage. Minocycline (50 mg/kg intraperitoeally) was given every other day from weeks 12 to 20. Multimodal MRI showed that treatment with minocycline significantly reduced lesion size and improved cerebral blood flow. Minocycline improved performance in the MWM and prolonged survival. We propose that BBB disruption occurred secondary to hypoxia, which induced an MMP-9-mediated infiltration of leukocytes. Minocycline significantly reduced WM damage, improved behavior, and prolonged life. PMID:25712499

  17. Protective effects of drag-reducing polymers on ischemic reperfusion injury of isolated rat heart.

    Science.gov (United States)

    Hu, Feng; Wang, Yali; Gong, Kaizheng; Ge, Gaoyuan; Cao, Mingqiang; Zhao, Pei; Sun, Xiaoning; Zhang, Zhengang

    2016-01-01

    Drag-reducing polymers (DRPs) are blood-soluble macromolecules that can increase blood flow and reduce vascular resistance. The purpose of the present study was to observe the effect of DRPs on ischemic reperfusion (I/R) injury of isolated rat hearts. Experiments were performed on isolated rat hearts subjected to 30 min of ischemia followed by 90 min of reperfusion in Langendorff preparations. Adult Wistar rats were divided into the following five groups: control group, I/R group, group III (I/R and 2×10(-7)  g/ml PEO reperfusion), group IV (I/R and 1×10(-6)  g/ml PEO reperfusion), and group V (I/R and 5×10(-6)  g/ml PEO reperfusion). Left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), maximum rate of ventricular pressure increase and decrease ( ± dp/dtmax), heart rate (HR) and coronary flow were measured. Lactate dehydrogenase (LDH) and creatine kinase (CK) activity and coronary flow, myocardial infarction size and cardiomyocytes apoptosis were also assayed. Our results showed that PEO decreased LVEDP and increased LVSP, ± dP/dtmax in group IV and group V compared with the I/R group (all P rat hearts and it may offer a new potential approach for the treatment of acute ischemic heart diseases. PMID:25633566

  18. Xuebijing injection reduces organ injuries and improves survival by attenuating inflammatory responses and endothelial injury in heatstroke mice

    OpenAIRE

    Xu, Qiulin; Liu, Jingxian; Guo, Xiaohua; Tang, Youqing; Zhou, Gengbiao; Liu, Yanan; Huang, Qiaobing; Geng, Yan; Liu, Zhifeng; Su, Lei

    2015-01-01

    Background The pathogenesis of heatstroke is a multi-factorial process involved with an interplay among subsequent inflammation, endothelial injury and coagulation disturbances, which makes pharmacological therapy of heatstroke a challenging problem. Xuebijing injection (XBJ), a traditional Chinese medicine used to sepsis, has been reported to suppress inflammatory responses and restore coagulation disturbances. However, little is known about the role of XBJ in heatstroke. Methods Mice were t...

  19. PhTx3-4, a Spider Toxin Calcium Channel Blocker, Reduces NMDA-Induced Injury of the Retina

    Directory of Open Access Journals (Sweden)

    Nancy Scardua Binda

    2016-03-01

    Full Text Available The in vivo neuroprotective effect of PhTx3-4, a spider toxin N-P/Q calcium channel blocker, was studied in a rat model of NMDA-induced injury of the retina. NMDA (N-Methyl-d-Aspartate-induced retinal injury in rats reduced the b-wave amplitude by 62% ± 3.6%, indicating the severity of the insult. PhTx3-4 treatment increased the amplitude of the b-wave, which was almost equivalent to the control retinas that were not submitted to injury. The PhTx3-4 functional protection of the retinas recorded on the ERG also was observed in the neuroprotection of retinal cells. NMDA-induced injury reduced live cells in the retina layers and the highest reduction, 84%, was in the ganglion cell layer. Notably, PhTx3-4 treatment caused a remarkable reduction of dead cells in the retina layers, and the highest neuroprotective effect was in the ganglion cells layer. NMDA-induced cytotoxicity of the retina increased the release of glutamate, reactive oxygen species (ROS production and oxidative stress. PhTx3-4 treatment reduced glutamate release, ROS production and oxidative stress measured by malondialdehyde. Thus, we presented for the first time evidence of in vivo neuroprotection from NMDA-induced retinal injury by PhTx3-4 (-ctenitoxin-Pn3a, a spider toxin that blocks N-P/Q calcium channels.

  20. Burn prevention mechanisms and outcomes: pitfalls, failures and successes.

    Science.gov (United States)

    Atiyeh, Bishara S; Costagliola, Michel; Hayek, Shady N

    2009-03-01

    Burns are responsible for significant mortality and morbidity worldwide and are among the most devastating of all injuries, with outcomes spanning the spectrum from physical impairments and disabilities to emotional and mental consequences. Management of burns and their sequelae even in well-equipped, modern burn units of advanced affluent societies remains demanding and extremely costly. Undoubtedly, in most low and middle income countries (LMICs) with limited resources and inaccessibility to sophisticated skills and technologies, the same standard of care is obviously not possible. Unfortunately, over 90% of fatal fire-related burns occur in developing or LMICs with South-East Asia alone accounting for over half of these fire-related deaths. If burn prevention is an essential part of any integrated burn management protocol anywhere, focusing on burn prevention in LMICs rather than treatment cannot be over-emphasized where it remains the major and probably the only available way of reducing the current state of morbidity and mortality. Like other injury mechanisms, the prevention of burns requires adequate knowledge of the epidemiological characteristics and associated risk factors, it is hence important to define clearly, the social, cultural and economic factors, which contribute to burn causation. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs) such as the United States due to sustained research on the epidemiology and risk factors, the same cannot be said for many LMICs. Many health authorities, agencies, corporations and even medical personnel in LMICs consider injury prevention to have a much lower priority than disease prevention for understandable reasons. Consequently, burns prevention programmes fail to receive the government funding that they deserve. Prevention programmes need to be executed with patience, persistence, and precision, targeting high

  1. Bubble bath burns: an unusual case.

    Science.gov (United States)

    Nizamoglu, Metin; Tan, Alethea; El-Muttardi, Naguib

    2016-01-01

    We present an unusual case of flash burn injury in an adolescent following accidental combination of foaming bath bubbles and tea light candle flame. There has not been any reported similar case described before. This serves as a learning point for public prevention and clinicians managing burn injuries. PMID:27583271

  2. Skin Dendritic Cells in Burn Patients

    OpenAIRE

    D’Arpa, N.; D’Amelio, L.; Accardo-Palumbo, A.; Pileri, D.; Mogavero, R.; Amato, G.; Napoli, B.; Alessandro, G.; Lombardo, C.; F. Conte

    2009-01-01

    The body's immunological response to burn injury has been a subject of great inquiry in recent years. Burn injury disturbs the immune system, resulting in a progressive suppression of the immune response that is thought to contribute to the development of sepsis. Dendritic cells (DCs) are potent antigen-presenting cells that possess the ability to stimulate naïve T cells.

  3. CD11d integrin blockade reduces the systemic inflammatory response syndrome after spinal cord injury

    OpenAIRE

    Bao, Feng; Brown, Arthur; Dekaban, Gregory A.; Omana, Vanessa; Weaver, Lynne C.

    2011-01-01

    Traumatic injury to the spinal cord triggers a systemic inflammatory response syndrome (SIRS), in which inflammatory cells from the circulation invade organs such as the liver, lung and kidney, leading to damage of these organs. Our previous study (Gris, et al, Exp. Neurol, 2008) demonstrated that spinal cord injury (SCI) activates circulating neutrophils that then invade the lung and kidney from 2 to 24 h after injury, increasing myeloperoxidase activity, cyclooxygenase-2 and matrix metallop...

  4. A CD11d monoclonal antibody treatment reduces tissue injury and improves neurological outcome after fluid percussion brain injury in rats.

    Science.gov (United States)

    Bao, Feng; Shultz, Sandy R; Hepburn, Jeff D; Omana, Vanessa; Weaver, Lynne C; Cain, Donald P; Brown, Arthur

    2012-09-20

    Traumatic brain injury (TBI) is an international health concern often resulting in chronic neurological abnormalities, including cognitive deficits, emotional disturbances, and motor impairments. An anti-CD11d monoclonal antibody that blocks the CD11d/CD18 integrin and vascular cell adhesion molecule (VCAM)-1 interaction following experimental spinal cord injury improves functional recovery, while reducing the intraspinal number of neutrophils and macrophages, oxidative activity, and tissue damage. Since the mechanisms of secondary injury in the brain and spinal cord are similar, we designed a study to evaluate fully the effects of anti-CD11d treatment after a moderate lateral fluid percussion TBI in the rat. Rats were treated at 2 h after TBI with either the anti-CD11d antibody or an isotype-matched control antibody 1B7, and both short (24- to 72-h) and long (4-week) recovery periods were examined. The anti-CD11d integrin treatment reduced neutrophil and macrophage levels in the injured brain, with concomitant reductions in lipid peroxidation, astrocyte activation, amyloid precursor protein accumulation, and neuronal loss. The reduced neuroinflammation seen in anti-CD11d-treated rats correlated with improved performance on a number of behavioral tests. At 24 h, the anti-CD11d group performed significantly better than the 1B7 controls on several water maze measures of spatial cognition. At 4 weeks post-injury the anti-CD11d-treated rats had better sensorimotor function as assessed by the beam task, and reduced anxiety-like behaviors, as evidenced by elevated-plus maze testing, compared to 1B7 controls. These findings suggest that neuroinflammation is associated with behavioral deficits after TBI, and that anti-CD11d antibody treatment is a viable strategy to improve neurological outcomes after TBI. PMID:22676851

  5. Acute Lung Injury Is Reduced in fat-1 Mice Endogenously Synthesizing n-3 Fatty Acids

    Science.gov (United States)

    Mayer, Konstantin; Kiessling, Almuth; Ott, Juliane; Schaefer, Martina Barbara; Hecker, Matthias; Henneke, Ingrid; Schulz, Richard; Günther, Andreas; Wang, Jingdong; Wu, Lijun; Roth, Joachim; Seeger, Werner; Kang, Jing X.

    2009-01-01

    Rationale: Acute lung injury (ALI) remains an important cause of mortality in intensive care units. Inflammation is controlled by cytokines and eicosanoids derived from the n-6 fatty acid (FA) arachidonic acid (AA). The n-3 FA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and mediators derived from EPA and DHA possess reduced inflammatory potency. Objectives: To determine whether the ability of fat-1 mice to endogenously convert n-6 to n-3 FA, and thus generate an increased ratio of n-3 to n-6 FA, impacts experimental ALI. Methods: We investigated ALI induced by intratracheal instillation of endotoxin in fat-1 and wild-type (WT) mice, assessing leukocyte numbers, protein concentration, and prostaglandin and cytokine levels in bronchoalveolar lavage fluid, as well as free FA in plasma, and lung ventilator compliance. Body temperature and motor activity of mice—markers of sickness behavior—were also recorded. Measurements and Main Results: In ALI, fat-1 mice exhibited significantly reduced leukocyte invasion, protein leakage, and macrophage inflammatory protein-2 and thromboxane B2 levels in lavage fluid compared with WT mice. Free AA levels were increased in the plasma of WT mice in response to endotoxin, whereas EPA and DHA were increased in the fat-1 group. Ventilator compliance was significantly improved in fat-1 mice. Body temperature and motor activity were decreased in ALI. fat-1 Mice recovered body temperature and motor activity faster. Conclusions: fat-1 Mice exhibited reduced features of ALI and sickness behavior. Increasing the availability of n-3 FA may thus be beneficial in critically ill patients with ALI. PMID:19136374

  6. Benefits of reducing prenatal exposure to coal-burning pollutants to children's neurodevelopment in China

    Energy Technology Data Exchange (ETDEWEB)

    Perera, F.; Li, T.Y.; Zhou, Z.J.; Yuan, T.; Chen, Y.H.; Qu, L.R.; Rauh, V.A.; Zhang, Y.G.; Tang, D.L. [Columbia University, New York, NY (United States). Dept. of Environmental Health Science

    2008-10-15

    Coal burning provides 70% of the energy for China's industry and power, but releases large quantities of polycyclic aromatic hydrocarbons (PAHs) and other pollutants. PAHs are reproductive and developmental toxicants, mutagens, and carcinogens. We evaluated the benefit to neurobehavioral development from the closure of a coal-fired power plant that was the major local source of ambient PAHs. The research was conducted in Tongliang, Chongqing, China, where a coal-fired power plant operated seasonally before it was shut down in May 2004. Two identical prospective cohort studies enrolled nonsmoking women and their newborns in 2002 (before shutdown) and 2005 (after shutdown). Prenatal PAH exposure was measured by PAH-DNA adducts (benzo(a)pyrene-DNA) in umbilical cord blood. Child development was assessed by the Gesell Developmental Schedules at 2 years of age. Prenatal exposure to other neurotoxicants and potential confounders (including lead, mercury, and environmental tobacco smoke) was measured. We compared the cohorts regarding the association between PAH-DNA adduct levels and neurodevelopmental outcomes. Significant associations previously seen in 2002 between elevated adducts and decreased motor area developmental quotient (DQ) (p = 0.043) and average DQ (p = 0.047) were not observed in the 2005 cohort (p = 0.546 and p = 0.146). However, the direction of the relationship did not change. The findings indicate that neurobehavioral development in Tongliang children benefitedby elimination of PAH exposure from the coal-burning plant, consistent with the significant reduction in PAH-DNA adducts in cord blood of children in the 2005 cohort. The results have implications for children's environmental health in China and elsewhere.

  7. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

    Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

  8. Epidemiology of paediatric burns in Iran

    OpenAIRE

    Karimi, H.; Montevalian, A.; Motabar, A.R.; Safari, R.; Parvas, M.S.; Vasigh, M.

    2012-01-01

    We surveyed the epidemiology of the patients in a tertiary burn care centre (the Motahari Burn Hospital) in Tehran in the 4-yr period 2005-2009. Scalding was the major cause of burn injury for patients under the age of 6, while there were many more flame and electrical burns in late childhood. Males were mainly affected (male to female ratio, 1.7:1). Most burns occurred in the summer, probably due to older children’s increased outdoor activities during school vacations. Most of the injuries t...

  9. [Burns care following a nuclear incident].

    Science.gov (United States)

    Bargues, L; Donat, N; Jault, P; Leclerc, T

    2010-09-30

    Radiation injuries are usually caused by radioactive isotopes in industry. Detonations of nuclear reactors, the use of military nuclear weapons, and terrorist attacks represent a risk of mass burn casualties. Ionizing radiation creates thermal burns, acute radiation syndrome with pancytopenia, and a delayed cutaneous syndrome. After a latency period, skin symptoms appear and the depth of tissue damages increase with dose exposure. The usual burn resuscitation protocols have to be applied. Care of these victims also requires assessment of the level of radiation, plus decontamination by an experienced team. In nuclear disasters, the priority is to optimize the available resources and reserve treatment to patients with the highest probability of survival. After localized nuclear injury, assessment of burn depth and surgical techniques of skin coverage are the main difficulties in a burn centre. Training in medical facilities and burn centres is necessary in the preparation for management of the different types of burn injuries. PMID:21991218

  10. Seasonal trends in reduced leaf gas exchange and ozone-induced foliar injury in three ozone sensitive woody plant species

    International Nuclear Information System (INIS)

    Seasonal trends in leaf gas exchange and ozone-induced visible foliar injury were investigated for three ozone sensitive woody plant species. Seedlings of Populus nigra L., Viburnum lantana L., and Fraxinus excelsior L. were grown in charcoal-filtered chambers, non-filtered chambers and open plots. Injury assessments and leaf gas exchange measurements were conducted from June to October during 2002. All species developed typical ozone-induced foliar injury. For plants exposed to non-filtered air as compared to the charcoal-filtered air, mean net photosynthesis was reduced by 25%, 21%, and 18% and mean stomatal conductance was reduced by 25%, 16%, and 8% for P. nigra, V. lantana, and F. excelsior, respectively. The timing and severity of the reductions in leaf gas exchange were species specific and corresponded to the onset of visible foliar injury. - Reductions in leaf gas exchange corresponded to the onset of ozone-induced visible foliar injury for seedlings exposed to ambient ozone exposures

  11. Seasonal trends in reduced leaf gas exchange and ozone-induced foliar injury in three ozone sensitive woody plant species

    Energy Technology Data Exchange (ETDEWEB)

    Novak, K. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland)]. E-mail: kristopher.novak@wsl.ch; Schaub, M. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland); Fuhrer, J. [Swiss Federal Research Station for Agroecology and Agriculture FAL, 8046 Zurich (Switzerland); Skelly, J.M. [Department of Plant Pathology, The Pennsylvania State University, University Park, PA 16802 (United States); Hug, C. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland); Landolt, W. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland); Bleuler, P. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland); Kraeuchi, N. [Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903 Birmensdorf (Switzerland)

    2005-07-15

    Seasonal trends in leaf gas exchange and ozone-induced visible foliar injury were investigated for three ozone sensitive woody plant species. Seedlings of Populus nigra L., Viburnum lantana L., and Fraxinus excelsior L. were grown in charcoal-filtered chambers, non-filtered chambers and open plots. Injury assessments and leaf gas exchange measurements were conducted from June to October during 2002. All species developed typical ozone-induced foliar injury. For plants exposed to non-filtered air as compared to the charcoal-filtered air, mean net photosynthesis was reduced by 25%, 21%, and 18% and mean stomatal conductance was reduced by 25%, 16%, and 8% for P. nigra, V. lantana, and F. excelsior, respectively. The timing and severity of the reductions in leaf gas exchange were species specific and corresponded to the onset of visible foliar injury. - Reductions in leaf gas exchange corresponded to the onset of ozone-induced visible foliar injury for seedlings exposed to ambient ozone exposures.

  12. Rosuvastatin reduces neointima formation in a rat model of balloon injury

    Directory of Open Access Journals (Sweden)

    Preusch MR

    2010-11-01

    Full Text Available Abstract Background Processes of restenosis, following arterial injury, are complex involving different cell types producing various cytokines and enzymes. Among those enzymes, smooth muscle cell-derived matrix metalloproteinases (MMPs are thought to take part in cell migration, degrading of extracellular matrix, and neointima formation. MMP-9, also known as gelatinase B, is expressed immediately after vascular injury and its expression and activity can be inhibited by statins. Using an established in vivo model of vascular injury, we investigated the effect of the HMG-CoA reductase inhibitor rosuvastatin on MMP-9 expression and neointima formation. Materials and methods 14-week old male Sprague Dawley rats underwent balloon injury of the common carotid artery. Half of the animals received rosuvastatin (20 mg/kg body weight/day via oral gavage, beginning 3 days prior to injury. Gelatinase activity and neointima formation were analyzed 3 days and 14 days after balloon injury, respectively. 14 days after vascular injury, proliferative activity was assessed by staining for Ki67. Results After 14 days, animals in the rosuvastatin group showed a decrease in total neointima formation (0.194 ± 0.01 mm2 versus 0.124 ± 0.02 mm2, p Conclusions Rosuvastatin attenuates neointima formation without affecting early MMP-9 activity in a rat model of vascular injury.

  13. Performance-based regulation: enterprise responsibility for reducing death, injury, and disease caused by consumer products.

    Science.gov (United States)

    Sugarman, Stephen D

    2009-12-01

    This article offers a bold new idea for confronting the staggering level of death, injury, and disease caused by five consumer products: cigarettes, alcohol, guns, junk food, and motor vehicles. Business leaders try to frame these negative outcomes as "collateral damage" that is someone else's problem. That framing not only is morally objectionable but also overlooks the possibility that, with proper prodding, industry could substantially lessen these public health disasters. I seek to reframe the public perception of who is responsible and propose to deploy a promising approach called "performance-based regulation" to combat the problem. Performance-based regulation would impose on manufacturers a legal obligation to reduce the negative social costs of their products. Rather than involving them in litigation or forcing them to operate differently (as "command-and-control" regimes do), performance-based regulation allows the firms to determine how best to decrease bad public health consequences. Like other public health strategies, performance-based regulation focuses on those who are far more likely than individual consumers to achieve real gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good. PMID:20018990

  14. Severe Calorie Restriction Reduces Cardiometabolic Risk Factors and Protects Rat Hearts from Ischemia/Reperfusion Injury

    Science.gov (United States)

    Melo, Dirceu S.; Costa-Pereira, Liliane V.; Santos, Carina S.; Mendes, Bruno F.; Costa, Karine B.; Santos, Cynthia Fernandes F.; Rocha-Vieira, Etel; Magalhães, Flávio C.; Esteves, Elizabethe A.; Ferreira, Anderson J.; Guatimosim, Sílvia; Dias-Peixoto, Marco F.

    2016-01-01

    Background and Aims: Recent studies have proposed that if a severe caloric restriction (SCR) is initiated at the earliest period of postnatal life, it can lead to beneficial cardiac adaptations later on. We investigated the effects of SCR in Wistar rats from birth to adult age on risk factors for cardiac diseases (CD), as well as cardiac function, redox status, and HSP72 content in response to ischemia/reperfusion (I/R) injury. Methods and Results: From birth to the age of 3 months, CR50 rats were fed 50% of the food that the ad libitum group (AL) was fed. Food intake was assessed daily and body weight were assessed weekly. In the last week of the SCR protocol, systolic blood pressure and heart rate were measured and the double product index was calculated. Also, oral glucose and intraperitoneal insulin tolerance tests were performed. Thereafter, rats were decapitated, visceral fat was weighed, and blood and hearts were harvested for biochemical, functional, tissue redox status, and western blot analyzes. Compared to AL, CR50 rats had reduced the main risk factors for CD. Moreover, the FR50 rats showed increased cardiac function both at baseline conditions (45% > AL rats) and during the post-ischemic period (60% > AL rats) which may be explained by a decreased cardiac oxidative stress and increased HSP72 content. Conclusion: SCR from birth to adult age reduced risk factors for CD, increased basal cardiac function and protected hearts from the I/R, possibly by a mechanism involving ROS. PMID:27092082

  15. Nicotinamide treatment reduces behavioral impairments and provides cortical protection after fluid percussion injury in the rat.

    Science.gov (United States)

    Hoane, Michael R; Tan, Arlene A; Pierce, Jeremy L; Anderson, Gail D; Smith, Douglas C

    2006-10-01

    This study examined the ability of nicotinamide (vitamin B3) to improve functional outcome in a dose-dependent manner following fluid percussion injury (FPI). Injured (duration of unconsciousness mean = 85.8 sec; apnea = 9.9 sec), rats were administered nicotinamide (500 or 50 mg/kg; ip) or saline at 15 min and 24 h. Serum analysis of nicotinamide concentrations were conducted 1 h following the last injection. Sensorimotor and cognitive tests were conducted for 35 days following FPI. Both the 500 and 50 mg/kg doses of nicotinamide significantly facilitated recovery on the vibrissae-forelimb placing test compared to saline treatment, which showed chronic impairments. Both treatments also significantly improved performance on the bilateral tactile adhesive removal test. On the cognitive tests, the 500 mg/kg dose, but not the 50 mg/kg dose, improved performance on a working memory task in the Morris water maze (MWM). However, acquisition of a reference memory task in the MWM was not improved. Serum analysis showed that the 500 mg/kg dose significantly raised nicotinamide concentrations by 30-fold and the 50 mg/kg dose by 3-fold compared to the saline administration. This study demonstrated that raising nicotinamide concentrations resulted in the reduction of the behavioral impairments following FPI. In fact, the 500 mg/kg dose prevented the occurrence of the behavioral deficits on the bilateral tactile removal and working memory tests. Both doses significantly reduced tissue loss and glial fibrillary acid protein (GFAP) expression in the cortex. The 500 mg/kg dose reduced GFAP expression in the hippocampus. This data suggests that nicotinamide has substantial preclinical efficacy for TBI, and there appears to be some differences in the ability of the doses to improve performance in the MWM. PMID:17020488

  16. Ursolic acid reduces the metalloprotease/anti-metalloprotease imbalance in cerebral ischemia and reperfusion injury

    Directory of Open Access Journals (Sweden)

    Wang Y

    2016-05-01

    Full Text Available Yanzhe Wang, Zhiyi He, Shumin Deng Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China Background: Activators of PPARs, particularly PPARγ, may be effective neuroprotective drugs against inflammatory responses in cerebral ischemia and reperfusion injury. Ursolic acid (UA may act as a PPARγ agonist and serve as an anti-inflammatory agent. In this study, we used a rat middle cerebral artery occlusion and reperfusion model to examine how UA acts as a neuroprotective agent to modulate the metalloprotease/anti-metalloprotease balance. Methods: The middle cerebral artery occlusion and reperfusion model (occlusion for 2 hours followed by reperfusion for 48 hours was induced in male Sprague Dawley rats. UA was administered intragastrically 0.5, 24, and 47 hours after reperfusion. Bisphenol A diglycidyl ether (a PPARγ antagonist was intraperitoneally administered 1, 24.5, and 47.5 hours after reperfusion. Forty-eight hours after reperfusion, neurological deficits and infarct volume were estimated. The PPARγ level and the metalloprotease/anti-metalloprotease balance were examined by Western blotting and immunohistochemistry. The activation of MAPK signaling pathways was also assessed. Results: UA-treated (5, 10, or 20 mg/kg rats showed significant improvement in neurological deficit score, infarct volume, and the number of intact neurons compared with control rats (P<0.01. Both the PPARγ protein level and the percentage of PPARγ-positive cells were increased in the UA-treated groups (P<0.01. Compared with the control group, the UA-treated groups exhibited reduced protein levels of MMP2, MMP9, and activated MAPKs (P<0.01 but an increased level of TIMP1 (P<0.01. UA exerted its protective effects in a dose-dependent manner. Co-treatment with UA and bisphenol A diglycidyl ether completely abolished the UA-induced changes in PPARγ expression; however UA continued to exert a

  17. Incidence of Cold Injury and Effects of Reduced Air Pressure in High Altitude Areas of the Himalayas

    OpenAIRE

    B. D. Varma

    1984-01-01

    Data covering the three-year period, 1981-1984, from the forward area hospitals, receiving patients from units operating in high altitude areas of the Himalaya reveal an average admission of 247 and 171 cases of cold injury and effects of reduced air pressure respectively. Chillblain was the commonest (85.8%) form of cold injury and high altitude pulmonary oedema the commonest (76.2%) clinical syndrome in the hopoxia group. In both groups, the disease was mild in 61 per cent cases and severe ...

  18. Negative pressure wound therapy decreases mortality in a murine model of burn-wound sepsis involving Pseudomonas aeruginosa infection.

    Directory of Open Access Journals (Sweden)

    Yang Liu

    Full Text Available BACKGROUND: The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. METHODS: Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination. RESULTS: Applying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT. CONCLUSIONS: Our data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs.

  19. Baicalein pretreatment reduces liver ischemia/reperfusion injury via induction of autophagy in rats.

    Science.gov (United States)

    Liu, Anding; Huang, Liang; Guo, Enshuang; Li, Renlong; Yang, Jiankun; Li, Anyi; Yang, Yan; Liu, Shenpei; Hu, Jifa; Jiang, Xiaojing; Dirsch, Olaf; Dahmen, Uta; Sun, Jian

    2016-01-01

    We previously demonstrated that baicalein could protect against liver ischemia/reperfusion (I/R) injury in mice. The exact mechanism of baicalein remains poorly understood. Autophagy plays an important role in protecting against I/R injury. This study was designed to determine whether baicalein could protect against liver I/R injury via induction of autophagy in rats. Baicalein was intraperitoneally injected 1 h before warm ischemia. Pretreatment with baicalein prior to I/R insult significantly blunted I/R-induced elevations of serum aminotransferase levels and significantly improved the histological status of livers. Electron microscopy and expression of the autophagic marker LC3B-II suggested induction of autophagy after baicalein treatment. Moreover, inhibition of the baicalein-induced autophagy using 3-methyladenine (3-MA) worsened liver injury. Furthermore, baicalein treatment increased heme oxygenase (HO)-1 expression, and pharmacological inhibition of HO-1 with tin protoporphyrin IX (SnPP) abolished the baicalein-mediated autophagy and the hepatocellular protection. In primary rat hepatocytes, baicalein-induced autophagy also protected hepatocytes from hypoxia/reoxygenation injury in vitro and the beneficial effect was abrogated by 3-MA or Atg7 siRNA, respectively. Suppression of HO-1 activity by SnPP or HO-1 siRNA prevented the baicalein-mediated autophagy and resulted in increased hepatocellular injury. Collectively, these results suggest that baicalein prevents hepatocellular injury via induction of HO-1-mediated autophagy. PMID:27150843

  20. Burn healing plants in Iranian Traditional Medicine

    OpenAIRE

    Sh. Fahimi; H. Hajimehdipoor; Abdollahi, M.; S.A. Mortazavi

    2015-01-01

    Burns are known as one of the most common forms of injury with devastating consequences. Despite the discovery of several antiseptics, burn wound healing has still remained a challenge to modern medicine. Herbal products seem to possess moderate efficacy with no or less toxicity and are less expensive compared to synthetic drugs. Burn is a well-known disorder in Iranian Traditional Medicine (ITM). Iranian physicians have divided burns into various types based on the cause and recommended trea...

  1. Burn wound: How it differs from other wounds?

    OpenAIRE

    Tiwari, V K

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock wh...

  2. Effects of glutamine combined with panthenol on intestinal injury in burned canis familiaris%谷氨酰胺联合泛醇对烧伤家犬肠道损伤的影响及机制研究

    Institute of Scientific and Technical Information of China (English)

    王裴; 赵云; 戚华兵; 彭曦; 尤忠义; 汪仕良

    2012-01-01

    目的 观察应用谷氨酰胺、泛醇及其复方制剂对减轻烧伤家犬肠道损伤的疗效并探讨其机制.方法 采用30%体表面积Ⅲ度烧伤家犬模型,动物随机分为正常对照、烧伤对照、泛醇、谷氨酰胺、泛醇+谷氨酰胺5个组,每组6只家犬,观察伤后7 d各组动物肠道损伤和修复指标.结果 烧伤家犬乙酰胆碱、肠黏膜蛋白含量明显降低,血浆二胺氯化酶(DAO)含量和损伤指数则明显增高(P<0.05),给予谷氨酰胺、泛醇以及复方药物均可明减轻烧伤后肠道损伤,降低血浆DAO活性和黏膜损伤指数(P<0.05);给予泛醇则能明显增加乙酰胆碱合成.与单方组相比,复方制剂组上述各项指标均明显优于单方组.结论 烧伤后肠道损伤明显,给予谷氨酰胺能明显减轻肠道损伤,给予泛醇能明显促进乙酰胆碱合成,促进胃肠运动,复方制剂疗效明显优于单方.%Objective To observe the effects of glutamine , panthenol and its compound preparation on lessening intestinal injury in burned canis familiaris . Methods Thirty canis familiaris were randomly divided into five groups , i. e. normal control ( C) group, burn control (B) group, glutamine group , panthenol group and its compound preparation group. Burned canis familiaris were inflicted with 30% TBSA full thickness burn injury. Observe the intestinal injury and repair post burn 7 d. Results After burn injury , the activity of plasma diamine oxidase (DAO) , intestine mucosal damage index were significantly higher , and the contents of intestine mucosal protein and plasma acetylcholine were remarkable decrease than those of C group (P < 0. 05 ). Compare with B group , the activity of plasma DAO, intestine mucosal damage index were markedly decreased in glutamine group , and the plasma acetylcholine contents was significantly increased in panthenol group . Compare with simple recipe group , there were more conspicuous therapeutic effect on compound preparation

  3. Epidemiological investigation of hospitalized children with burn injuries in a hospital of Fuzhou%福州某医院烧伤住院患儿流行病学调查

    Institute of Scientific and Technical Information of China (English)

    李琳; 林仁琴; 许乐; 潘琼; 戴嘉喜; 江美云; 陈昭宏

    2016-01-01

    伤后2h内入院者为主,占79.7%(1 121/1 407).烧伤后在现场以看护者脱去患儿衣物者或未行任何处理居多.本组患儿主要在入院后2周内出院(80.0%,1 126/1 407),热液烫伤、火焰烧伤、电烧伤、高温固体烫伤、化学烧伤引起的烧伤患儿住院天数比较,差异明显(X 2=17.33,P=0.002).本组患儿主要采取非手术治疗方式,最终大部分患儿好转或痊愈出院. 结论 笔者单位烧伤住院患儿主要为幼儿期男童室内热液烫伤,多集中于夏季用餐及洗澡时间,因此需大力普及烧伤预防知识.%Objective To analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital,so as to provide evidence to complete an adequate,timely,and effective prevention and treatment system of children with burn injuries.Methods Medical records of children with burn injuries,aged 14 and under,hospitalized in the Department of Burns from July 2012 to June 2015 were collected.Data of gender and age,location and cause of injury,time of injury,state of injury,admission time after injury,first aid,length of hospital stay,and treatment and so on were recorded.They were divided into 4 age brackets:less than or equal to 1 year old,more than 1 year old and less than or equal to 3 years old,more than 3 years old and less than or equal to 7 years old,more than 7 years old and less than or equal to 14 years old,then gender and cause of injury of children in the 4 age brackets were analyzed.Admission months of the children were divided into spring (March to May),summer (June to August),autumn (September to November) and winter (December to February of the following year),and then the cause of injury of children in each season was analyzed.Severities of male and female children,length of hospital stay of children with different causes of injury were analyzed.Data were processed with chi-square test,Wilcoxon rank-sum test.Results Out of 2 608

  4. Rosiglitazone ameliorates diffuse axonal injury by reducing loss of tau and up-regulating caveolin-1 expression

    Institute of Scientific and Technical Information of China (English)

    Yong-lin Zhao; Jin-ning Song; Xu-dong Ma; Bin-fei Zhang; Dan-dong Li; Hong-gang Pang

    2016-01-01

    Rosiglitazone up-regulates caveolin-1 levels and has neuroprotective effects in both chronic and acute brain injury. Therefore, we postu-lated that rosiglitazone may ameliorate diffuse axonal injuryvia its ability to up-regulate caveolin-1, inhibit expression of amyloid-beta precursor protein, and reduce the loss and abnormal phosphorylation of tau. In the present study, intraperitoneal injection of rosiglitazone signiifcantly reduced the levels ofamyloid-beta precursor protein and hyperphosphorylated tau (phosphorylated at Ser404 (p-tau (S404)), and it increased the expression of total tau and caveolin-1 in the rat cortex. Our results show that rosiglitazone inhibits the expression of amyloid-beta precursor protein and lowers p-tau (S404) levels, and it reduces the loss of total tau, possibly by up-regulating caveolin-1. These actions of rosiglitazone may underlie its neuroprotective effects in the treatment of diffuse axonal injury.

  5. Hepatic and intestinal blood flow following thermal injury

    International Nuclear Information System (INIS)

    Because cardiac output decreases after burn injuries, investigators have assumed, based upon dye clearance techniques, that hepatic and intestinal blood flow are also decreased following these injuries. Blood flow to the liver, stomach, small intestine, and kidney was determined by the uptake of 201thallium and 125I-labeled fatty acid (para-125I-phenyl-3-methyl pentanoic acid) in a 20% body surface area scald injury that also included plasma volume replacement resuscitation. Uptake of these radioisotopes was determined 15 minutes, 18 hours, and 72 hours after injury. The uptake of the 201thallium and 125I-labeled fatty acid by the gastrointestinal tissues was not statistically different at any of the time periods after comparison of the injured and control (sham-treated) animals. 201Thallium uptake by the kidney was significantly diminished 15 minutes after the burn injury (P less than 0.01). Based on these blood flow measurement techniques, the data suggest that the 20% body surface area scald injury did not alter blood flow to the liver or gastrointestinal tract within the initial 72 hours after the burn injury even though a decrease in renal blood flow was easily detected. These results suggest that the dysfunction of the gastrointestinal system or hepatic system observed after an acute burn injury is not simply the result of hypovolemic shock, which reduces both renal and mesenteric blood flow. These gastrointestinal and hepatic alterations may be related to a factor or factors other than intestinal ischemia

  6. Reducing Motor Vehicle-Related Injuries at an Arizona Indian Reservation: Ten Years of Application of Evidence-Based Strategies.

    Science.gov (United States)

    Piontkowski, Stephen R; Peabody, Jon S; Reede, Christine; Velascosoltero, José; Tsatoke, Gordon; Shelhamer, Timothy; Hicks, Kenny R

    2015-12-01

    Unintentional injury is a significant public health burden for American Indians and Alaska Natives and was the leading cause of death among those aged 1 to 44 years between 1999 and 2004. Of those deaths, motor vehicle-related deaths cause the most mortality, justifying the need for intervention at an American Indian Reservation in Arizona (United States). We describe motor vehicle injury prevention program operations from 2004 through 2013. This community-based approach led by a multidisciplinary team primarily comprised of environmental public health and law enforcement personnel implemented evidence-based strategies to reduce the impact of motor vehicle-related injuries and deaths, focusing on reducing impaired driving and increasing occupant restraint use. Strategies included: mass media campaigns to enhance awareness and outreach; high-visibility sobriety checkpoints; passing and enforcing 0.08% blood alcohol concentration limits for drivers and primary occupant restraint laws; and child car seat distribution and education. Routine monitoring and evaluation data showed a significant 5% to 7% annual reduction of motor vehicle crashes (MVCs), nighttime MVCs, MVCs with injuries/fatalities, and nighttime MVCs with injuries/fatalities between 2004 and 2013, but the annual percent change in arrests for driving under the influence (DUI) was not significant. There was also a 144% increase in driver/front seat passenger seat belt use, from 19% in 2011 before the primary occupant restraint law was enacted to 47% during the first full year of enforcement (2013). Car seat checkpoint data also suggested a 160% increase in car seat use, from less than 20% to 52% in 2013. Implementation of evidence-based strategies in injury prevention, along with employment of key program approaches such as strong partnership building, community engagement, and consistent staffing and funding, can narrow the public health disparity gap experienced among American Indian and Alaska Native

  7. Microtubule stabilization reduces scarring and causes axon regeneration after spinal cord injury

    NARCIS (Netherlands)

    F. Hellal (Farida); A. Hurtado (Andres); J. Ruschel (Jörg); K.C. Flynn (Kevin); C.J. Laskowski (Claudia); M. Umlauf (Martina); L.C. Kapitein (Lukas); D. Strikis (Dinara); V. Lemmon (Vance); J. Bixby (John); C.C. Hoogenraad (Casper); F. Bradke (Frank)

    2011-01-01

    textabstractHypertrophic scarring and poor intrinsic axon growth capacity constitute major obstacles for spinal cord repair. These processes are tightly regulated by microtubule dynamics. Here, moderate microtubule stabilization decreased scar formation after spinal cord injury in rodents through va

  8. Three Intermittent Sessions of Cryotherapy Reduce the Secondary Muscle Injury in Skeletal Muscle of Rat

    OpenAIRE

    Oliveira, Nuno M. L.; Elaine P. Rainero; Salvini, Tania F.

    2006-01-01

    Although cryotherapy associated to compression is recommended as immediate treatment after muscle injury, the effect of intermittent sessions of these procedures in the area of secondary muscle injury is not established. This study examined the effect of three sessions of cryotherapy (30 min of ice pack each 2h) and muscle compression (sand pack) in the muscle-injured area. Twenty-four Wistar rats (312 ± 20g) were evaluated. In three groups, the middle belly of tibialis anterior (TA) muscle w...

  9. Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury*

    OpenAIRE

    Xu, Kan; Chen, Qi-xin; Li, Fang-cai; Chen, Wei-Shan; Lin, Min; Wu, Qiong-hua

    2009-01-01

    Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Meth...

  10. Angiopoietin-1 treatment reduces inflammation but does not prevent ventilator-induced lung injury.

    Directory of Open Access Journals (Sweden)

    Maria A Hegeman

    Full Text Available BACKGROUND: Loss of integrity of the epithelial and endothelial barriers is thought to be a prominent feature of ventilator-induced lung injury (VILI. Based on its function in vascular integrity, we hypothesize that the angiopoietin (Ang-Tie2 system plays a role in the development of VILI. The present study was designed to examine the effects of mechanical ventilation on the Ang-Tie2 system in lung tissue. Moreover, we evaluated whether treatment with Ang-1, a Tie2 receptor agonist, protects against inflammation, vascular leakage and impaired gas exchange induced by mechanical ventilation. METHODS: Mice were anesthetized, tracheotomized and mechanically ventilated for 5 hours with either an inspiratory pressure of 10 cmH2O ('low' tidal volume ∼7.5 ml/kg; LVT or 18 cmH2O ('high' tidal volume ∼15 ml/kg; HVT. At initiation of HVT-ventilation, recombinant human Ang-1 was intravenously administered (1 or 4 µg per animal. Non-ventilated mice served as controls. RESULTS: HVT-ventilation influenced the Ang-Tie2 system in lungs of healthy mice since Ang-1, Ang-2 and Tie2 mRNA were decreased. Treatment with Ang-1 increased Akt-phosphorylation indicating Tie2 signaling. Ang-1 treatment reduced infiltration of granulocytes and expression of keratinocyte-derived chemokine (KC, macrophage inflammatory protein (MIP-2, monocyte chemotactic protein (MCP-1 and interleukin (IL-1β caused by HVT-ventilation. Importantly, Ang-1 treatment did not prevent vascular leakage and impaired gas exchange in HVT-ventilated mice despite inhibition of inflammation, vascular endothelial growth factor (VEGF and Ang-2 expression. CONCLUSIONS: Ang-1 treatment downregulates pulmonary inflammation, VEGF and Ang-2 expression but does not protect against vascular leakage and impaired gas exchange induced by HVT-ventilation.

  11. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

    International Nuclear Information System (INIS)

    We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting

  12. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı

    2011-07-01

    Full Text Available Burn injury is one of the most serious injuries that mankind may face. In addition to serious inflammation, excessive fluid loss, presence of hemodynamic instability due to intercurrent factors such as debridements, infections and organ failure, very different levels and intensities of pain, psychological problems such as traumatic stress disorder, depression, delirium at different levels that occur in patient with severe burn are the factors which make it difficult to provide the patient comfort. In addition to a mild to moderate level of baseline permanent pain in burn patients, which is due to tissue damage, there is procedural pain as well, which occurs by treatments such as grafting and dressings, that are severe, short-term burst style 'breakthrough' pain. Movement and tactile stimuli are also seen in burn injury as an effect to sensitize the peripheral and central nervous system. Even though many burn centers have established protocols to struggle with the pain, studies show that pain relief still inadequate in burn patients. Therefore, the treatment of burn pain and the prevention of possible emergence of future psychiatric problems suc as post-traumatic stress disorder, the sedative and anxiolytic agents should be used as a recommendation according to the needs and hemodynamic status of individual patient. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 26-30

  13. Cognitive emotion regulation strategies and neuroticism in relation to depressive symptoms following burn injury: a longitudinal study with a 2-year follow-up

    NARCIS (Netherlands)

    Van Loey, N.E.E.; Oggel, A.; Goemanne, A.S.; Braem, L.; Vanbrabant, L.; Geenen, R.

    2014-01-01

    Sustaining burns is considered a stressful life event that has the power to elicit depressive symptoms. This study aimed to identify predictors of depressive symptoms by investigating the role of demographic variables, the number of operations (burn severity), neuroticism, and cognitive emotion regu

  14. Simvastatin Reduces Lipopolysaccharides-Accelerated Cerebral Ischemic Injury via Inhibition of Nuclear Factor-kappa B Activity.

    Science.gov (United States)

    Anthony Jalin, Angela M A; Lee, Jae-Chul; Cho, Geum-Sil; Kim, Chunsook; Ju, Chung; Pahk, Kisoo; Song, Hwa Young; Kim, Won-Ki

    2015-11-01

    Preceding infection or inflammation such as bacterial meningitis has been associated with poor outcomes after stroke. Previously, we reported that intracorpus callosum microinjection of lipopolysaccharides (LPS) strongly accelerated the ischemia/reperfusion-evoked brain tissue damage via recruiting inflammatory cells into the ischemic lesion. Simvastatin, 3-hydroxy-3-methylgultaryl (HMG)-CoA reductase inhibitor, has been shown to reduce inflammatory responses in vascular diseases. Thus, we investigated whether simvastatin could reduce the LPS-accelerated ischemic injury. Simvastatin (20 mg/kg) was orally administered to rats prior to cerebral ischemic insults (4 times at 72, 48, 25, and 1-h pre-ischemia). LPS was microinjected into rat corpus callosum 1 day before the ischemic injury. Treatment of simvastatin reduced the LPS-accelerated infarct size by 73%, and decreased the ischemia/reperfusion-induced expressions of pro-inflammatory mediators such as iNOS, COX-2 and IL-1β in LPS-injected rat brains. However, simvastatin did not reduce the infiltration of microglial/macrophageal cells into the LPS-pretreated brain lesion. In vitro migration assay also showed that simvastatin did not inhibit the monocyte chemoattractant protein-1-evoked migration of microglial/macrophageal cells. Instead, simvastatin inhibited the nuclear translocation of NF-κB, a key signaling event in expressions of various proinflammatory mediators, by decreasing the degradation of IκB. The present results indicate that simvastatin may be beneficial particularly to the accelerated cerebral ischemic injury under inflammatory or infectious conditions. PMID:26535078

  15. Human mesenchymal stromal cells reduce influenza A H5N1-associated acute lung injury in vitro and in vivo.

    Science.gov (United States)

    Chan, Michael C W; Kuok, Denise I T; Leung, Connie Y H; Hui, Kenrie P Y; Valkenburg, Sophie A; Lau, Eric H Y; Nicholls, John M; Fang, Xiaohui; Guan, Yi; Lee, Jae W; Chan, Renee W Y; Webster, Robert G; Matthay, Michael A; Peiris, J S Malik

    2016-03-29

    Influenza can cause acute lung injury. Because immune responses often play a role, antivirals may not ensure a successful outcome. To identify pathogenic mechanisms and potential adjunctive therapeutic options, we compared the extent to which avian influenza A/H5N1 virus and seasonal influenza A/H1N1 virus impair alveolar fluid clearance and protein permeability in an in vitro model of acute lung injury, defined the role of virus-induced soluble mediators in these injury effects, and demonstrated that the effects are prevented or reduced by bone marrow-derived multipotent mesenchymal stromal cells. We verified the in vivo relevance of these findings in mice experimentally infected with influenza A/H5N1. We found that, in vitro, the alveolar epithelium's protein permeability and fluid clearance were dysregulated by soluble immune mediators released upon infection with avian (A/Hong Kong/483/97, H5N1) but not seasonal (A/Hong Kong/54/98, H1N1) influenza virus. The reduced alveolar fluid transport associated with down-regulation of sodium and chloride transporters was prevented or reduced by coculture with mesenchymal stromal cells. In vivo, treatment of aged H5N1-infected mice with mesenchymal stromal cells increased their likelihood of survival. We conclude that mesenchymal stromal cells significantly reduce the impairment of alveolar fluid clearance induced by A/H5N1 infection in vitro and prevent or reduce A/H5N1-associated acute lung injury in vivo. This potential adjunctive therapy for severe influenza-induced lung disease warrants rapid clinical investigation. PMID:26976597

  16. Epidemiology of major burns at the Lebanese Burn Center in Geitawi, Lebanon

    OpenAIRE

    Ghanimé, G.; Rizkallah, N.; Said, J.M.

    2013-01-01

    Burn care is one of the few areas in medicine considered both medically and surgically challenging, with burn injuries affecting people of all ages and both sexes. Between May 1992 and March 2012, 1,524 patients were admitted to the Lebanese Burn Center in Geitawi, with an average length of stay (LOS) of 36.5 days. The most frequently encountered injuries were thermal burns, generally resulting from domestic accidents. Of our patients, 47% were from rural areas and burned body surface (BBS) w...

  17. Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN

    2003-01-01

    Hypothesis: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. Design: Before-after trial. Setting: A 30-bed burn referral center in a private, university-affiliated hospital. Methods: We studied 35 severely burned children who were divided into 2 grou

  18. A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Duncan KJ

    2016-01-01

    Full Text Available Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA. The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11. Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing

  19. Burns and beauty nails

    Science.gov (United States)

    Bélanger, Richard E; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. The beauty nail adhesive contained cyanoacrylate. In addition to its well-appreciated adhesive capacity, cyanoacrylate, in the presence of cotton or other tissues, is known to produce an exothermic reaction that may cause burns. Cyanoacrylate-based products, due to their possible adverse effects, should be kept away from children as advised. Odd injuries should always raise concerns about the possibility of inflicted injury. PMID:24421671

  20. BARC solution for burn injuries

    CERN Multimedia

    2003-01-01

    The Bhabha Atomic Research Centre (BARC), has developed Hydrogel which is expected to be mass marketed soon in India. Dr Anil Kakodkar, Chairman of Atomic Energy Commission, said the product not only heals the wound, but also eliminates scars (1/2 page).

  1. CHBPR N-Acetyl-Seryl-Aspartyl-Lysyl-Proline Attenuates Renal Injury and Dysfunction in Hypertensive Rats with Reduced Renal Mass

    OpenAIRE

    LIAO, Tang-dong; Yang, Xiao-Ping; D’Ambrosio, Martin; Zhang, Yanlu; Rhaleb, Nour-Eddine; Carretero, Oscar A.

    2009-01-01

    N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is a naturally occurring peptide whose plasma concentration is increased 4- to 5-fold by angiotensin-converting enzyme inhibitors. We previously reported that in models of both hypertension and postmyocardial infarction, Ac-SDKP reduces cardiac inflammation and fibrosis. However, it is unknown whether Ac-SDKP can prevent or reverse renal injury and dysfunction in hypertension. In the present study, we tested the hypothesis that in rats with 5/6 ...

  2. Serine-threonine protein kinase activation may be an effective target for reducing neuronal apoptosis after spinal cord injury

    Directory of Open Access Journals (Sweden)

    Mu Jin

    2015-01-01

    Full Text Available The signaling mechanisms underlying ischemia-induced nerve cell apoptosis are poorly understood. We investigated the effects of apoptosis-related signal transduction pathways following ischemic spinal cord injury, including extracellular signal-regulated kinase (ERK, serine-threonine protein kinase (Akt and c-Jun N-terminal kinase (JNK signaling pathways. We established a rat model of acute spinal cord injury by inserting a catheter balloon in the left subclavian artery for 25 minutes. Rat models exhibited notable hindlimb dysfunction. Apoptotic cells were abundant in the anterior horn and central canal of the spinal cord. The number of apoptotic neurons was highest 48 hours post injury. The expression of phosphorylated Akt (p-Akt and phosphorylated ERK (p-ERK increased immediately after reperfusion, peaked at 4 hours (p-Akt or 2 hours (p-ERK, decreased at 12 hours, and then increased at 24 hours. Phosphorylated JNK expression reduced after reperfusion, increased at 12 hours to near normal levels, and then showed a downward trend at 24 hours. Pearson linear correlation analysis also demonstrated that the number of apoptotic cells negatively correlated with p-Akt expression. These findings suggest that activation of Akt may be a key contributing factor in the delay of neuronal apoptosis after spinal cord ischemia, particularly at the stage of reperfusion, and thus may be a target for neuronal protection and reduction of neuronal apoptosis after spinal cord injury.

  3. COMPARISON OF THE EFFECTS OF AGING AND IL-6 ON THE HEPATIC INFLAMMATORY RESPONSE IN TWO MODELS OF SYSTEMIC INJURY: SCALD INJURY VERSUS I.P. LPS ADMINISTRATION

    OpenAIRE

    Gomez, Christian R.; Nomellini, Vanessa; Baila, Horea; Oshima, Kiyoko; Kovacs, Elizabeth J.

    2009-01-01

    Regardless of age, a marked elevation in circulating IL-6 levels correlates with increased mortality after injury or an inflammatory challenge. We previously reported that aged IL-6 knockout mice given LPS have improved survival and reduced inflammatory response than LPS-treated aged wild type (WT) mice. Herein, we analyzed the effects of aging and IL-6 on the hepatic inflammatory response in two models of systemic injury: dorsal scald (burn) injury versus intraperitoneal LPS administration. ...

  4. Psychological Aspects of Paediatric Burns (A Clinical Review)

    OpenAIRE

    A Sousa

    2010-01-01

    Burn injuries in childhood can be traumatic with lasting effects until adulthood. This article reviews the various psychological issues one confronts when treating paediatric patients with burn injuries. A wide range of factors influence recovery and rehabilitation from paediatric burns. The role of family members, family dynamics, parental reactions, parental psychiatric illness, and pre-morbid psychiatric illness in the child are important factors. The entire family and the burned child hav...

  5. Epidemiologic Characteristics of Occupational Burns in Yazd, Iran

    OpenAIRE

    Seyyed Jalil Mirmohammadi; Amir Houshang Mehrparvar; Kazem Kazemeini; Mehrdad Mostaghaci

    2013-01-01

    Objective: Occupational burns are among the important causes of work-related fatalities and absenteeism. Epidemiologic assessment of these injuries is important to define high-risk jobs. We designed this study to evaluate the epidemiology of occupational burns in Yazd, an industrial province in Iran. Methods: This is a prospective study on work-related burns in a 1-year period (2008-2009). A questionnaire was completed for them about the characteristics of the burn injury. Results: Th...

  6. Increased blood pressure can reduce fatigue of thenar muscles paralyzed after spinal cord injury

    NARCIS (Netherlands)

    Butler, JE; Ribot-Ciscar, E; Zijdewind, Inge; Thomas, CK

    2004-01-01

    The aim of this study was to evaluate whether increases in blood pressure, and presumably muscle perfusion pressure, improve the endurance of thenar muscles paralyzed chronically by cervical spinal cord injury (SCI). Resting mean arterial pressure (MAP) was low in all eight subjects (64 +/- 2 mmHg).

  7. Stanniocalcin 2 alters PERK signalling and reduces cellular injury during cerulein induced pancreatitis in mice

    Directory of Open Access Journals (Sweden)

    DiMattia Gabriel E

    2011-05-01

    Full Text Available Abstract Background Stanniocalcin 2 (STC2 is a secreted protein activated by (PKR-like Endoplasmic Reticulum Kinase (PERK signalling under conditions of ER stress in vitro. Over-expression of STC2 in mice leads to a growth-restricted phenotype; however, the physiological function for STC2 has remained elusive. Given the relationship of STC2 to PERK signalling, the objective of this study was to examine the role of STC2 in PERK signalling in vivo. Results Since PERK signalling has both physiological and pathological roles in the pancreas, STC2 expression was assessed in mouse pancreata before and after induction of injury using a cerulein-induced pancreatitis (CIP model. Increased Stc2 expression was identified within four hours of initiating pancreatic injury and correlated to increased activation of PERK signalling. To determine the effect of STC2 over-expression on PERK, mice systemically expressing human STC2 (STC2Tg were examined. STC2Tg pancreatic tissue exhibited normal pancreatic morphology, but altered activation of PERK signalling, including increases in Activating Transcription Factor (ATF 4 accumulation and autophagy. Upon induction of pancreatic injury, STC2Tg mice exhibited limited increases in circulating amylase levels and increased maintenance of cellular junctions. Conclusions This study links STC2 to the pathological activation of PERK in vivo, and suggests involvement of STC2 in responding to pancreatic acinar cell injury.

  8. Reducing Covert Self-Injurious Behavior Maintained by Automatic Reinforcement through a Variable Momentary DRO Procedure

    Science.gov (United States)

    Toussaint, Karen A.; Tiger, Jeffrey H.

    2012-01-01

    Covert self-injurious behavior (i.e., behavior that occurs in the absence of other people) can be difficult to treat. Traditional treatments typically have involved sophisticated methods of observation and often have employed positive punishment procedures. The current study evaluated the effectiveness of a variable momentary differential…

  9. Angiopoietin-1 Treatment Reduces Inflammation but Does Not Prevent Ventilator-Induced Lung Injury

    NARCIS (Netherlands)

    M.A. Hegeman; M.P. Hennus; M. van Meurs; P.M. Cobelens; A. Kavelaars; N.J. Jansen; M.J. Schultz; A.J. van Vught; G. Molema; C.J. Heijnen

    2010-01-01

    Background: Loss of integrity of the epithelial and endothelial barriers is thought to be a prominent feature of ventilator-induced lung injury (VILI). Based on its function in vascular integrity, we hypothesize that the angiopoietin (Ang)-Tie2 system plays a role in the development of VILI. The pre

  10. Reduced N400 Semantic Priming Effects in Adult Survivors of Paediatric and Adolescent Traumatic Brain Injury

    Science.gov (United States)

    Knuepffer, C.; Murdoch, B. E.; Lloyd, D.; Lewis, F. M.; Hinchliffe, F. J.

    2012-01-01

    The immediate and long-term neural correlates of linguistic processing deficits reported following paediatric and adolescent traumatic brain injury (TBI) are poorly understood. Therefore, the current research investigated event-related potentials (ERPs) elicited during a semantic picture-word priming experiment in two groups of highly functioning…

  11. Reduced satellite cell numbers with spinal cord injury and aging in humans

    NARCIS (Netherlands)

    Verdijk, L.B.; Dirks, M.L.; Snijders, T.; Prompers, J.J.; Beelen, M.; Jonkers, R.A.; Thijssen, D.H.J.; Hopman, M.T.E.; Loon, L.J. van

    2012-01-01

    INTRODUCTION: Both sarcopenia and spinal cord injury (SCI) are characterized by the loss of skeletal muscle mass and function. Despite obvious similarities in atrophy between both models, differences in muscle fiber size and satellite cell content may exist on a muscle fiber type-specific level. MET

  12. Effect of Thiol-reducing Agents and Antioxidants on Sulfasalazine-induced Hepatic Injury in Normotermic Recirculating Isolated Perfused Rat Liver

    OpenAIRE

    Heidari, Reza; Esmailie, Neda; Azarpira, Negar; Najibi, Asma; Niknahad, Hossein

    2016-01-01

    Sulfasalzine is a widely administered drug against inflammatory-based disorders in human. However several cases of liver injury are associated with its administration. There is no stabilized safe protective agent against sulfasalazine-induced liver injury. Current investigation was designed to evaluate if N-acetylcysteine (NAC) and dithioteritol (DTT) as thiol reducing agents and/or vitamins C and E as antioxidants have any protective effects against sulfasalazine-induced hepatic injury in an...

  13. Prophylactic Ozone Administration Reduces Intestinal Mucosa Injury Induced by Intestinal Ischemia-Reperfusion in the Rat

    Directory of Open Access Journals (Sweden)

    Ozkan Onal

    2015-01-01

    Full Text Available Objectives. Intestinal ischemia-reperfusion injury is associated with mucosal damage and has a high rate of mortality. Various beneficial effects of ozone have been shown. The aim of the present study was to show the effects of ozone in ischemia reperfusion model in intestine. Material and Method. Twenty eight Wistar rats were randomized into four groups with seven rats in each group. Control group was administered serum physiologic (SF intraperitoneally (ip for five days. Ozone group was administered 1 mg/kg ozone ip for five days. Ischemia Reperfusion (IR group underwent superior mesenteric artery occlusion for one hour and then reperfusion for two hours. Ozone + IR group was administered 1 mg/kg ozone ip for five days and at sixth day IR model was applied. Rats were anesthetized with ketamine∖xyzlazine and their intracardiac blood was drawn completely and they were sacrificed. Intestinal tissue samples were examined under light microscope. Levels of superoxide dismutase (SOD, catalase (CAT, glutathioneperoxidase (GSH-Px, malondyaldehide (MDA, and protein carbonyl (PCO were analyzed in tissue samples. Total oxidant status (TOS, and total antioxidant capacity (TAC were analyzed in blood samples. Data were evaluated statistically by Kruskal Wallis test. Results. In the ozone administered group, degree of intestinal injury was not different from the control group. IR caused an increase in intestinal injury score. The intestinal epithelium maintained its integrity and decrease in intestinal injury score was detected in Ozone + IR group. SOD, GSH-Px, and CAT values were high in ozone group and low in IR. TOS parameter was highest in the IR group and the TAC parameter was highest in the ozone group and lowest in the IR group. Conclusion. In the present study, IR model caused an increase in intestinal injury.In the present study, ozone administration had an effect improving IR associated tissue injury. In the present study, ozone therapy

  14. Prophylactic Ozone Administration Reduces Intestinal Mucosa Injury Induced by Intestinal Ischemia-Reperfusion in the Rat

    Science.gov (United States)

    Onal, Ozkan; Yetisir, Fahri; Sarer, A. Ebru Salman; Zeybek, N. Dilara; Onal, C. Oztug; Yurekli, Banu; Celik, H. Tugrul; Sirma, Ayse; Kılıc, Mehmet

    2015-01-01

    Objectives. Intestinal ischemia-reperfusion injury is associated with mucosal damage and has a high rate of mortality. Various beneficial effects of ozone have been shown. The aim of the present study was to show the effects of ozone in ischemia reperfusion model in intestine. Material and Method. Twenty eight Wistar rats were randomized into four groups with seven rats in each group. Control group was administered serum physiologic (SF) intraperitoneally (ip) for five days. Ozone group was administered 1 mg/kg ozone ip for five days. Ischemia Reperfusion (IR) group underwent superior mesenteric artery occlusion for one hour and then reperfusion for two hours. Ozone + IR group was administered 1 mg/kg ozone ip for five days and at sixth day IR model was applied. Rats were anesthetized with ketamine∖xyzlazine and their intracardiac blood was drawn completely and they were sacrificed. Intestinal tissue samples were examined under light microscope. Levels of superoxide dismutase (SOD), catalase (CAT), glutathioneperoxidase (GSH-Px), malondyaldehide (MDA), and protein carbonyl (PCO) were analyzed in tissue samples. Total oxidant status (TOS), and total antioxidant capacity (TAC) were analyzed in blood samples. Data were evaluated statistically by Kruskal Wallis test. Results. In the ozone administered group, degree of intestinal injury was not different from the control group. IR caused an increase in intestinal injury score. The intestinal epithelium maintained its integrity and decrease in intestinal injury score was detected in Ozone + IR group. SOD, GSH-Px, and CAT values were high in ozone group and low in IR. TOS parameter was highest in the IR group and the TAC parameter was highest in the ozone group and lowest in the IR group. Conclusion. In the present study, IR model caused an increase in intestinal injury.In the present study, ozone administration had an effect improving IR associated tissue injury. In the present study, ozone therapy prevented

  15. Soluble urokinase-type plasminogen activator receptor levels in patients with burn injuries and inhalation trauma requiring mechanical ventilation: an observational cohort study

    OpenAIRE

    Backes, Yara; van der Sluijs, Koenraad F; Tuip de Boer, Anita M; Hofstra, Jorrit Jan; Vlaar, Alexander PJ; Determann, Rogier M; Knape, Paul; David P Mackie; Schultz, Marcus J.

    2011-01-01

    Introduction Soluble urokinase-type plasminogen activator receptor (suPAR) has been proposed as a biologic marker of fibrinolysis and inflammation. The aim of this study was to investigate the diagnostic and prognostic value of systemic and pulmonary levels of suPAR in burn patients with inhalation trauma who need mechanical ventilation. Methods suPAR was measured in plasma and nondirected lung-lavage fluid of mechanically ventilated burn patients with inhalation trauma. The samples were obta...

  16. Outlier detection and removal improves accuracy of machine learning approach to multispectral burn diagnostic imaging

    Science.gov (United States)

    Li, Weizhi; Mo, Weirong; Zhang, Xu; Squiers, John J.; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.

    2015-12-01

    Multispectral imaging (MSI) was implemented to develop a burn tissue classification device to assist burn surgeons in planning and performing debridement surgery. To build a classification model via machine learning, training data accurately representing the burn tissue was needed, but assigning raw MSI data to appropriate tissue classes is prone to error. We hypothesized that removing outliers from the training dataset would improve classification accuracy. A swine burn model was developed to build an MSI training database and study an algorithm's burn tissue classification abilities. After the ground-truth database was generated, we developed a multistage method based on Z-test and univariate analysis to detect and remove outliers from the training dataset. Using 10-fold cross validation, we compared the algorithm's accuracy when trained with and without the presence of outliers. The outlier detection and removal method reduced the variance of the training data. Test accuracy was improved from 63% to 76%, matching the accuracy of clinical judgment of expert burn surgeons, the current gold standard in burn injury assessment. Given that there are few surgeons and facilities specializing in burn care, this technology may improve the standard of burn care for patients without access to specialized facilities.

  17. Toward reducing impact induced brain injury: Lessons from a computational study of army and football helmet pads

    CERN Document Server

    Moss, W C; Blackman, E G

    2012-01-01

    We use computational simulations to compare the impact response of different football and U.S. Army helmet pad materials. We conduct experiments to characterize the material response of different helmet pads. We simulate experimental helmet impact tests performed by the U.S. Army to validate our methods. We then simulate a cylindrical impactor striking different pads. The acceleration history of the impactor is used to calculate the Head Injury Criterion for each pad. We conduct sensitivity studies exploring the effects of pad composition, geometry, and material stiffness. We find that: (1) The football pad materials do not outperform the currently used military pad material in militarily-relevant impact scenarios; (2) Optimal material properties for a pad depend on impact energy; and (3) Thicker pads perform better at all velocities. Our analysis suggests that by using larger helmet shells with correspondingly thicker pads, impact-induced traumatic brain injury may be significantly reduced. Keywords: helmet,...

  18. bcl-xl over-expression in transgenic mice reduces cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Furong Wang; Yongsheng Jiang; Yan Liu; Wenwu Xiao; Suming Zhang

    2008-01-01

    reperfusion, cerebral infarct volume was reduced by 30% in bcl-xl transgenic mice compared with wild-type mice. Simultaneously, the number of apoptotic cells in the ischemic cerebral cortex was significantly less in the transgenic mice compared with the wild-type mice. Overall, the number of apoptotic cells in the transgenic mice remained at a relatively low level. Prior to and subsequent to cerebral ischemia/reperfusion, transgenic mice exhibited markedly higher Bcl-xl protein levels compared with wild-type mice. In addition, after reperfusion, the level of Bcl-xl protein was increased in both transgenic and wild-type mice, but there was no significant difference (P > 0.05) between the two groups. The level of cytochrome C in the transgenic mice was low in the first 24 hours after reperfusion and increased thereafter but was still lower compared with wild-type mice. Neurological function scores demonstrated that transgenic mice exhibited milder neurological function impairment compared with wild-type mice. CONCLUSION: bcl-xl over-expression can inhibit cytochrome C release and result in an inhibitory effect on neural cell apoptosis, thereby alleviating neural cell injury. This is likely to occur due to exogenous over-expression of bcl-xl rather than endogenous production of bcl-xl.

  19. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

    Full Text Available Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns Rehabilitation′ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration

  20. Human umbilical cord mesenchymal stem cells reduce systemic inflammation and attenuate LPS-induced acute lung injury in rats

    Directory of Open Access Journals (Sweden)

    Li Jianjun

    2012-09-01

    Full Text Available Abstract Background Mesenchymal stem cells (MSCs possess potent immunomodulatory properties and simultaneously lack the ability to illicit immune responses. Hence, MSCs have emerged as a promising candidate for cellular therapeutics for inflammatory diseases. Within the context of this study, we investigated whether human umbilical cord-derived mesenchymal stem cells (UC-MSCs could ameliorate lipopolysaccharide- (LPS- induced acute lung injury (ALI in a rat model. Methods ALI was induced via injection of LPS. Rats were divided into three groups: (1 saline group(control, (2 LPS group, and (3 MSC + LPS group. The rats were sacrificed at 6, 24, and 48 hours after injection. Serum, bronchoalveolar lavage fluid (BALF, and lungs were collected for cytokine concentration measurements, assessment of lung injury, and histology. Results UC-MSCs increased survival rate and suppressed LPS-induced increase of serum concentrations of pro-inflammatory mediators TNF-α, IL-1β, and IL-6 without decreasing the level of anti-inflammatory cytokine IL-10. The MSC + LPS group exhibited significant improvements in lung inflammation, injury, edema, lung wet/dry ratio, protein concentration, and neutrophil counts in the BALF, as well as improved myeloperoxidase (MPO activity in the lung tissue. Furthermore, UC-MSCs decreased malondialdehyde (MDA production and increased Heme Oxygenase-1 (HO-1 protein production and activity in the lung tissue. Conclusion UC-MSCs noticeably increased the survival rate of rats suffering from LPS-induced lung injury and significantly reduced systemic and pulmonary inflammation. Promoting anti-inflammatory homeostasis and reducing oxidative stress might be the therapeutic basis of UC-MSCs.

  1. Arginase 2 deletion reduces neuro-glial injury and improves retinal function in a model of retinopathy of prematurity.

    Directory of Open Access Journals (Sweden)

    Subhadra P Narayanan

    Full Text Available BACKGROUND: Retinopathy of prematurity (ROP is a major cause of vision impairment in low birth weight infants. While previous work has focused on defining the mechanisms of vascular injury leading to retinal neovascularization, recent studies show that neurons are also affected. This study was undertaken to determine the role of the mitochondrial arginine/ornithine regulating enzyme arginase 2 (A2 in retinal neuro-glial cell injury in the mouse model of ROP. METHODS AND FINDINGS: Studies were performed using wild type (WT and A2 knockout (A2-/- mice exposed to Oxygen Induced Retinopathy (OIR. Neuronal injury and apoptosis were assessed using immunohistochemistry, TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling and Western blotting. Electroretinography (ERG was used to assess retinal function. Neuro-glial injury in WT ROP mice was evident by TUNEL labeling, retinal thinning, decreases in number of rod bipolar cells and glial cell activation as compared with room air controls. Significant reduction in numbers of TUNEL positive cells, inhibition of retinal thinning, preservation of the rod bipolar cells and prevention of glial activation were observed in the A2-/- retinas. Retinal function was markedly impaired in the WT OIR mice as shown by decreases in amplitude of the b-wave of the ERG. This defect was significantly reduced in A2-/- mice. Levels of the pro-apoptotic proteins p53, cleaved caspase 9, cytochrome C and the mitochondrial protein Bim were markedly increased in WT OIR retinas compared to controls, whereas the pro-survival Mitochondrial protein BCL-xl was reduced. These alterations were largely blocked in the A2-/- OIR retina. CONCLUSIONS: Our data implicate A2 in neurodegeneration during ROP. Deletion of A2 significantly improves neuronal survival and function, possibly through the regulation of mitochondrial membrane permeability mediated apoptosis during retinal ischemia. These molecular events are associated with

  2. Macrophage depletion reduced brain injury following middle cerebral artery occlusion in mice

    OpenAIRE

    Ma, Yuanyuan; Li, Yaning; Jiang, Lu; Wang, Liping; Jiang, Zhen; Wang, Yongting; Zhang, Zhijun; Yang, Guo-Yuan

    2016-01-01

    Background Macrophages are involved in demyelination in many brain diseases. However, the role of macrophages in the recovery phase of the ischemic brain is unknown. The present study aims to explore the role of macrophages in the ischemic brain injury and tissue repair following a 90-min transient middle cerebral artery occlusion in mice. Methods Clodronate liposomes were injected into mice to deplete periphery macrophages. These mice subsequently underwent middle cerebral artery occlusion. ...

  3. Interventions to reduce needle stick injuries at a tertiary care centre

    OpenAIRE

    Mehta A; Rodrigues C; Singhal T; Lopes N; D′Souza N; Sathe K; Dastur F

    2010-01-01

    Background: Occupational exposure to blood/body fluids is associated with risk of infection with blood borne pathogens like human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Materials and Methods: We carefully document needle stick injuries (NSI) and implement post-exposure prophylaxis (PEP). We report a four-year continuing surveillance study where 342 healthcare workers (HCWs) sustained NSI. PEP was given to HCWs injured from seropositive sources. I...

  4. Genetic replacement of surfactant protein-C reduces respiratory syncytial virus induced lung injury

    OpenAIRE

    Glasser, Stephan W.; Senft, Albert P; Melissa D. Maxfield; Ruetschilling, Teah L.; Baatz, John E.; Page, Kristen; Korfhagen, Thomas R.

    2013-01-01

    Background Individuals with deficiencies of pulmonary surfactant protein C (SP-C) develop interstitial lung disease (ILD) that is exacerbated by viral infections including respiratory syncytial virus (RSV). SP-C gene targeted mice (Sftpc -/-) lack SP-C, develop an ILD-like disease and are susceptible to infection with RSV. Methods In order to determine requirements for correction of RSV induced injury we have generated compound transgenic mice where SP-C expression can be induced on the Sftpc...

  5. Caspase-1 Is Hepatoprotective during Trauma and Hemorrhagic Shock by Reducing Liver Injury and Inflammation

    OpenAIRE

    Menzel, Christoph L.; Sun, Qian; Loughran, Patricia A.; Pape, Hans-Christoph; Billiar, Timothy R; Scott, Melanie J.

    2011-01-01

    Adaptive immune responses are induced in liver after major stresses such as hemorrhagic shock (HS) and trauma. There is emerging evidence that the inflammasome, the multiprotein platform that induces caspase-1 activation and promotes interleukin (IL)-1β and IL-18 processing, is activated in response to cellular oxidative stress, such as after hypoxia, ischemia and HS. Additionally, damage-associated molecular patterns, such as those released after injury, have been shown to activate the infla...

  6. The approach taken to reducing the risk of transfusion related acute lung injury in Canada

    OpenAIRE

    Growe G; Petraszko T; Bigham Mark

    2008-01-01

    Transfusion related acute lung injury (TRALI) has become a major reported cause of severe transfusion reactions and mortality. Over the past four years significant changes have been taken in Canada in order both to improve the recognition of the risk and to decrease its incidence. An international meeting was held in April of 2004 entitled "Towards an Understanding of TRALI". As a result of the analysis and recommendations from this meeting, the Canadian Blood Services established an ongoing ...

  7. Exogenous normal lymph reduces liver injury induced by lipopolysaccharides in rats

    Directory of Open Access Journals (Sweden)

    Z.G. Zhao

    2014-02-01

    Full Text Available The liver is one of the target organs damaged by septic shock, wherein the spread of endotoxins begins. This study aimed to investigate the effects of exogenous normal lymph (ENL on lipopolysaccharide (LPS-induced liver injury in rats. Male Wistar rats were randomly divided into sham, LPS, and LPS+ENL groups. LPS (15 mg/kg was administered intravenously via the left jugular vein to the LPS and LPS+ENL groups. At 15 min after the LPS injection, saline or ENL without cell components (5 mL/kg was administered to the LPS and LPS+ENL groups, respectively, at a rate of 0.5 mL/min. Hepatocellular injury indices and hepatic histomorphology, as well as levels of P-selectin, intercellular adhesion molecule 1 (ICAM-1, myeloperoxidase (MPO, and Na+-K+-ATPase, were assessed in hepatic tissues. Liver tissue damage occurred after LPS injection. All levels of alanine aminotransferase (ALT and aspartate aminotransferase (AST in plasma as well as the wet/dry weight ratio of hepatic tissue in plasma increased. Similarly, P-selectin, ICAM-1, and MPO levels in hepatic tissues were elevated, whereas Na+-K+-ATPase activity in hepatocytes decreased. ENL treatment lessened hepatic tissue damage and decreased levels of AST, ALT, ICAM-1, and MPO. Meanwhile, the treatment increased the activity of Na+-K+-ATPase. These results indicated that ENL could alleviate LPS-induced liver injury, thereby suggesting an alternative therapeutic strategy for the treatment of liver injury accompanied by severe infection or sepsis.

  8. Exogenous normal lymph reduces liver injury induced by lipopolysaccharides in rats

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Z.G.; Zhang, L.L.; Niu, C.Y.; Zhang, J. [Institute of Microcirculation, Hebei North University, Zhangjiakou, China, Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei (China)

    2014-02-17

    The liver is one of the target organs damaged by septic shock, wherein the spread of endotoxins begins. This study aimed to investigate the effects of exogenous normal lymph (ENL) on lipopolysaccharide (LPS)-induced liver injury in rats. Male Wistar rats were randomly divided into sham, LPS, and LPS+ENL groups. LPS (15 mg/kg) was administered intravenously via the left jugular vein to the LPS and LPS+ENL groups. At 15 min after the LPS injection, saline or ENL without cell components (5 mL/kg) was administered to the LPS and LPS+ENL groups, respectively, at a rate of 0.5 mL/min. Hepatocellular injury indices and hepatic histomorphology, as well as levels of P-selectin, intercellular adhesion molecule 1 (ICAM-1), myeloperoxidase (MPO), and Na{sup +}-K{sup +}-ATPase, were assessed in hepatic tissues. Liver tissue damage occurred after LPS injection. All levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in plasma as well as the wet/dry weight ratio of hepatic tissue in plasma increased. Similarly, P-selectin, ICAM-1, and MPO levels in hepatic tissues were elevated, whereas Na{sup +}-K{sup +}-ATPase activity in hepatocytes decreased. ENL treatment lessened hepatic tissue damage and decreased levels of AST, ALT, ICAM-1, and MPO. Meanwhile, the treatment increased the activity of Na{sup +}-K{sup +}-ATPase. These results indicated that ENL could alleviate LPS-induced liver injury, thereby suggesting an alternative therapeutic strategy for the treatment of liver injury accompanied by severe infection or sepsis.

  9. Exogenous normal lymph reduces liver injury induced by lipopolysaccharides in rats

    International Nuclear Information System (INIS)

    The liver is one of the target organs damaged by septic shock, wherein the spread of endotoxins begins. This study aimed to investigate the effects of exogenous normal lymph (ENL) on lipopolysaccharide (LPS)-induced liver injury in rats. Male Wistar rats were randomly divided into sham, LPS, and LPS+ENL groups. LPS (15 mg/kg) was administered intravenously via the left jugular vein to the LPS and LPS+ENL groups. At 15 min after the LPS injection, saline or ENL without cell components (5 mL/kg) was administered to the LPS and LPS+ENL groups, respectively, at a rate of 0.5 mL/min. Hepatocellular injury indices and hepatic histomorphology, as well as levels of P-selectin, intercellular adhesion molecule 1 (ICAM-1), myeloperoxidase (MPO), and Na+-K+-ATPase, were assessed in hepatic tissues. Liver tissue damage occurred after LPS injection. All levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in plasma as well as the wet/dry weight ratio of hepatic tissue in plasma increased. Similarly, P-selectin, ICAM-1, and MPO levels in hepatic tissues were elevated, whereas Na+-K+-ATPase activity in hepatocytes decreased. ENL treatment lessened hepatic tissue damage and decreased levels of AST, ALT, ICAM-1, and MPO. Meanwhile, the treatment increased the activity of Na+-K+-ATPase. These results indicated that ENL could alleviate LPS-induced liver injury, thereby suggesting an alternative therapeutic strategy for the treatment of liver injury accompanied by severe infection or sepsis

  10. Heat Shock Protein 90 Inhibitors Prolong Survival, Attenuate Inflammation, and Reduce Lung Injury in Murine Sepsis

    OpenAIRE

    Chatterjee, Anuran; Dimitropoulou, Christiana; Drakopanayiotakis, Fotios; ANTONOVA, Galina; Snead, Connie; Cannon, Joseph; Venema, Richard C.; Catravas, John D.

    2007-01-01

    Rationale: Severe sepsis is the leading cause of death for patients in intensive care units. Patients with severe sepsis develop multiple organ failure, including acute lung injury (ALI), resulting from a deregulated inflammatory response. Inhibitors of the ubiquitous chaperone, heat shock protein 90 (Hsp90), block the activity of certain proinflammatory mediators in vitro. We hypothesized that Hsp90 inhibitors may ameliorate the inflammation and ALI associated with severe sepsis.

  11. Combined Treatments Reduce Chilling Injury and Maintain Fruit Quality in Avocado Fruit during Cold Quarantine

    OpenAIRE

    Sivankalyani, Velu; Feygenberg, Oleg; Maorer, Dalia; Zaaroor, Merav; Fallik, Elazar; Alkan, Noam

    2015-01-01

    Quarantine treatment enables export of avocado fruit (Persea americana) to parts of the world that enforce quarantine against fruit fly. The recommended cold-based quarantine treatment (storage at 1.1°C for 14 days) was studied with two commercial avocado cultivars ‘Hass’ and ‘Ettinger’ for 2 years. Chilling injuries (CIs) are prevalent in the avocado fruit after cold-quarantine treatment. Hence, we examined the effect of integrating several treatments: modified atmosphere (MA; fruit covered ...

  12. Methods and Procedures in the rescue of burn injury patients in the bus rapid transit (BRT) bomb blasts case in Xiamen%厦门公交车纵火案烧伤伤员救治的护理管理

    Institute of Scientific and Technical Information of China (English)

    黄榕; 殷婷婷; 卓龙彩; 夏哲远; 孔悦

    2013-01-01

    目的:探讨批量烧伤伤员救治的方法与程序。方法:迅速启动批量伤员救治应急预案,准备各种抢救物资,合理分配人员,高效实施救治,积极应对突发公共卫生事件。结果:18名患者平稳度过休克期,救治工作取得阶段性成果。结论:有效的救护管理体系可以在突发公共卫生事件中发挥重要作用。%Objective:To explore the methods and procedures in the rescue of mass patients with burn injuries. Methods:The emergency preparedness which included the preparation of medical supplies, rational division of nursing staff, and effective treatment were carried out to respond positively to the public health emergencies. Results:Eighteen burn injury patients passed the shock stage smoothly and signiifcant results were achieved. Conclusion:The effective ifrst aid system plays a major role in public health emergencies.

  13. 烧伤临床营养新理念:从营养支持到营养治疗%A new concept of nutrition in treatment of burn injury:from nutrition support to nutrition therapy

    Institute of Scientific and Technical Information of China (English)

    彭曦; 汪仕良

    2011-01-01

    For many years,the major concerns in the treatment of a major burn injury have always been shock resuscitation,infection control,and wound treatment,while nutrition has been considered as a subordinate concern.The concept of nutrition in the treatment of a major burn has been recognized as “nutrition support”,only with the purpose of restraining negative nitrogen balance through administration of energy and protein,in order to prevent malnutrition in patients with severe burn.In recent 10 years,however,increasing evidences have showed that optimal nutritional management could improve the outcome of severe burn patients.Now it is recognized that nutrition is not only to provide exogenous nutrients to improve nutritional status of the patients,but also to regulate celI metabolism,enhance cell activity,maintain and uphold the structure and function of the gastrointestinal mucosa,thus to improve patient's outcome.Therefore,the term of “nutrition support”seems to be far from comprehensiveness to reflect the purpose and the aim of this important treatment strategy.Medical literatures especially those in nutritional guidelines have begun to use the term of “nutrition therapy” instead of “ nutrition support”,which typifies the changes in nutritional concept,aim,means,and clinical evaluation.The aim of nutrition has changed from simply “providing nutritional substrate and improving nutritional status of patients” to “ regulating cell metabolism,maintaining organ structure and function,and ultimately improving outcome of patient”.Meanwhile,nutritional means has been more consummate,including special nutrients,hormones,and growth factors,in addition to use of conventional nutrients,in order to enhance therapeutic effect of nutrition in treatment of massive burn injury.Burn nutrition is no longer confined to maintenance of positive nitrogen balance,it should also consider the regulation of cell activity,metabolic status,immune and organ function

  14. Changes of intermediary taurine and tryptophan metabolism after combined radiation-thermal injury

    International Nuclear Information System (INIS)

    The dynamics of changes of the taurine and tryptophane concentration in blood serum of rats has been studied during 30 days after 3b degree burn of 15% of body surface after total even exposure to radiation in doses of 3 and 6 Gy, and after combined radiation thermal injury. Combined radiation-thermal injury was found to be characterized by reduced concentration of taurine but an increase of the tryptophane level from the second-third day after the injury

  15. Burning Issue: Handling Household Burns

    Science.gov (United States)

    ... take steps to avoid household burns. Never leave cooking food unattended on the stove. Set your water heater’s thermostat to 120 °F or lower to prevent scalding burns. And install smoke alarms on every floor of your home. Keep yourself and your family safe from unexpected ...

  16. Targeting hexokinase II to mitochondria to modulate energy metabolism and reduce ischaemia-reperfusion injury in heart.

    Science.gov (United States)

    Nederlof, Rianne; Eerbeek, Otto; Hollmann, Markus W; Southworth, Richard; Zuurbier, Coert J

    2014-04-01

    Mitochondrially bound hexokinase II (mtHKII) has long been known to confer cancer cells with their resilience against cell death. More recently, mtHKII has emerged as a powerful protector against cardiac cell death. mtHKII protects against ischaemia-reperfusion (IR) injury in skeletal muscle and heart, attenuates cardiac hypertrophy and remodelling, and is one of the major end-effectors through which ischaemic preconditioning protects against myocardial IR injury. Mechanisms of mtHKII cardioprotection against reperfusion injury entail the maintenance of regulated outer mitochondrial membrane (OMM) permeability during ischaemia and reperfusion resulting in stabilization of mitochondrial membrane potential, the prevention of OMM breakage and cytochrome C release, and reduced reactive oxygen species production. Increasing mtHK may also have important metabolic consequences, such as improvement of glucose-induced insulin release, prevention of acidosis through enhanced coupling of glycolysis and glucose oxidation, and inhibition of fatty acid oxidation. Deficiencies in expression and distorted cellular signalling of HKII may contribute to the altered sensitivity of diabetes to cardiac ischaemic diseases. The interaction of HKII with the mitochondrion constitutes a powerful endogenous molecular mechanism to protect against cell death in almost all cell types examined (neurons, tumours, kidney, lung, skeletal muscle, heart). The challenge now is to harness mtHKII in the treatment of infarction, stroke, elective surgery and transplantation. Remote ischaemic preconditioning, metformin administration and miR-155/miR-144 manipulations are potential means of doing just that. PMID:24032601

  17. Beneficial effects of hydrogen gas in a rat model of traumatic brain injury via reducing oxidative stress.

    Science.gov (United States)

    Ji, Xituan; Liu, Wenbo; Xie, Keliang; Liu, Weiping; Qu, Yan; Chao, Xiaodong; Chen, Tao; Zhou, Jun; Fei, Zhou

    2010-10-01

    Traumatic brain injury (TBI) is a leading cause of mortality and disability among the young population. It has been shown that hydrogen gas (H(2)) exerts a therapeutic antioxidant activity by selectively reducing hydroxyl radical (OH, the most cytotoxic ROS). Recently, we have found that H(2) inhalation significantly improved the survival rate and organ damage of septic mice. In the present study, we investigated the effectiveness of H(2) therapy on brain edema, blood-brain barrier (BBB) breakdown, neurological dysfunction and injury volume in TBI-challenged rats. In addition, we investigated the effects of H(2) treatment on the changes of oxidative products and antioxidant enzymes in brain tissue of TBI-challenged rats. Hydrogen treatment was given by exposure to 2% H(2) from 5 min to 5h after sham or TBI operation, respectively. Here, we found that TBI-challenged rats showed significant brain injuries characterized by the increase of BBB permeability, brain edema and lesion volume as well as neurological dysfunction, which was significantly attenuated by 2% H(2) treatment. In addition, we found that the decrease of oxidative products and the increase of endogenous antioxidant enzymatic activities in the brain tissue may be associated with the protective effects of H(2) treatment in TBI-challenged rats. The present study supports that H(2) inhalation may be a more effective therapeutic strategy for patients with TBI. PMID:20654594

  18. Treatment of radiation burns, 1987 [videorecording

    International Nuclear Information System (INIS)

    After the accident at Chernobyl, patients with various degrees of radiation burns were given treatment at Moscow hospital No. 6. The video shows the radiation injuries as well as therapy and treatment in detail

  19. Protect the Ones You Love: Burns Safety

    Science.gov (United States)

    ... Recreational Safety Child Abuse and Neglect Prevention Youth Violence Prevention ... keep our children safe and secure and help them live to their full potential. Knowing how to prevent leading causes of child injury, like burns, is a step ...

  20. Nutrition and Metabolic Support in Burn

    Directory of Open Access Journals (Sweden)

    Perihan Ergin Özcan

    2011-07-01

    Full Text Available Burn injury results in a dramatic increase of the basal metabolic rate. Severe burn injury nearly doubles resting energy expenditure and hypermetabolism associated with burn results in a loss of body fat stores and a loss of visceral and structural protein mass. The clinical effects of these changes include immunosuppression, delayed wound healing, and generalized muscle weakness. Post burn, the metabolic and catabolic responses are prolonged in severity and time course, lasting weeks to months in contrast to the days and weeks observed in other injuries. Nutrition support provides the substrates and nutrients to prevent the complications of deficiencies as well as supporting wound healing, and recovery from hormonal and metabolic abnormalities after thermal injury. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 21-5

  1. Clinician Attitudes, Screening Practices, and Interventions to Reduce Firearm-Related Injury.

    Science.gov (United States)

    Roszko, Paul J D; Ameli, Jonathan; Carter, Patrick M; Cunningham, Rebecca M; Ranney, Megan L

    2016-01-01

    Firearm injury is a leading cause of injury-related morbidity and mortality in the United States. We sought to systematically identify and summarize existing literature on clinical firearm injury prevention screening and interventions. We conducted a systematic search of PubMed, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and ClinicalTrials.gov for English-language original research (published 1992-2014) on clinical screening methods, patient-level firearm interventions, or patient/provider attitudes on the same. Unrelated studies were excluded through title, abstract, and full-text review, and the remaining articles underwent data abstraction and quality scoring. Of a total of 3,260 unique titles identified, 72 were included in the final review. Fifty-three articles examined clinician attitudes/practice patterns; prior training, experience, and expectations correlated with clinicians' regularity of firearm screening. Twelve articles assessed patient interventions, of which 6 were randomized controlled trials. Seven articles described patient attitudes; all were of low methodological quality. According to these articles, providers rarely screen or counsel their patients-even high-risk patients-about firearm safety. Health-care-based interventions may increase rates of safe storage of firearms for pediatric patients, suicidal patients, and other high-risk groups. Some studies show that training clinicians can increase rates of effective firearm safety screening and counseling. Patients and families are, for the most part, accepting of such screening and counseling. However, the current literature is, by and large, not high quality. Rigorous, large-scale, adequately funded studies are needed. PMID:26905894

  2. Incidence of cardiac events in burned patients.

    Science.gov (United States)

    Meyers, David G; Hoestje, Sara M; Korentager, Richard A

    2003-06-01

    Given the increased level of adrenergic stimulation in burn patients, it would be expected that they would experience an increased incidence of cardiac arrhythmias and other cardiac events. We performed a retrospective chart review of 56 acute burn patients matched by age, length of hospital stay, and sex to 56 trauma patients, all of whom had been continuously monitored electrocardiographically. Burn and trauma patients were similar in injury severity, admission laboratory values, and prior history of cardiopulmonary diseases. Arrhythmias were noted in 34% of burn patients and 28% of trauma patients. One myocardial infarction and six deaths occurred in burn patients. No myocardial infarctions or deaths were observed in trauma patients. A past history of cardiopulmonary disease increased the risk of myocardial infarction or death by 6.6 times. Cardiac arrhythmias and other events are relatively infrequent and benign in burn patients and are similar to those experienced by other patients with acute injuries. PMID:12781616

  3. Exogenous normal lymph reduces liver injury induced by lipopolysaccharides in rats

    OpenAIRE

    Zhao, Z. G.; L. L. Zhang; C.Y. Niu; J. Zhang

    2014-01-01

    The liver is one of the target organs damaged by septic shock, wherein the spread of endotoxins begins. This study aimed to investigate the effects of exogenous normal lymph (ENL) on lipopolysaccharide (LPS)-induced liver injury in rats. Male Wistar rats were randomly divided into sham, LPS, and LPS+ENL groups. LPS (15 mg/kg) was administered intravenously via the left jugular vein to the LPS and LPS+ENL groups. At 15 min after the LPS injection, saline or ENL without cell components (5 mL/kg...

  4. Reducing Meloidogyne incognita Injury to Cucumber in a Tomato-Cucumber Double-Cropping System

    OpenAIRE

    Colyer, P. D.; Kirkpatrick, T. L.; Vernon, P. R.; Barham, J. D.; Bateman, R.J.

    1998-01-01

    The effects of a root-knot nematode-resistant tomato cultivar and application of the nematicide ethoprop on root-knot nematode injury to cucumber were compared in a tomato-cucumber double-cropping system. A root-knot nematode-resistant tomato cultivar, Celebrity, and a susceptible cultivar, Heatwave, were grown in rotation with cucumber in 1995 and 1996. Celebrity suppressed populations of Meloidogyne incognita in the soil and resulted in a low root-gall rating on the subsequent cucumber crop...

  5. Transcriptomic and behavioural characterisation of a mouse model of burn pain identify the cholecystokinin 2 receptor as an analgesic target

    Science.gov (United States)

    Yin, Kathleen; Deuis, Jennifer R; Lewis, Richard J

    2016-01-01

    Burn injury is a cause of significant mortality and morbidity worldwide and is frequently associated with severe and long-lasting pain that remains difficult to manage throughout recovery. We characterised a mouse model of burn-induced pain using pharmacological and transcriptomic approaches. Mechanical allodynia elicited by burn injury was partially reversed by meloxicam (5 mg/kg), gabapentin (100 mg/kg) and oxycodone (3 and 10 mg/kg), while thermal allodynia and gait abnormalities were only significantly improved by amitriptyline (3 mg/kg) and oxycodone (10 mg/kg). The need for relatively high opioid doses to elicit analgesia suggested a degree of opioid resistance, similar to that shown clinically in burn patients. We thus assessed the gene expression changes in dorsal root ganglion neurons and pathophysiological mechanisms underpinning burn injury-induced pain using a transcriptomic approach. Burn injury was associated with significantly increased expression of genes associated with axon guidance, neuropeptide signalling, behavioural defence response and extracellular signalling, confirming a mixed neuropathic and inflammatory aetiology. Notably, among the pain-related genes that were upregulated post-injury was the cholecystokinin 2 receptor (Cckbr), a G protein-coupled receptor known as a pain target involved in reducing opioid effectiveness. Indeed, the clinically used cholecystokinin receptor antagonist proglumide (30 mg/kg) was effective at reversing mechanical allodynia, with additional analgesia evident in combination with low-dose oxycodone (1 mg/kg), including significant reversal of thermal allodynia. These findings highlight the complex pathophysiological mechanisms underpinning burn injury-induced pain and suggest that cholecystokinin-2 receptor antagonists may be useful clinically as adjuvants to decrease opioid requirements and improve analgesic management. PMID:27573516

  6. Pretreatment with remifentanil protects against the reduced-intestinal contractility related to the ischemia and reperfusion injury in rat

    Directory of Open Access Journals (Sweden)

    Hale Sayan-Ozacmak

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES: Serious functional and structural alterations of gastrointestinal tract are observed in failure of blood supply, leading to gastrointestinal dismotility. Activation of opioid receptors provides cardioprotective effect against ischemia-reperfusion (I/R injury. The aim of the present study was to determine whether or not remifentanil could reduce I/R injury of small intestine. METHODS: Male Wistar Albino rats were subjected to mesenteric ischemia (30 min followed by reperfusion (3 h. Four groups were designed: sham control; remifentanil alone; I/R control; and remifentanil + I/R. Animals in remifentanil + I/R group were subjected to infusion of remifentanil (2 ug kg-1 min-1 for 60 min, half of which started before inducing ischemia. Collecting the ileum tissues, evaluation of damage was based on contractile responses to carbachol, levels of lipid peroxidation and neutrophil infiltration, and observation of histopathological features in intestinal tissue. RESULTS: Following reperfusion, a significant decrease in carbachol-induced contractile response, a remarkable increase in both lipid peroxidation and neutrophil infiltration, and a significant injury in mucosa were observed. An average contractile response of remifentanil + I/R group was significantly different from that of the I/R group. Lipid peroxidation and neutrophil infiltration were also significantly suppressed by the treatment. The tissue samples of the I/R group were grade 4 in histopathological evaluation. In remifentanil + I/R group, on the other hand, the mucosal damage was moderate, staging as grade 1. CONCLUSIONS: The pretreatment with remifentanil can attenuate the intestinal I/R injury at a remarkable degree possibly by lowering lipid peroxidation and leukocyte infiltration.

  7. Triptolide inhibits NF-κB activation and reduces injury of donor lung induced by ischemia/reperfusion

    Institute of Scientific and Technical Information of China (English)

    Jing-kang HE; Shu-dong YU; Hong-Jun ZHU; Jun-chao WU; Zhen-ghong QIN

    2007-01-01

    Aim: To investigate the protective effect of triptolide (TRI) on ischemia/reperfusion- induced injury of transplanted rabbit lungs and to investigate the mechanisms underlying the actions of TRI. Methods: We established the rabbit lung trans- plantation model and studied lung injury induced by ischemia/reperfusion and the inhibitory effect of TRI on NF-r,B. The severity of lung injury was determined by a gradual decline in PvO2, the degree of lung edema, the increase in the myeloperoxidase (MPO) activity, and the ultrastructural changes of transplanted lungs. The activation of NF-r,B was measured by immunohistochemistry. The increase in intercellular adhesion molecule- 1 (ICAM- 1), which is the target gene of NF-κB, was evaluated by ELISA. Results: After reperfusion, there was a gradual decline in the PvO2 level in the control group (group I). The level of PvO2 in the group treated with lipopolysaccharide (group Ⅱ) was significantly decreased, whereas that of the group treated with TRI (group Ⅲ) was markedly improved (P<0.01). In group Ⅲ, the activity of MPO was downregulated, and the pulmonary edema did not become severe and the ultrastructure of the donor lung remained normal. The activity of NF-κB and the expression of ICAM-1 was significantly increased in the donor lungs. TRI blocked NF-κB activation and ICAM-1 expression. Conclusion: The effects of TRI on reducing injury to donor lungs induced by ischemia/reperfusion may possibly be mediated by inhibiting the activity of NF-κB and the expression of the NF-rd3 target gene ICAM-1. Thus, TRI could be used in lung transplantations for improving the function of donor lungs.

  8. Reduced thalamic volume in preterm infants is associated with abnormal white matter metabolism independent of injury

    Energy Technology Data Exchange (ETDEWEB)

    Wisnowski, Jessica L. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Ceschin, Rafael C. [University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Department of Biomedical Informatics, Pittsburgh, PA (United States); Choi, So Young [University of Southern California, Brain and Creativity Institute, Los Angeles, CA (United States); Schmithorst, Vincent J. [University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Painter, Michael J. [University of Pittsburgh, Department of Pediatrics, Division of Neurology, Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Nelson, Marvin D. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Blueml, Stefan [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Rudi Schulte Research Institute, Santa Barbara, CA (United States); Panigrahy, Ashok [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States)

    2015-05-01

    Altered thalamocortical development is hypothesized to be a key substrate underlying neurodevelopmental disabilities in preterm infants. However, the pathogenesis of this abnormality is not well-understood. We combined magnetic resonance spectroscopy of the parietal white matter and morphometric analyses of the thalamus to investigate the association between white matter metabolism and thalamic volume and tested the hypothesis that thalamic volume would be associated with diminished N-acetyl-aspartate (NAA), a measure of neuronal/axonal maturation, independent of white matter injury. Data from 106 preterm infants (mean gestational age at birth: 31.0 weeks ± 4.3; range 23-36 weeks) who underwent MR examinations under clinical indications were included in this study. Linear regression analyses demonstrated a significant association between parietal white matter NAA concentration and thalamic volume. This effect was above and beyond the effect of white matter injury and age at MRI and remained significant even when preterm infants with punctate white matter lesions (pWMLs) were excluded from the analysis. Furthermore, choline, and among the preterm infants without pWMLs, lactate concentrations were also associated with thalamic volume. Of note, the associations between NAA and choline concentration and thalamic volume remained significant even when the sample was restricted to neonates who were term-equivalent age or older. These observations provide convergent evidence of a neuroimaging phenotype characterized by widespread abnormal thalamocortical development and suggest that the pathogenesis may involve impaired axonal maturation. (orig.)

  9. Reduced thalamic volume in preterm infants is associated with abnormal white matter metabolism independent of injury

    International Nuclear Information System (INIS)

    Altered thalamocortical development is hypothesized to be a key substrate underlying neurodevelopmental disabilities in preterm infants. However, the pathogenesis of this abnormality is not well-understood. We combined magnetic resonance spectroscopy of the parietal white matter and morphometric analyses of the thalamus to investigate the association between white matter metabolism and thalamic volume and tested the hypothesis that thalamic volume would be associated with diminished N-acetyl-aspartate (NAA), a measure of neuronal/axonal maturation, independent of white matter injury. Data from 106 preterm infants (mean gestational age at birth: 31.0 weeks ± 4.3; range 23-36 weeks) who underwent MR examinations under clinical indications were included in this study. Linear regression analyses demonstrated a significant association between parietal white matter NAA concentration and thalamic volume. This effect was above and beyond the effect of white matter injury and age at MRI and remained significant even when preterm infants with punctate white matter lesions (pWMLs) were excluded from the analysis. Furthermore, choline, and among the preterm infants without pWMLs, lactate concentrations were also associated with thalamic volume. Of note, the associations between NAA and choline concentration and thalamic volume remained significant even when the sample was restricted to neonates who were term-equivalent age or older. These observations provide convergent evidence of a neuroimaging phenotype characterized by widespread abnormal thalamocortical development and suggest that the pathogenesis may involve impaired axonal maturation. (orig.)

  10. Dietary L-arginine supplementation reduces Methotrexate-induced intestinal mucosal injury in rat

    Directory of Open Access Journals (Sweden)

    Koppelmann Tal

    2012-04-01

    Full Text Available Abstract Background Arginine (ARG and nitric oxide maintain the mucosal integrity of the intestine in various intestinal disorders. In the present study, we evaluated the effects of oral ARG supplementation on intestinal structural changes, enterocyte proliferation and apoptosis following methotrexate (MTX-induced intestinal damage in a rat. Methods Male rats were divided into four experimental groups: Control rats, CONTR-ARG rats, were treated with oral ARG given in drinking water 72 hours before and 72 hours following vehicle injection, MTX rats were treated with a single dose of methotrexate, and MTX-ARG rats were treated with oral ARG following injection of MTX. Intestinal mucosal damage, mucosal structural changes, enterocyte proliferation and enterocyte apoptosis were determined 72 hours following MTX injection. RT-PCR was used to determine bax and bcl-2 mRNA expression. Results MTX-ARG rats demonstrated greater jejunal and ileal bowel weight, greater ileal mucosal weight, greater ileal mucosal DNA and protein levels, greater villus height in jejunum and ileum and crypt depth in ileum, compared to MTX animals. A significant decrease in enterocyte apoptosis in the ileum of MTX-ARG rats (vs MTX was accompanied by decreased bax mRNA and protein expression and increased bcl-2 protein levels. Conclusions Treatment with oral ARG prevents mucosal injury and improves intestinal recovery following MTX- injury in the rat.

  11. Cheiloplasty in Post-burn Deformed Lips

    OpenAIRE

    Saadeldeen, W.M.

    2009-01-01

    The lip is a part of the face that is frequently affected by burn injury. Post-burn scar sequelae in this area often result in cosmetic disfigurement and psychological upsets in patients, especially young adult females. A burn destroys the aesthetic features and lines of the lip. Plastic and reconstructive surgery of the face has a long history. Many local and regional flaps have been used for reconstruction of surgical or traumatic defects. Procedures to enhance the cosmetic features of the ...

  12. Neuroendocrine Stress Response after Burn Trauma

    OpenAIRE

    Lindahl, Andreas

    2013-01-01

    Some aspects of the stress response during acute intensive care for severe burns are described and quantified by measuring hormonal and neuroendocrine patterns and relating these to organ function in the short term. This includes an assessment of whether there are markers for the severity of stress that are better than conventional descriptors of the severity of a burn in predicting failing organ function. P-CgA after a major burn injury is an independent and better predictor of organ dysfunc...

  13. Topical agents in burn care

    OpenAIRE

    Momčilović Dragan

    2002-01-01

    Introduction Understanding of fluid shifts and recognition of the importance of early and appropriate fluid replacement therapy have significantly reduced mortality in the early post burn period. After the bum patient successfully passes the resuscitation period, the burn wound represents the greatest threat to survival. History Since the dawn of civilization, man has been trying to find an agent which would help burn wounds heal, and at the same time, not harm general condition of the injure...

  14. Intensive Care Management in Pediatric Burn Patients

    Directory of Open Access Journals (Sweden)

    Ayşe Ebru Sakallıoğlu Abalı

    2011-07-01

    Full Text Available Burn injury is still a leading cause of morbidity and mortality in children. This article aimed to review the current principles of management from initial assessment to early management and intensive care for pediatric burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 62-9

  15. A ring burn--electric or contact?

    Science.gov (United States)

    Attalla, M F; el-Ekiabi, S; Al-Baker, A

    1990-02-01

    A circumferential band of deep burn affecting the ring finger sustained by a car electrician is presented. Although it was caused by short circuiting the car battery by a metal spanner and the ring he was wearing, the injury was purely a contact burn. PMID:2322399

  16. Acute pain management in burn patients

    DEFF Research Database (Denmark)

    Gamst-Jensen, Hejdi; Vedel, Pernille Nygaard; Lindberg-Larsen, Viktoria Oline;

    2014-01-01

    OBJECTIVE: Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain...

  17. Burning Mouth Syndrome

    Science.gov (United States)

    ... OralHealth > Topics > Burning Mouth Syndrome > Burning Mouth Syndrome Burning Mouth Syndrome Main Content Key Points Symptoms Diagnosis Primary and Secondary BMS Treatment Helpful Tips Key Points Burning mouth syndrome is burning pain in the mouth that may ...

  18. Pretreatment with interleukin-33 reduces warm hepatic ischemia/reperfusion injury in mice

    Institute of Scientific and Technical Information of China (English)

    LI Shu; ZHU Feng-xue; ZHANG Hong-bin; LI Hui; AN You-zhong

    2013-01-01

    Background Interleukin (IL)-33 is a recently identified member of the IL-1 family that binds to the receptor,ST2L.This study examined IL-33 production in mouse liver and investigated its role in hepatic ischemia/reperfusion (I/R) injury.Methods Male BALB/c mice ((22±3) g) were subjected to 90 minutes partial hepatic ischemia,followed by 6 hours reperfusion.First,mice were randomized into two groups:control group (laparotomy only,without blocking blood supply) and ischemia model group.IL-33 mRNA and serum protein levels were measured at 30,60,90 minutes after ischemia and 2 and 6 hours after reperfusion.Second,mice were randomized into four groups:control,model (injection of rabbit IgG polyclonal antibody),recombinant IL-33 intervention and anti-ST2L antibody intervention group.Mice were sacrificed 6 hours after reperfusion.Liver pathology was observed via transmission electron microscopy.Serum aspartate aminotransferase (AST),alanine aminotransferase (ALT),IL-4,IL-5,IL-13,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-a) levels were measured.Results Levels of IL-33 mRNA and protein did not change during ischemia (P >0.05) but increased significantly during reperfusion (P <0.05).After reperfusion for 6 hours,serum levels of ALT,AST,IL-4,IL-5,IL-13,IFN-γ and TNF-α were significantly increased (P <0.05),and hepatocellular ultrastructure was damaged.Pretreatment with IL-33 attenuated severity of liver damage compared with controls,but pretreatment with anti-ST2L antibody increased severity.Serum levels of IL-4,IL-5 and IL-13 protein increased whereas IFN-γ decreased following IL-33 pretreatment.Pretreatment with anti-ST2L antibody significantly decreased serum IL-4,IL-5,IL-13 levels and increased serum IFN-γ levels compared with controls (P <0.05).There was no change in the level of TNF-α.Conclusion IL-33 is produced systematically and locally in liver during I/R injury.Pretreatment with IL-33 is therapeutic for hepatic I/R injury,possibly via

  19. 广州市中小学生烧烫伤影响因素病例对照分析%A matched case-control study on the risk factors of burn injury among primary and secondary school students in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    刘伟佳; 刘伟; 林汉生; 张维蔚; 林蓉; 麦锦城; 何秀芳; 杜琳

    2010-01-01

    Objective To investigate the relative factors of burn injury among primary and secondary school students in Guangzhou and to provide scientific evidence for intervention.Methods 1:1 case-control study was conducted in 428 cases and 428 controls based on different sex and classes. The relationship between relative factors and burn injury was analyzed by univariate and multivariate conditional logistic regression. Results Following facts were discovered: burn injury mainly occurred in the upper limbs (57.9%), home was the place that most of burn injury (58.2%)took place, 51.0% of the burn injuries was caused by hot liquid, 43.9% burn injury needed medical treatment and 7.7% burn injury left with sequelae as dysfunction or disability. Data from the multivariate conditional logistic regression showed that boarding students (OR=2.47), older age of the mothers (OR=1.03), non-nuclear family (OR=1.25-1.84) were risk factors of burn injury.Being the only child (OR=0.60), having sufficient time for sleep (OR=0.84), good performance record (OR=0.85), higher maternal education background were protective factors on burn injury.Conclusion Among primary and secondary school students in Guangzhou, burn injury mainly occurred in the upper limbs, and home was the place that most of burn injury took place.%目的 探讨广州市中小学生烧烫伤发生的影响因素.方法 采用整群随机抽样方法,在广州市区县中小学按性别、班级1∶1配对原则,选择428对烧烫伤病例和对照组,采用单因素和多因素条件logistic回归分析.结果 广州市中小学生烧烫伤发生主要部位是上肢(57.9%),主要发生地点是家中(58.2%).51.0%烧烫伤是热水导致的;43.9%的烧烫伤需要医疗单位处理;7.7%伤后留下后遗症(活动不如往常、功能受限、致残).多因素分析结果显示,住宿生(OR=2.47)、母亲年龄大(OR=1.03)、非核心家庭(OR=1.25~1.84)等是烧烫伤发生的影响因素.独生子女(OR=0.60)

  20. Intestinal injury can be reduced by intra-arterial postischemic perfusion with hypertonic saline

    Directory of Open Access Journals (Sweden)

    Oleg Kornyushin

    2013-01-01

    Full Text Available AIM: To investigate the effect of local intestinal perfusion with hypertonic saline (HTS on intestinal ischemia-reperfusion injury (IRI in both ex vivo and in vivo rat models. METHODS: All experiments were performed on male Wistar rats anesthetized with pentobarbital sodium given intraperitoneally at a dose of 60 mg/kg. Ex vivo vascularly perfused rat intestine was subjected to 60-min ischemia and either 30-min reperfusion with isotonic buffer (controls, or 5 min with HTS of 365 or 415 mOsm/L osmolarity (HTS365mOsm or HTS415mOsm, respectively followed by 25-min reperfusion with isotonic buffer. The vascular intestinal perfusate flow (IPF rate was determined by collection of the effluent from the portal vein in a calibrated tube. Spontaneous intestinal contraction rate was monitored throughout. Irreversible intestinal injury or area of necrosis (AN was evaluated histochemically using 2.3.5-triphenyltetrazolium chloride staining. In vivo, 30-min ischemia was followed by either 30-min blood perfusion or 5-min reperfusion with HTS365mOsm through the superior mesenteric artery (SMA followed by 25-min blood perfusion. Arterial blood pressure (BP was measured in the common carotid artery using a miniature pressure transducer. Histological injury was evaluated in both preparations using the Chui score. RESULTS: Ex vivo, intestinal IRI resulted in a reduction in the IPF rate during reperfusion (P < 0.05 vs sham. The postischemic recovery of the IPF rate did not differ between the controls and the HTS365mOsm group. In the HTS415mOsm group, postischemic IPF rates were lower than in the controls and the HTS365mOsm group (P < 0.05. The intestinal contraction rate was similar at baseline in all groups. An increase in this parameter was observed during the first 10 min of reperfusion in the control group as compared to the sham-treated group, but no such increase was seen in the HTS365mOsm group. In controls, AN averaged 14.8% ± 5.07% of the total tissue

  1. Skin Injuries Reduce Survival and Modulate Corticosterone, C-Reactive Protein, Complement Component 3, IgM, and Prostaglandin E 2 after Whole-Body Reactor-Produced Mixed Field (n + γ-Photons) Irradiation

    OpenAIRE

    Kiang, Juliann G; Ledney, G. David

    2013-01-01

    Skin injuries such as wounds or burns following whole-body γ-irradiation (radiation combined injury (RCI)) increase mortality more than whole-body γ-irradiation alone. Wound-induced decreases in survival after irradiation are triggered by sustained activation of inducible nitric oxide synthase pathways, persistent alteration of cytokine homeostasis, and increased susceptibility to systemic bacterial infection. Among these factors, radiation-induced increases in interleukin-6 (IL-6) concentrat...

  2. 9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制%The prevention and control of lower respiratory tract infection in 9 cases of patients with large area burn combined inhalation injury

    Institute of Scientific and Technical Information of China (English)

    沈小玥; 穆晓苏; 徐晓莉; 黄慧敏; 方红梅; 尹湘毅; 李亚楠; 尹诺

    2016-01-01

    目的:探讨9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制措施。方法调查9例大面积烧伤合并吸入性损伤患者的下呼吸道分泌物培养的病原菌细菌谱及耐药情况。结果共检出下呼吸道病原菌2种,共38株,其中鲍曼不动杆菌37株,占97.36%(37/38);嗜麦芽假单胞菌1株,占2.64%(1/38)。鲍曼不动杆菌耐药率达到75.59%,对替加环素、米诺环素敏感性90%以上。经过严格实施感染预防与控制,合理使用抗菌药物等综合措施后取得了良好的疗效,鲍曼不动杆菌检出率明显下降。结论本文患者的下呼吸道病原菌以鲍曼不动杆菌最常见,虽然鲍曼不动杆菌感染率及耐药率高,但可以通过有效的消毒隔离、严格的下呼吸道医院感染预防措施及合理应用抗菌药物等方法,使鲍曼不动杆菌的检出率明显下降。%Objective To prevent and reduce lower respiratory tract infection in the batch of patients with large area burn combined inhalation injury. Methods 9 cases of large area burn with inhalation injury patients were investigated of bacterial spectrum and drug resistance of lower respiratory tract secretion. Results In the survey, we detected a total of 38 strains of 2 kinds of the lower respiratory tract pathogen, including 37 strains of acinetobacter baumannii accounting for 97. 36% and 1 strain of eosinophilic malt pseudomonas accounting for 2.64%. Acinetobacter baumannii antibiotic resistant rate rised up to 75.59%. The sensitive rate of tigecy⁃cline and minocycline rised significantly (>90%) . After strict infection control, reasonable use of antibiotics and other comprehensive measures, we have obtained a good curative effect. The detection rate of acinetobacter baumannii declined obviously. Conclusion In large area burn with inhalation injury patients, acinetobacter baumannii is the most common in lower respiratory tract

  3. The injury mortality burden in Guinea

    Directory of Open Access Journals (Sweden)

    Mamady Keita

    2012-09-01

    Full Text Available Abstract Background The injury mortality burden of Guinea has been rarely addressed. The paper aimed to report patterns of injury mortality burden in Guinea. Methods We retrieved the mortality data from the Guinean Annual Health Statistics Report 2007. The information about underlying cause of deaths was collected based on Guinean hospital discharge data, Hospital Mortuary and City Council Mortuary data. The causes of death are coded in the 9th International Classification of Diseases (ICD-9. Multivariate Poisson regression was used to test the impacts of sex and age on mortality rates. The statistical analyses were performed using Statatm 10.0. Results In 2007, 7066 persons were reported dying of injuries in Guinea (mortality: 72.8 per 100,000 population. Transportation, fire/burn, falls, homicide and drowning were the five leading causes of fatal injuries for the whole population, accounting for 37%, 22%, 12%, 10% and 6% of total deaths, respectively. In general, age-specific injury causes displayed similar patterns of the whole population except that poisoning replaced falls as a leading cause among children under five years old. Males were at 30-50% more risk of dying from six commonest causes than females and old age groups had higher injury mortality rates than younger age groups. Conclusion Transportation, fire/burn, falls, homicide, and drowning accounted for the majority of total injury mortality burden in Guinea. Males and old adults were high-risk population of fatal injuries and should be targeted by injury prevention. Lots of work is needed to improve weak capacities for injury control in order to reduce the injury mortality burden.

  4. Oral rehydration solutions for burn management in the field and underdeveloped regions: a review

    OpenAIRE

    Vyas, Krishna S; Wong, Lesley K

    2013-01-01

    Burn injuries are the fourth most common type of trauma worldwide, and the appropriate care of burn injuries in resource-limited settings such as the battlefield, underdeveloped nations, or in mass casualtiesremains a significant challenge. Rehydration constitutes the primary treatment of the systemic effects of burns and is a major factor in patient recovery. The standard of care for the replenishment of fluid and electrolyte losses in burn injury remains intravenous fluid therapy, but oral ...

  5. Burns in Tanzania: Morbidity and Mortality, Causes and Risk Factors: A Review.

    OpenAIRE

    Outwater, Anne H; Ismail, Hawa; Mgalilwa, Lwidiko; Justin Temu, Mary; Mbembati, Naboth A

    2013-01-01

    Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not “accidents” but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that preventio...

  6. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

    OpenAIRE

    Kobra Gaseminegad; Bita Kamranfar; Parviz Nemazi; Faride Ahrari; Jaber Musavi; Kamran As'adi; Seyed Hamid Salehi; Somaie Faramarzi; Saeed Shoar

    2012-01-01

    There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We ch...

  7. High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: A cluster randomised trial

    OpenAIRE

    Steffen, Kathrin; Emery, Carolyn; Romiti, Maria; Kang, Jian; Bizzini, Mario; Dvorak, Jiri; Finch, Caroline; Meeuwisse, Willem

    2013-01-01

    A protective effect on injury risk in youth sports through neuromuscular warm-up training routines has consistently been demonstrated. However, there is a paucity of information regarding the quantity and quality of coach-led injury prevention programmes and its impact on the physical performance of players. The aim of this cluster-randomised controlled trial was to assess whether different delivery methods of an injury prevention programme (FIFA 11+) to coaches could improve player performan...

  8. An Epidemiologic Survey on Burns in Yazd from 2008 till 2009

    OpenAIRE

    Negar Delbari; Kazem Kazemeini; Mohammad Jalilmanesh; Amir Houshang Mehrparvar; Seyed Jalil Mirmohammadi; Mehrdad Mostaghaci

    2012-01-01

    Burns are injuries which may require long hospitalization and may result in important impairment and disability. Burn injuries are still common especially in developing countries. Assessment of the epidemiology of burns is very important for introduction of preventive methods. This study was conducted in Yazd to assess and describe the epidemiology of burns including its main causes, and its demographics. In a prospective study during a 1 year period, we assessed the epidemiology of burns in ...

  9. Complicated Burn Resuscitation.

    Science.gov (United States)

    Harrington, David T

    2016-10-01

    More than 4 decades after the creation of the Brooke and Parkland formulas, burn practitioners still argue about which formula is the best. So it is no surprise that there is no consensus about how to resuscitate a thermally injured patient with a significant comorbidity such as heart failure or cirrhosis or how to resuscitate a patient after an electrical or inhalation injury or a patient whose resuscitation is complicated by renal failure. All of these scenarios share a common theme in that the standard rule book does not apply. All will require highly individualized resuscitations. PMID:27600129

  10. Luteolin Reduces Alzheimer’s Disease Pathologies Induced by Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Darrell Sawmiller

    2014-01-01

    Full Text Available Traumatic brain injury (TBI occurs in response to an acute insult to the head and is recognized as a major risk factor for Alzheimer’s disease (AD. Indeed, recent studies have suggested a pathological overlap between TBI and AD, with both conditions exhibiting amyloid-beta (Aβ deposits, tauopathy, and neuroinflammation. Additional studies involving animal models of AD indicate that some AD-related genotypic determinants may be critical factors enhancing temporal and phenotypic symptoms of TBI. Thus in the present study, we examined sub-acute effects of moderate TBI delivered by a gas-driven shock tube device in Aβ depositing Tg2576 mice. Three days later, significant increases in b-amyloid deposition, glycogen synthase-3 (GSK-3 activation, phospho-tau, and pro-inflammatory cytokines were observed. Importantly, peripheral treatment with the naturally occurring flavonoid, luteolin, significantly abolished these accelerated pathologies. This study lays the groundwork for a safe and natural compound that could prevent or treat TBI with minimal or no deleterious side effects in combat personnel and others at risk or who have experienced TBI.

  11. Luteolin Reduces Alzheimer’s Disease Pathologies Induced by Traumatic Brain Injury

    Science.gov (United States)

    Sawmiller, Darrell; Li, Song; Shahaduzzaman, Md; Smith, Adam J.; Obregon, Demian; Giunta, Brian; Borlongan, Cesar V.; Sanberg, Paul R.; Tan, Jun

    2014-01-01

    Traumatic brain injury (TBI) occurs in response to an acute insult to the head and is recognized as a major risk factor for Alzheimer’s disease (AD). Indeed, recent studies have suggested a pathological overlap between TBI and AD, with both conditions exhibiting amyloid-beta (Aβ) deposits, tauopathy, and neuroinflammation. Additional studies involving animal models of AD indicate that some AD-related genotypic determinants may be critical factors enhancing temporal and phenotypic symptoms of TBI. Thus in the present study, we examined sub-acute effects of moderate TBI delivered by a gas-driven shock tube device in Aβ depositing Tg2576 mice. Three days later, significant increases in b-amyloid deposition, glycogen synthase-3 (GSK-3) activation, phospho-tau, and pro-inflammatory cytokines were observed. Importantly, peripheral treatment with the naturally occurring flavonoid, luteolin, significantly abolished these accelerated pathologies. This study lays the groundwork for a safe and natural compound that could prevent or treat TBI with minimal or no deleterious side effects in combat personnel and others at risk or who have experienced TBI. PMID:24413756

  12. The approach taken to reducing the risk of transfusion related acute lung injury in Canada.

    Science.gov (United States)

    Growe, G H; Petraszko, T R; Bigham, Mark

    2008-07-01

    Transfusion related acute lung injury (TRALI) has become a major reported cause of severe transfusion reactions and mortality. Over the past four years significant changes have been taken in Canada in order both to improve the recognition of the risk and to decrease its incidence. An international meeting was held in April of 2004 entitled "Towards an Understanding of TRALI". As a result of the analysis and recommendations from this meeting, the Canadian Blood Services established an ongoing review committee and established a laboratory diagnostic facility to identify at risk donors and recipients. A system has been developed to identify implicated donors and exclude them from the blood donor pool. Other steps have been taken to exclude potentially high risk donors, such as previously pregnant females, from the plasma and platelet donor pool. A considerable amount of education also has been offered to clinical services in the country. This paper summarizes the definitions, categorizations of implicated donors, and the ongoing precautionary activities related to plasma products. Noted within the article are the methods used for locating and selecting data. These were primarily based on the international TRALI conference in 2004, and from ongoing discussions and information provided by the Canadian Blood Services TRALI Review Committee. No ethics referral or approval was requested, and a summary is included in the article. PMID:20041083

  13. The approach taken to reducing the risk of transfusion related acute lung injury in Canada

    Directory of Open Access Journals (Sweden)

    Growe G

    2008-01-01

    Full Text Available Transfusion related acute lung injury (TRALI has become a major reported cause of severe transfusion reactions and mortality. Over the past four years significant changes have been taken in Canada in order both to improve the recognition of the risk and to decrease its incidence. An international meeting was held in April of 2004 entitled "Towards an Understanding of TRALI". As a result of the analysis and recommendations from this meeting, the Canadian Blood Services established an ongoing review committee and established a laboratory diagnostic facility to identify at risk donors and recipients. A system has been developed to identify implicated donors and exclude them from the blood donor pool. Other steps have been taken to exclude potentially high risk donors, such as previously pregnant females, from the plasma and platelet donor pool. A considerable amount of education also has been offered to clinical services in the country. This paper summarizes the definitions, categorizations of implicated donors, and the ongoing precautionary activities related to plasma products. Noted within the article are the methods used for locating and selecting data. These were primarily based on the international TRALI conference in 2004, and from ongoing discussions and information provided by the Canadian Blood Services TRALI Review Committee. No ethics referral or approval was requested, and a summary is included in the article.

  14. Epidemiological Analysis of 483 cases of Work Injury Patients Caused by Burn%483例烧伤所致工伤患者的流行病学分析

    Institute of Scientific and Technical Information of China (English)

    纪雪亮; 李建新; 易先锋; 蓝蔚; 陈胜; 涂荣梅; 刘衍智

    2014-01-01

    Objective To provide epidemiologic information of burns for clinical studies and industrial prevention. Methods Collected 483 burn patients admitted in our department from January 2010 to December 2012. They were work injury patients. The clinical data of them were analyzed retrospectively mainly on the distribution of sex, age, the nature of employer, occupation, the intensity of labor, protection, injuries, treatment and prognosis. Results The male to female ratio was 5.71:1 in burn patients who were industrial injury patients. The young is the highest proportion. The injury patients from the private enterprise were the most. Most of the patients come from the front work. The main cause is the lfame, hot object, electrical and thermal lfuid. There were a lot of deifciencies in prevention and emergency measures. The date of hospitalization was long, and the cost of treatment was high. But the prognosis was poor. Conclusion There was a lack of protection for burn occurred in the work. But the consequences were serious. So we must strengthen the safety propaganda, improve the protection measures. And the relevant departments must strengthen supervision.%目的:为临床研究和工伤预防提供有效的烧伤流行病资料。方法回顾性分析2010年1月至2012年12月期间我院收治工伤职工中的483例烧伤患者,分析其性别和年龄分布、单位性质、工伤职工职业分布、劳动强度差异、防护情况、受伤情况、诊治经过和转归情况。结果工伤职工中烧伤患者男女比例为5.71∶1,中青年占据的比例最高。私营企业的工伤职工最多。大部分患者来自于一线工作岗位,病因多为火焰、热物体、电及热液;其预防、急救措施存在着不足。患者住院日期长、治疗费用高、转归情况较差。结论发生在工作中的烧伤防护不足、后果严重,需要加强安全宣传、完善保护措施及有关部门的监管力度。

  15. Long-Term Propranolol Use in Severely Burned Pediatric Patients: A Randomized Controlled Study

    Science.gov (United States)

    Herndon, David N.; Rodriguez, Noe A.; Diaz, Eva C.; Hegde, Sachin; Jennings, Kristofer; Mlcak, Ronald P.; Suri, Jaipreet S.; Lee, Jong O.; Williams, Felicia N.; Meyer, Walter; Suman, Oscar E.; Barrow, Robert E.; Jeschke, Marc G.; Finnerty, Celeste C.

    2012-01-01

    Objective To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective randomized single-center controlled study in pediatric patients with large burns. Summary Background Data Severe burns trigger a hypermetabolic response that persists for up to 2 years after burn. Propranolol given for 1 month post burn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods One-hundred seventy nine pediatric patients with >30% total body surface area burns were randomized to receive control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months after burn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjust for non-normality, repeated measures, and regression analyses. P <0.05 was considered significant. Results Long-term propranolol treatment significantly reduced the percent of the predicted heart rate and percent of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions Propranolol treatment for 12 months, following thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients. This study is registered at clinicaltrials.gov, NCT00675714. PMID:22895351

  16. Increased Expression of Aldehyde Dehydrogenase 2 Reduces Renal Cell Apoptosis During Ischemia/Reperfusion Injury After Hypothermic Machine Perfusion.

    Science.gov (United States)

    Zhong, Zibiao; Hu, Qianchao; Fu, Zhen; Wang, Ren; Xiong, Yan; Zhang, Yang; Liu, Zhongzhong; Wang, Yanfeng; Ye, Qifa

    2016-06-01

    Hypothermic machine perfusion (MP) can reduce graft's injury after kidney transplantation; however, the mechanism has not been elucidated. In the past decade, many studies showed that aldehyde dehydrogenase 2 (ALDH2) is a protease which can inhibit cell apoptosis. Therefore, this study aims to explore whether ALDH2 takes part in reducing organ damage after MP. Eighteen healthy male New Zealand rabbits (12 weeks old, weight 3.0 ± 0.3 kg) were randomly divided into three groups: normal group, MP group, and cold storage (CS) group (n = 6). The left kidney of rabbits underwent warm ischemia for 35 min through clamping the left renal pedicle and then reperfusion for 1 h. Left kidneys were preserved by MP or CS (4°C for 4 h) in vivo followed by the right nephrectomy and 24-h reperfusion, and then the specimens and blood were collected. Finally, concentration of urine creatinine (Cr), blood urea nitrogen (BUN), and 4-HNE were tested. Renal apoptosis was detected by TUNEL staining, and the expression of ALDH2, cleaved-caspase 3, bcl-2/ bax, MAPK in renal tissue was detected by immunohistochemistry or Western blot; 24 h after surgery, the concentration of Cr in MP group was 355 ± 71μmol/L, in CS group was 511 ± 44 μmol/L (P bcl-2/bax in MP group was significantly higher than that in CS group (P < 0.05); expression of cleaved caspase-3 in both MP and CS group significantly increased as compared with that in normal group (P < 0.05). In conclusion, increased expression of ALDH2 can reduce the renal cell apoptosis through inhibiting MAPK pathway during ischemia/reperfusion injury (IRI) after hypothermic MP. PMID:26582147

  17. Assessing inhalation injury in the emergency room

    Directory of Open Access Journals (Sweden)

    Tanizaki S

    2015-07-01

    Full Text Available Shinsuke Tanizaki Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan Abstract: Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care. Intubation should be considered if any of the following signs exist: respiratory distress, stridor, hypoventilation, use of accessory respiratory muscles, blistering or edema of the oropharynx, or deep burns to the face or neck. Any patients suspected to have inhalation injuries should receive a high concentration of supplemental oxygen to quickly reverse hypoxia and to displace carbon monoxide from protein binding sites. Management of carbon monoxide and cyanide exposure in smoke inhalation patients remains controversial. Absolute indications for hyperbaric oxygen therapy do not exist because there is a low correlation between carboxyhemoglobin levels and the severity of the clinical state. A cyanide antidote should be administered when cyanide poisoning is clinically suspected. Although an ideal approach for respiratory support of patients with inhalation injuries do not exist, it is important that they are supported using techniques that do not further exacerbate respiratory failure. A well-organized strategy for patients with inhalation injury is critical to reduce morbidity and mortality. Keywords: inhalation injury, burn, carbon monoxide poisoning, cyanide poisoning

  18. Protect the Ones You Love From Burns

    Centers for Disease Control (CDC) Podcasts

    2008-12-10

    This podcast, developed as part of the Protect the Ones You Love initiative, discusses steps parents can take to help protect their children from burns, one of the leading causes of child injury.  Created: 12/10/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 12/10/2008.

  19. Development and evaluation of an affordable lift device to reduce musculo-skeletal injuries among home support workers.

    Science.gov (United States)

    Heacock, Helen; Paris-Seeley, Nancy; Tokuno, Craig; Frederking, Sara; Keane, Brian; Mattie, Johanne; Kanigan, Ryan; Watzke, James

    2004-07-01

    Home support workers (HSWs) work in clients' homes assisting with rehabilitation and activities of daily living. Like all health-care professionals, HSWs are at an increased risk for developing back injuries. Lift devices have been shown to reduce injuries to the worker. Presently, there are few lifting devices for home use that cost under $4000 CDN. Our study involved designing a safe and affordable lift device (retail cost under $2000 CDN) to be used by HSWs in the home and evaluating it in a typical bathroom. Thirty-eight HSWs and three seniors evaluated the BCIT lift, a commercially available lift (BHM Medical Inc.) and the manual method of transfer and lift. Results indicated that the BCIT lift was an improvement over the manual method of transferring, and approximated the more expensive, automatic lift in terms of perceived exertion, ease of use and safety. Feedback provided to the researchers has been incorporated into a new, ergonomically sound and marketable lift device. PMID:15159204

  20. Role of JAK-STAT pathway in reducing cardiomyocytes hypoxia/reoxygenation injury induced by S1P postconditioning.

    Science.gov (United States)

    Wang, Yuqing; Wang, Dongfei; Zhang, Lizhi; Ye, Fangyu; Li, Mengmeng; Wen, Ke

    2016-08-01

    This experiment was designed to explore the protection of sphingosine1-phosphate (S1P) postconditioning on rat myocardial cells injured by hypoxia/reoxygenation acting via the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signal pathway. The data showed that S1P could significantly increase cell viability, lower the rate of apoptosis, decrease the content of lactate dehydrogenase (LDH) and caspase3 activity in the culture medium, increase the activity of total superoxide dismutase (T-SOD) and manganese superoxide dismutase (Mn-SOD), reduce the loss of mitochondrial membrane potential and the fluorescence intensity of intracellular calcium, as well as increase the phosphorylation of JAK2 and STAT3 in comparison with the H/R group. When the JAK inhibitor AG490 or the STAT inhibitor stattic were added, the effects of S1P were inhibited. Our date shows that S1P protects H9c2 cells from hypoxia/reoxygenation injury and that the protection by S1P was inhibited by AG490 and stattic. Therefore S1P protects H9c2 cells against hypoxia/reoxygenation injury via the JAK-STAT pathway. PMID:27215146

  1. Fish Oil-Based Fat Emulsion Reduces Acute Kidney Injury and Inflammatory Response in Antibiotic-Treated Polymicrobial Septic Mice

    Science.gov (United States)

    Shih, Juey-Ming; Shih, Yao-Ming; Pai, Man-Hui; Hou, Yu-Chen; Yeh, Chiu-Li; Yeh, Sung-Ling

    2016-01-01

    Acute kidney injury (AKI) is a common complication in sepsis. This study compared the effects of a fish oil-based with a mixed oil fat emulsion on remote renal injury in an antibiotic-treated septic murine model. Mice were randomly assigned to a normal control (NC) group and three septic groups. Sepsis was induced by cecal ligation and puncture (CLP). The antibiotic was injected intraperitoneally (IP) after CLP and then daily till the time of sacrifice. Three hours after antibiotic treatment, one of the septic groups was injected IP with a fish oil-based emulsion (FO), while the other two groups were given either a mixed oil emulsion (MO) or saline (SC). The septic groups were further divided into two separate time groups, with blood and kidneys samples collected at 24 h or 72 h post-CLP. The results showed that sepsis leads to the activation of neutrophils, T helper (Th)1/Th-2/Th-17 and Treg cells (p emulsion had decreased plasma NGAL by 22% and Treg by 33%. Furthermore, renal gene expressions of MyD88 and TLR4 reduced by 46% and 62%, respectively, whereas heat shock protein 70 and peroxisome proliferator-activated receptor-γ increased by 158% and 69%, respectively (p emulsion has favorable effects, maintaining blood T cell percentage, downregulating Treg expression, attenuating systemic and local inflammation and offering renal protection under conditions of antibiotic-treated polymicrobial sepsis. PMID:26999192

  2. Fish Oil-Based Fat Emulsion Reduces Acute Kidney Injury and Inflammatory Response in Antibiotic-Treated Polymicrobial Septic Mice.

    Science.gov (United States)

    Shih, Juey-Ming; Shih, Yao-Ming; Pai, Man-Hui; Hou, Yu-Chen; Yeh, Chiu-Li; Yeh, Sung-Ling

    2016-03-01

    Acute kidney injury (AKI) is a common complication in sepsis. This study compared the effects of a fish oil-based with a mixed oil fat emulsion on remote renal injury in an antibiotic-treated septic murine model. Mice were randomly assigned to a normal control (NC) group and three septic groups. Sepsis was induced by cecal ligation and puncture (CLP). The antibiotic was injected intraperitoneally (IP) after CLP and then daily till the time of sacrifice. Three hours after antibiotic treatment, one of the septic groups was injected IP with a fish oil-based emulsion (FO), while the other two groups were given either a mixed oil emulsion (MO) or saline (SC). The septic groups were further divided into two separate time groups, with blood and kidneys samples collected at 24 h or 72 h post-CLP. The results showed that sepsis leads to the activation of neutrophils, T helper (Th)1/Th-2/Th-17 and Treg cells (p group, the group given the fish oil-based emulsion had decreased plasma NGAL by 22% and Treg by 33%. Furthermore, renal gene expressions of MyD88 and TLR4 reduced by 46% and 62%, respectively, whereas heat shock protein 70 and peroxisome proliferator-activated receptor-γ increased by 158% and 69%, respectively (p blood T cell percentage, downregulating Treg expression, attenuating systemic and local inflammation and offering renal protection under conditions of antibiotic-treated polymicrobial sepsis. PMID:26999192

  3. Shock-absorbing insoles reduce the incidence of lower limb overuse injuries sustained during Royal Marine training.

    Science.gov (United States)

    House, Carol; Reece, Allyson; Roiz de Sa, Dan

    2013-06-01

    This study was undertaken to determine whether the incidence of lower limb overuse injuries (LLOIs) sustained during Royal Marine training could be reduced by issuing the recruits with shock-absorbing insoles (SAIs) to wear in their military boots. This was a retrospective longitudinal trial conducted in two phases. Injury data from 1,416 recruits issued with standard Saran insoles and 1,338 recruits issued with SAI were compared. The recruits in the two groups were of similar height, body mass, and aerobic fitness and followed the same training course. The incidence of LLOI sustained by the recruits was lower (p periostitis, tenosynovitis of foot, achilles tendonopathy, other tendonopathy and anterior knee pain were lower (p < 0.05) in the SAI Group. Tibial stress fracture incidence was lower (p < 0.05) in the SAI Group but metatarsal and femoral stress fracture incidences were the same for the two insole groups. Thus, issuing SAIs to military recruits undertaking a sustained, arduous physical training program with a high incidence of LLOI would provide a beneficial reduction in the incidence of LLOI. PMID:23756077

  4. Angular Impact Mitigation System for Bicycle Helmets to Reduce Head Acceleration and Risk of Traumatic Brain Injury

    Science.gov (United States)

    Hansen, Kirk; Dau, Nathan; Feist, Florian; Deck, Caroline; Willinger, Rémy; Madey, Steven M.; Bottlang, Michael

    2013-01-01

    Angular acceleration of the head is a known cause of traumatic brain injury (TBI), but contemporary bicycle helmets lack dedicated mechanisms to mitigate angular acceleration. A novel Angular Impact Mitigation (AIM) system for bicycle helmets has been developed that employs an elastically suspended aluminum honeycomb liner to absorb linear acceleration in normal impacts as well as angular acceleration in oblique impacts. This study tested bicycle helmets with and without AIM technology to comparatively assess impact mitigation. Normal impact tests were performed to measure linear head acceleration. Oblique impact tests were performed to measure angular head acceleration and neck loading. Furthermore, acceleration histories of oblique impacts were analyzed in a computational head model to predict the resulting risk of TBI in the form of concussion and diffuse axonal injury (DAI). Compared to standard helmets, AIM helmets resulted in a 14% reduction in peak linear acceleration (p < 0.001), a 34% reduction in peak angular acceleration (p < 0.001), and a 22% to 32% reduction in neck loading (p < 0.001). Computational results predicted that AIM helmets reduced the risk of concussion and DAI by 27% and 44%, respectively. In conclusion, these results demonstrated that AIM technology could effectively improve impact mitigation compared to a contemporary expanded polystyrene-based bicycle helmet, and may enhance prevention of bicycle-related TBI. Further research is required. PMID:23770518

  5. Lipoic acid enhances survival of transplanted neural stem cells by reducing transplantation-associated injury

    Directory of Open Access Journals (Sweden)

    Gao J

    2013-07-01

    Full Text Available Junling Gao,1,* Jason R Thonhoff,1,2,* Tiffany J Dunn,1 Ping Wu1 1Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, TX, USA; 2Department of Neurology, The Methodist Hospital, Houston, TX, USA *These authors contributed equally to this work Abstract: The efficacy of stem cell-based therapy for neurological diseases depends highly on cell survival post-transplantation. One of the key factors affecting cell survival is the grafting procedure. The current study aims to determine whether needle insertion into intact rat spinal cords creates a hypoxic environment that is prone to lipid peroxidation damage upon reperfusion, and whether an antioxidant protects human neural stem cells (hNSCs both in vitro and post-transplantation into rat spinal cords. We show here that a single needle injection creates a hypoxic environment within the rat spinal cord that peaks at approximately 12 hours before reperfusion occurs. Lipid peroxidation damage at the transplantation site is evident by 48 hours post-needle insertion. In an in vitro model, hypoxia-reperfusion results in apoptotic death of hNSCs. Pretreatment with the antioxidant, α-lipoic acid, protects hNSCs against hypoxia-reperfusion injury and oxidative stress–mediated cell death. Increasing glutathione, but not Akt signaling, contributes to the protective effect of lipoic acid. Pretreating hNSCs with lipoic acid also increases the cell survival rate 1 month post-transplantation. Further investigation is warranted to develop improved techniques to maximize the survival of transplanted stem cells. Keywords: neural stem cell, transplantation, hypoxia-reperfusion, antioxidant, cell survival, lipoic acid

  6. Combined Treatments Reduce Chilling Injury and Maintain Fruit Quality in Avocado Fruit during Cold Quarantine.

    Science.gov (United States)

    Sivankalyani, Velu; Feygenberg, Oleg; Maorer, Dalia; Zaaroor, Merav; Fallik, Elazar; Alkan, Noam

    2015-01-01

    Quarantine treatment enables export of avocado fruit (Persea americana) to parts of the world that enforce quarantine against fruit fly. The recommended cold-based quarantine treatment (storage at 1.1°C for 14 days) was studied with two commercial avocado cultivars 'Hass' and 'Ettinger' for 2 years. Chilling injuries (CIs) are prevalent in the avocado fruit after cold-quarantine treatment. Hence, we examined the effect of integrating several treatments: modified atmosphere (MA; fruit covered with perforated polyethylene bags), methyl jasmonate (MJ; fruit dipped in 2.5 μM MJ for Hass or 10 μM MJ for Ettinger for 30 s), 1-methylcyclopropene (1-MCP; fruit treated with 300 ppb 1-MCP for 18 h) and low-temperature conditioning (LTC; a gradual decrease in temperature over 3 days) on CI reduction during cold quarantine. Avocado fruit stored at 1°C suffered from severe CI, lipid peroxidation, and increased expression of chilling-responsive genes of fruit peel. The combined therapeutic treatments alleviated CI in cold-quarantined fruit to the level in fruit stored at commercial temperature (5°C). A successful therapeutic treatment was developed to protect 'Hass' and 'Ettinger' avocado fruit during cold quarantine against fruit fly, while maintaining fruit quality. Subsequently, treated fruit stored at 1°C had a longer shelf life and less decay than the fruit stored at 5°C. This therapeutic treatment could potentially enable the export of avocado fruit to all quarantine-enforcing countries. Similar methods might be applicable to other types of fruit that require cold quarantine. PMID:26501421

  7. Preventive administration of cromakalim reduces aquaporin-4 expression and blood-brain barrier permeability in a rat model of cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Shilei Wang; Yanting Wang; Yan Jiang; Qingxian Chang; Peng Wang; Shiduan Wang

    2011-01-01

    Cromakalim, an adenosine triphosphate-sensitive potassium channel opener, exhibits protective effects on cerebral ischemia/reperfusion injury. However, there is controversy as to whether this effect is associated with aquaporin-4 and blood-brain barrier permeability. Immunohistochemistry results show that preventive administration of cromakalim decreased aquaporin-4 and IgG protein expression in rats with ischemia/reperfusion injury; it also reduced blood-brain barrier permeability, and alleviated brain edema, ultimately providing neuroprotection.

  8. Reducing kickback of portable combustion chain saws and related injury risks: laboratory tests and deductions.

    Science.gov (United States)

    Dąbrowski, Andrzej

    2012-01-01

    Portable chain saws are still very dangerous machines. Reduced prices of these machines mean they are widely available to people who like DIY (do it yourself) and professionals. Kickback of chain saws is extremely dangerous for the operator. This paper discusses the results of laboratory investigations of combustion chain saws. The tests were conducted on a standardized kickback test stand and covered the course of kickback, its energy, angle and duration. The results showed that during the contact of a saw chain with wood, the first to appear was the process of wood cutting, which absorbed 90-95% of the reduced energy of the cutting system. The greater the absorbed energy, the smaller the kickback angle. Wood cutting work is particularly influenced by proper chain tension, the use of chains with anti-kickback links, guide bars with sliding endings and a quickly activated chain brake. PMID:22995138

  9. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau;

    2012-01-01

    Aim: The aim of this study was to determine whether a natriuretic peptide infusion during reperfusion can reduce cardiomyocyte ischemia–reperfusion damage. Materials and methods: The effect of B-type natriuretic peptide (BNP) activity was assessed in vitro and in vivo: the cellular effect...... in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (∼15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... with controls (P=0.02). A similar trend was observed in the pigs that received CD-NP infusion, although this was not significant (P=0.3). BNP and CD-NP infusion in pigs reduced total cardiac troponin T release by 46 and 40%, respectively (P=0.0015 and 0.0019), and were associated with improved RNA integrity...

  10. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau;

    2012-01-01

    Aim: The aim of this study was to determine whether a natriuretic peptide infusion during reperfusion can reduce cardiomyocyte ischemia–reperfusion damage. Materials and methods: The effect of B-type natriuretic peptide (BNP) activity was assessed in vitro and in vivo: the cellular effect...... in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (~15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... with controls (P=0.02). A similar trend was observed in the pigs that received CD-NP infusion, although this was not significant (P=0.3). BNP and CD-NP infusion in pigs reduced total cardiac troponin T release by 46 and 40%, respectively (P=0.0015 and 0.0019), and were associated with improved RNA integrity...

  11. Lactobacillus rhamnosus GG reduces hepatic TNFα production and inflammation in chronic alcohol-induced liver injury

    OpenAIRE

    Wang, Yuhua; Liu, Yanlong; Kirpich, Irina; Ma, Zhenhua; Wang, Cuiling; Zhang, Min; Suttles, Jill; McClain, Craig; Feng, Wenke

    2013-01-01

    The therapeutic effects of probiotic treatment in alcoholic liver disease (ALD) have been studied in both patients and experimental animal models. Although the precise mechanisms of the pathogenesis of ALD are not fully understood, gut-derived endotoxin has been postulated to play a crucial role in hepatic inflammation. Previous studies have demonstrated that probiotic therapy reduces circulating endotoxin derived from intestinal Gram-negative bacteria in ALD. In this study, we investigated t...

  12. Micafungin Concentrations in the Plasma and Burn Eschar of Severely Burned Patients

    OpenAIRE

    Sasaki, Junichi; Yamanouchi, Satoshi; Kudo, Daisuke; Endo, Tomoyuki; Nomura, Ryosuke; Takuma, Kiyotsugu; Kushimoto, Shigeki; Shinozawa, Yotaro; Kishino, Satoshi; Hori, Shingo; Aikawa, Naoki

    2012-01-01

    Micafungin concentrations in plasma and burn eschar after daily intravenous infusion (1 h) of micafungin (200 to 300 mg) were investigated for six patients with severe burns. Micafungin treatment was initiated more than 72 h after the burn injuries. The peak and trough levels in the plasma after the initial administration and repeated administrations for more than 4 days were comparable with or slightly lower than the reported values for healthy volunteers. Micafungin concentrations in the pl...

  13. Sustained Isoprostane E2 Elevation, Inflammation and Fibrosis after Acute Ischaemia-Reperfusion Injury Are Reduced by Pregnane X Receptor Activation.

    Directory of Open Access Journals (Sweden)

    Aimen O Amer

    Full Text Available Liver grafts donated after cardiac death are increasingly used to expand the donor pool but are prone to ischaemic-type biliary lesions. The anti-inflammatory effects of the activated pregnane X receptor have previously been shown to be beneficial in a number of inflammatory liver conditions. However, its role in reducing peri-portal inflammation and fibrosis following ischaemia-reperfusion injury has not been investigated. Hepatic injury and its response to pregnane X receptor activation was examined after partial hepatic ischaemia-reperfusion injury induced by surgically clamping the left and middle lobar blood vessels in rats. Molecular and pathological changes in the liver were examined over the following 28 days. Ischaemia-reperfusion injury resulted in transient cholestasis associated with microvillar changes in biliary epithelial cell membranes and hepatocellular injury which resolved within days after reperfusion. However, in contrast to chemically-induced acute liver injuries, this was followed by sustained elevation in isoprostane E2, peri-portal inflammation and fibrosis that remained unresolved in the ischaemic reperfused lobe for at least 28 days after clamping. Administration of pregnenolone-16α-carbonitrile--a rodent-specific pregnane X receptor activator--resulted in significant reductions in cholestasis, hepatic injury, ischaemic lobe isoprostane E2 levels, peri-portal inflammation and fibrosis. Hepatic ischaemia-reperfusion injury therefore results in inflammatory and fibrotic changes that persist well beyond the initial ischaemic insult. Drug-mediated activation of the pregnane X receptor reduced these adverse changes in rats, suggesting that the pregnane X receptor is a viable drug target to reduce ischaemic-type biliary lesions in recipients of liver transplants donated after cardiac death.

  14. Astrocyte-Specific Overexpression of Insulin-Like Growth Factor-1 Protects Hippocampal Neurons and Reduces Behavioral Deficits following Traumatic Brain Injury in Mice.

    Directory of Open Access Journals (Sweden)

    Sindhu K Madathil

    Full Text Available Traumatic brain injury (TBI survivors often suffer from long-lasting cognitive impairment that stems from hippocampal injury. Systemic administration of insulin-like growth factor-1 (IGF-1, a polypeptide growth factor known to play vital roles in neuronal survival, has been shown to attenuate posttraumatic cognitive and motor dysfunction. However, its neuroprotective effects in TBI have not been examined. To this end, moderate or severe contusion brain injury was induced in mice with conditional (postnatal overexpression of IGF-1 using the controlled cortical impact (CCI injury model. CCI brain injury produces robust reactive astrocytosis in regions of neuronal damage such as the hippocampus. We exploited this regional astrocytosis by linking expression of hIGF-1 to the astrocyte-specific glial fibrillary acidic protein (GFAP promoter, effectively targeting IGF-1 delivery to vulnerable neurons. Following brain injury, IGF-1Tg mice exhibited a progressive increase in hippocampal IGF-1 levels which was coupled with enhanced hippocampal reactive astrocytosis and significantly greater GFAP levels relative to WT mice. IGF-1 overexpression stimulated Akt phosphorylation and reduced acute (1 and 3d hippocampal neurodegeneration, culminating in greater neuron survival at 10d after CCI injury. Hippocampal neuroprotection achieved by IGF-1 overexpression was accompanied by improved motor and cognitive function in brain-injured mice. These data provide strong support for the therapeutic efficacy of increased brain levels of IGF-1 in the setting of TBI.

  15. Effect of Thiol-reducing Agents and Antioxidants on Sulfasalazine-induced Hepatic Injury in Normotermic Recirculating Isolated Perfused Rat Liver

    Science.gov (United States)

    Heidari, Reza; Esmailie, Neda; Azarpira, Negar; Najibi, Asma; Niknahad, Hossein

    2016-01-01

    Sulfasalzine is a widely administered drug against inflammatory-based disorders in human. However several cases of liver injury are associated with its administration. There is no stabilized safe protective agent against sulfasalazine-induced liver injury. Current investigation was designed to evaluate if N-acetylcysteine (NAC) and dithioteritol (DTT) as thiol reducing agents and/or vitamins C and E as antioxidants have any protective effects against sulfasalazine-induced hepatic injury in an ex vivo model of isolated rat liver. Rat liver was canulated and perfused via portal vein in a closed recirculating system. Different concentrations of sulfasalazine and/or thiol reductants and antioxidants were administered and markers of organ injury were monitored at different time intervals. It was found that 5 mM of sulfasalazine caused marked liver injury as judged by rise in liver perfusate level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (p < 0.05). A significant amount of lipid peroxidation and hepatic glutathione depletion were detected in drug-treated livers, accompanied with significant histopathological changes of the organ. Administration of NAC (500 μM), DTT (400 μM), Vitamin C (200 μM), or vitamin E (200 μM) significantly alleviated sulfasalazine-induced hepatic injury in isolated perfused rat liver. The data obtained from current investigation indicate potential therapeutic properties of thiol reductants and antioxidants against sulfasalazine-induced liver injury. PMID:27123164

  16. Effect of Thiol-reducing Agents and Antioxidants on Sulfasalazine-induced Hepatic Injury in Normotermic Recirculating Isolated Perfused Rat Liver.

    Science.gov (United States)

    Heidari, Reza; Esmailie, Neda; Azarpira, Negar; Najibi, Asma; Niknahad, Hossein

    2016-04-01

    Sulfasalzine is a widely administered drug against inflammatory-based disorders in human. However several cases of liver injury are associated with its administration. There is no stabilized safe protective agent against sulfasalazine-induced liver injury. Current investigation was designed to evaluate if N-acetylcysteine (NAC) and dithioteritol (DTT) as thiol reducing agents and/or vitamins C and E as antioxidants have any protective effects against sulfasalazine-induced hepatic injury in an ex vivo model of isolated rat liver. Rat liver was canulated and perfused via portal vein in a closed recirculating system. Different concentrations of sulfasalazine and/or thiol reductants and antioxidants were administered and markers of organ injury were monitored at different time intervals. It was found that 5 mM of sulfasalazine caused marked liver injury as judged by rise in liver perfusate level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (p Vitamin C (200 μM), or vitamin E (200 μM) significantly alleviated sulfasalazine-induced hepatic injury in isolated perfused rat liver. The data obtained from current investigation indicate potential therapeutic properties of thiol reductants and antioxidants against sulfasalazine-induced liver injury. PMID:27123164

  17. From Cholera to Burns: A Role for Oral Rehydration Therapy

    OpenAIRE

    Milner, S. M.; Green, W.B.; Asuku, M.E.; M. Feldman; Makam, R.; Noppenberger, D; Price, L A; Prosciak, M.; van Loon, I.N.

    2011-01-01

    According to the practice guidelines of the American Burn Association on burn shock resuscitation, intravenous (IV) fluid therapy is the standard of care for the replacement of fluid and electrolyte losses in burn injury of ≥20% of the total body surface area. However, in mass burn casualties, IV fluid resuscitation may be delayed or unavailable. Oral rehydration therapy (ORT), which has been shown to be highly effective in the treatment of dehydration in epidemics of cholera, could be an alt...

  18. CASE REPORT Playing Football Burns More Than Just Calories

    OpenAIRE

    Wain, Richard A. J.; Shah, Syed H. A.

    2010-01-01

    Objective: To highlight the case of a sports-related alkali burn due to a common household chemical and emphasize the importance of a detailed medical history in chemical burns patients. Methods: A single-patient case study is presented along with references from existing literature. Results: Alkaline burn injuries associated with sports have previously been described in the literature; however, this case demonstrates an unusual presentation of a chemical burn with a readily available househo...

  19. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    OpenAIRE

    Parviz Saleh; Hamid Noshad

    2014-01-01

    Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1...

  20. Posttraumatic Stress and Cognitive Processes in Patients with Burns

    OpenAIRE

    Sveen, Josefin

    2011-01-01

    A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn. The psychometric properties of a Swedish version of the Impact of Event Scale-...