Sample records for burn injury reduces

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

    Directory of Open Access Journals (Sweden)

    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.;


    with 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 mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization...... of the skin showed a more polymorphonuclear neutrophil granulocytes (PMNs)-dominated inflammation in the group of mice with infected burn wound compared with the with burn wound group. In contrast, a higher degree of inflammation was observed in the burn wound group compared with the group of mice...

  3. LA50 in burn injuries. (United States)

    Seyed-Forootan, K; Karimi, H; Motevalian, S A; Momeni, M; Safari, R; Ghadarjani, M


    Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P age and inhalation injury were the main risk factors for death. Authorities should pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.

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

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    Kemalettin Koltka


    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

  5. National programme for prevention of burn injuries

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    Gupta J


    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.

  6. Functional and psychological outcomes following burn injury: reduced income and hidden emotions are predictors of greater distress. (United States)

    Reeve, Jeanne; James, Frances; McNeill, Rob; Brown, Paul; Cameron, Linda; Mills, Stephen


    The aim of this study is to determine whether functional and psychosocial outcomes after burn injury in New Zealand are consistent with the international literature. Fifty participants with burns >10% TBSA and a mean of 5.1 years since burn completed a survey that included questionnaires and open-ended questions. The rates of psychosocial distress for this sample were consistent with international reports. Psychological distress was predicted by negative change in income and by reports that the individual has hidden thoughts and emotions from others. Respondents also described positive changes in their life as a result of the burn injury that were independent of negative outcomes. Participants indicated good long-term functional improvement but ongoing psychological distress. Important indicators for poor outcome may be loss of income and reluctance to discuss emotions.

  7. The biology of burn injury. (United States)

    Evers, Lars H; Bhavsar, Dhaval; Mailänder, Peter


    Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

  8. Exercise following burn injury. (United States)

    de Lateur, Barbara J; Shore, Wendy S


    Fatigue is a major barrier to recovery for burned individuals. Studies indicate that a slow return to normal or near-normal muscle strength is the natural course of recovery. With no special interventions, other than the "usual care" tailored to the needs of the individual, postburn patients will make gradual improvement in strength and aerobic capacity. Using the principle of initial condition (the worse the initial condition, the greater the response to exercise intervention) the authors outline an augmented exercise program that should result in a robust improvement in aerobic capacity.

  9. Burn Injury Arise From Flying Balloon Toys


    Yalcin Kulahci; Fatih Zor; Mehmet Bozkurt; Serdar Ozturk; Mustafa Sengezer


    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 balloon...

  10. Hospital costs associated with pediatric burn injury. (United States)

    Klein, Matthew B; Hollingworth, William; Rivara, Frederick P; Kramer, C Bradley; Askay, Shelley W; Heimbach, David M; Gibran, Nicole S


    Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age dollar costs using an inflation index and a cost to charge ratio. Univariate and multivariate regressions were performed to identify the factors most significantly associated with cost. In addition, we performed a subset cost analysis for patients with burns more than 20% TBSA. A total of 1443 pediatric patients (age dollars was dollars 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life.

  11. The hair color-highlighting burn: a unique burn injury. (United States)

    Peters, W


    A unique, preventable, 2.8 x 3.7-cm, full-thickness scalp burn resulted after a woman underwent a professional color-highlighting procedure at a hair salon. The burn appeared to result from scalp contact with aluminum foil that had been overheated by a hair dryer during the procedure. The wound required debridement and skin grafting and 3 subsequent serial excisions to eliminate the resulting area of burn scar alopecia. The preventive aspects of this injury are discussed.

  12. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction

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    Hong Yan


    Full Text Available This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group, or burn injury combined with seawater immersion (BI group, or only immersion in seawater (I group, or control animals with no injury or immersion (C group. The circulating endothelial cell (CEC count and coagulation-fibrinolysis parameters were measured. The CEC count in B group increased at 4 h, 7 h, and 10 h after injury and then reduced, whereas it continuously increased to a greater extent in BI group (P<0.05. The von Willebrand factor (vWF activity, plasminogen activator inhibitor (PAI-1, and the ratio of thromboxane B2 (TXB2 to 6-keto-prostaglandin F1α (6-K-PGF1α in BI group had a marked increase after injury, and the tissue-type plasminogen activator (tPA in the BI group decreased. Microscope observations revealed thrombus formation in lungs of the animals in BI group, but not in C, I, or B groups. Burn injury causes endothelial dysfunction, and seawater immersion lastingly aggravates this injury, leading to a higher risk of developing thrombosis.

  13. New treatment strategies to reduce burn wound progression

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    Schmauss, Daniel


    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

  14. Analgesic effects of dexamethasone in burn injury

    DEFF Research Database (Denmark)

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


    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...... 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....... injury was produced on the medial aspect of the nondominant calf (12.5 cm2, 47 degrees C for 7 minutes). Quantitative sensory testing included pain ratings to thermal and mechanical stimuli (visual analog scale [VAS]), assessments of thermal and mechanical detection thresholds, and areas of allodynia...

  15. Fluid management in major burn injuries

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    Haberal Mehmet


    Full Text Available It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

  16. Burn Injury Arise From Flying Balloon Toys

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    Yalcin Kulahci


    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(4.000: 291-296

  17. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci


    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

  18. Sexual Function Following Burn Injuries: Literature Review. (United States)

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


    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.

  19. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction



    This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group), or burn injury combined with seawater immersion (BI group), or only immersion in seawater (I group), or control animals with no injury or immersion (C group). The circulating endothelial cell (CEC) count and coagulation-fibrinolysis paramet...

  20. A five-year review of burn injuries in Irrua

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    Iyamu Christopher E


    Full Text Available Abstract Background The management of burns remains a challenge in developing countries. Few data exist to document the extent of the problem. This study provides data from a suburban setting by documenting the epidemiology of burn injury and ascertaining outcome of management. This will help in planning strategies for prevention of burns and reducing severity of complications. Methods A total of 72 patients admitted for burns between January 1st, 2002 and December 31st, 2006 at the Irrua specialist teaching hospital were studied retrospectively. Sources of information were the case notes and operation registers. Data extracted included demographics as well as treatment methods and outcome Results The results revealed male to female ratio of 2.1:1. Over 50% of the injuries occurred at home. There was a seasonal variation with over 40% of injuries occurring between November and January. The commonest etiologic agent was flame burn from kerosene explosion. There were 7 deaths in the series. Conclusion Burns are preventable. We recommend adequate supply of unadulterated petroleum products and establishment of burn centers.

  1. Disseminated intravascular coagulation in burn injury. (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco


    Disseminated intravascular coagulation (DIC) is a complex and multifaceted disorder characterized by the activation of coagulation and fibrinolytic pathways, consumption of coagulation factors, and depletion of coagulation regulatory proteins. The introduction into the circulation of cellular debris characterized by strong thromboplastic activity due to tissue factor exposition or release (in or from burned tissues), which can thereby activate extrinsic pathway of coagulation system and trigger massive thrombin generation when present in sufficient concentration, represents the most plausible biological explanation to support the development of intravascular coagulation in patients with burn injury. Severe burns left untreated might also lead to an immunological and inflammatory response (activation of the complement cascade), which can amplify fibrinolysis and blood clotting. Overall, the real prevalence of DIC in patients with burns is as yet unclear. Postmortem, retrospective, and even longitudinal investigations are in fact biased by several factors, such as the objective difficulty to establish whether DIC might have occurred as a primary complication of burns or rather as a consequence of other superimposed pathologies (e.g., sepsis, multiple organ failure), the different diagnostic criteria for assessing DIC, and the heterogeneity of the patient samples studied. Nevertheless, the current scientific evidence is consistent with the hypothesis that biochemical changes suggestive for DIC (hypercoagulability, hypo- and hyperfibrinolysis) are commonplace in patients with burn trauma, and their severity increases exponentially with the severity of injury. Overt DIC seems to occur especially in critically ill burn patients or in those with severe burns (up to third degree) and large involvement of body surface area, in whom an appropriate therapy might be effective to prevent the otherwise fulminant course. Although early prophylaxis with antithrombin concentrates

  2. Medical management of paediatric burn injuries: best practice. (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A


    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  3. Burn injuries related to suicide. (United States)

    Persley, G V; Pegg, S P


    Of 1060 admissions to the burns unit, Royal Brisbane Hospital, over a 12-year period, there were 30 cases (2.8%) of attempted suicide. Fourteen (47%) of these patients died. The psychosocial features of people using self-ignition as a method of suicide are consistent with those of suicide in general. The morbidity if high and the outcome is often fatal, especially for those using a flammable liquid.

  4. Firefighter burn injuries: predictable patterns influenced by turnout gear. (United States)

    Kahn, Steven A; Patel, Jignesh H; Lentz, Christopher W; Bell, Derek E


    Approximately 100 firefighters suffer fatal injuries annually and tens of thousands receive nonfatal injuries. Many of these injuries require medical attention and restricted activity but may be preventable. This study was designed to elucidate etiology, circumstances, and patterns of firefighter burn injury so that further prevention strategies can be designed. In particular, modification of protective equipment, or turnout gear, is one potential strategy to prevent burn injury. An Institutional Review Board-approved retrospective review was conducted with records of firefighters treated for burn injury from 2005 to 2009. Data collected included age, gender, TBSA, burn depth, anatomic location, total hospital days per patient, etiology, and circumstances of injury. Circumstances of injury were stratified into the following categories: removal/dislodging of equipment, failure of equipment to protect, training errors, and when excessive external temperatures caused patient sweat to boil under the gear. Over the 4-year period, 20 firefighters were treated for burn injury. Mean age was 38.9 ± 8.9 years and 19 of 20 patients were male. Mean burn size was 1.1 ± 2.7% TBSA. Eighteen patients suffered second-degree burns, while two patients suffered first-degree burns. Mean length of hospitalization was 2.45 days. Scald burns were responsible for injury to 13 firefighters (65%). Flame burns caused injury to four patients (20%). Only three patients received contact burns (15%). The face was the site most commonly burned, representing 29% of injuries. The hand/wrist and ears were the next largest groups, with 23 and 16% of the injuries, respectively. Other areas burned included the neck (10%), arm (6.5%), leg (6.5%), knees (3%), shoulders (3%), and head (3%). Finally, the circumstance of injury was evaluated for each patient. Misuse and noncontiguous areas of protective equipment accounted for 14 of the 20 injuries (70%). These burns were caused when hot steam

  5. Pattern of burn injury in hang-glider pilots. (United States)

    Campbell, D C; Nano, T; Pegg, S P


    High-voltage electrical injury has been well documented in a number of situations, such as the occupational hazard of linesmen and construction workers, and in the context of overhead railway power lines. Two cases of hang-glider pilots contacting 11,000-volt power lines have recently been treated in the Royal Brisbane Hospital Burns Unit. They demonstrate an interesting pattern of injury, not described in current burns literature, involving both hand and lower abdominal burns. Both patients sustained full-thickness patches of burn injury, with underlying muscle damage and peripheral neurological injury. This distribution of injury seems to be closely related to the design of the hang glider.

  6. Airway Management and Smoke Inhalation Injury in the Burn Patient (United States)


    deficit and alveolar -arterial gradient during resuscitation contribute independently but modestly to the prediction of mortality after burn injury. J Burn...parenchymal injuries (eg, tracheal, bronchial, and alveolar injuries) caused by chemical and particulate constituents of smoke. Unless otherwise...perivascular fuzziness or cuffing, alveolar or intersitital pulmonary edema, consolidation, and atelectasis, have been reported.20–23 In sheep, Park and


    Institute of Scientific and Technical Information of China (English)

    王卫东; 陈宗荣; 李蓉; 楼淑芳


    The nitric oxide and cyclic GMP production in myocardium early after burn injury in tats were investigated. Nitric oxide synthase activity was measured in cytosols from the left ventricular wall of burned rats.Cytosols from the control group animals were shown to contain mainly Ca2+ dependent nitric oxide synthase (cNOS) with small amount of Ca2+ independent nitric oxide synthase (iNOS). Following burn injury,there was a marked increase in iNOS activity with a peak at 8h post-butyl, however, myocardial cNOS activity was found to decline obviously. Parallel to iNOS induction there was a significant increase in myocardial nitric oxide and cyelic GMP production. All these chenges were alleviated by treatment of the rats with dexamethasone. Since increases in cyclic GMP levels in the heart were associated with reduced myocardial contractility, it is possible that enhanced production of nitric oxide by a Ca2+ independent NO synthase accounts, at least in part, for the depression of myocardial contractility seen in burn animals and patients.

  8. Early pulmonary immune hyporesponsiveness is associated with mortality after burn and smoke inhalation injury. (United States)

    Davis, Christopher S; Albright, Joslyn M; Carter, Stewart R; Ramirez, Luis; Kim, Hajwa; Gamelli, Richard L; Kovacs, Elizabeth J


    This prospective study aims to address mortality in the context of the early pulmonary immune response to burn and inhalation injury. The authors collected bronchoalveolar lavage fluid from 60 burn patients within 14 hours of their injury when smoke inhalation was suspected. Clinical and laboratory parameters and immune mediator profiles were compared with patient outcomes. Patients who succumbed to their injuries were older (P = .005), had a larger % TBSA burn (P burn on mortality, nonsurvivors also had reduced levels of IL-2, IL-4, granulocyte colony-stimulating factor, interferon-γ, macrophage inflammatory protein-1β, and tumor necrosis factor-α (P response to burn and smoke inhalation may be attenuated in patients who succumb to their injuries.

  9. Do burns increase the severity of terror injuries? (United States)

    Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef


    The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score

  10. Physical fitness in people after burn injury : a systematic review

    NARCIS (Netherlands)

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


    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

  11. 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


    OBJECTIVE: To gain insight into the physical fitness of people after burn injury compared with healthy subjects, and to present an overview of the effectiveness of exercise training programs in improving physical fitness in people after burn injury. DATA SOURCES: Electronic databases EMBASE, PubMed,

  12. Burns (United States)

    A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

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

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    Antoinette Runge


    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.

  14. Using online blogs to explore positive outcomes after burn injuries. (United States)

    Garbett, Kirsty; Harcourt, Diana; Buchanan, Heather


    This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.

  15. 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


    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.

  16. Burn Injury: A Challenge for Tissue Engineers

    Directory of Open Access Journals (Sweden)

    Yerneni LK


    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

  17. Burns and injuries resulting from the use of gel candles. (United States)

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


    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.

  18. 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

  19. Effect of Topical Platelet-Rich Plasma on Burn Healing After Partial-Thickness Burn Injury. (United States)

    Ozcelik, Umit; Ekici, Yahya; Bircan, Huseyin Yuce; Aydogan, Cem; Turkoglu, Suna; Ozen, Ozlem; Moray, Gokhan; Haberal, Mehmet


    BACKGROUND To investigate the effects of platelet-rich plasma on tissue maturation and burn healing in an experimental partial-thickness burn injury model. MATERIAL AND METHODS Thirty Wistar albino rats were divided into 3 groups of 10 rats each. Group 1 (platelet-rich plasma group) was exposed to burn injury and topical platelet-rich plasma was applied. Group 2 (control group) was exposed to burn injury only. Group 3 (blood donor group) was used as blood donors for platelet-rich plasma. The rats were killed on the seventh day after burn injury. Tissue hydroxyproline levels were measured and histopathologic changes were examined. RESULTS Hydroxyproline levels were significantly higher in the platelet-rich plasma group than in the control group (P=.03). Histopathologically, there was significantly less inflammatory cell infiltration (P=.005) and there were no statistically significant differences between groups in fibroblast development, collagen production, vessel proliferations, or epithelization. CONCLUSIONS Platelet-rich plasma seems to partially improve burn healing in this experimental burn injury model. As an initial conclusion, it appears that platelet-rich plasma can be used in humans, although further studies should be performed with this type of treatment.

  20. Reducing slide sheet injury. (United States)

    Varcin-Coad, Lynn


    Slide sheets are often stated to be the cause of hand and forearm injuries. While there are many other possible reasons injuries to nursing staff, carer and client occur, the most important linking factors relating to musculoskeletal disorders and manual handling of people is the ongoing inappropriateness or lack of suitably designed and equipped work areas. As physiotherapist Lynn Varcin-Coad writes, staff are bearing the brunt of inefficiencies of design and lack of high order risk control.

  1. Coping with severe burns in the early stage after burn injury. (United States)

    Bras, Marijana; Loncar, Zoran; Brajković, Lovorka; Gregurek, Rudolf; Micković, Vlatko


    This study examined the relationship between coping strategies, anxiety and depression levels and burn injury characteristics in the early phase of the treatment in burn-injured patients. Seventy patients with severe burns were interviewed within two weeks of their burn trauma. Coping strategies were measured by the coping with burns questionnaire (CBQ). Anxiety and depression levels were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. There were no statistically significant gender differences in various coping strategies. Avoidance was associated with higher levels of anxiety, depression and hopelessness. The percentage of total body surface area (TBSA) and localization of burns were not associated with coping patterns. Implications for the assessment and management of burn injured patients were discussed.

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

    Directory of Open Access Journals (Sweden)

    Ashley N. Guillory


    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.

  3. Threshold age and burn size associated with poor outcomes in the elderly after burn injury. (United States)

    Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R; Amini-Nik, Saeid


    Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care.

  4. 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


    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.

  5. Summer camps for children with burn injuries: a literature review. (United States)

    Maslow, Gary R; Lobato, Debra


    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.

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

    DEFF Research Database (Denmark)

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


    One of the oldest methods of pain relief following a burn injury is local application of ice or cold water. Experimental data indicate that cooling may also reduce the severity of tissue injury and promote wound healing, but there are no controlled studies in humans evaluating the anti-inflammato......One of the oldest methods of pain relief following a burn injury is local application of ice or cold water. Experimental data indicate that cooling may also reduce the severity of tissue injury and promote wound healing, but there are no controlled studies in humans evaluating the anti......-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...... (Pindex (P0...

  7. Oxidative stress and anti-oxidative mobilization in burn injury. (United States)

    Parihar, Arti; Parihar, Mordhwaj S; Milner, Stephen; Bhat, Satyanarayan


    A severe burn is associated with release of inflammatory mediators which ultimately cause local and distant pathophysiological effects. Mediators including Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) are increased in affected tissue, which are implicated in pathophysiological events observed in burn patients. The purpose of this article is to understand the role of oxidative stress in burns, in order to develop therapeutic strategies. All peer-reviewed, original and review articles published in the English language literature relevant to the topic of oxidative stress in burns in animals and human subjects were selected for this review and the possible roles of ROS and RNS in the pathophysiology of burns are discussed. Both increased xanthine oxidase and neutrophil activation appear to be the oxidant sources in burns. Free radicals have been found to have beneficial effects on antimicrobial action and wound healing. However following a burn, there is an enormous production of ROS which is harmful and implicated in inflammation, systemic inflammatory response syndrome, immunosuppression, infection and sepsis, tissue damage and multiple organ failure. Thus clinical response to burn is dependent on the balance between production of free radicals and its detoxification. Supplementation of antioxidants in human and animal models has proven benefit in decreasing distant organ failure suggesting a cause and effect relationship. We conclude that oxidative damage is one of the mechanisms responsible for the local and distant pathophysiological events observed after burn, and therefore anti-oxidant therapy might be beneficial in minimizing injury in burned patients.

  8. Evaluation of burn injuries related to liquefied petroleum gas. (United States)

    Tarim, Mehmet Akin


    Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.

  9. Burn Injury Caused by Laptop Computers


    Sharma, G


    Laptop burn is a real condition and medical reports indicate that using a laptop across the legs can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. A 24-year-old man presented with an asymptomatic reddish brown pigmentation on the thighs. After an extensive work-up, burning caused by use of a laptop was observed. Burning was induced in 3 days by using laptop for 4 h daily. Laptop should be used in properly ventilated and air-conditioned rooms. The ...

  10. Evolving Changes in the Management of Burns and Environmental Injuries (United States)


    other complications. When volume status is in doubt, measurement of the base deficit, lactate, central venous pressure, central venous saturation of...patients with burn injuries. J Trauma 2010;69:584–8 [discussion: 8]. 63. Jeschke MG, Kulp GA, Kraft R, et al. Intensive insulin therapy in severely burned...pediatric patients: a prospective randomized trial. Am J Respir Crit Care Med 2010;182:351–9. 64. Jeschke MG, Kraft R, Song J, et al. Insulin

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

    LENUS (Irish Health Repository)

    Davidson, C C


    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.

  12. Epidemiology of burn injuries in Singapore from 1997 to 2003. (United States)

    Song, Colin; Chua, Alvin


    The Singapore General Hospital (SGH) Burn Centre receives more than 93% of burn cases occurring in Singapore. The Centre also received patients from the Southeast Asian region. The collection and analysis of burn epidemiology data in recent years from Singapore would provide insights into new prevention/management strategies in terms of population profile and economic activities. Data pertaining to burn patients admitted to SGH Burn Centre between January 1997 and December 2003 were studied retrospectively in terms of admissions' demographics, extent of burn (TBSA), causes of burns, length of hospital stay (LOS) and mortality. A total of 2019 burn patients were admitted with an annual admission of 288. This presented an incidence rate for burn injury (with admission) of 0.07 per 1000 general population. The male to female ratio is 2.2:1 and the mean age of admission is 32.5years. The mean extent of burn was 11.5% and patients with burn size 10% TBSA and less made up the majority of admissions at 70.7% while patients with burn size 30% TBSA and more made up 8.2%. The most common cause of burn injury is scald at 45.6% followed by flame at 35.2%. The overall mean LOS and mortality are 10.8days and 4.61%, respectively. An annual trend of falling mortality rate for admissions with burn size >30% TBSA was observed-60% in year 2000 to 30% in 2003. This is a result of massive early excision and grafting of severe burn patients. 17.6% of patients were children of 12years and below, showing a 11.9% reduction from previous study in the 80s. This is consistent with the city's demographics of falling fertility rate and improved living and social conditions. Occupational burn admissions account for 33.4% of total admissions, a reduction of 11.6% from a study in the early 90s. Occurrence of occupational flame burns decreased by 9.5% due to an improvement in fire prevention and management of the industrial sectors. However, chemical burns increased by 12.6% as the chemical sector

  13. 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


    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.

  14. Treatment of severe burn injury of 98% TBSA with 95% full-thickness burn and severe inhalation injury: a case report

    Institute of Scientific and Technical Information of China (English)

    杨磊; 王甲汉; 周一平


    @@ The treatment of extensive severe burn injury is very difficult, especially when some complications are involved. A burned patient sustained 98% total body surface area (TBSA) with 95% full thickness burn and severe inhalation injury was admitted to our hospital in 08- 2000. After aggressive treatment, the patient recovered fully. This paper reports the treatment of the patient.

  15. Epidemiology and outcome of burn injuries in tertiary care hospital of Northern India

    Directory of Open Access Journals (Sweden)

    Ram Kishan Abrol


    Conclusions: Burn injuries can be reduced by bringing about regulations to develop safer cooking appliances, promoting less inflammable fabrics to be worn out at home and educating the community especially women. [Int J Res Med Sci 2015; 3(10.000: 2711-2713

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


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


    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.

  17. Peripheral antinociceptive effects of morphine after burn injury

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Kehlet, H


    In a double-blind study, 2 mg of morphine in saline, or saline only, was given subcutaneously into a second-degree bilateral leg-burn injury in 12 volunteers. Heat-pain thresholds and pressure-pain thresholds were significantly increased by local morphine administration. These results confirm...

  18. [Some aspects worth concern in the management of burn injury]. (United States)

    Yang, Zong-cheng


    Although the outcome of burn patients has been improved, many aspects of management of severe burn patients remain controversial. Here we focus on the management of hypermetabolism and the resuscitation of respiratory function. Currently, the fluid resuscitation method shifts from insufficient fluid regimen to excessive fluid loading. The benefit of colloid infusion and restrictive blood transfusion need to be authenticated by further clinical trial, and the best form of fluid resuscitation has yet to be identified. The respiratory management of burn patients had been improved. Early tracheostomy, ventilation with low tidal volume and bronchoalveolar toilet are recommended. Many potential beneficial treatment strategies have been identified by recent research in the metabolic response to burn injury. Although immunomodulation therapy is promising, most of them are not clinical viable,and further clinical research is warranted.

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

    DEFF Research Database (Denmark)

    Pedersen, J L; Kehlet, H


    area). The burns decreased pain thresholds and increased pain responses to both thermal and mechanical stimuli within the burn (P hyperalgesia (mean 89 cm2) to punctate mechanical stimuli (P ...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...

  20. National trends in burn and inhalation injury in burn patients: results of analysis of the nationwide inpatient sample database. (United States)

    Veeravagu, Anand; Yoon, Byung C; Jiang, Bowen; Carvalho, Carla M; Rincon, Fred; Maltenfort, Mitchell; Jallo, Jack; Ratliff, John K


    The aim of this study was describe national trends in prevalence, demographics, hospital length of stay (LOS), hospital charges, and mortality for burn patients with and without inhalational injury and to compare to the National Burn Repository. Burns and inhalation injury cause considerable mortality and morbidity in the United States. There remains insufficient reporting of the demographics and outcomes surrounding such injuries. The National Inpatient Sample database, the nation's largest all-payer inpatient care data repository, was utilized to select 506,628 admissions for burns from 1988 to 2008 based on ICD-9-CM recording. The data were stratified based on the extent of injury (%TBSA) and presence or absence of inhalational injury. Inhalation injury was observed in only 2.2% of burns with burns with 80 to 99% TBSA. Burn patients with inhalation injury were more likely to expire in-hospital compared to those without (odds ratio, 3.6; 95% confidence interval, 2.7-5.0; P Patients treated at rural facilities and patients with hyperglycemia had lower mortality rates. Each increase in percent of TBSA of burns increased LOS by 2.5%. Patients with burns covering 50 to 59% of TBSA had the longest hospital stay at a median of 24 days (range, 17-55). The median in-hospital charge for a burn patient with inhalation injury was US$32,070, compared to US$17,600 for those without. Overall, patients who expired from burn injury accrued higher in-hospital charges (median, US$50,690 vs US$17,510). Geographically, California and New Jersey were the states with the highest charges, whereas Vermont and Maryland were states with the lowest charges. The study analysis provides a broad sampling of nationwide demographics, LOS, and in-hospital charges for patients with burns and inhalation injury.

  1. Military and civilian burn injuries during armed conflicts. (United States)

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


    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.

  2. The Epidemiology of Emergency Department-Treated Burn Injuries Associated with Portable Heaters in the United States, 2003-2013. (United States)

    Brooks, Raina D; McGwin, Gerald

    The purpose of this study is to examine the epidemiology of portable space heater-related burn injuries among an emergency department nationally representative population of the United States. The data analyzed in this study were collected from the Consumer Products Safety Commission's 2003-2013 National Electronic Injury Surveillance System. There were approximately 53,636 space heater-related thermal burn injuries attributed to portable space heaters from 2003 to 2013. The rate of injuries was relatively constant during the 10-year span. The number of burn injuries was highest during winter months. Young children, older adults, males, and Blacks had the highest rates of injury. The body part most commonly injured was the hand, which accounted for 33.3% of all burn injuries. It is important to understand the characteristics of persons who have an increased risk of portable space heater burn and trip/fall injuries, so that preventative methods and awareness strategies can be used to help reduce the number of annual portable space heater injuries.

  3. A rat model of unilateral hindpaw burn injury: slowly developing rightwards shift of the morphine dose-response curve. (United States)

    Wang, Shuxing; Lim, Grewo; Yang, Liling; Zeng, Qing; Sung, Backil; Jeevendra Martyn, J A; Mao, Jianren


    Management of pain after burn injury is an unresolved clinical issue. In a rat model of hindpaw burn injury, we examined the effects of systemic morphine on nociceptive behaviors following injury. Injury was induced by immersing the dorsal part of one hindpaw into a hot water bath (85 degrees C) for 4, 7, or 12 s under pentobarbital anesthesia. Mechanical allodynia to von Frey filament stimulation and thermal hyperalgesia to radiant heat were assessed. Burn injury induced by the 12-s (but not 4-, or 7-s) hot water immersion resulted in reliable and lasting mechanical allodynia and thermal hyperalgesia evident by day 1. In addition, there was an upregulation of protein kinase Cgamma and a progressive downregulation of mu-opioid receptors within the spinal cord dorsal horn ipsilateral to injury as revealed by immunohistochemistry and Western blot. In both injured and sham rats, the anti-nociceptive effects of subcutaneous morphine were examined on post-injury days 7 and 14. While the morphine AD50 dose was comparable on day 7 between burn (1.61 mg/kg) and control (1.7 mg/kg) rats, the morphine dose-response curve was shifted to the right in burn-injured rats (4.6 mg/kg) on post-injury day 14 as compared with both the injured rats on post-injury day 7 and sham rats on day 14 (1.72 mg/kg). These data indicate that hindpaw burn injury reliably produces persistent mechanical allodynia and thermal hyperalgesia and that the reduced efficacy of morphine anti-nociception in chronic burn injury may be in part due to a downregulation of spinal mu-opioid receptors.

  4. How to manage burns in primary care.


    Waitzman, A. A.; Neligan, P. C.


    Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns.


    Piríz Campos, Rosa María; Martín Espinosa, Noelia María


    Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can seriously be compromised. In this chapter, the intention is to clarify the nursing care for the affected area, once patient's life risk is stabilized and controlled. This care should be based on an adequate approach to local handling of burn injuries, after their severity and prognosis have been stated. To do this, it will be used the standardized nursing language NNN, referring to Nursing Diagnosis NANDA (North American Nursing Diagnosis Association), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). This taxonomy is very useful to describe the Nursing clinical practice of burns care because it can easily be used by nurses participating in the care of this type of patients. Nursing plans using the NNN taxonomy can be designed using existing software applications.

  6. 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


    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

  7. Aerobic exercise capacity after burn injury in children and adolescentsin the Netherlands

    NARCIS (Netherlands)

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


    Abstract Purpose: Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially for pediatric burns, persist long after the injury. Loss of physical fitness after burns seems logical, considering inflammatory and stress responses and a lo

  8. Ustioni da fuoco / Burn injuries / Les brûlures

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    Liliana Copertino


    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.

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

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Ferreira


    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.

  10. Burned rice straw reduces the availability of clomazone to barnyardgrass. (United States)

    Xu, Chao; Liu, Weiping; Sheng, G Daniel


    Field burning of crop residue is a common post-harvest practice to dispose of these agricultural by-products and for land clearing. Burned crop residues may effectively adsorb pesticides and thus influence their bioavailability in agricultural soils. The adsorption of clomazone by a soil amended with a burned rice straw (BRS) was measured. The availability of clomazone to barnyardgrass in the soil in the absence and presence of BRS was tested. The BRS was 1000-20,000 times more effective than soil in sorbing clomazone. The sorption of clomazone by soil increased with increasing BRS amount in the soil. In a bioassay, the injury of barnyardgrass 9 days after planting decreased with increasing BRS amount in soil indicating the effect of BRS on clomazone availability. Residual analyses showed higher concentrations of clomazone in soils receiving higher rates of the herbicide than in soils with lower application rates suggesting the adsorptive role of BRS. At typical application rate of clomazone (0.3 microg g(-1)), BRS amounts of 0.02 wt.% and higher caused an appreciable reduction to a complete loss in clomazone availability. Calculations suggest that field burning of rice straw may result in sufficiently high amounts (>0.02 wt.%) of BRS, and hence contribute to often experienced loss of pesticide availability in agricultural soils. Our results may be extended to field situations where other crop residues and vegetation are burned. Alternative management of crop residues may improve the bioavailability of pesticides in agricultural soils.

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

    DEFF Research Database (Denmark)

    Pedersen, J L; Kehlet, H


    was not significantly different between the two zones of hyperalgesia. In conclusion, secondary hyperalgesia in man is not restricted to mechanical stimuli, as significant hyperalgesia to heat developed within the zone of secondary hyperalgesia to punctate mechanical stimuli. The data, combined with other evidence......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...

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

    NARCIS (Netherlands)

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


    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

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

    NARCIS (Netherlands)

    Bosmans, Mark; Hofland, Helma; de jong, Alette; Van Loey, Nancy


    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

  14. Neutrophil dysfunction after thermal injury: alteration of phagolysosomal acidification in patients with large burns. (United States)

    Bjerknes, R; Vindenes, H


    The neutrophil phagolysosomal acidification during phagocytosis of Staphylococcus aureus was examined in six patients with large burns, using a flow cytometric technique allowing the simultaneous measurement of phagocytosis and phagolysosomal pH. The kinetics of neutrophil phagolysosomal acidification were altered during the first 20 days following injury, as the initial alkalinization of the phagolysosomes documented in control neutrophils could not be demonstrated in patient cells. Only at discharge and follow-up were the kinetics of phagolysosomal acidification normal. In addition, measurements of neutrophil maximal phagolysosomal acidification showed a lower pH in patient phagolysosomes than in the controls during the first 5 days of hospitalization. The changes of phagolysosomal acidification did not correlate with the alterations of neutrophil maturity or phagocytic capacity. The results demonstrate alterations of an oxygen-independent microbicidal mechanism in neutrophils from patients with large burns, which may contribute to the reduced capacity of neutrophil intracellular killing following thermal injury.

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

    Directory of Open Access Journals (Sweden)

    Ssentongo Robert


    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.

  16. Factors related to child maltreatment in children presenting with burn injuries. (United States)

    Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye


    The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. Pmaltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.

  17. Hot asphalt burns: a review of injuries and management options. (United States)

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


    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.

  18. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report (United States)

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan


    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  19. Management of burn injuries – recent developments in resuscitation, infection control and outcomes research

    Directory of Open Access Journals (Sweden)

    Dries David J


    Full Text Available Abstract Introduction Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. Methods A selected review of recent reports published by the American Burn Association is provided. Results The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. Conclusion Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue

  20. Decreased pulmonary inflammation after ethanol exposure and burn injury in intercellular adhesion molecule-1 knockout mice. (United States)

    Bird, Melanie D; Morgan, Michelle O; Ramirez, Luis; Yong, Sherri; Kovacs, Elizabeth J


    Clinical and laboratory evidence suggests that alcohol consumption dysregulates immune function. Burn patients who consume alcohol before their injuries demonstrate higher rates of morbidity and mortality, including acute respiratory distress syndrome, than patients without alcohol at the time of injury. Our laboratory observed higher levels of proinflammatory cytokines and leukocyte infiltration in the lungs of mice after ethanol exposure and burn injury than with either insult alone. To understand the mechanism of the increased pulmonary inflammatory response in mice treated with ethanol and burn injury, we investigated the role of intercellular adhesion molecule (ICAM)-1. Wild-type and ICAM-1 knockout (KO) mice were treated with vehicle or ethanol and subsequently given a sham or burn injury. Twenty-four hours postinjury, lungs were harvested and analyzed for indices of inflammation. Higher numbers of neutrophils were observed in the lungs of wild-type mice after burn and burn with ethanol treatment. This increase in pulmonary inflammatory cell accumulation was significantly lower in the KO mice. In addition, levels of KC, interleukin-1beta, and interleukin-6 in the lung were decreased in the ICAM-1 KO mice after ethanol exposure and burn injury. Interestingly, no differences were observed in serum or lung tissue content of soluble ICAM-1 24 hours postinjury. These data suggest that upregulation of adhesion molecules such as ICAM-1 on the vascular endothelium may play a critical role in the excessive inflammation seen after ethanol exposure and burn injury.

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

    NARCIS (Netherlands)

    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.


    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 d

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



    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...

  3. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Kendrick Denise


    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.

  5. Ventilator-associated pneumonia after combined burn and trauma is caused by associated injuries and not the burn wound. (United States)

    Eckert, Matthew J; Wade, Terence E; Davis, Kimberly A; Luchette, Fred A; Esposito, Thomas J; Poulakidas, Stathis J; Santaniello, John M; Gamelli, Richard L


    An increased risk of ventilator-associated pneumonia (VAP) has previously been demonstrated in trauma patients urgently intubated in the prehospital (ie, field) and emergency department (ED) settings. This study investigated the impact of urgent intubation on subsequent VAP in patients who sustained both a burn injury and a traumatic injury. We undertook a retrospective review of both trauma registry data and medical records for all patients with combined thermal and traumatic injuries admitted to a single verified burn center and level I trauma center. Patients undergoing field or ED intubation during the 5-year period ending December 2002 were identified and studied. Data abstracted included admission demographics and vital signs, presence of inhalation injury, location at the time of intubation, presence of associated injury, percentage TBSA burn, hospital and intensive care unit length of stay, and hospital day of VAP diagnosis. Seventy-eight of the 3388 patients (2.3%) admitted during the study period sustained a combination of burn wounds and trauma and underwent urgent field or ED intubation. The majority of patients were men (71%), with a mean age of 46 +/- 24 years. There was one failed oral intubation, which required cricothyroidotomy. The location of the patient at the time of intubation was ED, 66%; burn center ED, 17%; and field, 17%. Eighty percent of all patients were diagnosed with an inhalation injury. VAP was diagnosed in 39 patients (50%), with a mean time to diagnosis of 10 +/- 9 days. TBSA burn, smoke inhalation, and time (in days) to diagnosis of VAP were not independent risk factors for the occurrence of pneumonia in any of the 3 groups. However, those intubated at the initial ED were more likely to develop VAP (P = .028) compared to those intubated in the field or in the burn center. The incidence of associated injuries was significantly greater (P burn patients also sustain blunt trauma. VAP occurs in 50% of the patients requiring urgent

  6. Lightning discharges and discharges from overhead power lines with human burn injuries as consequences

    Directory of Open Access Journals (Sweden)

    Javor Sanja


    Full Text Available Discharges from overhead power lines and lightning discharges may severely endanger human life and health. If non-lethal, burn injuries may also last for a lifetime, so as Lichtenberg figures caused by lightning discharges. Some accidents with burns are discussed in this paper and recommendations given for safety reasons. Specific energy transferred by typical lightning strokes currents given in the standard IEC 62305 is calculated. The aim of the paper is to suggest a simple expression for the estimation of safe approach distances to overhead lines, especially if high temperatures and changes in terrain reduced the secure height above ground, or if carrying elevated objects. Results of these calculations are compared to safe approach distances given in regulations of different countries. Safe distances from railway power lines are also considered.

  7. Combination of Radiation and Burn Injury Alters FDG Uptake in Mice (United States)

    Carter, Edward A.; Winter, David; Tolman, Crystal; Paul, Kasie; Hamrahi, Victoria; Tompkins, Ronald; Fischman, Alan J.


    Radiation exposure and burn injury have both been shown to alter glucose utilization in vivo. The present study was designed to study the effect of burn injury combined with radiation exposure, on glucose metabolism in mice using [18F] Fluorodeoxyglucose (18FDG). Groups of male mice weighing approximately 30g were studied. Group 1 was irradiated with a 137Cs source (9 Gy). Group 2 received full thickness burn injury on 25% total body surface area followed by resuscitated with saline (2mL, IP). Group 3 received radiation followed 10 minutes later by burn injury. Group 4 were sham treated controls. After treatment, the mice were fasted for 23 hours and then injected (IV) with 50 µCi of 18FDG. One hour post injection, the mice were sacrificed and biodistribution was measured. Positive blood cultures were observed in all groups of animals compared to the shams. Increased mortality was observed after 6 days in the burn plus radiated group as compared to the other groups. Radiation and burn treatments separately or in combination produced major changes in 18FDG uptake by many tissues. In the heart, brown adipose tissue (BAT) and spleen, radiation plus burn produced a much greater increase (p<0.0001) in 18FDG accumulation than either treatment separately. All three treatments produced moderate decreases in 18FDG accumulation (p<0.01) in the brain and gonads. Burn injury, but not irradiation, increased 18FDG accumulation in skeletal muscle; however the combination of burn plus radiation decreased 18FDG accumulation in skeletal muscle. This model may be useful for understanding the effects of burns + irradiation injury on glucose metabolism and in developing treatments for victims of injuries produced by the combination of burn plus irradiation. PMID:23143615

  8. Caregiver-related predictors of thermal burn injuries among Iranian children: A case-control study (United States)

    Sadeghi-Bazargani, Homayoun; Mohammadi, Reza; Ayubi, Erfan; Almasi-Hashiani, Amir; Pakzad, Reza; Sullman, Mark J. M.; Safiri, Saeid


    Purpose Burns are a common and preventable cause of injury in children. The aim of this study was to investigate child and caregiver characteristics which may predict childhood burn injuries among Iranian children and to examine whether confounding exists among these predictors. Methods A hospital based case-control study was conducted using 281 burn victims and 273 hospital-based controls, which were matched by age, gender and place of residence (rural/urban). The characteristics of the children and their caregivers were analyzed using crude and adjusted models to test whether these were predictors of childhood burn injuries. Results The age of the caregiver was significantly lower for burn victims than for the controls (Pcaregiver spent outdoors with the child and their economic status had a significant positive association with the odds of a burn injury (Pcaregivers was independently associated with the child's odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04–1.21). The research also found that children with ADHD (Inattentive subscale: Crude OR = 2.14, 95% CI: 1.16–3.95, Adjusted OR = 5.65, 95% CI: 2.53–12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23–2.41, Adjusted OR = 2.53, 95% CI: 1.65–3.87) also had increased odds of suffering a burn injury. However, several variables were identified as possible negative confounder variables, as the associations were stronger in the multivariate model than in the crude models. Conclusion The caregiver's characteristics which were predictors of burn injuries among Iranian children were: being younger, high socio-economic status, Type A behavioural pattern and spending more time outdoors. In addition, the relationship between a child's ADHD scores and the odds of a burn injury may be negatively confounded by the caregivers predictor variables. PMID:28151942

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

    DEFF Research Database (Denmark)

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


    -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...... on 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...... (Presponses (Presponses (Pskin temperature (P>0...

  10. Combination of Radiation and Burn Injury Alters FDG Uptake in Mice



    Radiation exposure and burn injury have both been shown to alter glucose utilization in vivo. The present study was designed to study the effect of burn injury combined with radiation exposure, on glucose metabolism in mice using [18F] Fluorodeoxyglucose (18FDG). Groups of male mice weighing approximately 30g were studied. Group 1 was irradiated with a 137Cs source (9 Gy). Group 2 received full thickness burn injury on 25% total body surface area followed by resuscitated with saline (2mL, IP)...

  11. 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

  12. Aircraft Engine Technology for Green Aviation to Reduce Fuel Burn (United States)

    Hughes, Christopher E.; VanZante, Dale E.; Heidmann, James D.


    The NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project and Integrated Systems Research Program Environmentally Responsible Aviation Project in the Aeronautics Research Mission Directorate are conducting research on advanced aircraft technology to address the environmental goals of reducing fuel burn, noise and NOx emissions for aircraft in 2020 and beyond. Both Projects, in collaborative partnerships with U.S. Industry, Academia, and other Government Agencies, have made significant progress toward reaching the N+2 (2020) and N+3 (beyond 2025) installed fuel burn goals by fundamental aircraft engine technology development, subscale component experimental investigations, full scale integrated systems validation testing, and development validation of state of the art computation design and analysis codes. Specific areas of propulsion technology research are discussed and progress to date.

  13. Airbag-related chest wall burn as a marker of underlying injury: a case report

    Directory of Open Access Journals (Sweden)

    Monkhouse Simon J


    Full Text Available Abstract Introduction This case of a man who sustained an airbag-induced thoracic injury and burn, highlights the potential harm that can be caused by airbags. It also serves to illustrate that a surface burn which looks small and benign can actually be a surface marker of a more serious injury. Staff working in emergency departments need to be aware of the risk of possible airbag-associated injuries. Case presentation A 65-year-old man was the driver in a frontal collision. He was wearing a seatbelt. The airbag was activated and caused a superficial chest wall burn. Initial chest x-rays were unremarkable but following deterioration in his condition, a computed tomography scan revealed a serious sternal fracture. The location of the fracture was marked on the surface by the burn. Conclusion Airbags can cause significant chest wall injuries and burns. Surface burns at the point of impact should not be dismissed as trivial as the forces involved can cause significant injury. We recommend that all people with chest wall injuries and/or burns due to airbags should have more detailed chest imaging as initial emergency radiographs can be falsely reassuring.

  14. 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.

  15. Characteristics of and strategies for patients with severe burn-blast combined injury

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHEN Chuan-an; TUO Xiao-ye; LIANG Li-ming; WANG Shu-jun; SHENG Zhi-yong; LU Jiang-yang; WEN Zhong-guang; YANG Hong-ming; JIA Xiao-ming; LI Li-gen; CAO Wei-hong; HAO Dai-feng


    Background Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.Methods Five patients with severe burn-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% (89.6%±7.2%) of TBSA (full-thickness burns 75%-92%(83.4%±7.3%)). All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.Results One patient died of septic shock 23 hours after admission (four days after injury), the others survived.Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.Conclusions Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients' condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.

  16. Pulmonary inflammation after ethanol exposure and burn injury is attenuated in the absence of IL-6. (United States)

    Chen, Michael M; Bird, Melanie D; Zahs, Anita; Deburghgraeve, Cory; Posnik, Bartlomiej; Davis, Christopher S; Kovacs, Elizabeth J


    Alcohol consumption leads to an exaggerated inflammatory response after burn injury. Elevated levels of interleukin-6 (IL-6) in patients are associated with increased morbidity and mortality after injury, and high systemic and pulmonary levels of IL-6 have been observed after the combined insult of ethanol exposure and burn injury. To further investigate the role of IL-6 in the pulmonary inflammatory response, we examined leukocyte infiltration and cytokine and chemokine production in the lungs of wild-type and IL-6 knockout mice given vehicle or ethanol (1.11 g/kg) and subjected to a sham or 15% total body surface area burn injury. Levels of neutrophil infiltration and neutrophil chemoattractants were increased to a similar extent in wild-type and IL-6 knockout mice 24 h after burn injury. When ethanol exposure preceded the burn injury, however, a further increase of these inflammatory markers was seen only in the wild-type mice. Additionally, signal transducer and activator of transcription-3 (STAT3) phosphorylation did not increase in response to ethanol exposure in the IL-6 knockout mice, in contrast to their wild-type counterparts. Visual and imaging analysis of alveolar wall thickness supported these findings and similar results were obtained by blocking IL-6 with antibody. Taken together, our data suggest a causal relationship between IL-6 and the excessive pulmonary inflammation observed after the combined insult of ethanol and burn injury.

  17. Propylthiouracil (PTU)-induced hypothyroidism alleviates burn-induced multiple organ injury. (United States)

    Sener, Göksel; Sehirli, Ozer; Velioğlu-Oğünç, Ayliz; Ercan, Feriha; Erkanli, Gözde; Gedik, Nursal; Yeğen, Berrak C


    Oxidative stress has an important role in the development of multiorgan failure after major burn. This study was designed to determine the possible protective effect of experimental hypothyroidism in hepatic and gastrointestinal injury induced by thermal trauma. Sprague Dawley rats were administered saline or PTU (10 mgkg(-1) i.p.) for 15 days, and hypothyroidism was confirmed by depressed serum T(3) and T(4) concentrations. Under brief ether anesthesia, shaved dorsum of rats was exposed to 90 degrees C (burn group) or 25 degrees C (control group) water bath for 10s. PTU or saline treatment was repeated at the 12th hour of the burn. Rats were decapitated 24h after injury and tissue samples from liver, stomach and ileum were taken for the determination of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen contents. Formation of reactive oxygen species in tissue samples was monitored by using chemiluminescence (CL) technique with luminol and lucigenin probes. Tissues were also examined microscopically. Tumor necrosis factor (TNF)-alpha and lactate dehydrogenase (LDH) were assayed in serum samples. Severe skin scald injury (30% of total body surface area) caused a significant decrease in GSH level, which was accompanied with significant increases in MDA level, MPO activity, CL levels and collagen content of the studied tissues (pPTU treatment reversed all these biochemical indices, as well as histopathological alterations induced by thermal trauma. Our results suggest that PTU-induced hypothyroidism reduces oxidative damage in the hepatic, gastric and ileal tissues probably due to hypometabolism, which is associated with decreased production of reactive oxygen metabolites and enhancement of antioxidant mechanisms.

  18. Burn injury during long-term oxygen therapy in Denmark and Sweden

    DEFF Research Database (Denmark)

    Tanash, Hanan A; Ringbaek, Thomas; Huss, Fredrik;


    BACKGROUND: Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury that requ......BACKGROUND: Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury...... that required contact with a health care specialist, between Sweden (a country with a strict policy regarding smoking while on LTOT) and Denmark (a country with less strict smoking policy). METHODS: This was a population-based, cohort study of patients initiating LTOT due to any cause in Sweden and Denmark...

  19. Role of stanniocalcin1 in brain injury of coal-burning-borne fluorosis rats

    Institute of Scientific and Technical Information of China (English)



    Objective To observe the change of stanniocalcin 1(STC1) and calcium content in brain of coal-burning-borne fluorosis rats,and to explore the role of STC1 in brain injury of coal-burning-borne fluorosis.Methods Twenty four male SD rats were randomly divided into control,low,medium,

  20. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir


    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. Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells☆


    Fazal, Nadeem; Shelip, Alla; Alzahrani, Alhusain J.


    After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show ...

  2. Interleukin-18 delays neutrophil apoptosis following alcohol intoxication and burn injury. (United States)

    Akhtar, Suhail; Li, Xiaoling; Kovacs, Elizabeth J; Gamelli, Richard L; Choudhry, Mashkoor A


    Studies have shown that burn patients who are intoxicated at the time of injury are more susceptible to infection and have a higher incidence of mortality. A major cause of death in burn and trauma patients regardless of their alcohol (EtOH) exposure is multiple organ dysfunction, which is driven in part by the systemic inflammatory response and activated neutrophils. Neutrophils are short lived and undergo apoptosis to maintain homeostasis and resolution of inflammation. A delay in apoptosis of neutrophils is one important mechanism which allows for their prolonged presence and the release of potentially harmful enzymes. The purpose of this study was to examine whether EtOH intoxication combined with burn injury influences neutrophil apoptosis and whether IL-18 plays any role in this setting. To accomplish this investigation, rats were gavaged with EtOH (3.2 g/kg) 4 h before being subjected to sham or burn injury of ~12.5% of the total body surface area, and then killed on d 1 after injury. Peripheral blood neutrophils were isolated and lysed. The lysates were analyzed for pro- and antiapoptotic proteins. We found that EtOH combined with burn injury prolonged neutrophil survival. This prolonged neutrophil survival was accompanied by a decrease in the levels of the neutrophil proapoptotic protein Bax, and an increase in antiapoptotic proteins Mcl-1 and Bcl-xl. Administration of IL-18 antibody following burn injury normalized the levels of Bax, Mcl-1 and Bcl-xl. The decrease in caspase-3 and DNA fragmentation observed following EtOH and burn injury was also normalized in rats treated with anti-IL-18 antibody. These findings suggest that IL-18 delays neutrophil apoptosis following EtOH and burn injury by modulating the pro- and antiapoptotic proteins.

  3. 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

  4. Reducing child hazards in the home. A joint venture in injury control. (United States)

    Sullivan, M; Cole, B; Lie, L; Twomey, J


    Injuries are a leading cause of childhood mortality and morbidity in the home, particularly in children less than 6 years of age. In an effort to prevent childhood injuries, the Hennepin County Burn Center began a joint venture with a public health agency to reduce home hazards for children less than 6 years of age who were treated at the burn center. Children were referred to a public health nurse for a home safety assessment. During the initial visit, child hazards were identified and recommendations were made for reducing injury risk. Parental compliance with recommendations was evaluated during a second home visit approximately 1 month later. Home safety assessments were completed in 21 homes, and a total of 131 recommendations were made. Burn prevention recommendations accounted for 43.5% of the total recommendations, poison control recommendations accounted for 36.6%, and other injury control recommendations accounted for 19.9%. Parents complied with 43.5% of the total 131 recommendations. Burn prevention recommendations had a compliance rate of 42%. Poison control recommendations had the highest rate of compliance at 58%. Other injury control recommendations had a compliance rate of 19%. The program had a positive effect on reducing home hazards. It was an appropriate response by practitioners already involved in the care of children, many of whom are at risk of injury.

  5. Burn Institute (United States)

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  6. Inhalation injury in burn patients: establishing the link between diagnosis and prognosis. (United States)

    You, Kicheol; Yang, Hyeong-Tae; Kym, Dohern; Yoon, Jaechul; HaejunYim; Cho, Yong-Suk; Hur, Jun; Chun, Wook; Kim, Jong-Hyun


    This study was to re-evaluate inhalation injury as a prognostic factor in burn patients and to determine the factors that should be considered when refining the definition of inhalation injury. A total of 192 burn patients (152 men, 40 women; mean age, 46.1±13.8 years) who were suspected to have an inhalation injury and underwent bronchoscopy between January 2010 and June 2012 were included in this prospective observational study. All patients underwent bronchoscopy within 24h of sustaining the burn. The bronchoscopic findings were classified as normal, mild, moderate, and severe. Mechanical ventilation was administered, when required. Age, percentage of TBSA burned, ABSI score, requirement of mechanical ventilation and PF ratio, but not inhalation injury, COHb level, and bronchoscopic grades, significantly differed between the survivors and non-survivors (pburns. Other components such as severity of inhalation injury determined using bronchoscopy, and administration of mechanical ventilation might help predict the morbidity and mortality of burn patients with inhalation injury and all of the factors should be considered when the definition of inhalation injury is refined.

  7. Burns (United States)

    ... home, work, and school. Remove electrical cords from floors and keep them out of reach. Know about and practice fire escape routes at ... Burn, thermal - close-up Airway burn Skin First degree burn ...

  8. High pressure droplet burning experiments in reduced gravity (United States)

    Chauveau, Christian; Goekalp, Iskender


    A parametric investigation of single droplet gasification regimes is helpful in providing the necessary physical ideas for sub-grid models used in spray combustion numerical prediction codes. A research program has been initiated at the LCSR to explore the vaporization regimes of single and interacting hydrocarbon and liquid oxygen droplets under high pressure conditions. This paper summarizes the status of the LCSR program on the high pressure burning of single fuel droplets; recent results obtained under normal and reduced gravity conditions with suspended droplets are presented. In the work described here, parabolic flights of the CNES Caravelle is used to create a reduced gravity environment of the order of 10(exp -2) g(sub O). For all the droplet burning experiments reported here, the suspended droplet initial diameters are scattered around 1.5 mm; and the ambient air temperature is 300 K. The ambient pressure is varied between 0.1 MPa and 12 MPa. Four fuels are investigated: methanol (Pc = 7.9 MPa), n-heptane (Pc = 2.74 MPa), n-hexane (Pc = 3.01 MPa) and n-octane (Pc = 2.48 MPa).

  9. Thermal Injury Model in the Rabbit Ear with Quantifiable Burn Progression and Hypertrophic Scar. (United States)

    Friedrich, Emily E; Niknam-Bienia, Solmaz; Xie, Ping; Jia, Sheng-Xian; Hong, Seok Jong; Mustoe, Thomas A; Galiano, Robert D


    Hypertrophic scar is a major clinical outcome of deep-partial thickness to full thickness thermal burn injury. Appropriate animal models are a limitation to burn research due to the lack of, or access to, animal models which address the endpoint of hypertrophic scar. Lower species, such as rodents, heal mainly by contracture, which limits the duration of study. Higher species, such as pigs, heal more similarly to humans, but are associated with high cost, long duration for scar development, challenges in quantifying scar hypertrophy, and poor manageability. Here we present a quantifiable deep-partial thickness burn model in the rabbit ear. Burns were created using a dry-heated brass rod for 10 s and 20 s at 90°C. At the time of eschar excision on day 3, excisional wounds were made on the contralateral ear for comparison. Burn wound progression, in which the wound size expands over time is a major distinction between excisional and thermal injuries, was quantified at 1 h and 3 d after the injuries using calibrated photographs and histology and the size of the wounds was found to be unchanged from the initial wound size at 1 h, but 10% in the 20 s burn wounds at 3 d. A quantifiable hypertrophic scar, measured by histology as the scar elevation index, was present in both 20 s burn wounds and excisional wounds at day 35. ImageJ measurements revealed that the 20 s burn wound scars were 22% larger than the excisional wound scars and the 20 s burn scar area measurements from histology were 26% greater than in the excisional wound scar. The ability to measure both burn progression and scar hypertrophy over a 35-day time frame suits this model to screening early intervention burn wound therapeutics or scar treatments in a burn-specific scar model. This article is protected by copyright. All rights reserved.

  10. Burn Injuries in Children and the Use of Biological Dressings (United States)


    is the subcutaneous fat, which con- tains free nerve endings and the roots of hair follicles . Burns are classified as first, second, or third degree...and hair follicles , is also destroyed, third-degree burns appear dry, white, charred, or leathery, and the tissue has no sensation. Burns that extend...Emer Care 2013;29: 939Y948) TARGET AUDIENCE This CME activity is intended for physicians who care for children. Pediatricians, emergency physicians

  11. The role of seizure disorders in burn injury and outcome in Sub-Saharan Africa. (United States)

    Boschini, Laura P; Tyson, Anna F; Samuel, Jonathan C; Kendig, Claire E; Mjuweni, Stephano; Varela, Carlos; Cairns, Bruce A; Charles, Anthony G


    Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. The authors compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. The authors conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. Prevalence of seizure disorder was 10.7% in the study population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. Whereas mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days vs 21.6 days. Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in Sub-Saharan Africa and must be included in an overall burn prevention strategy in our environment.

  12. Central activation of TRPV1 and TRPA1 by novel endogenous agonists contributes to mechanical allodynia and thermal hyperalgesia after burn injury. (United States)

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


    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.

  13. [Burn injuries during MR scanning: a case report

    NARCIS (Netherlands)

    Vister, J.; Erning, L. van; Steens, S.C.A.; Meijer, F.J.A.


    In this paper we report one case of skin burns in MRI caused by induced electrical currents. Two second degree skin burns occurred during imaging, while operating within all current safety guidelines. The currents are induced by the magnetic-gradient field, as well as the radiofrequency pulses. A cl

  14. Coping with burns: the role of coping self-efficacy in the recovery from traumatic stress following burn injuries. (United States)

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


    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 strongest predictor of both initial PTSD symptoms and degree of symptom change with higher CSE levels associated with lower initial symptoms and a steeper decline of symptoms over time. Of the other variables only avoidant coping was associated with higher initial symptom levels, and only emotional expression associated with greater rate of recovery. Current findings suggest that CSE plays a pivotal role in recovery from posttraumatic stress after a burn injury, even when the role of burn-related impairments is taken into consideration. Implications of findings are discussed.

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

    Directory of Open Access Journals (Sweden)

    Jamila Chahed


    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

  16. Coronary Flow Velocity Reserve in Burn Injury: A Prospective Clinical Cohort Study. (United States)

    Caliskan, Mustafa; Turk, Emin; Karagulle, Erdal; Ciftci, Ozgur; Oguz, Hakan; Kostek, Osman; Moray, Gokhan; Haberal, Mehmet


    The authors sought to evaluate coronary microvascular function and left ventricular diastolic dysfunction using transthoracic Doppler echocardiography in burn patients. In this study, 32 adult burn patients with partial or full-thickness scald burns that were hospitalized and treated were included. The control group was matched for age and sex and was composed of otherwise healthy volunteers. Transthoracic Doppler echocardiography examinations and simultaneous laboratory tests for cardiac evaluation were performed on the sixth month after burn injury as well as with the control group. High-sensitivity C-reactive protein levels were significantly higher in the burn patients than in controls (5.17 ± 3.86 vs 2.42 ± 1.78; P = .001). Lateral isovolumic relaxation time was significantly higher in the burn injury group than in the control group (92.7 ± 15.7 vs 85.5 ± 8.3; P = .03). Baseline coronary diastolic peak flow velocity of the left anterior descending artery was similar in both groups. However, hyperemic diastolic peak flow velocity and coronary flow velocity reserve (2.26 ± 0.48 vs 2.94 ± 0.47; P < .001) were significantly lower in the burn injury group than in the control group. Coronary flow velocity reserve was significantly and inversely correlated with high-sensitivity C-reactive protein, burn ratio, creatinine, and mitral A-wave max velocity. At the sixth month of treatment, burn patients had high-sensitivity C-reactive protein levels during this period, suggesting that inflammation still exists. In addition, subclinical coronary microvascular and left ventricular diastolic dysfunction can occur in burn patients without traditional cardiovascular risk factors. However, these results must be supported by additional studies.

  17. Financial burden of burn injuries in iran: a report from the burn registry program. (United States)

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


    Understanding the cost of burn treatment is very important for patients, their families, governmental authorities and insurance companies. It alleviates patient and familial stress, provides a framework for better use of resources, and facilitates better performance between burn centers. Hospital burn costs can provide a basis for authorities to budget for acute burn treatment, for further management of chronic complications, and for planning prevention and public educational programs in Iran. To identify costs we used data from our burn registry program. Over the two-year assessment period, we treated roughly 28,700 burn patients, 1,721 of whom were admitted, with a mortality rate of 5.9%. The male to female ratio was 1.7:1 (63% male; 37% female). Flame burns were most frequent (49.8%) followed by scalds (35.7%). Mean hospital stay was 14.41 days (range 0-64 days). Mean TBSA was 17.39%. Skin grafts were carried out in 65.4% of the patients, with a mean of 5.2 surgeries per patient. The total cost of all patient admissions over the two years was US$ 4,835,000. The maximum treatment cost for one patient was US$ 91,000. The mean cost per patient was US$ 2,810 (29,500,000 Rials). The mean cost for each percent of burn was US$ 162. The mean cost for a one-day stay in hospital was US$ 195. The mean cost of each operation was US$ 540. Patients who contracted infections endured longer hospital stays, meaning increased costs of US$ 195 per day. With comparable outcome and results, the cost of burn treatment in Iran is cheaper than in the US and Europe.


    Directory of Open Access Journals (Sweden)

    Shanti Prakash


    Full Text Available INTRODUCTION: Platelet count evaluation in a burn trauma patient has much significance because it has been studied in literature that decrease i n platelet count is an indicator of septicaemia in the patient and vice versa thus knowing the count level of platelets, the treatment of burn patients can be done accordingly. Septicaemia is most important cause of mortality in burn patients, the survival of the patients can only be assured if septicaemia is detected early and controlled. Platelet s play an important role in haemostaticdisorder and immune response impairment in burn patient . [1] The aim of study is to see the significance of platelet count i nvestigation in burn patient and then their outcome, whether survival or not survival. MATERIAL METHODS: We investigated 480 burn patients within the ages of 18 and 60 Years and the percentage of the burn was between 20% and 70%. Platelet count was investi gated by visual method in all patients. The investigation of the platelet count was done on day 1, 3, 7, 14 & 21 of the patients. Other parameters TLC , neutrophil count was done by visual methods. Serum creatinine estimation was also done in all patients. RESULT: In our study we found that the platelet count gradually increased towards normal count and maintained till the discharge in survival patients, and in non - survival the platelet count gradually declined. The statistical significant of difference in m ean platelet counts on different post burn days in survivors and non survivors were studied by using standard t test. It was observed that the actual difference between two means is more than double of the SED between two means in different post burn days – i . e. , (Day 1, 3, 7, 14 &, 21. So difference is significant (P<0.05. CONCLUSION: It can be concluded that platelet count decreases initially in all cases of burn sepsis. It gradually rises to normal in case of survivors and declines gradually in non surv ivors. So serial declining

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

    Institute of Scientific and Technical Information of China (English)


    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.

  20. Effect of insulin on the inflammatory and acute phase response after burn injury. (United States)

    Jeschke, Marc G; Boehning, Darren F; Finnerty, Celeste C; Herndon, David N


    After a severe burn, the liver plays a pivotal role by modulating inflammatory processes, metabolic pathways, immune functions, and the acute phase response. Therefore, liver integrity and function are important for recovery. A thermal injury, however, causes hepatic damage by inducing hepatic edema, fatty infiltration, hepatocyte apoptosis, and metabolic derangements associated with insulin resistance and impaired insulin signaling. In preliminary studies, we found that these pathophysiological processes are related to hepatic inflammation, altered intracellular signaling, and mitochondrial dysfunction. We hypothesize that modulation of these processes with insulin could improve hepatic structure and function and, therefore, outcome of burned and critically ill patients. Insulin administration improves survival and decreases the rate of infections in severely burned and critically ill patients. Here, we show that insulin administration decreases the synthesis of proinflammatory cytokines and signal transcription factors and improves hepatic structure and function after a severe burn injury; insulin also restores hepatic homeostasis and improves hepatic dysfunction postburn via alterations in the signaling cascade.

  1. The Combination of SAT and SBT Protocols May Help Reduce the Incidence of Ventilator-Associated Pneumonia in the Burn Intensive Care Unit. (United States)

    Lee, Yann-Leei Larry; Sims, Kaci D; Butts, Charles C; Frotan, M Amin; Kahn, Steven; Brevard, Sidney B; Simmons, Jon D

    There are few published reports on the unique nature of burn patients using a paired spontaneous awakening and spontaneous breathing protocol. A combined protocol was implemented in our burn intensive care unit (ICU) on January 1, 2012. This study evaluates the impact of this protocol on patient outcomes in a burn ICU. We performed a retrospective review of our burn registry over 4 years, including all patients placed on mechanical ventilation. In the latter 2 years, patients meeting criteria underwent daily spontaneous awakening trial; if successful, spontaneous breathing trial was performed. Patient data included age, burn size, percent full-thickness burn, tracheostomy, and inhalation injury. Outcome measures included ventilator days, ICU and hospital lengths of stay, pneumonia, and disposition. Data were analyzed using Graphpad Prism and IBM SPSS software, with statistical significance defined as P < .05. There were 171 admissions in the preprotocol period and 136 after protocol implementation. Protocol patients had greater percent full-thickness burns, but did not differ in other characteristics. The protocol group had significantly shorter ICU length of stay, fewer ventilator days, and lower pneumonia incidence. Hospital length of stay, disposition, and mortality were not significantly different. Among patients with inhalation injuries, the protocol group exhibited fewer ventilator and ICU days. Protocol implementation in a burn ICU was accompanied by decreased ventilator days and a reduced incidence of pneumonia. A combined spontaneous awakening and breathing protocol is safe and may improve clinical practice in the burn ICU.

  2. Use of Topical PC-NSAIDs to Treat Burn Injury and Pain (United States)


    of surface epidermis and collagen discoloration and rearrangement (center) and damage to the hair follicle , shaft and roots (right). The...clotting time. 3) Determine the mechanism of action of PC-NSAIDs in the treatment of burn pain/healing. Milestones and target dates: 1) Complete testing...for topical and iv Indo, Indo-PC, Ibu and Ibu-PC in hind limb burn injury model – target was month 6 – 0% complete 2) Complete testing for topical and

  3. The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study. (United States)

    Cukor, Judith; Wyka, Katarzyna; Leahy, Nicole; Yurt, Roger; Difede, JoAnn


    Burn injuries are unique in their medical and psychological impact, yet there has been little exploration of psychiatric treatment for this population. This uncontrolled pilot study assessed feasibility, acceptability, and preliminary efficacy of a treatment protocol designed to address posttraumatic stress disorder, depression, coping with scarring, and community integration among adult burn survivors. A 14-session, manualized treatment protocol was created using cognitive-behavioral interventions including imaginal exposure, behavioral activation, cognitive restructuring, modeling, and in vivo exposure. Responses were measured using the Clinician Administered PTSD Scale, Beck Depression Index, Community Integration Questionnaire, Oswestry Disability Questionnaire, and Burn Specific Health Scale. Nine of 10 enrolled patients (60% women; mean = 42 years old) completed treatment. Burn size was 0.5% to 65%; mechanism of injury included flame (4), scald (5), and contact (1) burns. Mean acute hospitalization was 30.1 days (range = 13-87); mean time from injury to treatment was 3.2 months (range = 1-7). Baseline mean posttraumatic stress score was 68 on the Clinician Administered PTSD Scale (severe); scores decreased by 36% to a mean of 45.3 at posttreatment, with a large effect size. Baseline self-reported depression was 21 (moderate) on the Beck Depression Index, decreasing by 47% to a mean of 12 posttreatment (nonclinical). Change in community reintegration score was significant and large, and body image showed significant improvement. The protocol showed promise in the treatment of posttraumatic stress disorder, depression, self-image, and community reintegration following burn injury. These findings suggest that coping may improve with treatment and symptoms should not be dismissed as unavoidable consequences of burn injury.

  4. Non-severe burn injury leads to depletion of bone volume that can be ameliorated by inhibiting TNF-α. (United States)

    O'Halloran, Emily; Kular, Jasreen; Xu, Jiake; Wood, Fiona; Fear, Mark


    Bone loss after severe burn injury is well established, and is thought to be a consequence of the severe hyper-metabolic response as well as changes in cytokine and glucocorticoid levels that decrease bone synthesis and increase rate of loss. However, 90% of presentations are for non-severe burns which do not elicit this response. Little is known about whether these non-severe injuries may also affect bone tissue, and whether other mechanisms may be involved. To investigate whether bone loss occurs after a non-severe burn injury we used a mouse model of an approximately 8% total body surface area (TBSA) full-thickness burn and micro-CT. We also assessed whether blocking TNF-α after a burn injury by administration of an antibody could modulate the impacts of the burn on bone tissue. There was a significant loss of trabecular bone volume of (3.27% compared to 5.27%, p=0.0051) after non-severe burn injury. Trabecular number was significantly decreased (0.57/mm after injury compared to 1.02/mm controls, p=0.0051) and spacing increased after burn injury (0.40 compared to 0.28, p=0.0083). Anti-TNF-α antibodies significantly improved trabecular bone volume (8.53%, p=0.0034) and number after burn injury (1.28/mm, p=0.0034). There was no significant change observed in cortical bone after burn injury or administration of anti-TNF-α antibodies. These findings show that non-severe burn injury can lead to changes in bone metabolism. Monitoring bone density in patients with non-severe injuries and interventions to limit the impacts of the inflammatory storm may benefit patient recovery and outcomes.

  5. 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


    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


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION A major public health problem in India is burns injuries. It is prevalent especially in low and middle income countries, where over 95% of all burn deaths occur. Fire related burns alone account for over 0.3 million deaths per year. But Death is not the only consequence. There are around 80% of the fire victims who become disfigured and permanently disabled. For some this means living with the stigma and rejection that all too often comes with disability and disfigurement.

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

    DEFF Research Database (Denmark)

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


    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...... reports of case series, did not result in an excess of squamous cell carcinoma of the skin or of any other type of skin cancer during up to 25 years' follow up of a large unselected cohort of patients hospitalized for burn injuries....

  8. "Tetracycline hydrochloride chemical burn" as self-inflicted mucogingival injury: A rare case report

    Directory of Open Access Journals (Sweden)

    Mundoor Manjunath Dayakar


    Full Text Available Injuries to oral soft tissue can be accidental, iatrogenic, and factitious trauma. Chemical, thermal, and physical agents are the main causative agents for oral soft-tissue burns. The present case describes the chemical burn of oral mucosa caused by tetracycline hydrochloride and its management. Diagnosis was made on the basis of definitive history elicited from the patient. The early detection of the lesion by the patient and immediate institution of therapeutic measures ensure a rapid cure and possible prevention of further mucogingival damage. In addition, we believe that proper guidance and education of the patient is an important prophylactic measure in preventing this self-inflicting injury.

  9. Burn injuries caused by a hair-dryer--an unusual case of child abuse. (United States)

    Darok, M; Reischle, S


    About 1.4-26% burn injuries in children appear to be abusive in origin. A 2.5-year-old girl was referred to our institute because of suspected child abuse. Clinical examination and later interrogation of the mother revealed non-recent deep second degree burn injuries on both gluteal regions, caused by the partner of the mother by pressing a hand-held hair-dryer against the skin. The authors present the findings of this unusual method of child abuse.

  10. Brown adipose tissue and its modulation by a mitochondria-targeted peptide in rat burn injury-induced hypermetabolism. (United States)

    Yo, Kikuo; Yu, Yong-Ming; Zhao, Gaofeng; Bonab, Ali A; Aikawa, Naoki; Tompkins, Ronald G; Fischman, Alan J


    Hypermetabolism is a prominent feature of burn injury, and altered mitochondria function is presumed to contribute to this state. Recently, brown adipose tissue (BAT) was found to be present not only in rodents but also in humans, and its activity is associated with resting metabolic rate. In this report, we elucidate the relationship between burn injury-induced hypermetabolism and BAT activity and the possible role of the mitochondria-targeted peptide SS31 in attenuating burn injury-induced hypermetabolism by using a rat burn injury model. We demonstrate that burn injury induces morphological changes in interscapular BAT (iBAT). Burn injury was associated with iBAT activation, and this effect was positively correlated with increased energy expenditure. BAT activation was associated with augmentation of mitochondria biogenesis, and UCP1 expression in the isolated iBAT mitochondria. In addition, the mitochondria-targeted peptide SS31 attenuated burn injury-induced hypermetabolism, which was accompanied by suppression of UCP1 expression in isolated mitochondria. Our results suggest that BAT plays an important role in burn injury-induced hypermetabolism through its morphological changes and expression of UCP1.

  11. 77 FR 66419 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for... (United States)


    ...'' as severe burn injuries. We believe that VA's definition of severe burn injury for purposes of... consistent with congressional intent. This definition generally reflects the purpose found at 38 U.S.C. 3901... affect in a material way the economy, a sector of the economy, productivity, competition, jobs,...

  12. Transfer of patients with severe burn injury%严重烧伤伤员的转运

    Institute of Scientific and Technical Information of China (English)



    Transfer of patients with severe burn injury is an important issue during the rescue of mass casualties,as it may give rise to great influence on the prognosis of patients.Timing of transfer,preparation before transfer,and details for attention are elaborated in this article,aiming to further specify the procedures of transfer of patients with burn injury.

  13. 77 FR 70389 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for... (United States)


    ... Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile or Other Conveyance and... INFORMATION CONTACT: Nancy Copeland, Consultant, Regulations Staff (211D), Compensation Service, Veterans... adding ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as...

  14. Inflammatory and protein metabolism signaling responses in human skeletal muscle after burn injury. (United States)

    Merritt, Edward K; Cross, James M; Bamman, Marcas M


    Severe burn injuries lead to a prolonged hypercatabolic state resulting in dramatic loss of skeletal muscle mass. Postburn muscle loss is well documented but the molecular signaling cascade preceding atrophy is not. The purpose of this study is to determine the response to burn injury of signaling pathways driving muscle inflammation and protein metabolism. Muscle biopsies were collected in the early flow phase after burn injury from the vastus lateralis of a noninjured leg in patients with 20 to 60% TBSA burns and compared with uninjured, matched controls. Circulating levels of proinflammatory cytokines were also compared. Immunoblotting was performed to determine the protein levels of key signaling components for translation initiation, proteolysis, and tumor necrosis factor/nuclear factor kappa B (NFκB)and interleukin (IL)-6/STAT3 signaling. Burn subjects had significantly higher levels of circulating proinflammatory cytokines, with no difference in muscle STAT3 activity and lower NFκB activity. No differences were found in any translational signaling components. Regarding proteolytic signaling in burn, calpain-2 was 47% higher, calpastatin tended to be lower, and total ubiquitination was substantially higher. Surprisingly, a systemic proinflammatory response 3 to 10 days postburn did not lead to elevated muscle STAT3 or NFκB signaling. Signaling molecules governing translation initiation were unaffected, whereas indices of calcium-mediated proteolysis and ubiquitin-proteasome activity were upregulated. These novel findings are the first in humans to suggest that the net catabolic effect of burn injury in skeletal muscle (ie, atrophy) may be mediated, at least during the early flow phase, almost entirely by an increased proteolytic activity in the absence of suppressed protein synthesis signaling.

  15. The hospital costs associated with acute paediatric burn injuries

    NARCIS (Netherlands)

    ter Meulen, E.W.; M.J. Poley (Marten); M. Van Dijk (Monique); Rogers, A.D.; H. Rode (Heinz)


    textabstractBackground. Ongoing rationing of healthcare threatens services that are well established, and cripples others that desperately require investment. Burn, for one, remains a neglected epidemic in South Africa (SA), despite the magnitude of the problem. Objective. To identify the prominent

  16. Combined Injury Modeling: Radiation and Burn Workshop Report (United States)


    Sepsis resulting from burns differs from that from radiation. Viruses and fungi , in addition to bacteria, can enter the bloodstream and develop...In Reviews in Cancer Biology & Therapeutics (ed. Kasid, Notario, Haimovitz-Friedman and Bar-Eli) Research Signpost, 2007. Williams C. Successful

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

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva


    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.

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

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva


    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.

  19. Exercise training after burn injury: a survey of practice. (United States)

    Diego, Alejandro M; Serghiou, Michael; Padmanabha, Anand; Porro, Laura J; Herndon, David N; Suman, Oscar E


    Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits.

  20. Reducing violent injuries: priorities for pediatrician advocacy. (United States)

    Dolins, J C; Christoffel, K K


    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.

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

    Directory of Open Access Journals (Sweden)

    L.D. Morris


    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.

  2. Intensive insulin treatment attenuates burn-initiated acute lung injury in rats: role of the protective endothelium. (United States)

    Zhang, Wan-Fu; Zhu, Xiong-Xiang; Hu, Da-Hai; Xu, Cheng-Feng; Wang, Yun-Chuan; Lv, Gen-Fa


    Nonmetabolic effects of intensive insulin therapy in critically ill patients have been reported, but the underlying mechanisms are unclear. This study was designed to test the hypothesis that intensive insulin treatment would attenuate burn-induced acute lung injury by protecting the pulmonary microvascular endothelium. The rat model of burn injury was achieved by exposure to 92°C water for 18 seconds. The rats were randomly allocated into the sham, burn/normal saline (NS), and burn/intensive insulin treatment groups. Blood glucose level was maintained between 5 and 7 mmol/L in rats in the burn/intensive insulin treatment group. Pulmonary injury was assessed by hematoxylin and eosin staining, scanning electron microscopy, bronchoalveolar lavage fluid protein concentrations, the lung wet:dry weight ratio, and lung myeloperoxidase activity. Pulmonary microvascular endothelial cells were examined by transmission electron microscopy. Western blotting was used to determine the protein expression of caspase-3. Intensive insulin treatment markedly attenuated the acute lung injury, revealed by improvements in histological features and significant decreases in bronchoalveolar lavage fluid protein concentrations, pulmonary wet:dry weight ratio, and myeloperoxidase activity at 12 hours after injury (P insulin treatment group when compared with the burn/NS group. Overall, intensive insulin treatment efficiently attenuated pulmonary microvascular endothelial cell dysfunction, decreased cell apoptosis, and inhibited acute lung injury after a burn. These findings may be useful in preventing organ failure after burn injury.

  3. Comparison of Proinflammatory Gene Expression in Lesions Caused by either Burn Injuries or Cutaneous Leishmaniasis


    Akhzari; Rezvan; Zolhavarieh; Moafi


    Background Leishmaniasis is a worldwide disease prevalent in tropical and sub-tropical countries in the world. Characterization of inflammatory responses produced in cutaneous Leishmaniasis has not yet been completed. The current study aims to assess and compare pro-inflammatory cytokines between burning injuries and Leishmania infection. Methods the specific primers were designed for 10 proinflammatory genes including CCL4, CCL3,...


    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝


    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.

  5. Early and Late Acute Kidney Injury in Severely Burned Patients (United States)

    Witkowski, Wojciech; Kawecki, Marek; Surowiecka-Pastewka, Agnieszka; Klimm, Wojciech; Szamotulska, Katarzyna; Niemczyk, Stanisław


    Background This study evaluated factors influencing early and late occurrence of AKI in severely burned patients and assessed the relationship between time of occurrence of AKI and mortality of AKI patients. Material/Methods Renal function was evaluated at 3 time points: at admission, at the critical point or middle point of hospitalization, and at the endpoint for which death or a discharge from the center was considered. AKI criteria were: decrease in GFR of less than 60 ml/min at admission, decrease in GFR of more than 75% compared to baseline, and decrease in the daily diuresis of less than 500 ml/24 h. Results At admission, 15.1% of the patients had eGFR burns, respiratory failure, low protein concentration (for all ppatients. Mortality was 100% with the initial GFR ≥60, 100% with the initial GFR patients and mortality in this group was 79.2%. Mortality in the entire group with AKI was 88.0% versus 24.5%. Conclusions The frequent occurrence of AKI, especially early, worsens the prognosis for survival. Assessment of renal function should be included in the prognostic scales for burned patients. PMID:27746455

  6. Reduction of progressive burn injury by using a new nonselective endothelin-A and endothelin-B receptor antagonist, TAK-044: an experimental study in rats. (United States)

    Battal, M N; Hata, Y; Matsuka, K; Ito, O; Matsuda, H; Yoshida, Y; Kawazoe, T


    Endothelins are well-known vasoconstrictor peptides produced by vascular endothelial cells that have been reported to have a fundamental role in regulation of the systemic blood circulation. Plasma levels of endothelins are increased by burn injury, which also causes thrombosis and occlusion of vessels in the dermis as well as a vascular response in the adjacent uninjured dermis. Diminished blood flow leads to progressive ischemia and necrosis of the dermis beneath and around the burn (zone of stasis). If blood flow could be restored in this zone, secondary tissue damage would be minimized. In this study we examined the effects of a new nonselective endothelin receptor antagonist, TAK-044 (Takeda Chemical Industries, Ltd., Osaka, Japan), on burn trauma in rats. Fifty male Sprague-Dawley rats weighing an average of 450 gm were burned with a brass probe that produced a row of three burns 10 x 30 mm in size and two intervening unburned areas 5 x 30 mm in size. Rats were divided into five groups of 10 animals. Four groups received 0.01, 0.1, 1 or 10 mg/kg of TAK-044 via the dorsal vein of the penis immediately after burn trauma, while the control group received the same volume of saline. Skin blood flow was measured with a laser-Doppler flowmeter, and the development of edema and the area of necrotic tissue also were determined. Inhibition of endothelin activity by TAK-044 after burn injury improved microvascular perfusion in the zone of stasis and prevented the progression of tissue damage in this zone. This supports the role of endothelins in the progression of burn injury in the zone of stasis. TAK-044 was most effective in preventing progressive burn damage at a dose of 1 mg/kg. The extent of necrosis and edema was reduced significantly, and blood flow in the zone of stasis was increased in the treated rats.

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

    Directory of Open Access Journals (Sweden)

    Ebrahim Nasiri


    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.

  8. Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep. (United States)

    Morita, Naoki; Traber, Maret G; Enkhbaatar, Perenlei; Westphal, Martin; Murakami, Kazunori; Leonard, Scott W; Cox, Robert A; Hawkins, Hal K; Herndon, David; Traber, Lillian D; Traber, Daniel L


    Victims of fire accidents who sustain both thermal injury to the skin and smoke inhalation have gross evidence of oxidant injury. Therefore, we hypothesized that delivery of vitamin E, an oxygen superoxide scavenger, directly into the airway would attenuate acute lung injury postburn and smoke inhalation. Sheep (N = 17 female, 35 +/- 5 kg) were divided into 3 groups: (1) injured, then nebulized with vitamin E (B&S, Vitamin E, n = 6); (2) injured, nebulized with saline (B&S, Saline, n = 6); and (3) not injured, not treated (Sham, n = 5). While under deep anesthesia with isoflurane, the sheep were subjected to a flame burn (40% total body surface area, 3rd degree) and inhalation injury (48 breaths of cotton smoke, Ringer lactate solution (4 mL/kg/%burn/24 h) and placed on a ventilator [positive end-expiratory pressure (PEEP) = 5 cm H2O, tidal volume = 15 mL/kg] for 48 h. B&S injury halved the lung alpha-tocopherol concentrations (0.9 +/- 0.1 nmol/g) compared with sham-injured animals (1.5 +/- 0.3), whereas vitamin E treatment elevated the lung alpha-tocopherol concentrations (7.40 +/- 2.61) in the injured animals. B&S injury decreased pulmonary gas exchange (PaO2/FiO2 ratios) from 517 +/- 15 at baseline to 329 +/- 49 at 24 h and to 149 +/- 32 at 48 h compared with sham ratios of 477 +/- 14, 536 +/- 48, and 609 +/- 49, respectively. Vitamin E treatment resulted in a significant improvement of pulmonary gas exchange; ratios were 415 +/- 34 and 283 +/- 42 at 24 and 48 h, respectively. Vitamin E nebulization therapy improved the clinical responses to burn and smoke inhalation-induced acute lung injury.

  9. The epidemiology and characteristics of burn injuries in pediatric patients%小儿烧伤流行病学特点及预防

    Institute of Scientific and Technical Information of China (English)

    邹晓防; 宋卫平; 李斌; 何兰; 蔡景宁; 曹卫红


    目的分析小儿烧伤的原因及临床表现,以减少和预防小儿烧伤的发生。方法对空军总医院烧伤整形科自2009年9月~2012年9月收治的432例0~14岁烧伤患儿病例资料,包括发病率、患儿的年龄、性别、致伤原因、季节分布、烧伤程度、发生的地点进行回顾总结及分析。结果小儿烧伤患者占本院同期烧伤患者的60.2%,男性占56.3%,0~3岁小儿发病率最高,为68.9%,致伤原因主要是热液烫伤为81.7%,春季发病率最高为33.3%,烧伤程度以轻、中度为主占,两者合计为74.3%,农村患儿为76.6%。结论小儿烧伤的发生有其特点,应针对小儿烧伤发生特点采取有效的措施,降低小儿烧伤的发生。%Objective To investigate epidemiology and characteristics of burn injuries in pediatric patients, and reduce the incidence of pediatric burn. Method Retrospective statistical description of incidence of burn injuries, sexual ratio, children’s age, cause of burn, seasonal distribution, severity of burn, distribution of season, geographic location for 432 burn case of 0~14 years old in the hospital from Sep. 2009 to 2012 Sep. were performed with. Result Pediatric burn accounted for 60.2% among the patients with burns at the same period in hospital. Incidence rate 0f male children is 56.3%. The highest incidence of burn during 0~3 years children accounted for 68.9%. The incidence rate of burn is 33%in summer. Scald burn were the most frequent form of burn. The burn injuries were mostly minor and moderate. 76.6%of burn in children is occurred in rural area.

  10. The effectiveness of using pictures in teaching young children about burn injury accidents. (United States)

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


    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.

  11. The Effect of Massage on Anticipatory Anxiety and Procedural Pain in Patients with Burn Injury (United States)

    Najafi Ghezeljeh, Tahereh; Mohades Ardebili, Fatimah; Rafii, Forough; Manafi, Farzad


    BACKGROUND Pain related to burn injuries is one of the most troublesome pain intensity. This study aimed to investigate the effect of massage on anticipatory anxiety, procedural pain intensity, vital signs and relaxation level of patients with burn injury. METHODS In this quasi-experimental study, through convenience sampling, 60 hospitalized adult burn patients were selected from a specialized burn and reconstructive hospital. Subjects were assigned to massage and control groups through simple randomization. Massage was offered by using non aromatic oil about 10-15 minutes before wound care on intact part of the body once a day for 20 minutes on patients’ bedside for 3 consecutive days. In the 3 days, the control group did not received any massage and were asked to stay at bed. Demographic and clinical characteristics and vital signs, Visual Analogue Scale and the Persian version of Burn Specific Pain Anxiety Scale were used to determine baseline and procedural pain, anxiety and relaxation levels and anticipatory anxiety. RESULTS No significant difference was noted between mean score of pain intensity, anxiety and relaxation level, and vital signs in massage and control groups after intervention following wound care. In massage and control groups, there was no significant differences between mean scores of anticipatory anxiety before and after intervention. There was no significant difference between the mean scores of anticipatory anxiety in massage and control groups after intervention prior wound care. CONCLUSION Massage was shown not to have any effect on anticipatory anxiety and procedural pain. PMID:28289612

  12. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study. (United States)

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


    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (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 postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff 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 burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  13. A prospective clinical study of flow-mediated dilatation in burn injury. (United States)

    Turk, Emin; Caliskan, Mustafa; Karagulle, Erdal; Aydogan, Cem; Oguz, Hakan; Kulaksizoglu, Sevsen; Yildirim, Erkan; Moray, Gokhan; Haberal, Mehmet


    The authors investigated endothelial function using flow-mediated dilatation (FMD) in burn patients. This study was done in burn patients with specific criteria on admission. Blood lipid profile at 1st day, high-sensitivity C-reactive protein, and FMD were assessed at 1st and 7th days, as well as at 1st and 3rd months. The highest values of high-sensitivity C-reactive protein were detected on the 7th day, which were significantly higher than those at 1st and 3rd months. The lowest value of FMD was observed on the 7th day. FMD values were higher during the 1st month compared with the 7th day. The highest value of FMD was detected in the 3rd month. It was found that FMD values measured at 7th day and 1st month were significantly lower in patients with a burn percentage of 40 or greater. Our results suggest that inflammation is more prominent on 7th day following burn. The decrease in FMD values on 7th day after injury can be attributed to endothelial damage. The increase in FMD on 3rd month after burn is attributable to effective burn treatment and gradual decrease of inflammatory mediators. The data from this study suggest that there is endothelial dysfunction and low-grade inflammation in burn patients. This condition is more prominent in patients with a burn ratio greater than 40%. Burn patients more frequently have impaired FMD, which may be indicative of arterial endothelial dysfunction and a marker for increased atherosclerosis.

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


    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 It is also available for download at

  15. Review of Adult Electrical Burn Injury Outcomes Worldwide: An Analysis of Low-Voltage vs High-Voltage Electrical Injury. (United States)

    Shih, Jessica G; Shahrokhi, Shahriar; Jeschke, Marc G

    The aims of this article are to review low-voltage vs high-voltage electrical burn complications in adults and to identify novel areas that are not recognized to improve outcomes. An extensive literature search on electrical burn injuries was performed using OVID MEDLINE, PubMed, and EMBASE databases from 1946 to 2015. Studies relating to outcomes of electrical injury in the adult population (≥18 years of age) were included in the study. Forty-one single-institution publications with a total of 5485 electrical injury patients were identified and included in the present study. Fourty-four percent of these patients were low-voltage injuries (LVIs), 38.3% high-voltage injuries (HVIs), and 43.7% with voltage not otherwise specified. Forty-four percentage of studies did not characterize outcomes according to LHIs vs HVIs. Reported outcomes include surgical, medical, posttraumatic, and others (long-term/psychological/rehabilitative), all of which report greater incidence rates in HVI than in LVI. Only two studies report on psychological outcomes such as posttraumatic stress disorder. Mortality rates from electrical injuries are 2.6% in LVI, 5.2% in HVI, and 3.7% in not otherwise specified. Coroner's reports revealed a ratio of 2.4:1 for deaths caused by LVI compared with HVI. HVIs lead to greater morbidity and mortality than LVIs. However, the results of the coroner's reports suggest that immediate mortality from LVI may be underestimated. Furthermore, on the basis of this analysis, we conclude that the majority of studies report electrical injury outcomes; however, the majority of them do not analyze complications by low vs high voltage and often lack long-term psychological and rehabilitation outcomes after electrical injury indicating that a variety of central aspects are not being evaluated or assessed.

  16. Clothing Flammability and Burn Injuries: Public Opinion Concerning an Overlooked, Preventable Public Health Problem. (United States)

    Frattaroli, Shannon; Spivak, Steven M; Pollack, Keshia M; Gielen, Andrea C; Salomon, Michele; Damant, Gordon H


    The objective of this study was to describe knowledge of clothing flammability risk, public support for clothing flammability warning labels, and stronger regulation to reduce the risk. As part of a national survey of homeowners about residential sprinkler systems, the authors included questions about clothing flammability. The authors used an online web panel to sample homeowners and descriptive methods to analyze the resulting data. The sample included 2333 homeowners. Knowledge of clothing flammability and government oversight of clothing flammability risk was low. Homeowners were evenly split about the effectiveness of current standards; however, when presented with clothing-related burn injury and death data, a majority (53%) supported stricter standards. Most homeowners (64%) supported warning labels and indicated that such labels would either have no effect on their purchasing decisions (64%) or be an incentive (24%) to purchase an item. Owners of sprinkler-equipped homes were more likely to support these interventions than owners of homes without sprinkler systems. Public knowledge about clothing flammability risks is low. Most homeowners supported clothing labels to inform consumers of this risk and increased government intervention to reduce the risk.

  17. Association between early airway damage-associated molecular patterns and subsequent bacterial infection in patients with inhalational and burn injury. (United States)

    Maile, Robert; Jones, Samuel; Pan, Yinghao; Zhou, Haibo; Jaspers, Ilona; Peden, David B; Cairns, Bruce A; Noah, Terry L


    Bacterial infection is a major cause of morbidity affecting outcome following burn and inhalation injury. While experimental burn and inhalation injury animal models have suggested that mediators of cell damage and inflammation increase the risk of infection, few studies have been done on humans. This is a prospective, observational study of patients admitted to the North Carolina Jaycee Burn Center at the University of North Carolina who were intubated and on mechanical ventilation for treatment of burn and inhalational injury. Subjects were enrolled over a 2-yr period and followed till discharge or death. Serial bronchial washings from clinically indicated bronchoscopies were collected and analyzed for markers of tissue injury and inflammation. These include damage-associated molecular patterns (DAMPs) such as hyaluronic acid (HA), double-stranded DNA (dsDNA), heat-shock protein 70 (HSP-70), and high-mobility group protein B-1 (HMGB-1). The study population was comprised of 72 patients who had bacterial cultures obtained for clinical indications. Elevated HA, dsDNA, and IL-10 levels in bronchial washings obtained early (the first 72 h after injury) were significantly associated with positive bacterial respiratory cultures obtained during the first 14 days postinjury. Independent of initial inhalation injury severity and extent of surface burn, elevated levels of HA dsDNA and IL-10 in the central airways obtained early after injury are associated with subsequent positive bacterial respiratory cultures in patients intubated after acute burn/inhalation injury.

  18. In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury. (United States)

    Izamis, Maria-Louisa; Sharma, Nripen S; Uygun, Basak; Bieganski, Robert; Saeidi, Nima; Nahmias, Yaakov; Uygun, Korkut; Yarmush, Martin L; Berthiaume, Francois


    Trauma such as burns induces a hypermetabolic response associated with altered central carbon and nitrogen metabolism. The liver plays a key role in these metabolic changes; however, studies to date have evaluated the metabolic state of liver using ex vivo perfusions or isotope labeling techniques targeted to specific pathways. Herein, we developed a unique mass balance approach to characterize the metabolic state of the liver in situ, and used it to quantify the metabolic changes to experimental burn injury in rats. Rats received a sham (control uninjured), 20% or 40% total body surface area (TBSA) scald burn, and were allowed to develop a hypermetabolic response. One day prior to evaluation, all animals were fasted to deplete glycogen stores. Four days post-burn, blood flow rates in major vessels of the liver were measured, and blood samples harvested. We combined measurements of metabolite concentrations and flow rates in the major vessels entering and leaving the liver with a steady-state mass balance model to generate a quantitative picture of the metabolic state of liver. The main findings were: (1) Sham-burned animals exhibited a gluconeogenic pattern, consistent with the fasted state; (2) the 20% TBSA burn inhibited gluconeogenesis and exhibited glycolytic-like features with very few other significant changes; (3) the 40% TBSA burn, by contrast, further enhanced gluconeogenesis and also increased amino acid extraction, urea cycle reactions, and several reactions involved in oxidative phosphorylation. These results suggest that increasing the severity of injury does not lead to a simple dose-dependent metabolic response, but rather leads to qualitatively different responses.

  19. Outcomes in Adult Survivors of Childhood Burn Injuries as Compared with Matched Controls. (United States)

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


    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 < .05) after adjustment (major depression RR = 1.5 [confidence limit {CL}: 1.2-1.8], anxiety disorder RR = 1.5 [CL: 1.3-1.8), substance 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.

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

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    Mohammad Javad Fatemi


    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.

  1. The effect of levamisole on mortality rate among patients with severe burn injuries (United States)

    Fatemi, Mohammad Javad; Salehi, Hamid; Akbari, Hossein; Alinejad, Faranak; Saberi, Mohsen; Mousavi, Seyed Jaber; Soltani, Majid; Taghavi, Shahrzad; Payandan, Hossein


    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. PMID:24381625

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

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    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:; Wu, T-H. [Institute of Nuclear Energy Research, ROCEA, Tao-Yuan, Taiwan (China)


    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.


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    Minka Hristova


    Full Text Available Melatonin is indoleamine hormone derived from L-tryptophan. Due to its lipophilic nature, it is accessible to every cell. Melatonin has immunomodulatory and antioxidant activities thus protecting tissue injury. Heat shock proteins such as HSP32 known as heme oxygenase-1 (HO-1 possesses antioxidant, anti-inflammatory, and vasodilatory properties and plays an important role in the protecting of tissues from several stresses. The aim of study is to investigate the expression of HO-1 in gastric mucosa and its connection with oxidative stress and melatonin mediated protection after thermal injury. On rats back, under anesthesia, third degree burn was applied involving 30% of total body surface area (TBSA. Melatonin (10 mg per kg body mass was injected i.p. immediately and 12 hours after thermal skin injury. We used tissue malondialdehyde (MDA, lipid peroxidation product, as a marker of oxidative stress. Gastric mucosa histopathology were observed on light microscopy and light immunohistochemistry investigating the HO-1 too. Results: The levels of MDA in gastric mucosa were elevated (p< 0.05. The HO-1 expression was significantly increased in rats with trauma. Melatonin inhibited elevation in lipid peroxidation product and augmented the increase in expression of HO-1 in the gastric mucosa. In conclusion, our data suggest that HO-1 induction following burn injury is an adaptive response protecting gastric mucosal against further oxidative damage. Melatonin increased the antioxidant capacity and restricted burn-induced oxidative damage in gastric mucosa and thus could be used therapeutically in organ protection.

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

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    Mehtap Kavurmaci


    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.

  5. Activated nuclear factor kappa B and airway inflammation after smoke inhalation and burn injury in sheep. (United States)

    Cox, Robert A; Burke, Ann S; Jacob, Sam; Oliveras, Gloria; Murakami, Kazunori; Shimoda, Katsumi; Enkhbaatar, Perenlei; Traber, Lillian D; Herndon, David N; Traber, Daniel L; Hawkins, Hal K


    In a recent study, we have shown a rapid inflammatory cell influx across the glandular epithelium and strong proinflammatory cytokine expression at 4 hours after inhalation injury. Studies have demonstrated a significant role of nuclear factor kappa B in proinflammatory cytokine gene transcription. This study examines the acute airway inflammatory response and immunohistochemical detection of p65, a marker of nuclear factor kappa B activation, in sheep after smoke inhalation and burn injury. Pulmonary tissue from uninjured sheep and sheep at 4, 8, 12, 24, and 48 hours after inhalation and burn injury was included in the study. Following immunostaining for p65 and myeloperoxidase, the cell types and the percentage of bronchial submucosal gland cells staining for p65 and the extent of myeloperoxidase stained neutrophils in the bronchial submucosa were determined. Results indicate absence of detection of P65 before 12 hours after injury. At 12 hours after injury, strong perinuclear staining for p65 was evident in bronchial gland epithelial cells, macrophages, and endothelial cells. Bronchial submucosal gland cells showed a significant increase in the percentage of cells stained for p65 compared with uninjured animals and earlier times after injury, P macrophages, and endothelial cells. Quantitation of the neutrophil influx into the bronchial submucosa showed a significant increase compared with uninjured tissue at 24 and 48 hours after injury, P < .05. In conclusion, immunohistochemical detection of activated p65 preceded the overall inflammatory response measured in the lamina propria. However, detection of p65 did not correlate with a recent study showing rapid emigration of neutrophils at 4 hours postinjury. Together, these results suggest that p65 immunostaining may identify cells that are activated to produce proinflammatory cytokines after injury; however, the immunoexpression may not adequately reflect the temporal activation of gene transcription that may

  6. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review. (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W


    Resuscitation of burn victims with high-dose ascorbic acid (vitamin C [VC]) was reported in Japan in the year 2000. Benefits of VC include reduction in fluid requirements, resulting in less tissue edema and body weight gain. In turn, these patients suffer less respiratory impairment and reduced requirement for mechanical ventilation. Despite these results, few burn centers resuscitate patients with VC in fear that it may increase the risk of renal failure. A retrospective review of 40 patients with greater than 20% TBSA between 2007 and 2009 was performed. Patients were divided into two groups: one received only lactated Ringer's (LR) solution and another received LR solution plus 66 mg/kg/hr VC. Both groups were resuscitated with the Parkland formula to maintain stable hemodynamics and adequate urine output (>0.5 ml/kg/hr). Patients with >10-hour delay in transfer to the burn center were excluded. Data collected included age, gender, weight, %TBSA, fluid administered in the first 24 hours, urine output in the first 24 hours, and Acute Physiology and Chronic Health Evaluation II score. PaO2 in millimeters mercury:%FIO2 ratio and positive end-expiratory pressure were measured at 12-hour intervals, and hematocrit was measured at 6-hour intervals. Comorbidities, mortality, pneumonia, fasciotomies, and renal failure were also noted. After 7 patients were excluded, 17 patients were included in the VC group and 16 in the LR group. VC and LR were matched for age (42 ± 16 years vs 50 ± 20 years, P = .2), burn size (45 ± 21%TBSA vs 39 ± 15%TBSA, P = .45), Acute Physiology and Chronic Health Evaluation II (17 ± 7 vs 18 ± 8, P = .8), and gender. Fluid requirements in the first 24 hours were 5.3 ± 1 ml/kg/%TBSA for VC and 7.1 ± 1 ml/kg/%TBSA for LR (P < .05). Urine output was 1.5 ± 0.4 ml/kg/hr for VC and 1 ± 0.5 ml/kg/hr for LR (P < .05). Vasopressors were needed in four VC patients and nine LR patients (P = .07). VC patients required vasopressors to maintain mean

  7. Midazolam exacerbates morphine tolerance and morphine-induced hyperactive behaviors in young rats with burn injury. (United States)

    Song, Li; Wang, Shuxing; Zuo, Yunxia; Chen, Lucy; Martyn, Jeevendra A; Mao, Jianren


    Midazolam and morphine are often used in pediatric intensive care unit (ICU) for analgesia and sedation. However, how these two drugs interact behaviorally remains unclear. Here, we examined whether (1) co-administration of midazolam with morphine would exacerbate morphine tolerance and morphine-induced hyperactive behaviors, and (2) protein kinase C (PKC) would contribute to these behavioral changes. Male rats of 3-4 weeks old were exposed to a hindpaw burn injury. In Experiment 1, burn-injured young rats received once daily saline or morphine (10mg/kg, subcutaneous, s.c.), followed 30min later by either saline or midazolam (2mg/kg, intraperitoneal, i.p.), for 14 days beginning 3 days after burn injury. In Experiment 2, young rats with burn injury were administered with morphine (10mg/kg, s.c.), midazolam (2mg/kg, i.p.), and chelerythrine chloride (a non-specific PKC inhibitor, 10nmol, intrathecal) for 14 days. For both experiments, cumulative morphine anti-nociceptive dose-response (ED50) was tested and hyperactive behaviors such as jumping and scratching were recorded. Following 2 weeks of each treatment, ED50 dose was significantly increased in rats receiving morphine alone as compared with rats receiving saline or midazolam alone. The ED50 dose was further increased in rats receiving both morphine and midazolam. Co-administration of morphine and midazolam also exacerbated morphine-induced hyperactive behaviors. Expression of the NR1 subunit of the N-methyl-d-aspartate (NMDA) receptor and PKCγ in the spinal cord dorsal horn (immunohistochemistry; Western blot) was upregulated in burn-injured young rats receiving morphine alone or in combination with midazolam, and chelerythrine prevented the development of morphine tolerance. These results indicate that midazolam exacerbated morphine tolerance through a spinal NMDA/PKC-mediated mechanism.

  8. Management of a Patient With Faciocervical Burns and Inhalational Injury Due to Hydrofluoric Acid Exposure. (United States)

    Yuanhai, Zhang; Xingang, Wang; Liangfang, Ni; Chunmao, Han


    Hydrofluoric acid, a highly dangerous substance, can cause tissue damage and systemic toxicity by its unique mechanisms. Many cases of severe faciocervical burns due to hydrofluoric acid exposure are lethal. Herein, we present a case of 37-year-old man who suffered from hydrofluoric acid burns to his face, anterior neck, lips, and nasal cavity. On admission, this patient coughed with much sputum, and the chest auscultation detected rough breath sounds, wheezes, and very weak heart sounds, indicating possible inhalation injury. This case highlights the extreme complexity of managing this kind of injury. Timely and accurate wound treatment and respiratory tract care, as well as active systematic support treatment, played vital roles in the management of this patient.

  9. A case of chemical scalp burns after hair highlights: experimental evidence of oxidative injuries. (United States)

    Bertani, Roberta; Sgarbossa, Paolo; Pendolino, Flavio; Facchin, Giangiacomo; Snenghi, Rossella


    Hair highlights are quite common procedures carried out in hair salons by using a mixture of a lightening powder containing persulfates with a suspension containing hydrogen peroxide: a representative case of chemical scalp burns is described as a consequence of this treatment. The aim of the paper is to demonstrate the strict relationship between the scalp damage and the commercial products used in a case of hair highlighting. The results of some chemical analyses have been reported, showing, in particular, that the chemical reactivity of the mixture changes in the time, thus strongly suggesting that the procedure for the application of the mixture is critical for the occurrence of possible accidents. The presence in the powder of chemical compounds bearing aliphatic chains as surfactants explains the appearance of dramatic symptoms after days due to a slow dissolution of the oxidant compounds in the stratum corneum of skin with no effect in reducing injury of palliative treatments. Safety suggestions and recommendations for producers and workers are also included.

  10. Brain hemorrhage after electrical burn injury: Case report and probable mechanism (United States)

    Axayacalt, Gutierrez Aceves Guillermo; Alejandro, Ceja Espinosa; Marcos, Rios Alanis; Inocencio, Ruiz Flores Milton; Alfredo, Herrera Gonzalez Jose


    Background: High-voltage electric injury may induce lesion in different organs. In addition to the local tissue damage, electrical injuries may lead to neurological deficits, musculoskeletal damage, and cardiovascular injury. Severe vascular damage may occur making the blood vessels involved prone to thrombosis and spontaneous rupture. Case Description: Here, we present the case of a 39-year-old male who suffered an electrical burn with high tension wire causing intracranial bleeding. He presented with an electrical burn in the parietal area (entry zone) and the left forearm (exit zone). The head tomography scan revealed an intraparenchimatous bleeding in the left parietal area. In this case, the electric way was the scalp, cranial bone, blood vessels and brain, upper limb muscle, and skin. The damage was different according to the dielectric property in each tissue. The injury was in the scalp, cerebral blood vessel, skeletal muscle, and upper limb skin. The main damage was in brain’s blood vessels because of the dielectric and geometric features that lead to bleeding, high temperature, and gas delivering. Conclusion: This is a report of a patient with an electric brain injury that can be useful to elucidate the behavior of the high voltage electrical current flow into the nervous system. PMID:27904757

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

    Directory of Open Access Journals (Sweden)

    Satar Rezaei


    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. 

  12. Camphor burns of the palm and non-suicidal self-injury: An uncommonly reported, but socially relevant issue

    Directory of Open Access Journals (Sweden)

    Ravi Kumar Chittoria


    Full Text Available Camphor is a waxy white sublimating chemical derived from natural as well as synthetic sources and widely used in various communities worldwide for a number of medicinal, culinary, and religious reasons. Camphor is burnt as an offering to God in many religious communities. We report three incidences of self inflicted injury from burning camphor on the palm resulting in full thickness burns. Non-suicidal self-injury is socially unacceptable destruction or alteration of body tissue when there is no suicidal intent or pervasive developmental disorder and we have explored an association between this and burn injury. This report also highlights the unique social and cultural pattern of this burn injury and the importance of psycho-therapeautic help for these victims.

  13. Camphor burns of the palm and non-suicidal self-injury: An uncommonly reported, but socially relevant issue. (United States)

    Chittoria, Ravi Kumar; Mohapatra, Devi Prasad; Friji, Meethale Thiruvoth; Kumar, S Dinesh; Asokan, Arjun; Pandey, Sandhya


    Camphor is a waxy white sublimating chemical derived from natural as well as synthetic sources and widely used in various communities worldwide for a number of medicinal, culinary, and religious reasons. Camphor is burnt as an offering to God in many religious communities. We report three incidences of self inflicted injury from burning camphor on the palm resulting in full thickness burns. Non-suicidal self-injury is socially unacceptable destruction or alteration of body tissue when there is no suicidal intent or pervasive developmental disorder and we have explored an association between this and burn injury. This report also highlights the unique social and cultural pattern of this burn injury and the importance of psycho-therapeautic help for these victims.

  14. The interaction between burn injury and vitamin D metabolism and consequences for the patient. (United States)

    Klein, Gordon L


    The stress and inflammatory responses to burn injury are associated with bone loss. The stress response entails production of large amounts of endogenous glucocorticoids that decrease osteoblasts on the mineralization surface of bone and decreases differentiation of marrow stromal cells into osteoblasts, thereby decreasing the amount of bone formation. Deficiency of osteoblasts also blocks osteoclastogenesis thus leading to low bone turnover and bone loss. The inflammatory response generates cytokines such as interleukin 1-beta and interleukin-6, which normally increase osteoclastogenic bone resorption via stimulation of osteoblast production of RANK ligand. However, in the absence of osteoblasts as a target we postulate that they attack the parathyroid gland chief cells and up-regulate the calcium-sensing receptor. The consequence of this upregulation is the lowering of the circulating calcium necessary to suppress parathyroid hormone production and the development of hypocalcemia and urinary calcium wasting. It is the parathyroid hormone suppression that causes us to postulate acute deficiency of 1,25-dihydroxyvitamin D and the consequence of this for post-burn metabolism could include derepression of the gene that controls renin production, leading to elevated levels of angiotensin II, which can contribute to insulin resistance, as can vitamin D deficiency itself. Moreover, the skin from burned patients cannot synthesize vitamin D normally. Thus vitamin D supplementation is the only means by which to ensure vitamin D sufficiency for burn victims. The proper requirement for vitamin D in acutely burned patients remains unknown.

  15. Pulmonary expression of nitric oxide synthase isoforms in sheep with smoke inhalation and burn injury. (United States)

    Cox, Robert A; Jacob, Sam; Oliveras, Gloria; Murakami, Kazunori; Enkhbaatar, Perenlei; Traber, Lillian; Schmalstieg, Frank C; Herndon, David N; Traber, Daniel L; Hawkins, Hal K


    Previous studies have indicated increased plasma levels of inducible nitric oxide synthase in lung. This study further examines the pulmonary expression of nitric oxide synthase (NOS) isoforms in an ovine model of acute lung injury induced by smoke inhalation and burn injury (S+B injury). Female range bred sheep (4 per group) were sacrificed at 4, 8, 12, 24, and 48 hours after injury and immunohistochemistry was performed in tissues for various NOS isoforms. The study indicates that in uninjured sheep lung, endothelial (eNOS) is constitutively expressed in the endothelial cells associated with the airways and parenchyma, and in macrophages. Similarly, neuronal (nNOS) is constitutively present in the mucous cells of the epithelium and in neurons of airway ganglia. In uninjured lung, inducible (iNOS) was present in bronchial secretory cells and macrophages. In tissue after S+B injury, new expression of iNOS was evident in bronchial ciliated cells, basal cells, and mucus gland cells. In the parenchyma, a slight increase in iNOS immunostaining was seen in type I cells at 12 and 24 hours after injury only. Virtually no change in eNOS or nNOS was seen after injury.

  16. Reducing injury of lettuce from phosphine fumigation (United States)

    Low temperature fumigation with pure phosphine free of ammonia has been used in recent years for postharvest pest control on some fresh fruits and vegetables. However, long fumigation treatments cause injuries to lettuce. It is unknown what factors contributed to the injuries. It is important to min...

  17. 烧创伤相关肺损伤系统控制技术的研究与转化%Study and translation of systemic control technology for the burn and trauma related lung injuries

    Institute of Scientific and Technical Information of China (English)

    夏照帆; 王钟山; 房贺


    Burns and traumas are common injuries during both peacetime and wartime.Lung is the earliest organ subjected to dysfunction and the incidence is highest.The systemic protective technology for the burn and trauma related lung injuries is based on evidence-based medicine and translational medicine.It includes a series of effective measures,such as rescue and treatment scheme for massive burn casualties,prophylactic tracheostomy,protective ventilation strategy,sequential cell protection,and prevention and treatment of sequelae,which prevents aggravation of lung injuries caused by ischemia reperfusion,oxidative stress,and iatrogenic factors,as well as reduces the incidence of complications to ensure the recovery after burns and traumas.

  18. 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;


    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.......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...

  19. 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;


    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...

  20. Itching, pain, and anxiety levels are reduced with massage therapy in burned adolescents. (United States)

    Parlak Gürol, Ayşe; Polat, Sevinç; Akçay, Müfide Nuran


    Burn can be among the most severe physical and psychologic traumas a person may face. Patients with burns commonly have severe itching and pain. Severe itching has also been associated with anxiety, sleep disturbance, and disruption of daily living activities. The addition of complementary treatments to standard care may lead to improved pain management and may offer a safer approach for reducing pain and procedural anxiety for patients with burns. The authors conducted an experimental study to examine whether the effects of massage therapy reduced burned adolescents' pain, itching, and anxiety levels. Sixty-three adolescents were enrolled in this study shortly after admission (mean days = 3 +/- 0.48) at a burn unit in a large university hospital from February 2008 to June 2009. The measures including the pain, itching, and state anxiety were collected on the first and last days of the 5-week study period. The participants had an average age of 14.07 +/- 1.78 years and came usually from the lower socioeconomic strata. The authors observed that massage therapy reduced all these measures from the first to the last day of this study (P patients with burns, these applications are not yet common.

  1. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients (United States)

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


    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 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 pPatient 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%), pPatients in the high group required significantly longer ventilation compared to low patients (ppneumonia confirming the previous studies in critically ill patients. PMID:24074819

  2. Reducing Secondary Insults in Traumatic Brain Injury (United States)


    persons, and leaves 99,000 persons permanently disabled [1]. The total cost for treatment and rehabilitation of patients with brain injuries is...registry based or retrospective or include only secondary insults that occur in the intensive care unit ( ICU ) setting. Most prior investigations the surgical and neurosurgical ICU diagnosed with a traumatic brain injury requiring a diagnostic procedure were eligible for the study. The study

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

    Directory of Open Access Journals (Sweden)

    Rogers AD


    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

  4. Involvement of the p38 mitogen-activated protein kinase signal transduction pathway in burns-induced lung injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-lin; XIA Zhao-fan; WEI Duo; WANG Yong-jie; WANG Chang-rong


    @@ Acute lung injury (ALI) is a leading complication in extensively burned patients, especially those with inhalation injury.1 It can cause hypoxia resulting in injury of remote organs and dysfunction. P38 mitogen-activated protein kinase (p38 MAPK) is a stress activated protein kinase in the MAPK family.2 Most of the previous studies have demonstrated that p38 MAPK signal transduction pathway mediated ALI in rats with acute severe pancreatitis, sepsis etc.3-5 However, there is little information regarding the role of p38 MAPK signal transduction pathway in ALI after severe burn trauma.

  5. 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

  6. Ubiquitin and stromal cell-derived factor-1α in bronchoalveolar lavage fluid after burn and inhalation injury. (United States)

    Baker, Todd A; Davis, Christopher S; Bach, Harold H; Romero, Jacqueline; Burnham, Ellen L; Kovacs, Elizabeth J; Gamelli, Richard L; Majetschak, Matthias


    The objective of the study was to determine whether the CXC chemokine receptor (CXCR) 4 ligands ubiquitin and stromal cell-derived factor (SDF)-1α are detectable in bronchoalveolar lavage fluid (BALF) after burn and inhalation injury and whether their concentrations in BALF are associated with injury severity, physiological variables, or clinical outcomes. BALF was obtained on hospital admission from 51 patients (48 ± 18 years) with burn (TBSA: 23 ± 24%) and inhalation injury (controls: 10 healthy volunteers, 42 ± 8 years). BALF was analyzed for total protein and for ubiquitin and SDF-1α by enzyme-linked immunosorbent assay. Ubiquitin/SDF-1α levels were normalized to total BALF protein content. The extent of inhalation injury was determined during bronchoscopy using a standardized scoring system. Percent TBSA, Baux scores, revised Baux scores, and clinical variables were documented. Ubiquitin and SDF-1α were detectable in 40% of normal BALF specimens. After injury, ubiquitin was detectable in 90% (P patients (P burn and inhalation injury. Increases in BALF ubiquitin after inhalation injury may maintain CXCR4-mediated lung protection and repair processes. The finding that BALF ubiquitin decreased with higher grades of inhalation injury may provide a biological correlate for an insufficient local inflammatory response after severe inhalation injury.

  7. Effects of nutritional support route on intestinal structure and function in the early stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhong-yong; WANG Shi-liang; YU Bin; LI Ao


    To assess the clinical effects ofenteral nutrition on intestinal structure and function in the early stage of severe burns. Methods: Nineteen cases of severe burn injury were divided randomly into enteral nutrition group (EN) and parenteral nutrition group (PN). Gastrin, motilin, malondialdehyde (MDA), superoxide dismutase (SOD), endotoxin, rumor necrosis (TNF), diamine oxidase (DAO) and lactulose/mannitol (L/M) were determined on postburn day 1, 4, 8, 14 (PBD) respectively. Results: Serum gastrin and motilin on PBD 4 and 8 were significantly higher in EN group than in PN group (P<0.05-0.01). Plasma MDA on PBD4 and PBD8 was obviously lower in EN group than in PN group (P<0.01). Plasma SOD on PBD4 and PBD8 was significantly higher in EN group than in PN group (P<0.01). At the most time points, endotoxin and TNF were significantly lower in EN group than in PN group (P<0.01). Serum DAO tended to decrease in EN group, and on PBD4 it was obviously lower in EN group than in PN group (P<0.01). Gut permeability L/M on PBD4, PBD8 was obviously in EN group lower than in PN group (P<0.05-0.01). There was positive correlation between L/M and DAO, and between MDA and TNF (P<0.05-0.01), and negative correlation between L/M and SOD (P<0.01). Conclusion: On the basis of the findings, it is considered that the early enteral nutrition is more effective to preserve the secretion and motility of gastrointestinal tract, decrease intestinal ischemia and reperfusion injury, reduce intestinal permeability, decrease plasma endotoxin and mediators,and maintain mucosa barrier function. Enteral nutrition is superior to parenteral nutrition in the early stage of severe bum injury.

  8. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos. (United States)

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein


    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 to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  9. Saturday-morning television: do sponsors promote high-risk behavior for burn injury? (United States)

    Palmieri, Tina L; Aoki, Traci; Combs, Elena; Curri, Terese; Garma, Sylvia; Kaulkin, Cammie; Lawless, Mary Beth; Nelson, Kate; Sanders, Johanna; Warden, Nancy; Greenhalgh, David G


    Television has become an important tool for learning and socialization in children. Although television violence has been associated with adverse effects, data on depiction of fire and burn injury are lacking. We sought to determine whether Saturday-morning television programming, viewed primarily by children, depicts fire and burn injury as safe or without consequence, thus potentially increasing the incidence of burn injury in children. This was a prospective observational study. Saturday-morning children's television programs were videotaped from 7 AM to 11 AM for eight different television networks during a 6-month period. Tapes were scored for scenes depicting fire or smoke by independent observers. Recorded items included show category, scene type, gender target, context of fire, and outcome after exposure to flame. Fire events were documented during programs and their associated commercials. A total of 108 hours of children's programs, 16 hours per network, were recorded. Scenes depicting fire or smoke were identified 1960 times, with 39% of events occurring during the program itself and 61% in commercials. Fire was depicted as either safe or without consequence in 64% of incidents. Action adventure stories accounted for 56% of flame depictions. Overall, one incident involving flame and fire was portrayed for each 3 minutes of television programming. Saturday-morning television programming frequently depicts fire as safe, empowering, or exciting. The incidence of flame use in programming varies between stations but is most prevalent in action/adventure stories. Television commercials, although brief, provide the majority of the misinformation regarding fire. Medical professional societies should alert the public to this potential hazard and recommend responsible portrayal of fire in children's television programming.

  10. Do fentanyl and morphine influence body temperature after severe burn injury? (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W


    Fentanyl lacks the antiinflammatory properties of morphine. Morphine attenuates the inflammatory response through differential stimulation of μ-receptor subtypes. Patients who receive morphine during coronary artery bypass graft have been shown to experience less postoperative fever than those who receive fentanyl. Patients who receive continuous fentanyl infusions in increased room temperatures after thermal injury may be at increased risk to experience higher body temperature than those who receive morphine. The records of 28 patients with >20%TBSA burn in 30 intensive care unit rooms (13 received fentanyl and 15 received morphine or hydromorphone) and 12 trauma patients who received fentanyl in 22°C intensive care unit rooms were reviewed. Mean maximum core temperature and percentage of temperature recordings > 39°C in the first 48 hours of admission were compared between burn patients who received fentanyl, those who did not, and with trauma patients. Burn patients exposed to fentanyl experienced significantly higher temperatures (40.1 ± 0.9°C) compared with those given morphine (38.7 ± 0.8°C) and compared with trauma patients (37.5 ± 2.4°C), P Burn patients on fentanyl had temperatures > 39°C for a higher percentage of time (33 ± 27%) than those without fentanyl (7.2 ± 13%) and trauma patients (1 ± 2.8%), P Burn patients who receive fentanyl in 30°C rooms experience higher body temperatures and are febrile for a higher percentage of time than those receiving morphine only. Morphine has well-established antiinflammatory properties and likely attenuates the postburn inflammatory response more than fentanyl, resulting in lower body temperatures. This phenomenon needs to be further investigated in additional studies.

  11. Plasma proteome response to severe burn injury revealed by 18O-labeled "universal" reference-based quantitative proteomics. (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


    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 approximately 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.

  12. Increased expression of atrogenes and TWEAK family members after severe burn injury in nonburned human skeletal muscle. (United States)

    Merritt, Edward K; Thalacker-Mercer, Anna; Cross, James M; Windham, Samuel T; Thomas, Steven J; Bamman, Marcas M


    Severe burn induces rapid skeletal muscle proteolysis after the injury, which persists for up to 1 year and results in skeletal muscle atrophy despite dietary and rehabilitative interventions. The purpose of this research was to determine acute changes in gene expression of skeletal muscle mass regulators postburn injury. Specimens were obtained for biopsy from the vastus lateralis of a nonburned leg of eight burned subjects (6M, 2F: 34.8 ± 2.7 years: 29.9 ± 3.1% TBSA burn) at 5.1 ± 1.1 days postburn injury and from matched controls. mRNA expression of cytokines and receptors in the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) families, and the ubiquitin proteasome E3 ligases, atrogin-1 and MuRF-1, was determined. TNF receptor 1A was over 3.5-fold higher in burn. Expression of TNF-like weak inducer of apoptosis and its receptor were over 1.6 and 6.0-fold higher in burn. IL-6, IL-6 receptor, and glycoprotein 130 were elevated in burned subjects with IL-6 receptor over 13-fold higher. The level of suppressor of cytokine signaling-3 was also increased nearly 6-fold in burn. Atrogin-1 and MuRF-1 were more than 4- and 3-fold higher in burn. These results demonstrate for the first time that severe burn in humans has a remarkable impact on gene expression in skeletal muscle of a nonburned limb of genes that promote inflammation and proteolysis. Because these changes likely contribute to the acute skeletal muscle atrophy in areas not directly affected by the burn, in the future it will be important to determine the responsible systemic cues.

  13. Effect of artificial colloids on blood coagulation during shock stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-jun; XING Nan; CHEN Jiong; SHI Jian-wu; SU Guo-liang


    Background There are controversies about the use of artificial colloids.This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury.Methods Totally,18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia.Resuscitation therapy was applied 2 hours after the injury,using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns.The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group):succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection),hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)),and allogeneic plasma group (the colloid used was allogeneic plasma).Blood samples were collected from the animals prior to the burn injury and again at intervals of 4,8,24 and 48 hours post-injury.The platelet count (PLT),prothrombin time (PT),international normalized ratio (INR),activated partial thromboplastin time (APTT),and fibrinogen (Fib) were measured,followed by a statistical analysis of all results.Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3±52.7),(78.8±16.4)×109/L and (159.0±62.8),(87.3±32.0)×109/L respectively.But in the allogeneic plasma group at intervals of 8,24,and 48 hours were (234.3±52.6),(136.0±47.4),(75.8±31.0)×109/L.The decrease were all statistically significant (P <0.05,P <0.01) when compared to pre-burn ((383.3±77.9),(382.7±65.7),(381.0±49.4)×109/L).The PLT among the three groups,at all the time points,had no statistical difference (P >0.05).Compared to pre-burn ((10.8±0.9),(11.4±0.8),(10.6±0.7) seconds),the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5±1.5) and (16.2±1.3) seconds,whereas in the allogeneic plasma group at 8 and 24 hours the PT were

  14. Self-perceptions of young adults who survived severe childhood burn injury. (United States)

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


    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.

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


    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.

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

    Institute of Scientific and Technical Information of China (English)

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


    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 fullthickness 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<0.01), and reached the lowest point,0.63mL/L ± 0.20mL/L, 10.81mmol/L ±2.58mmol/L and 2.23 mmol/h ± 0.73mmol/h respectively, at the 12th h postburn. Although restored to some degree 24 h after thermal injury, the variables above were still statistically lower, compared with those of control animals at the 48th h postburn. The GMBF and EC were also significantly reduced after severe burns, consistent with the trend of gastric acid production changes.CONCLUSION Gastric acid production, as well as GMBF and EC was predominantly decreased in the early postburn stage, suggesting that gastric mucosal ischemia and hypoxia with resultant disturbance in energy metabolism, but not gastric acid proper, might be the decisive factor in the pathogenesis of AGML after thermal injury, and that the preventive use of 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.

  17. Preliminary evidence of early bone resorption in a sheep model of acute burn injury: an observational study. (United States)

    Klein, Gordon L; Xie, Yixia; Qin, Yi-Xian; Lin, Liangjun; Hu, Minyi; Enkhbaatar, Perenlei; Bonewald, Lynda F


    Treatment with bisphosphonates within the first 10 days of severe burn injury completely prevents bone loss. We therefore postulated that bone resorption occurs early post burn and is the primary explanation for acute bone loss in these patients. Our objective was to assess bone for histological and biomechanical evidence of early resorption post burn. We designed a randomized controlled study utilizing a sheep model of burn injury. Three sheep received a 40 % total body surface area burn under isoflurane anesthesia, and three other sheep received cotton-smoke inhalation and served as control. Burned sheep were killed 5 days post procedure and controls were killed 2 days post procedure. Backscatter scanning electron microscopy was performed on iliac crests obtained immediately postmortem along with quantitative histomorphometry and compression testing to determine bone strength (Young's modulus). Blood ionized Ca was also determined in the first 24 h post procedure as was urinary CTx. Three of three sheep killed at 5 days had evidence of scalloping of the bone surface, an effect of bone resorption, whereas none of the three sheep killed at 2 days post procedure had scalloping. One of the three burned sheep killed at 5 days showed quantitative doubling of the eroded surface and halving of the bone volume compared to sham controls. Mean values of Young's modulus were approximately one third lower in the burned sheep killed at 5 days compared to controls, p = 0.08 by unpaired t test, suggesting weaker bone. These data suggest early post-burn bone resorption. Urine CTx normalized to creatinine did not differ between groups at 24 h post procedure because the large amounts of fluids received by the burned sheep may have diluted urine creatinine and CTx and because the urine volume produced by the burned sheep was threefold that of the controls. We calculated 24 h urinary CTx excretion, and with this calculation CTx excretion/24 h in the burned sheep was

  18. Reducing Secondary Insults in Traumatic Brain Injury (United States)


    distinguished by aligning data from the data logger accelerometer against the simultaneous data streams of ICP, mean anerial pressure, and cerebral ... edema of central nervous system tissue within the closed confines of the cranial vault. The ability to estab- lish and maintain an appropriate...source of cerebral ischemia following severe brain injury in the Trau- matic Coma Data Bank . Acta Neurochir Suppl (Wien) 1993; 59: 121-5. II. Jeremitsky

  19. The impact of caregiver support on mortality following burn injury in the elderly. (United States)

    Alsafran, Salman K; Davis, James S; Tankel, Susan; Varas, Robin; Quintana, Olga; Manning, Ron; Glenn, Candace; Pizano, Louis R; Namias, Nicholas; Schulman, Carl I


    Advances in burn care have decreased mortality in the past 20 years, but affecting elderly mortality rates (>65 years) remain challenging. This study evaluates the impact of home caregiver support on elderly burn patients' mortality. The authors retrospectively reviewed patients aged 65 and older admitted to their burn center from July 1995 to October 2004. Patient demographics, Injury Severity Score, TBSA, and patients' primary caregiver were collected. The outcomes were mortality, disposition, and length of stay and these were evaluated using univariate and subsequently multivariate regression. Significance was calculated at P ≤ .05. A total of 112 patients were included in the analysis. The mean age was 76±8. Male patients constituted 47%, whereas 53% were female patients, and mean TBSA was 21±16%. Thirty patients' primary caregiver was a spouse, for 38 it was a child, and 44 had no caregiver. Fifty-eight patients survived (51.7%), and 54 patients died (48.3%). Only 21% of the survivors had a child as their primary caregiver; however, 48% of the nonsurvivors had a child as the primary caregiver (P ≤ 0.05). On multivariate analysis, age, TBSA, and child as primary caregiver were all independent predictors of mortality. Having a child as a caregiver provided the largest impact, with an odds ratio of 4.4 (95% confidence interval, 1.2-15.62; P = .02).

  20. The effects and mechanisms of insulin on systemic inflammatory response and immune cells in severe trauma, burn injury, and sepsis. (United States)

    Deng, Hu-Ping; Chai, Jia-Ke


    Insulin resistance, hyperglycemia, inflammatory disorders and immune dysfunction cause high morbidity and mortality in patients with severe trauma, burn injuries, or sepsis. Many studies have shown that intensive insulin therapy can combat insulin resistance, decrease blood glucose levels, and induce anabolic processes, thus, decreasing morbidity and mortality. Moreover, in recent years, it has been proven that insulin can attenuate systemic inflammatory responses and modulate the proliferation, apoptosis, differentiation and immune functions of certain immune cells, especially monocytes/macrophages, neutrophils, and T cells associated with severe trauma, burn injury, or sepsis. This effect of insulin may expand our understanding of intensive insulin therapy in critically ill patients. This review attempts to summarize studies on the modulatory effects and mechanisms of insulin therapy on systemic inflammation and immune cells in severe trauma, burn injury and sepsis, and further propose some questions for future studies.

  1. The Effects of Punica granatum Flower Extract on Skin Injuries Induced by Burn in Rats

    Directory of Open Access Journals (Sweden)

    Ebrahim Nasiri


    Full Text Available Background. We compared the efficacy of P. granatum (P flower extract with that of silver sulfadiazine (SSD for treating thermal burn injuries in rats. Methods. Ten Wistar rats in each group were topically given base cream, normal saline, cream containing 1% SSD, or creams containing 5% or 10% Punica granatum flower extract. The treatments were administered once daily until complete wound healing was observed. The wound area and healing time were assessed. In addition, percentage wound contraction and histopathological characteristics such as neovascularization and collagen formation were determined. The tannin content in P. granatum extract was determined. Results. The decrease in the average size of wounds on day 15 of the treatment was higher in rats treated with creams containing P. granatum extract than in rats treated with cream containing SSD (2.8±0.9 cm2 versus 8.4±3.2 cm2. The wounds completely healed on day 25 of the treatment in rats treated with creams containing P. granatum flower extract compared with those in rats treated with the other agents. Conclusion. These results indicated that P. granatum flower extract promoted wound healing in rats and could be used for managing burn injuries.

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

    Directory of Open Access Journals (Sweden)



    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

  3. Burn injury during long-term oxygen therapy in Denmark and Sweden: the potential role of smoking (United States)

    Tanash, Hanan A; Ringbaek, Thomas; Huss, Fredrik; Ekström, Magnus


    Background Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury that required contact with a health care specialist, between Sweden (a country with a strict policy regarding smoking while on LTOT) and Denmark (a country with less strict smoking policy). Methods This was a population-based, cohort study of patients initiating LTOT due to any cause in Sweden and Denmark. Data on diagnoses, external causes, and procedures were obtained from the Swedish and Danish National Patient Registers for inpatient and outpatient care. Patients were followed from January 1, 2000, until the first of the following: LTOT withdrawal, death, or study end (December 31, 2009). The primary end point was burn injury during LTOT. Results A total of 23,741 patients received LTOT in Denmark and 7,754 patients in Sweden. Most patients started LTOT due to COPD, both in Sweden (74%) and in Denmark (62%). The rate of burn injury while on LTOT was higher in Denmark than in Sweden; 170 (95% confidence interval [CI], 126–225) vs 85 (95% CI, 44–148) per 100,000 person-years; rate ratio 2.0 (95% CI, 1.0–4.1). The risk remained higher after adjustment for gender, age, and diagnosis in multivariate Cox regression, hazard ratio 1.8 (95% CI, 1.0−3.5). Thirty-day mortality after burn injury was 8% in both countries. Conclusion Compared to Sweden, the rate of burn injury was twice as high in Denmark where smoking is not a contraindication for prescribing LTOT. PMID:28123292

  4. Reduced rate of adenosine triphosphate synthesis by in vivo 31P nuclear magnetic resonance spectroscopy and downregulation of PGC-1beta in distal skeletal muscle following burn. (United States)

    Tzika, A Aria; Mintzopoulos, Dionyssios; Padfield, Katie; Wilhelmy, Julie; Mindrinos, Michael N; Yu, Hongue; Cao, Haihui; Zhang, Qunhao; Astrakas, Loukas G; Zhang, Jiangwen; Yu, Yong-Ming; Rahme, Laurence G; Tompkins, Ronald G


    Using a mouse model of burn trauma, we tested the hypothesis that severe burn trauma corresponding to 30% of total body surface area (TBSA) causes reduction in adenosine triphosphate (ATP) synthesis in distal skeletal muscle. We employed in vivo 31P nuclear magnetic resonance (NMR) in intact mice to assess the rate of ATP synthesis, and characterized the concomitant gene expression patterns in skeletal muscle in burned (30% TBSA) versus control mice. Our NMR results showed a significantly reduced rate of ATP synthesis and were complemented by genomic results showing downregulation of the ATP synthase mitochondrial F1 F0 complex and PGC-1beta gene expression. Our findings suggest that inflammation and muscle atrophy in burns are due to a reduced ATP synthesis rate that may be regulated upstream by PGC-1beta. These findings implicate mitochondrial dysfunction in distal skeletal muscle following burn injury. That PGC-1beta is a highly inducible factor in most tissues and responds to common calcium and cyclic adenosine monophosphate (cAMP) signaling pathways strongly suggests that it may be possible to develop drugs that can induce PGC-1beta.

  5. Genital burns and vaginal delivery. (United States)

    Pant, R; Manandhar, V; Wittgenstein, F; Fortney, J A; Fukushima, C


    Obstetric complications may result from burn scarring in the genital area. Women in developing countries typically squat around cooking fires, and burns are common. This recent case in Nepal describes obstructed labor in a young woman whose genital area had extensive scarring from a cooking fire injury. Proper antenatal assessment by health care providers can reduce the risk to mothers and infants of the consequences of a birth canal damaged or obstructed by burn scarring.

  6. Fabrication and hemocompatibility assessment of novel polyurethane-based bio-nanofibrous dressing loaded with honey and Carica papaya extract for the management of burn injuries (United States)

    Balaji, Arunpandian; Jaganathan, Saravana Kumar; Ismail, Ahmad Fauzi; Rajasekar, Rathanasamy


    Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique. The developed dressing material had a mean fiber diameter of 190±19.93 nm with pore sizes of 4–50 µm to support effective infiltration of nutrients and gas exchange. The successful blending of HN- and PA-based active biomolecules in PU was inferred through changes in surface chemistry. The blend subsequently increased the wettability (14%) and surface energy (24%) of the novel dressing. Ultimately, the presence of hydrophilic biomolecules and high porosity enhanced the water absorption ability of the PU-HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%), delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries. PMID:27621626

  7. Burn injury during long-term oxygen therapy in Denmark and Sweden: the potential role of smoking

    Directory of Open Access Journals (Sweden)

    Tanash HA


    Full Text Available Hanan A Tanash,1 Thomas Ringbaek,2 Fredrik Huss,3,4 Magnus Ekström1 1Department of Respiratory Medicine, Skåne University Hospital, Lund University, Lund, Sweden; 2Respiratory Department, Hvidovre Hospital, Copenhagen, Denmark; 3Department of Surgical Sciences, Plastic Surgery, 4Department of Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital, Uppsala, Sweden Background: Long-term oxygen therapy (LTOT increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury that required contact with a health care specialist, between Sweden (a country with a strict policy regarding smoking while on LTOT and Denmark (a country with less strict smoking policy. Methods: This was a population-based, cohort study of patients initiating LTOT due to any cause in Sweden and Denmark. Data on diagnoses, external causes, and procedures were obtained from the Swedish and Danish National Patient Registers for inpatient and outpatient care. Patients were followed from January 1, 2000, until the first of the following: LTOT withdrawal, death, or study end (December 31, 2009. The primary end point was burn injury during LTOT. Results: A total of 23,741 patients received LTOT in Denmark and 7,754 patients in Sweden. Most patients started LTOT due to COPD, both in Sweden (74% and in Denmark (62%. The rate of burn injury while on LTOT was higher in Denmark than in Sweden; 170 (95% confidence interval [CI], 126–225 vs 85 (95% CI, 44–148 per 100,000 person-years; rate ratio 2.0 (95% CI, 1.0–4.1. The risk remained higher after adjustment for gender, age, and diagnosis in multivariate Cox regression, hazard ratio 1.8 (95% CI, 1.0-3.5. Thirty-day mortality after burn injury was 8% in both countries. Conclusion: Compared to Sweden, the rate of burn injury was twice

  8. Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns. (United States)

    Willebrand, M; Sveen, J


    Parents of children with burns experience a range of psychological reactions and symptoms, and parents' health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents' symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n=107) of children aged 0.4-18 years that sustained burns 0.1-9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents' symptoms of posttraumatic stress, and negatively associated with parents' ratings of their child's health. In two separate multiple regressions with parents' symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents' symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity.

  9. Abdominal fat reducing outcome of exercise training: fat burning or hydrocarbon source redistribution? (United States)

    Kuo, Chia-Hua; Harris, M Brennan


    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.

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

    Directory of Open Access Journals (Sweden)

    Tanash HA


    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

  11. A Statistical Analysis of 2537 Cases of Burn Injuried Patients%2537例烧伤患者统计分析

    Institute of Scientific and Technical Information of China (English)

    韩利坤; 肖三麦


      目的了解烧伤的发病规律、特点,以减少或者预防烧伤的发生.方法根据我院2009年10月-2011年10月收治的2537例烧伤患者的性别、年龄、职业、烧伤面积、烧伤原因等特征,揭示烧伤的特点.结果2537例烧伤患者中,男性1698人,女性839人,男女性别比为2.02∶1;年龄段0~6岁的儿童发病构成比最高,达到40.01%,其中1~3岁儿童的发病构成比占到该组68.37%;职业分布上在岗工人的发病构成比最高,达到43.52%;烧伤面积以1%~10%的烧伤患者最多;烧伤原因中所占比例最高的为热液烧伤,为50.93%.结论烧伤重在预防,加强对儿童的监护和看管,加强对在岗工人的安全生产意识和预防措施.%Objective To understand the occurrence rule ,characteristics of burn injury ,so as to reduce or prevent the occurrence of it .Methods By investigating the sex ,age ,occupation ,burn area ,burn reason ,et al of the 2537 cases of burn injuried patients in our hospital from October ,2009 to October ,2011 ,this paper reveals the characteristics of burn injury .Results There were 1698 males whereas 839 females in the 2537 cases of burn injuried patients ,which shows sex ratio is 2 .02 :1 .Aged from 0 to 6 years old children got the highest incidence - up to 40 .01% ,in which 1 to 3 years old children got 68 .37% incidence .On the distribution of vocation ,workers on duty got the highest incidence ,which is 43 .52% .Most of patients’ burned area is 1% to 10% .The most fre-quent reason is hydrothermal burn injury ,which is 50 .93% .Conclusion The most important of reducing the occurrance of burn in -jury is prevention .We should pay more attention to children’s care and custody as well as strengthen the safe production consciousness and take preventive measures to workers on the job .

  12. Successful treatments of lung injury and skin burn due to hydrofluoric acid exposure. (United States)

    Kono, K; Watanabe, T; Dote, T; Usuda, K; Nishiura, H; Tagawa, T; Tominaga, M; Higuchi, Y; Onnda, M


    Recent growth in the electronics and chemical industries has brought about a progressive increase in the use of hydrofluoric acid (HF), along with the concomitant risk of acute poisoning among HF workers. We report severe cases of inhalation exposure and skin injury which were successfully treated by administering a 5% calcium gluconate solution with a nebulizer and applying 2.5% calcium gluconate jelly, respectively. Case 1: A 52-year old worker used HF for surface treatment after welding stainless steel, and was hospitalized with rapid onset of severe dyspnea. On admission to the critical care medical center he had widespread wheezing and crackles in his lungs. Chest radiograph showed a fine diffuse veiling over both lower pulmonary fields. Severe hypocalcemia with high concentrations of F in serum and urine were disclosed. He was immediately given 5% calcium gluconate solution by intermittent positive-pressure breathing (IPPB), utilizing a nebulizer. On the 21st hospital day, chest film and CT scan did not demonstrate any abnormality. He was discharged very much improved on the 22nd hospital day. Case 2: A 35-year old worker at an electronics factory was admitted to his local hospital with severe skin burn on his face and neck after exposure to 100% HF. Treatment began with immediate copious washing with water for 20 min. Calcium gluconate 2.5% gel (HF burn jelly) was applied to the area as a first-aid measure. Persistent high concentrations of serum and urinary F were disclosed for 2 weeks. After treatment with applications of HF burn jelly, he was confirmed as being completely recovered. The present cases and a review of published data suggest that an adequate method of emergency treatment for accidental HF poisoning is necessary.

  13. Macrophage migration inhibitory factor-A potential diagnostic tool in severe burn injuries? (United States)

    Grieb, Gerrit; Simons, David; Piatkowski, Andrzej; Bernhagen, Jürgen; Steffens, Guy; Pallua, Norbert


    Serum macrophage migration inhibitory factor (MIF) and procalcitonin (PCT) concentrations as well as leucocyte numbers were evaluated in a retrospective study with 23 patients with severe burn injuries. The MIF and PCT concentrations as well as the number of leucocytes (LEU) were monitored over a period of 5 days. The total body surface area (TBSA) and sepsis-related organ failure assessment (SOFA) scores were also evaluated. The MIF, PCT concentrations and leucocyte counts were profoundly increased in all patients with severe burn wounds. At the time of admission into the intensive care unit, no significant differences were observed for the MIF and PCT levels between patients with a TBSApatients with a TBSA>60% (Group 2). After 48 h, however, the MIF and PCT levels reached very high levels in a subgroup of the patients, whereas these levels became normal again in other subgroups. The group of patients with a TBSA>60% was, therefore, subdivided in three groups (subgroups 2a-c). The MIF and PCT data pairs in these subgroups appeared to correlate in an inhomogeneous manner. These levels in the subgroup 2a (i.e., lethal within 5 days) were strongly elevated over those observed in Group 1 (TBSAburn inflammation and systemic inflammatory response syndrome (SIRS) or sepsis with lethal outcome.

  14. Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries. (United States)

    Fang, Taolin; Lineaweaver, William C; Sailes, Frederick C; Kisner, Carson; Zhang, Feng


    Achieving permanent replacement of skin in extensive full-thickness and deep partial-thickness burn injuries and chronic wounds remains one of the fundamental surgical problems. Presently, split-thickness skin grafts are still considered the best material for surgical repair of an excised burn wound. However, in burns that affect greater than 50% of total body surface area, the patient has insufficient areas of unaffected skin from which split-thickness skin grafts can be harvested. The use of cultured epithelial (or epidermal) autografts (CEAs) has achieved satisfactory results. But the take rate of CEAs is poor in full-thickness bed or in chronically infected area. Providing temporary cover with allograft skin, or a more permanent allodermis, may increase clinical take. This review aims to (1) describe the use of CEAs in the regeneration of the epidermis, (2) introduce the application of the acellular dermal matrices (ADMs) in the clinics, and (3) enhance understanding of the CEAs applied with ADM as an appropriate strategy to treat the extended burn injuries. The current evidence regarding the cultured epithelial cell or keratinocyte autograft and dermal grafts applied in the treatment of burn injuries was investigated with an extensive electronic and manual search (MEDLINE and EMBASE). The included literature (N=136 publications) was critically evaluated focusing on the efficacy and safety of this technique in improving the healing of the deep dermal and full-thickness burn injuries. This review concluded that the use of ADM with CEAs is becoming increasingly routine, particularly as a life-saving tool after acute thermal trauma.

  15. An Adaptive QSE-reduced Nuclear Reaction Network for Silicon Burning (United States)

    Parete-Koon, Suzanne; Hix, W.; Thielemann, F.


    The nuclei of the "iron peak" are formed in massive stars shortly before core collapse and during their supernova outbursts as well as during thermonuclear supernovae. Complete and incomplete silicon burning during these events are responsible for the production of a wide range of nuclei with atomic mass numbers from 28 to 64. Because of the large number of nuclei involved, accurate modeling of silicon burning is computationally expensive. However, examination of the physics of silicon burning has revealed that the nuclear evolution is dominated by large groups of nuclei in mutual equilibrium. We present an improvement on our hybrid equilibrium-network scheme which takes advantage of this quasi-equilibrium in order to reduce the number of independent variables calculated. Because the size and membership of these groups vary as the temperature, density and electron faction change, achieving maximal efficiency requires dynamic adjustment of group number and membership. Toward this end, we are implementing a scheme beginning with a single QSE (NSE) group at appropriately high temperature, then progressing through 2, 3 and 4 group stages (with successively more independent variables) as temperature declines. This combination allows accurate prediction of the nuclear abundance evolution, deleptonization and energy generation at a further reduced computational cost when compared to a conventional nuclear reaction network or our previous 3 fixed group QSE-reduced network. During silicon burning, the resultant QSE-reduced network is up to 20 times faster than the full network it replaces without significant loss of accuracy. These reductions in computational cost and the number of species evolved make QSE-reduced networks well suited for inclusion within hydrodynamic simulations, particularly in multi-dimensional applications. This work has been supported by the National Science Foundation, by the Department of Energy's Scientic Discovery through Advanced Computing

  16. Compound 49b Reduces Inflammatory Markers and Apoptosis after Ocular Blast Injury (United States)


    few 12 posterior ocular injuries, using high-resolution optical coherence topography , gross pathology, and optokinetics [9]. In this study of...exposure to ocular blast or in closed- globe ocular injuries. For most ocular trauma studies, work has focused on corneal burns or trauma. However...exposure to ocular blast agree with work from corneal burns or other closed globe models. A recent 17 report from British soldiers in Iraq and

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

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    Sheng-Hua Wu


    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.

  18. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury. (United States)

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


    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.

  19. Burn injury induces histopathological changes and cellproliferation in liver of rats

    Institute of Scientific and Technical Information of China (English)


    AIM To investigate effects of severe burn injury (BI) inrat liver through the histopathological and inflammatorymarkers analysis.METHODS: Forty-two male Wistar rats were distributedinto two groups, control (C) and subjected to scaldBI (SBI). The animals were euthanized one, four and14 d post sham or 45% of the total body surface BI.Liver fragments were submitted to histopathological,morphoquantitative (hepatocyte area and cell density),ciclooxigenase-2 (COX-2) immunoexpression, and geneexpression [real-time polymerase chain reaction fortumor necrosis factor (TNF)-α, inducible nitric oxidesynthase (iNOS) and caspase-3] methods.RESULTS: Histopathological findings showed inflammatoryprocess in all periods investigated and hepatocytedegeneration added to increased amount of connectivetissue 14 d post injury. Hepatocyte area, the density ofbinucleated hepatocytes and density of sinusoidal cellsof SBI groups were increased when compared withcontrol. COX-2 immunoexpression was stronger in SBIgroups. No differences were found in TNF-α, iNOS andcaspase-3 gene expression.CONCLUSION: BI induces histopathological changes,upregulation of COX-2 immunoexpression, and cellproliferation in liver of rats.

  20. Calpain Inhibition Reduces Axolemmal Leakage in Traumatic Axonal Injury

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    János Sándor


    Full Text Available Calcium-induced, calpain-mediated proteolysis (CMSP has recently been implicated to the pathogenesis of diffuse (traumatic axonal injury (TAI. Some studies suggested that subaxolemmal CMSP may contribute to axolemmal permeability (AP alterations observed in TAI. Seeking direct evidence for this premise we investigated whether subaxolemmal CMSP may contribute to axolemmal permeability alterations (APA and pre-injury calpain-inhibition could reduce AP in a rat model of TAI. Horseradish peroxidase (HRP, a tracer that accumulates in axons with APA was administered one hour prior to injury into the lateral ventricle; 30 min preinjury a single tail vein bolus injection of 30 mg/kg MDL-28170 (a calpain inhibitor or its vehicle was applied in Wistar rats exposed to impact acceleration brain injury. Histological detection of traumatically injured axonal segments accumulating HRP and statistical analysis revealed that pre-injury administration of the calpain inhibitor MDL-28170 significantly reduced the average length of HRP-labeled axonal segments. The axono-protective effect of pre-injury calpain inhibition recently demonstrated with classical immunohistochemical markers of TAI was further corroborated in this experiment; significant reduction of the length of labeled axons in the drug-treated rats implicate CMSP in the progression of altered AP in TAI.

  1. Burn epidemiology and cost of medication in paediatric burn patients. (United States)

    Koç, Zeliha; Sağlam, Zeynep


    Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication.

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

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    Gaoxing Luo


    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.

  3. Mental and Physical Health Outcomes in Parents of Children with Burn Injuries as Compared with Matched Controls. (United States)

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


    Pediatric burn injuries are common, and the stress of caring for them can affect caregivers' health. This study's objective was to examine the rates of common mental and physical disorders of parents of burn-injured children (cases) compared with matched controls (controls). This is a population-based study linking the Regional Pediatric burn registry with administrative health information. Pediatric burn cases were matched 1:5 with control children from the general population based on age, sex, and geographical location then parents identified. One thousand and twenty-six parental cases and 4858 controls were identified. International Classification of Disease codes were used to identify diagnoses of common mental and physical disorders. Using rates of disease 2 years before and 2 years after the date of burn, the changes in the relative rates of health outcomes were compared between the cases and the controls. The cases had higher rates of postinjury mental and physical illness compared with the matches. However, it was found that controls also had increased rates postindex date and additionally cases had increased rates of preinjury illnesses. There was no difference in the relative rates of illnesses between the groups from pre- to post-index date. The higher rate of illness in cases postinjury could be explained by preinjury illness, and similar rate increases in the control cohort. Evaluation of the effect of a child's burn injury on parents should take into context the preexisting health of the parent. Socioeconomic factors associated with increased risk of burns may also be associated with adverse health outcomes.

  4. Risk factors for frequent work-related burn and cut injuries and low back pain among commercial kitchen workers in Japan. (United States)

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


    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.

  5. Necrostatin-1 Reduces Neurovascular Injury after Intracerebral Hemorrhage

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    Melanie D. King


    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. Both the H2S biosynthesis inhibitor aminooxyacetic acid and the mitochondrially targeted H2S donor AP39 exert protective effects in a mouse model of burn injury. (United States)

    Ahmad, Akbar; Szabo, Csaba


    Hydrogen sulfide (H2S) exerts beneficial as well as deleterious effects in various models of critical illness. Here we tested the effect of two different pharmacological interventions: (a) inhibition of H2S biosynthesis using the cystathionine-beta-synthase (CBS)/cystathionine-gamma-lyase (CSE) inhibitor aminooxyacetic acid (AOAA) and the mitochondrially targeted H2S donor [10-oxo-10-[4-(3-thioxo-3H-1,2-dithiol-5-yl)phenoxy]decyl]triphenyl-phosphonium (AP39). A 30% body surface area burn injury was induced in anesthetized mice; animals were treated with vehicle, AOAA (10mg/kg i.p. once or once a day for 6days), or AP39 (0.3mg/kg/day once or once a day for 6days). In two separate groups, animals were sacrificed, at 24h post-burn or on Day 7 post-burn, blood and lungs were collected and the following parameters were evaluated: myeloperoxidase (MPO) and malondialdehyde (MDA) in lung homogenates, plasma cytokines (Luminex analysis) and circulating indicators of organ dysfunction (Vetscan analysis). Lung MPO levels (an index of neutrophil infiltration) and MDA levels (an index of oxidative stress) were significantly increased in response to burn injury both at 24h and at 7days; both AOAA and AP39 attenuated these increases. From a panel of inflammatory cytokines (TNFα, IL-1β, IL-6, IL-10, MCP-1, MIP-2, VEGF and IFNγ) in the plasma, IL-6 and IL-10 levels were markedly elevated at 24h and VEGF was slightly elevated. IL-6 remained highly elevated at 7days post-burn while IL-10 levels decreased, but remained slightly elevated over baseline 7days post-burn. The changes in cytokine levels were attenuated both by AP39 and AOAA at both time points studied. The burn-induced increases in the organ injury markers ALP and ALT, amylase and creatinine were reduced by both AOAA and AP39. We conclude that both H2S biosynthesis inhibition (using AOAA) and H2S donation (using AP39) suppresses inflammatory mediator production and reduces multi-organ injury in a murine model of burn

  7. Use of cyanide antidotes in burn patients with suspected inhalation injuries in North America: a cross-sectional survey. (United States)

    Dumestre, Danielle; Nickerson, Duncan


    This study aimed to assess the use of cyanide antidotes and the determine the opinion on empiric administration of hydroxocobalamin in North American burn patients with suspected smoke inhalation injuries. An online cross-sectional survey was sent to directors of 90 major burn centers in North America, which were listed on the American Burn Association Web site. A multiple-choice format was used to determine the percentage of patients tested for cyanide poisoning on admission, the current administration of a cyanide antidote based solely on clinical suspicion of poisoning, and the antidote used. To ascertain views on immediate administration of hydroxocobalamin before confirmation of cyanide poisoning an option was included to expand the response in written format. Twenty-nine of 90 burn directors (32%) completed the survey. For the population of interest, the majority of burn centers (59%) do not test for cyanide poisoning on admission and do not administer an antidote based solely on clinical suspicion of cyanide poisoning (58%). The most commonly available antidote is hydroxocobalamin (50%), followed by the cyanide antidote kit (29%). The opinion regarding instant administration of hydroxocobalamin when inhalation injury is suspected is mixed: 31% support its empiric use, 17% do not, and the remaining 52% have varying degrees of confidence in its utility. In North America, most patients burnt in closed-space fires with inhalation injuries are neither tested for cyanide poisoning in a timely manner nor empirically treated with a cyanide antidote. Although studies have shown the safety and efficacy of empiric and immediate administration of hydroxocobalamin, most centers are not willing to do so.

  8. Identifying and Understanding the Health Information Experiences and Preferences of Individuals With TBI, SCI, and Burn Injuries

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    Nathan T Coffey MPH


    Full Text Available Introduction: Traumatic brain injury, spinal cord injury, and burn injury can cause lifelong disability and changes in quality of life. In order to meet the challenges of postinjury life, various types of health information are needed. We sought to identify preferred sources of health information and services for persons with these injuries and discover how accessibility could be improved. Methods: Thirty-three persons with injury participated in semistructured interviews. Responses to interview questions were coded using NVivo. Results: Participants’ difficulties accessing health information varied by injury type and individually. The majority of respondents found information via the Internet and advocated its use when asked to describe their ideal health information system. Nearly all participants supported the development of a comprehensive care website. When searching for health information, participants sought doctor and support group networks, long-term health outcomes, and treatments specific to their injury. Conclusion: To optimize the quality of health information resources, Internet-based health-care platforms should add or highlight access points to connect patients to medical professionals and support networks while aggregating specialized, injury-specific research and treatment information.

  9. Preparation of asiaticoside-loaded coaxially electrospinning nanofibers and their effect on deep partial-thickness burn injury. (United States)

    Zhu, Lifei; Liu, Xiaoyan; Du, Lina; Jin, Yiguang


    Sodium alginate and chitosan were in favor of wound healing. However, the two polymers were not compatible in one formulation due to the electrostatic interaction. Coaxially electrospinning technology could make two or more noneletrospun polymers to be electrospun in independent core and shell layer. Asiaticoside-loaded coaxially electrospinning nanofibers of alginate, polyvinyl alcohol (PVA) and chitosan (alginate/PVA/chitosan) were prepared and evaluated. Morphologies and microstructure of nanofibers were observed with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Drug release in vitro of coaxial nanofibers was also evaluated. Deep partial-thickness burn injury were established and used to evaluate the improved healing effect of asiaticoside-loaded coaxial nanofibers. Drug-loaded coaxial nanofibers prepared with the optimized formulations and technologies had the obvious core-shell structure. Coaxial nanofibers showed faster drug release profiles in vitro and this facilitated wound healing. Its healing effect on rats with deep partial-thickness burn injury was also significant based on morphology, wound healing ratio, and pathological sections. Positive expression of vascular endothelial growth factor (VEGF), cluster of differentiation 31 (CD31), and proliferating cell nuclear antigen (PCNA), and down regulation of tumor necrosis factor (TNF) and interleukin-6 (IL-6) also validated the improved effect of wound healing. In general, the asiaticoside-loaded coaxial nanofibers had obvious core-shell structure with smooth surface and uniform diameter. Its healing effect on deep partial-thickness burn injury of rats was obvious. Asiaticoside-loaded coaxial nanofibers provide a novel promising option for treatment of deep partial-thickness burn injury.

  10. The effect of virtual reality on pain and range of motion in adults with burn injuries. (United States)

    Carrougher, Gretchen J; Hoffman, Hunter G; Nakamura, Dana; Lezotte, Dennis; Soltani, Maryam; Leahy, Laura; Engrav, Loren H; Patterson, David R


    Few studies have empirically investigated the effects of immersive virtual reality (VR) on postburn physical therapy pain control and range of motion (ROM). We performed a prospective, randomized controlled study of the effects of adding VR to standard therapy in adults receiving active-assisted ROM physical therapy, by assessing pain scores and maximal joint ROM immediately before and after therapy on two consecutive days. Thirty-nine inpatients, aged 21 to 57 years (mean 35 years), with a mean TBSA burn of 18% (range, 3-60%) were studied using a within-subject, crossover design. All patients received their regular pretherapy pharmacologic analgesia regimen. During physical therapy sessions on two consecutive days (VR one day and no VR the other day; order randomized), each patient participated in active-assisted ROM exercises with an occupational or physical therapist. At the conclusion of each session, patients provided 0 to 100 Graphic Rating Scale measurements of pain after each 10-minute treatment condition. On the day with VR, patients wore a head-position-tracked, medical care environment-excluding VR helmet with stereophonic sound and interacted in a virtual environment conducive to burn care. ROM measurements for each joint exercised were recorded before and after each therapy session. Because of nonsignificant carryover and order effects, the data were analyzed using simple paired t-tests. VR reduced all Graphic Rating Scale pain scores (worst pain, time spent thinking about the pain, and pain unpleasantness by 27, 37, and 31% respectively), relative to the no VR condition. Average ROM improvement was slightly greater with the VR condition; however, this difference failed to reach clinical or statistical significance (P = .243). Ninety-seven percent of patients reported zero to mild nausea after the VR session. Immersive VR effectively reduced pain and did not impair ROM during postburn physical therapy. VR is easily used in the hospital setting and

  11. Fabrication and hemocompatibility assessment of novel polyurethane-based bio-nanofibrous dressing loaded with honey and Carica papaya extract for the management of burn injuries

    Directory of Open Access Journals (Sweden)

    Balaji A


    -HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%, delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries. Keywords: electrospinning, porous morphology, surface energy, protein adsorption

  12. 电灼伤的神经系统损伤%Nervous system injury of electrical burn

    Institute of Scientific and Technical Information of China (English)

    吴远; 李光勤


    因日常生活用电越来越广泛,电灼伤的发生率逐渐上升,具有较高的致死率和致残率。神经系统损伤是电灼伤常见的并发症,主要包括周围神经系统损伤、中枢神经系统损伤。周围神经系统损伤较多见,支配区出现无力、感觉异常、感觉缺失、神经痛、反射性交感神经营养不良症等;中枢神经系统损伤包括脊髓损伤和脑神经损伤,主要表现为电休克和各种神经系统后遗症。早期出现的神经系统损伤往往能被认识并加以治疗,而晚期出现的神经系统损伤常得不到重视。%With more use of electricity in daily life,the incidence rate of electrical burn is rising gradually,and electri-cal burn has higher mortality and disability.Nervous system injury is the common complication of electric burn and mainly includes the peripheral nervous system injury and central nervous system injury.The peripheral nervous system injury is more common,and it appears weakness,paresthesia,loss of sensation,neuralgia,reflex sympathetic dystrophy in control area and so on;the central nervous system injury mainly includes the brain and spinal cord injury,mainly for electrical shock and a variety of neurologic sequelae.The early emergence of nervous system injury can often be recog-nized and treated,the late emergence of nervous system injury can often be neglected.

  13. Comparison of measures of physiologic stress during treadmill exercise in a patient with 20% lower extremity burn injuries and healthy matched and nonmatched individuals. (United States)

    Wetzel, J L; Giuffrida, C; Petrazzi, A; Schlanser, J; McDowell-Montini, C; Pietrzyk, C; Landry, V L


    Patients with burn injuries are referred for rehabilitation within days after the injuries to encourage early ambulation and functional training. Many of these patients are hypermetabolic at rest. Metabolic demands of activity are added to the already hypermetabolic state and elevate total energy requirements and some physiologic measures. Reports on the physiologic stress imposed by therapeutic activities for patients with burn injuries are limited to low levels of metabolic demand (burn injuries. The purpose of this study was to report the clinical measures of myocardial and physiologic stress in a patient with 20% lower extremity total body surface area burns during an exercise challenge equivalent to stair climbing. Physiologic measures were assessed before and during a treadmill activity (5 METS) for a 40-year-old obese man 3 weeks after he had lower extremity burn injuries. These measures were compared with mean values for 62 healthy counterparts and 6 healthy subjects matched for age, gender, and fitness level. Heart rate, systolic blood pressure, rate pressure product, and the rating of perceived exertion for the patient with burn injuries were higher at baseline and during exercise than the mean values for the 62 healthy individuals and the 6 matched subjects. The steady state exercise values for heart rate, systolic blood pressure, rate pressure product, and rating of perceived exertion at 6 minutes were 189 beats per minute, 190 mm Hg, 3591, and 17, respectively, for the patient with burn injuries and were 111.3 beats per minute, 149 mm Hg, 1680, and 11.7, respectively, for the 6 matched subjects. Ventilation during exercise also increased for the patient with burn injuries more than for the matched subjects (3/4 vs 1/4). Pain experienced by the patient with burn injuries decreased with activity (9.8 vs 7.3 on a 15-cm scale). Treadmill walking produced near maximal responses for most physiologic measures for this patient who was hypermetabolic at rest

  14. SERCA overexpression reduces hydroxyl radical injury in murine myocardium. (United States)

    Hiranandani, Nitisha; Bupha-Intr, Tepmanas; Janssen, Paul M L


    Hydroxyl radicals (*OH) are involved in the pathogenesis of ischemia-reperfusion injury and are observed in clinical situations, including acute heart failure, stroke, and myocardial infarction. Acute transient exposure to *OH causes an intracellular Ca(2+) overload and leads to impaired contractility. We investigated whether upregulation of sarcoplasmic reticulum Ca(2+)-ATPase function (SERCA) can attenuate *OH-induced dysfunction. Small, contracting right ventricular papillary muscles from wild-type (WT) SERCA1a-overexpressing (transgenic, TG) and SERCA2a heterogeneous knockout (HET) mice were directly exposed to *OH. This brief 2-min exposure led to a transient elevation of diastolic force (F(dia)) and depression of developed force (F(dev)). In WT mice, F(dia) increased to 485 +/- 49% and F(dev) decreased to 11 +/- 3%. In sharp contrast, in TG mice F(dia) increased only to 241 +/- 17%, whereas F(dev) decreased only to 51 +/- 5% (P group. The results indicate that SERCA overexpression can reduce the *OH-induced contractile dysfunction in murine myocardium, whereas a reduced SR Ca(2+)-ATPase activity aggravates this injury. Loss of pPLB levels at Ser16 likely amplifies the differences observed in injury response.

  15. Effects of a 12-wk resistance exercise program on skeletal muscle strength in children with burn injuries. (United States)

    Suman, O E; Spies, R J; Celis, M M; Mlcak, R P; Herndon, D N


    The posttraumatic response to burn injury leads to marked and prolonged skeletal muscle catabolism and weakness, which persist despite standard rehabilitation programs of occupational and physical therapy. We investigated whether a resistance exercise program would attenuate muscle loss and weakness that is typically found in children with thermal injury. We assessed the changes in leg muscle strength and lean body mass in severely burned children with >40% total body surface area burned. Patients were randomized to a 12-wk standard hospital rehabilitation program supplemented with an exercise training program (n = 19) or to a home-based rehabilitation program without exercise (n = 16). Leg muscle strength was assessed before and after the 12-wk rehabilitation or training program at an isokinetic speed of 150 degrees /s. Lean body mass was assessed using dual-energy X-ray absorptiometry. We found that the participation in a resistance exercise program results in a significant improvement in muscle strength, power, and lean body mass relative to a standard rehabilitation program without exercise.

  16. 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.


    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

  17. The Effects of Alcohol Intoxication and Burn Injury on the Expression of Claudins and Mucins in the Small and Large Intestines. (United States)

    Hammer, Adam M; Khan, Omair M; Morris, Niya L; Li, Xiaoling; Movtchan, Nellie V; Cannon, Abigail R; Choudhry, Mashkoor A


    Alcohol intoxication at the time of burn injury exacerbates postburn pathogenesis. Recent findings suggest gut barrier integrity is compromised after combined alcohol and burn insult, which could contribute to these complications. Tight junction proteins and mucins play critical roles in keeping the gut barrier intact. Therefore, the goal of this study was to examine the effects of alcohol and burn injury on claudin and mucin expression in the intestines. We also evaluated if the combined insult differentially influences their expression in the small and large intestines. Male C57BL/6 mice were given a single dose of 2.9 g/kg ethanol before an approximately 12.5% body area burn. One and three days after injury, we profiled expression of several tight junction proteins, mucin, and bacterial 16S rRNA genes in the small and large intestines, using qPCR. We observed >50% decrease in claudin-4 and claudin-8 genes in both ileal and colonic epithelial cells 1 day after injury. Claudin-2 was significantly upregulated, and occludin was downregulated in the small intestine 1 day after injury. Mucin-3 expression was substantially elevated (>50%) in the small intestine, whereas mucin-2 and mucin-4 were considerably diminished in the colon (>50%) 1 day after injury. Most of the parameters were normalized to sham levels on day 3, except for mucin-3 and claudin-8, which remained decreased in the large intestine. Neither alcohol nor burn alone resulted in changes in junction or mucin gene expression compared to shams. This was accompanied with increases in the family of Gram-negative bacteria, Enterobacteriaceae, in both the small and the large intestines 1 day after injury. These findings suggest that alcohol and burn injury disrupts the normal gut microbiota and alters tight junction and mucin expression in the small and large intestines.

  18. Effect of burn injury on relative anaplerosis and gluconeogenesis in rats by 13C magnetic resonance spectrum

    Institute of Scientific and Technical Information of China (English)

    夏照帆; 田建广; 王光毅; 葛绳德; 唐洪泰


    Objective: To introduce a safe and specific approachof 13C magnetic resonance spectrum (13C MRS )spectroscopy and investigate the alterations in hepaticanabolism.Methods: Relative anaplerotic, pyruvate recyclingand gluconeogenic fluxes were measured by 13C MRSisotopomer analysis of blood glucose from rats with 40%body surface area burn injury, and from rats exposed tosham injury. A short chain fatty acid, [U-13C] propionatewhich was avidly extracted by the liver, was infusedintravenously to deliver 13C into the citric acid cycle.Proton-decoupled 13C MRS of deproteinized plasma orextracts of the freeze-clamped liver were used to determinethe distribution of 13C in blood or hepatic glucose.Results: There was no difference in the multipletsdetected in the glucose carbon-2 anomer from blood or liverafter 45 or 60 minutes of the infusion of the propionate,indicating that steady-state isotopic conditions wereachieved. Gluconeogenesis relative to citric acid cycle fluxwas not altered by burn injury; in both sham and burngroups the rate of glucose production was about equal toflux through citrate synthase. In the sham group ofanimals, the rate of entry of carbon skeletons into the citricacid cycle was about 4 times than that in the burn group.Similarly, flux through pyruvate kinase (again relative tocitrate synthase) was significantly increased after the burninjury.Conclusions: Since results from analysis of the bloodglucose are the same as that of the hepatic glucose, 13Cdistribution in the glucose and hepatic metabolism can beassessed based on the 13C MRS analysis of the bloodglucose.

  19. Current situation and reflection on rehabilitation after burn injury in China%中国烧伤康复治疗的现状与思考

    Institute of Scientific and Technical Information of China (English)

    吴军; 陈建


    After over 50 years'development,the modern burn care system of China has made remarkable progress,however,we still lack ample attention to functional rehabilitation and quality of life of burn patients recovering from burn injury.The burn rehabilitation in China is still in juvenile stage,but it is really encouraging that more and more burn care facilities are paying attention to it.To further promote the development of burn rehabilitation in China,more emphasis must be stressed on the formation of multidisciplinary team in our burn care system,the concept of early and integral rehabilitation should be promoted,and therapeutic regimens and research work on function and aesthetics related body parts like hand and face should be emphasized.Moreover,we should also carry out rehabilitation on pediatric burn patients and promulgate the idea of burn rehabilitation in the society at large with the purpose of seeking supports for burn rehabilitation from all sectors of the society.

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

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


    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 aims of the current study were 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. Poly(ADP-ribose) polymerase 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 after 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.

  1. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 10. Injuries of the Eye, Ear, Nose, Abdomen, Central Nervous System and Genitalia. Burns and Environmental Injuries. Revised. (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers injuries of the eyes, ears, nose, abdomen, central nervous system (CNS), and genitalia; burns; and environmental injuries. Objectives stated for the two chapters are for the student to be able to describe procedures…

  2. The challenges of dysphagia management and rehabilitation after extensive thermal burn injury: a complex case. (United States)

    Rumbach, Anna F; Ward, Elizabeth C; Cornwell, Petrea L; Bassett, Lynell V; Muller, Michael J


    The role of the speech pathologist in the burns population is still emerging, with detailed discussion of the assessment and management of dysphagia limited to date. This report describes the case of a 60-year-old man who developed severe contractures of the head and neck and oropharyngeal dysphagia after sustaining 53.5% deep partial- and full-thickness burns. Although some aspects of rehabilitation were confounded by a preexisting mild intellectual disability, the patient was able to participate in an intensive regimen of active and passive exercise to rehabilitate his oropharyngeal dysphagia. Significant oral contractures remained; however, the patient was discharged without tracheostomy and consuming a texture-modified diet with no signs of aspiration. To our knowledge, this is one of a small handful of reports that document speech pathology management of the burns population, and a first that identifies and outlines specific characteristics of, and rehabilitation strategies for, dysphagia in a burned individual.

  3. Burn and cut injuries related to job stress among kitchen workers in Japan. (United States)

    Haruyama, Yasuo; Matsuzuki, Hiroe; Tomita, Shigeru; Muto, Takashi; Haratani, Takashi; Muto, Shigeki; Ito, Akiyoshi


    To clarify the correlation between kitchen work-related burns and cuts and job stress, a self-administered questionnaire survey was conducted involving 991 kitchen workers among 126 kitchen facilities. The demographics, condition of burns and cuts, job stress with the Brief Job Stress Questionnaire (BJSQ), health condition, and work-related and environmental factors were surveyed. Multiple logistic regression models and trend tests were used according to quartiles (Q1, Q2, Q3, and Q4) of each sub-scale BJSQ. After adjustment for potential confounding variables, burns/cuts were associated with a higher score category (Q4) of job demands (OR: 2.56, 95% CI: 1.10-6.02/OR: 2.72, 95% CI: 1.30-5.69), psychological stress (OR: 4.49, 95% CI: 2.05-9.81/OR: 3.52, 95% CI: 1.84-6.72), and physical stress (OR: 2.41, 95% CI: 1.20-4.98/OR 2.16, 95% CI: 1.16-4.01). The ORs of the burn/cut injures increased from Q1 to Q4 with job demands (p for trend = 0.045/0.003), psychological stress (p for trendkitchen work-related burns and cuts are more likely to be correlated with job stress, and the higher the job stress score, the higher the frequency of burns and cuts among kitchen workers.

  4. Burns Caused by Medical Therapy (United States)


    fear of litigation, patients with such injuries, even if the injuries are minor, arc often referred to a burn center for care. Burn injury...the potential burn hazards found elsewhere in the hospital. Even fewer studies have addressed the burn risks posed by medical therapy administered...35. Mills GH, Ralph S). Bums due to pulse oximetry [ letter ]. Anaesthesia 1992j47:276·7. 36. Shdlock: FG, Kana! E. Burns associated with the use of

  5. 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


    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

  6. Poloxamer-188 Reduces Muscular Edema After Tourniquet-Induced Ischemia-Reperfusion Injury in Rats (United States)


    Trauma. 2011;70: 1192–1197) Muscle injury, such as ischemia-reperfusion injury (I-R),1blunt trauma injury, electrocution ,2 burn, crush,3 and laceration, is...188 solution (SythRx, Bellaire, TX) contained 150 mg/mL highly purified P-188, 3.08 mg/mL sodium chlo- ride, 2.38 mg/mL sodium citrate, and 0.366 mg...mL citric acid. The placebo solution contained the same ingredients with the exception of P-188. Doses consisted of 1.0 mL/kg body weight of P-188

  7. Bone marrow-derived myofibroblasts recruited to the upper dermis appear beneath regenerating epidermis after deep dermal burn injury. (United States)

    Yamaguchi, Ryo; Takami, Yoshihiro; Yamaguchi, Yoshihiro; Shimazaki, Syuji


    Fibroblasts and myofibroblasts migrating to sites of tissue repair after injury may not only be locally recruited but could also be recruited from the bone marrow. However, the characteristics and functional roles, if any, of these cells in wound healing are poorly understood. Here, we show unequivocally that bone marrow-derived fibroblasts do contribute to deep dermal burn wound healing. Bone-marrow stromal cells were collected from femurs of male Lewis rats, cultured for a week, and then the adherent cells were labeled with the fluorescent marker PKH-26. These cells stained positive for alpha-smooth muscle actin and prolyl 4-hydroxylase, but did not express RM-4 (a macrophage marker), CD34, or cytokeratin, characteristic of myofibroblastic differentiation. When injected intravenously into Lewis rats, they homed to the bone marrow. Five days after transplantation, a deep dermal burn was made on the back of the rat, and biopsies were taken 7, 10, and 14 days later. PKH-positive cells were not found at day 7, but by day 10, they were easily detected mainly in the upper dermis close beneath the regenerating epidermis. These PKH-positive cells still stained for alpha-SMA and prolyl 4-hydroxylase, but not RM4. Thus, it is suggested that myofibroblasts originating in the bone marrow contribute not only to promotion of granulation but also enhancement of dermal-epidermal interaction after thermal injury.

  8. Current status in rehabilitation of burn injury in China%中国烧伤康复的发展现状

    Institute of Scientific and Technical Information of China (English)

    贾赤宇; 邹晓防


    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 rate 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 muhidisciplinary 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.

  9. Tribal motor vehicle injury prevention programs for reducing disparities in motor vehicle-related injuries. (United States)

    West, Bethany A; Naumann, Rebecca B


    A previous analysis of National Vital Statistics System data for 2003-2007 that examined disparities in rates of motor vehicle-related death by race/ethnicity and sex found that death rates for American Indians/Alaska Natives were two to four times the rates of other races/ethnicities. To address the disparity in motor vehicle-related injuries and deaths among American Indians/Alaska Natives, CDC funded four American Indian tribes during 2004-2009 to tailor, implement, and evaluate evidence-based road safety interventions. During the implementation of these four motor vehicle-related injury prevention pilot programs, seat belt and child safety seat use increased and alcohol-impaired driving decreased. Four American Indian/Alaska Native tribal communities-the Tohono O'odham Nation, the Ho-Chunk Nation, the White Mountain Apache Tribe, and the San Carlos Apache Tribe-implemented evidence-based road safety interventions to reduce motor vehicle-related injuries and deaths. Each community selected interventions from the Guide to Community Preventive Services and implemented them during 2004-2009. Furthermore, each community took a multifaceted approach by incorporating several strategies, such as school and community education programs, media campaigns, and collaborations with law enforcement officers into their programs. Police data and direct observational surveys were the main data sources used to assess results of the programs. Results included increased use of seat belts and child safety seats, increased enforcement of alcohol-impaired driving laws, and decreased motor vehicle crashes involving injuries or deaths. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion as an example of a program that might be effective for reducing motor vehicle-related injury disparities in the United States. The Guide to Community Preventive Services recognizes these selected interventions as effective; this report examines the

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

    Directory of Open Access Journals (Sweden)

    Nilgün Aksoy


    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

  11. Severe Burn Injury Induces Thermogenically Functional Mitochondria in Murine White Adipose Tissue. (United States)

    Porter, Craig; Herndon, David N; Bhattarai, Nisha; Ogunbileje, John O; Szczesny, Bartosz; Szabo, Csaba; Toliver-Kinsky, Tracy; Sidossis, Labros S


    Chronic cold exposure induces functionally thermogenic mitochondria in the inguinal white adipose tissue (iWAT) of mice. Whether this response occurs in pathophysiological states remains unclear. The purpose of this study was to determine the impact of severe burn trauma on iWAT mitochondrial function in mice. Male BALB/c mice (10-12 weeks) received full-thickness scald burns to ∼30% of the body surface area. Inguinal white adipose tissue was harvested from mice at 1, 4, 10, 20, and 40 days postinjury. Total and uncoupling protein 1 (UCP1)-dependent mitochondrial thermogenesis were determined in iWAT. Citrate synthase activity was determined as a proxy of mitochondrial abundance. Immunohistochemistry was performed to assess iWAT morphology and UCP1 expression. Uncoupling protein 1-dependent respiration was significantly greater at 4 and 10 days after burn compared with sham, peaking at 20 days after burn (P white adipose tissue in vivo and may offer a mechanistic explanation for the chronic hypermetabolism observed in burn victims.

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

    DEFF Research Database (Denmark)

    Hostrup, Anders; Christensen, Gitte Lund; Bentzen, Bo Hjort;


    of the 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...

  13. Thermal injuries induce gene expression of endogenous c-fos, c-myc and bFGF in burned tissues

    Institute of Scientific and Technical Information of China (English)

    付小兵; 顾小曼; 孙同柱; 杨银辉; 孙晓庆; 盛志勇


    Objective To investigate the expression sequence and distribution characteristics of the protooncogenes c-fos, c-myc and endogenous basic fibroblast growth factor (bFGF ) genes in burned tissues, and to explore the possible effects of changes in the se genes' functions on wound healing. Methods Partial-thickness burns of 30% TBSA were established on backs of Wistar rats. Insitu hybridization and histological methods were used to detect expression of c-fos, c-myc and bFGF genes in normal and burned tissue at 3 h, 6 h, 1 d, 3 d , 7 d and 14 d postburn. Results Although expression of c-fos and c-myc genes and bFGF gene could be found in normal skin, the expression of all three were markedly induced by burn wounds and the expression models in sequence and distribution were quite different. Expre ssion of c-fos gene increased and peaked at 6 h. Signals were mainly localiz ed in both nuclei of dermal fibroblasts and monocytes. The expression of bFGF gene increased at 6 h and peaked at 1 d postburn, and was distributed in the cyt oplasm of fibroblasts. C-myc gene peaked 3 d postburn and was also distributed in the cytoplasm of fibroblasts. Conclusions These results indicated that thermal injury could induce the expression of c-fos, c-myc and bFGF at gene level, showing phasic control and regional distributi on. The phasic expression of these genes suggests that there is an interaction between protooncogenes and bFGF, which may play an important role in wound heali ng. The different expressions of c-fos and c-myc play an inducing role in reg ulating bFGF, and in turn affect wound healing.

  14. Development and verification of fuel burn-up calculation model in a reduced reactor geometry

    Energy Technology Data Exchange (ETDEWEB)

    Sembiring, Tagor Malem [Center for Reactor Technology and Nuclear Safety (PTKRN), National Nuclear Energy Agency (BATAN), Kawasan PUSPIPTEK Gd. No. 80, Serpong, Tangerang 15310 (Indonesia)], E-mail:; Liem, Peng Hong [Research Laboratory for Nuclear Reactor (RLNR), Tokyo Institute of Technology (Tokyo Tech), O-okayama, Meguro-ku, Tokyo 152-8550 (Japan)


    A fuel burn-up model in a reduced reactor geometry (2-D) is successfully developed and implemented in the Batan in-core fuel management code, Batan-FUEL. Considering the bank mode operation of the control rods, several interpolation functions are investigated which best approximate the 3-D fuel assembly radial power distributions across the core as function of insertion depth of the control rods. Concerning the applicability of the interpolation functions, it can be concluded that the optimal coefficients of the interpolation functions are not very sensitive to the core configuration and core or fuel composition in RSG GAS (MPR-30) reactor. Consequently, once the optimal interpolation function and its coefficients are derived then they can be used for 2-D routine operational in-core fuel management without repeating the expensive 3-D neutron diffusion calculations. At the selected fuel elements (at H-9 and G-6 core grid positions), the discrepancy of the FECFs (fuel element channel power peaking factors) between the 2-D and 3-D models are within the range of 3.637 x 10{sup -4}, 3.241 x 10{sup -4} and 7.556 x 10{sup -4} for the oxide, silicide cores with 250 g {sup 235}U/FE and the silicide core with 300 g {sup 235}U/FE, respectively.

  15. Temporal expression of wound healing-related genes in skin burn injury. (United States)

    Kubo, Hidemichi; Hayashi, Takahito; Ago, Kazutoshi; Ago, Mihoko; Kanekura, Takuro; Ogata, Mamoru


    Determination of the age of burns, as well as of wounds induced mechanically, is essential in forensic practice, particularly in cases of suspected child abuse. Here, we investigated temporal changes in the expression of 13 genes during wound healing after a burn. The expression of cytokines (IL-1β, IL-6, IL-10, TNF-α, and IFN-γ), chemokines (KC, MCP-1), proliferative factors (TGF-β, VEGF), proteases (MMP-2, 9, 13) and type I collagen in murine skin was examined by real-time PCR at 3, 6, 9, and 12 h and 1, 2, 3, 5, 7, and 14 days after a burn. Based on macroscopic and histological appearance, the healing process of a burn consists of 3 phases: inflammatory (from 3 h to 1 day after the burn), proliferative (from 1 to 7 days), and maturation (from 7 to 14 days). Expression of IL-1β, IL-6, TNF-α, IFN-γ and KC increased significantly in a biphasic pattern from 3 or 6 h to 12 h or 1 day and from 3 or 5 days to 7 days. Expression of MCP-1 increased significantly from 6 h to 5 days. Expression of both IL-10 and TGF-β increased significantly from 12 h to 7 days. Expression of VEGF, MMP-2, MMP-13 and type I collagen increased significantly from 3 days to 7 or 14 days. Expression of MMP-9 increased significantly from 6 h to 14 days. Our results suggest that evaluating the expression of a combination of these genes would enable the exact estimation of the age of a burn.

  16. Imatinib treatment reduces brain injury in a murine model of traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Enming Joe Su


    Full Text Available Current therapies for Traumatic brain injury (TBI focus on stabilizing individuals and on preventing further damage from the secondary consequences of TBI. A major complication of TBI is cerebral edema, which can be caused by the loss of blood brain barrier (BBB integrity. Recent studies in several CNS pathologies have shown that activation of latent platelet derived growth factor-CC (PDGF-CC within the brain can promote BBB permeability through PDGF receptor α (PDGFRα signaling, and that blocking this pathway improves outcomes. In this study we examine the efficacy for the treatment of TBI of an FDA approved antagonist of the PDGFRα, Imatinib. Using a murine model we show that Imatinib treatment, begun 45 minutes after TBI and given twice daily for 5 days, significantly reduces BBB dysfunction. This is associated with significantly reduced lesion size 24 hours, 7 days, and 21 days after TBI, reduced cerebral edema, determined from apparent diffusion co-efficient (ADC measurements, and with the preservation of cognitive function. Finally, analysis of CSF from human TBI patients suggests a possible correlation between high PDGF-CC levels and increased injury severity. Thus, our data suggests a novel strategy for the treatment of TBI with an existing FDA approved antagonist of the PDGFRα.

  17. MEBO for Treating Compound Burn Injury by Dust Explosion%MEBO治疗粉尘爆炸复合烧伤

    Institute of Scientific and Technical Information of China (English)

    李志刚; 黄合超


    目的:克服常规方法治疗粉尘爆炸复合烧伤的繁杂程序、处置带来的痛苦。方法:采用MEBO外涂及特制带刃不锈钢压舌板反复多次刮除液化物及创面粉尘,共治疗24例。结果:嵌于创面的粉尘异物随液化物分期分批清除,加速创面愈合,无瘢痕形成,亦无外伤性纹身形成。结论:利用MEBT/MEBO治疗粉尘爆炸复合烧伤,可彻底清除创面粉尘,消除粉尘残留给患者身心造成的损害。且方法简便易行,无痛苦,具有传统治疗方法无法替代的作用。%Objective: To avoid pains caused by the complicated procedure of the conventional therapy in treating compound dust explosion burn injury. Method: MEBO was applied externally and a specially made stainless steel spatula with knife edge was used to remove repeatedly the residual dust on the wounds and the liquefaction product. Results: 24 cases were healed. Residual dust and liquefaction product were removed in batches and wound healing was accelerated. No scar and no traumatic tattoo formed. Conclusion: MEBO is an ideal remedy for treating compound burn injury by dust explosion. It helps to remove residual dust thoroughly from the wounds and thus the psychosomatic injury of the patient is avoided. It is easy and simple to use.

  18. Continuous Venovenous Hemofiltration in Severely Burned Patients with Acute Kidney Injury: A Cohort Study (United States)


    FiO2: fraction of inspired oxygen; IHD: intermittent hemodialysis ; IQR: interquartile range; ISS: injury severity score; MODS: multiple organ...were compared. Definitions During the period after November 2005 our staff intensivists utilized the RIFLE (Risk, Injury, Failure, Loss, End-stage...for acute renal fail- ure which included: fluid resuscitation, minimization of nephro- toxic agents, and utilization of hemodialysis if classic

  19. Identifying and Reducing Health Risks Associated with Open-Air Burn Pits (United States)


    results in the Periodic Occupational Exposure Monitoring Summary ( POEMS ). Based on his review of the POEMS data, CPT Pratt opined: “The long inconclusive regarding whether exposure to burn pit emissions creates a long -term health risk for deployed personnel. Contrary to this position...Air Field was "unhealthy" and concluded that the primary contributor was the burn pit. He also listed potential long -term health risks associated

  20. 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


    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.

  1. Signals from Fat After Injury: Plasma Adipokines and Ghrelin Concentrations in the Severely Burned (United States)


    hor- mones , beta blockers and intensive insulin therapy. Furthermore, Table 1 Demographics of control and burn subjects. Values in the table are mean...possibilities to assess the status of the patient through the use of these hor- mones as biomarkers. This work also provides the basis on which to

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

    DEFF Research Database (Denmark)

    Møller-Kristensen, Mette; Hamblin, MR; Thiel, Steffen;


    , 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...

  3. Phytocontact Dermatitis due to Mustard Seed Mimicking Burn Injury: Report of a Case

    Directory of Open Access Journals (Sweden)

    Hakan Yabanoglu


    Full Text Available Mustard seeds have been used in traditional folk medicine as a stimulant, diuretic, and purgative and to treat a variety of ailments including peritonitis and neuralgia. Mustards are still used today in mustard plasters to treat rheumatism, arthritis, chest congestion, aching back, and sore muscles. To make a mustard plaster, mix equal parts of flour and powdered mustard and spread it as a paste on a doubled piece of soft cloth. Apply mustard plaster to the affected area for a maximum of 15 minutes. Prolonged application can result in burns to the skin and nerve damage. Skin lesions occur within hours after exposure, and there is no significant therapy procedure. This case report is about a patient with second-degree burn, occurred when a mixture including mustard seed was exposed to her skin in the pain therapy of the osteoarthritis in her left knee. There are no studies analyzing treatment of skin burns induced by mustard seed in the literature. While in this type of burns our experience is limited, we think that conservative approach should be first choice of treatment.

  4. Contribution of gene expression to metabolic fluxes in hypermetabolic livers induced through burn injury and cecal ligation and puncture in rats. (United States)

    Banta, Scott; Vemula, Murali; Yokoyama, Tadaaki; Jayaraman, Arul; Berthiaume, François; Yarmush, Martin L


    Severe injury activates many stress-related and inflammatory pathways that can lead to a systemic hypermetabolic state. Prior studies using perfused hypermetabolic rat livers have identified intrinsic metabolic flux changes that were not dependent upon the continual presence of elevated stress hormones and substrate loads. We investigated the hypothesis that such changes may be due to persistent alterations in gene expression. A systemic hypermetabolic response was induced in rats by applying a moderate burn injury followed 2 days later by cecum ligation and puncture (CLP) to produce sepsis. Control animals received a sham-burn followed by CLP, or a sham-burn followed by sham-CLP. Two days after CLP, livers were analyzed for gene expression changes using DNA microarrays and for metabolism alterations by ex vivo perfusion coupled with Metabolic Flux Analysis. Burn injury prior to CLP increased fluxes while decreases in gene expression levels were observed. Conversely, CLP alone significantly increased metabolic gene expression, but decreased many of the corresponding metabolic fluxes. Burn injury combined with CLP led to the most dramatic changes, where concurrent changes in fluxes and gene expression levels occurred in about 1/3 of the reactions. The data are consistent with the notion that in this model, burn injury prior to CLP increased fluxes through post-translational mechanisms with little contribution of gene expression, while CLP treatment up-regulated the metabolic machinery by transcriptional mechanisms. Overall, these data show that mRNA changes measured at a single time point by DNA microarray analysis do not reliably predict metabolic flux changes in perfused livers.


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    Full Text Available BACKGROUND Burn injuries are one of the most devastating injuries resulting into higher morbidity and mortality rates. Its higher incidence in developing countries like India creating a formidable health problem. OBJECTIVE To study the pattern of distribution of burn injuries in relation to various epidemiological, demographic and socio-cultural aspect and their impact assessment on mortality and morbidity. MATERIAL AND METHODS It was a prospective 1-year study conducted in all patients (n=499 admitted in Burn Unit of Dept. of Surgery, SGMH, Rewa (M.P., during the period August 2014-July 2015. The data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. Clinical assessment was done in the form of depth and extent of injury. The information obtained was tabulated and analysed, mean, Standard Deviation (SD were calculated where applicable. Chi-square test was used as a test of significance. RESULTS Incidence of burn injury was 6.02% out of total surgical ward admission. Females were 59.31%, while males were 40.68%. Majority 45.9% of patients were from 15-29 years’ age group; 83.5% victims belonged to rural areas and 88.37% patients were below poverty line. Housewives 39.67% followed by students 23.24%; 87.7% was accidental followed by suicidal 9%, homicidal 3.2%. Flame burn 71.74% was commonest and chimney 28.1% was most common source of heat. 54.7% of cases were hospitalized within 5-12 hours of injury. Mean TBSA was 45.3%, it was higher in intentional burns and females. Kitchen 67.53% was the commonest place. 67.13% of burns were superficial to deep. Mean hospital stay was 11.63 days. Overall mortality was 39.47%, septicemia 56.85% was the most common cause of death. CONCLUSION Female sex, accidental, extensive burn, young age, low socioeconomic status, rural area were the factors associated with increased mortality and morbidity. Preventive

  6. Heparins with reduced anti-coagulant activity reduce myocardial reperfusion injury. (United States)

    Barry, William H; Kennedy, Thomas P


    Heparin which is desulfated at the 2-O and 3-O positions (ODSH) has reduced anti-coagulant properties, and reduced interaction with heparin antibodies. Because of the reduced anti-coagulant effect, ODSH can be safely administered to animals and humans intravenously at doses up to 20 mg/kg, resulting in a serum concentration of up to 250µg/ml. Administration of ODSH causes a 35% reduction in infarct size in dogs and pigs subjected to coronary artery occlusion and reperfusion when given 5 min before reperfusion. ODSH has anti-inflamatory effects, manifest as a decrease in neutrophil infiltration into ischemic tissue at high doses, but this effect does not entirely account for the reduction in infarct size. ODSH decreases Na(+) and Ca(2+) loading in isolated cardiac myocytes subjected to simulated ischemia. This effect appears due to an ODSH-induced reduction in an enhanced Na(+) influx via the Na channel in the membrane of cardiac myocyes caused by oxygen radicals generated during ischemia and reperfusion. Reduction in Na(+) influx decreases Ca(2+) loading by reducing Ca2(+) influx via Na/Ca exchange, thus reducing Ca(2+) - dependent reperfusion injury. ODSH does not appear to interact with antibodies to the heparin/platelet factor 4 complex, and does not cause heparin-induced thrombocytopenia. Because of these therapeutic and safety considerations, ODSH would appear to be a promising heparin derivative for prevention of reperfusion injury in humans undergoing thrombolytic or catheter-based reperfusion for acute myocardial infarction. The review article discussed the use of heparin and the discussion of some of the important patents, including: US6489311; US7478358; PCTUS2008070836 and PCTUS2009037836.

  7. Pharmacological Sparing of Protein and Glucose in Burn Injury and/or Sepsis. (United States)


    carboxykinase (PEP-CK). Our own studies have shown that the gluconeogenic capacity is depressed in isolated perfused rat livers taken from guinea pigs ...represent a decrease in the activity of lipoprotein lipase (LPL), the enzyme responsible for the hydrolysis of plasma TG, because hepatic triacylglycerol...Increased tissue lipoprotein lipase activity in guinea pigs following burn trauma. Circ. Shock 8:131-136, 1981. 40 4IN 54. Bagby, G.J., and J.A. Spitzer

  8. A qualitative study of teachers' experiences of a school reintegration programme for young children following a burn injury. (United States)

    Wilson, Hannah M N; Gaskell, Sarah L; Murray, Craig D


    School reintegration programmes provide support to both children absent from school as a result of a serious health problem and their teachers, but little is known regarding their efficacy, or the impact of the situation on teachers. This qualitative study explored the experience of primary school teachers who were involved in a school reintegration programme, following a burn injury to a child in their class. Data was collected using semi-structured interviews with four primary school teachers. Transcripts were analysed using interpretative phenomenological analysis. The findings indicated that participants were positive regarding the programme, but detailed aspects which could be improved, for example better communication before the child's return. They discussed their fears and concerns, including a strong need to protect the child from further harm. Implications of this study include the need to provide adequate support to teachers in similar positions, and further develop school reintegration programmes to best facilitate the child's return to school.

  9. Extensive burns and inhalation injuries tracheotomy nursing of 24 cases%大面积烧伤合并吸入性损伤气管切开24例护理体会

    Institute of Scientific and Technical Information of China (English)



    Objective:To summarize the large-area burns complicated by inhalation injury patients with tracheotomy respiratory tract nursing experience.Methods:the I branch a total of 24 cases of severe burns complicated by inhalation injury treated patients, tracheotomy as soon as possible, various methods for airway moist, oxygen was provided for reasonable, timely sputum suction and promote expectoration, prevention and treatment of complications. Results:22 cases cured,1 case death, automatic discharge in 1 case.Conclusion:Large area burn dry tracheotomy, scientific and meticulous airway management can effectively reduce the occurrence of complications, improve the cure rate of large area burns complicated by inhalation injury.%目的:总结大面积烧伤合并吸入性损伤气管切开患者的呼吸道护理经验。方法:对收治的24例严重烧伤合并吸入性损伤患者,尽早气管切开,多种方法进行气道湿化,持续合理给氧,及时吸痰并促进咳痰,防治并发症。结果:治愈22例,死亡1例,自动出院1例。结论:大面积烧伤尽早气管切开、科学细致的呼吸道管理能有效减少并发症的发生,提高大面积烧伤合并吸入性损伤的治愈率。

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

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    McLean LM


    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

  11. Incidence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury in Burned Service Members: Preliminary Report (United States)


    APRN, BC, Douglas B. Cooper, PhD, Janyna M. Mercado , PhD, Jan E. Kennedy, PhD, Linda H. Yoder, RN, MBA, PhD, AOCN, FAAN, and COL John B. Holcomb, MC...TX): I agree that PTSD and mTBI are now well recognized combat injuries, especially in the popular media. Of concern are the differences and

  12. Burn Center Treatment of Patients With Severe Anhydrous Ammonia Injury: Case Reports and Literature Review (United States)


    resulting in stromal haze and scarring, and pigmented keratic precipitates. Prednisolone acetate and homatropine were added. He underwent bilateral corneal...Pulmonary function testing at 6 months showed a relatively fixed obstructive pat- tern (Table 1), and he reported difficulty performing the various...injury is well documented by fiberop- tic bronchoscopy, which initially shows erythema , congestion, and hemorrhage followed by extensive desquamation of

  13. A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students. (United States)

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


    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.

  14. Effect of exercise on burn-induced changes in tissue-specific glucose metabolism. (United States)

    Carter, Edward A; Paul, Kasie; Bonab, Ali A; Tompkins, Ronald G; Fischman, Alan J


    Exercise is a component of the clinical management for burn patients, to help reduce muscle wasting associated with prolonged hospitalization. In the present study the authors examined 2-deoxy-2-[18F] fluoro-D-glucose (18FDG) uptake in mice subjected to burn injury with and without exercise. Mice had their the dorsums shaven, were placed in molds, and the exposed area was immersed in 90°C water for 9 seconds followed by resuscitation with saline (2 ml) to produce a 30% full-thickness burn injury. Twenty-four hours later, the mice were subjected to treadmill exercise for 1 hour. Before exercise, mice were injected with ~50 μCi 18FDG. Mice were killed after running and a complete biodistribution was performed. Exercise produced a stimulation of 18FDG update by skeletal muscle and heart, while reducing 18FDG accumulation in brain. Burn injury had no significant effect on 18FDG update by skeletal muscle, but did increase 18FDG accumulation in heart, while reducing 18FDG accumulation in brain. However, exercise combined with a burn injury produced a significant increase in 18FDG uptake in the skeletal muscle compared with the burned mice, as great as that produced in the sham animals subjected to exercise. The combination of burn plus exercise appeared to prevent the stimulation of 18FDG uptake by the heart produced by burn injury alone. Exercise treatment did not correct the changes in 18FDG uptake in the brain produced by burn injury. Separately, exercise and burn injury significantly increased serum interleukin-6 levels, increases that were higher when exercise was combined with the burn injury. These findings suggest that exercise may exert some therapeutic effects in burn patients by tissue-specific modulation of glucose metabolism, and these changes may be related to interleukin-6.

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

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    Sandy S. Sopandi


    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

  16. Topical application of docosanol- or stearic acid-containing creams reduces severity of phenol burn wounds in mice. (United States)

    Khalil, M H; Marcelletti, J F; Katz, L R; Katz, D H; Pope, L E


    Because of their reported antiviral and anti-inflammatory activities, cream formulations containing n-docosanol (docosanol) or stearic acid were tested for effects on chemically-induced burns in mice. In this model, injury was induced by painting the abdomens of mice with a chloroform solution of phenol. This was followed by the topical application of test substances 0.5, 3, and 6 h later. Progression of the wounds was assessed by a single evaluator after 8 h, using a numerical score of gross morphology. Docosanol- and stearic acid-containing creams substantially and reproducibly lessened the severity and progression of skin lesions compared to untreated sites with a 76% and 57% reduction in mean lesion scores, respectively. Untreated wounds appeared red and ulcerated; docosanol cream-treated wounds showed only slight erythema.

  17. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries (United States)


    in close proximity to the blast center, can result in eardrum damage (rupture of the tympanic membrane TM), lung damage (pulmonary or alveolar ...rence of psychologic deficit .12,13 The Defense and Veterans Brain Injury Center reports 22% of soldiers returning from OIF/OEF as having evidence of...psychologic deficit , specifically, posttraumatic stress disorder (PTSD).13 This in- creased risk of altered mental status, concussive symptoms, and PTSD

  18. Ceftriaxone-induced toxic epidermal necrolysis mimicking burn injury: a case report

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    Billig Allan


    Full Text Available Abstract Introduction Toxic epidermal necrolysis is a rare exfoliative disorder with a high mortality rate. Case presentation We present a 70-year-old woman of Iranian descent who presented with toxic epidermal necrolysis that was initially diagnosed as a scald burn. Further anamnesis prompted by spread of the lesions during hospitalization revealed that the patient had been receiving ceftriaxone for several days. To the best of our knowledge, this is the first case of ceftriaxone-induced toxic epidermal necrolysis in the English literature. Conclusion Toxic epidermal necrolysis is an acute, life-threatening, exfoliative disorder with a high mortality rate. High clinical suspicion, prompt recognition, and initiation of supportive care is mandatory. Thorough investigation of the pathogenetic mechanisms is fundamental. Optimal treatment guidelines are still unavailable.

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

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    Sheng Zhi-Yong


    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.

  20. Epidemiological Study Of Burn Cases And Their Mortality Experiences Amongst Adults From A Tertiary Level Care Centre

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    Kumar P


    Full Text Available Research question: How to use hospital statistics in establishing epidemiology of burns amongst adults? Objectives: To identify epidemiological determinants for Ii Various burn injuries and ii their mortality experiences. Study design: Hospital based study carried out for a period of one year (1st January 1991 to 31st December 1991. Settings: Wards of department of Burn & Plastic Surgery, BJ Medical College, Ahmedabad. Participants: 386 adults (20 years and above admitted at the centre for burn injuries during 1991. Study variables: Epidemiological determinants (age, sex, temporal, place, etc. for various burn injuries and the determinants of mortality (type of burn, extent of burn, referral time lag etc. Outcome profile: Common profile of burn victims with relation to the epidemiological factors and other factors responsible for high mortality in burn cases. Statistical analysis: Chi- square and Z tests. Results:Burns occured more in females specially in the age group of 20-24 years. Eighty five percent were flame burns. Flame burns were more in females, while electric burns were more in males. Burns were less during monsoon (27.7% than winter (32.6% and summer (39.6%, but electric burns were twice more common during monsoon. Maximum burns (81.9% were domestic, occurring mainly either in kitchen or living room. They were seen more in late evening. Sixty two percent cases were severe as total burn surface area (TBSA was >40%. Case fatality correlated positively with TBSA and death was almost universal with TBSA >60%. Early referral reduced fatality significantly in less severe burns (TBSA<40% but failed to influence it in severe burns. Appraisal of alleged suicide cases (2.6% and of stove bursting (4.4% revealed that young females carry additional risk of burn injuries.

  1. An Experimental Study on Burning Characteristics of n-Heptane/Ethanol Mixture Pool Fires in a Reduced Scaled Tunnel (United States)

    Yozgatligil, Ahmet; Shafee, Sina


    Fire accidents in recent decades have drawn attention to safety issues associated with the design, construction and maintenance of tunnels. A reduced scale tunnel model constructed based on Froude scaling technique is used in the current work. Mixtures of n-heptane and ethanol are burned with ethanol volumetric fraction up to 30 percent and the longitudinal ventilation velocity varying from 0.5 to 2.5 m/s. The burning rates of the pool fires are measured using a precision load cell. The heat release rates of the fires are calculated according to oxygen calorimetry method and the temperature distributions inside the tunnel are also measured. Results of the experiments show that the ventilation velocity variation has a significant effect on the pool fire burning rate, smoke temperature and the critical ventilation velocity. With increased oxygen depletion in case of increased ethanol content of blended pool fires, the quasi-steady heat release rate values tend to increase as well as the ceiling temperatures while the combustion duration decreases.

  2. Reducing the Risk of ACL Injury in Female Athletes (United States)

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


    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,…


    Institute of Scientific and Technical Information of China (English)

    冉新泽; 阎永堂; 程天民; 林远; 郑怀恩; 魏书庆


    After the rats were iufficted with 8Gy total body gamma ray irradiation and 15% total body surface area (TBSA) full thickness burn injury, they were treated with blood transfusion (BT) and bone marrow transplantation (BMT). Then the survival of allografts grafted on the eschareetomized burn wounds in the 24, 48 and 72 h postinjury was observed. It was found that when the burn wounds were closed with allografts in the 24h postinjury, there were an early elevation of leucocytes, the appearance of the donor''s cells and a significantly higher survival rate of the rats on the 30 day postinjury. The allogaafts could survive longer and wounds showed no signs of infection and healed quicker. When the allografts were grafted in the 48 h or 72 h postinjury, only harmful effects to hasten the death of rats were observed.

  4. 接触性电烧伤的致伤机理和急诊治疗原则分析%Analyze the injury mechanism and emergency treatment principle of electric burn contact

    Institute of Scientific and Technical Information of China (English)



    Objective: To analyze the contact electric burn injury mechanism and emergency treatment principle.Methods:Retrospective analysis of clinical data of 75 cases of contact electric burn patients, to explore the injury mechanism and emergency treatment principle, to ensure that patients get better treatment.Results: 75 cases of patients with treatment, by saving actively targeted therapy, the cure rate was 93.3%; 1 patients with cardiac damage should be died; 4 cases of patients with amputation.Conclusion: Through the analysis of contact burn injury mechanism and emergency treatment principle, take targeted measures to improve patient treatment, the therapeutic effect, reduce the rate of disability, mortality, morbidity played a signiifcant.%目的:分析接触性电烧伤的致伤机理和急诊治疗原则。方法:回顾分析75例接触性电烧伤患者临床资料,探究其致伤机理及急诊治疗原则,确保患者得到更好治疗。结果:75例患者经针对性治疗,经积极抢救针对性治疗,治愈率93.3%;1例患者应心脏损伤抢救无效死亡;4例患者截肢。结论:通过分析接触性烧伤的致伤机理及急诊治疗原则,采取针对性治疗措施,对提高患者治疗效果,降低致残率、致死率、致病率起到显著意义。

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

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    Oguz Kayiran


    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.

  6. Extracorporeal Shock Wave Therapy Suppresses the Early Proinflammatory Immune Response to a Severe Cutaneous Burn Injury (United States)


    markedly reduced in ESWT-treated wounds. Reduced CD14, PGE2s, nitric oxide synthase (NOS-2) and Lipopolysac- charide (LPS)-binding protein transcript...1 promotes expression of IL-1b, MIP-2, MSP, IL-1ra, CCR5 , CCR3, Il-11, CCR4 and CD3Z both in vivo and in vitro (29). Self-resolving inflammation is a

  7. Burn care in South Africa: a micro cosmos of Africa. (United States)

    Rode, H; Cox, S G; Numanoglu, A; Berg, A M


    Burn injuries in Africa are common with between 300,000 and 17.5 million children under 5 years sustaining burn injuries annually, resulting in a high estimated fatality rate. These burns are largely environmentally conditioned and therefore preventable. The Western Cape Province in South Africa can be regarded as a prototype of paediatric burns seen on the continent, with large numbers, high morbidity and mortality rates and an area inclusive of all factors contributing to this extraordinary burden of injury. Most of the mechanisms to prevent burns are not easily modified due to the restraint of low socio-economic homes, overcrowding, unsafe appliances, multiple and complex daily demands on families and multiple psycho-social stressors. Children <4 years are at highest risk of burns with an average annual rate of 6.0/10,000 child-years. Burn care in South Africa is predominantly emergency driven and variable in terms of organization, clinical management, facilities and staffing. Various treatment strategies were introduced. The management of HIV positive children poses a problem, as well as the conflict of achieving equity of burn care for all children. Without alleviating poverty, developing minimum standards for housing, burn education, safe appliances and legislation, we will not be able to reduce the "curse of poor people" and will continue to treat the consequences.

  8. Cast Saw Burns: Evaluation of Simple Techniques for Reducing the Risk of Thermal Injury (United States)


    70% isopropyl alcohol applied with cotton cast padding, gauze dressing, or commercially available alcohol pads, and ultrasound gel applied with gauze...Applying 70% isopropyl alcohol with a commercially available pad or ultrasound gel on a gauze dressing only required 9.0 and 10.2 seconds, respectively...padding, gauze dressing, or commercially available alcohol prep pads (WEBCOL 2-ply medium Alcohol Prep; Kendall), and ultrasound gel (Grafco Ultrasound Gel

  9. Total liquid ventilation reduces oleic acid-induced lung injury in piglets

    Institute of Scientific and Technical Information of China (English)

    ZHU Yao-bin; LIU Dong-hai; ZHANG Yan-bo; LIU Ai-jun; FAN Xiang-ming; QIAO Chen-hui; WANG Qiang


    Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury.The aim of this study is to investigate the effect of total liquid ventilation on oleic acid (OA)-induced lung injury in piglets.Methods Twelve Chinese immature piglets were induced acute lung injury by OA.Twelve piglets were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes.Samples for blood gas analysis were collected before,and at 60-minute intervals after OA-induced lung injury.The degree of lung injury was quantified by histologic examination.The inflammatory cells and the levels of IL-1β,IL-6,IL-10 and TNF-α in plasma,tissue and bronchoalveolar lavage were analyzed.Results Neutrophil and macrophage counts in bronchoalveolar lavage were significantly decreased in the study group (P<0.05).The total lung injury score was also reduced in the study group (P<0.05).The cconcentrations of IL-1β,IL-6,IL-10and TNF-α in plasma,tissue and bronchoalveolar lavage were significantly reduced in the study group (P<0.05).Conclusions Total liquid ventilation reduces biochemical and histologic OA-induced lung injury in piglets.

  10. Acute Blast Injury Reduces Brain Abeta in Two Rodent Species (United States)


    De Gasperi 1,2,3, Miguel A. Gama Sosa1,2,3, Soong Ho Kim4, John W. Steele4,5, Michael C. Shaughness6, Eric Maudlin-Jeronimo6, Aaron A. Hall 6...Wetzlar, Ger- many). Immunohistochemical staining was performed as previ- ously described ( Gama Sosa et al., 2010) using a rabbit anti-APP antibody APP369...Traumatic brain injury: football, warfare, and long- term effects. N. Engl. J. Med. 363, 1293–1296. Elder, G. A., Dorr, N. P., De Gasperi, R., Gama Sosa, M. A

  11. Pediatric Burns in the Bedouin Population in Southern Israel

    Directory of Open Access Journals (Sweden)

    Arnon D. Cohen


    Full Text Available Burn trauma is an important public health concern, with increased risk for burns in children. A cross-sectional study was performed to describe the epidemiological characteristics and risk factors for burns in hospitalized Bedouin children in Soroka University Medical Center during the years 2001–2002. In a population of 558 hospitalized burn-injured patients, 282 Bedouin children were identified. Two hundred and sixty five patients (94.0% had burns involving less than 20% of the body surface area. Cause of the burns was scald in 190 patients (67.4%, fire in 80 patients (28.4%, chemical in 8 patients (2.8%, and explosion in 2 patients (0.7%. Two female patients (0.7% aged 11 and 17 years died of their burns that were caused by fire. The mean length of hospitalization was 9.8 days. Pediatric burn injury has become a significant public health problem in the Bedouin population of the Negev. To reduce the burden of burn injury, it is necessary to increase current efforts in prevention of burns.

  12. Unusual Burn as a Complication of Paraplegia Treatment Caused by an Electrotherapy Device

    Directory of Open Access Journals (Sweden)

    Celalettin Sever


    have not been reported earlier. We report the case of a 21-yearold man who suffered full thickness burns by electrical stimulation with electrode implanted on the anterior side of his left thigh. The burn area was treated consevatively within five weeks without any surgery. The burn injuries due to electrotherapy device are preventable and therefore, some basic measures may reduce the incidence of accidental burn injury. We hope that this case report will raise awareness about the dangers involved in the ever-increasing use of electrotherapy devices.

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

    KAUST Repository

    Heumueller, Thomas


    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.

  14. Creatine supplementation reduces doxorubicin-induced cardiomyocellular injury. (United States)

    Santacruz, Lucia; Darrabie, Marcus D; Mantilla, Jose Gabriel; Mishra, Rajashree; Feger, Bryan J; Jacobs, Danny O


    Heart failure is a common complication of doxorubicin (DOX) therapy. Previous studies have shown that DOX adversely impacts cardiac energy metabolism, and the ensuing energy deficiencies antedate clinical manifestations of cardiac toxicity. Brief exposure of cultured cardiomyocytes to DOX significantly decreases creatine transport, which is the cell's sole source of creatine. We present the results of a study performed to determine if physiological creatine supplementation (5 mmol/L) could protect cardiomyocytes in culture from cellular injury resulting from exposure to therapeutic levels of DOX. Creatine supplementation significantly decreased cytotoxicity, apoptosis, and reactive oxygen species production caused by DOX. The protective effect was specific to creatine and depended on its transport into the cell.

  15. Pretreatment with erythropoietin reduces hepatic ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Yu-Hong Luo; Zheng-Dong Li; Li-Xin Liu; Gao-Hong Dong


    BACKGROUND: During hepatectomy, a period of ischemia and restoration of the blood supply can result in hepatic ischemia-reperfusion injury (IRI). Current research indicates that erythropoietin (EPO) has a protective effect in animal models of cerebral ischemia, myocardial infarction, and renal IRI. However there is lack of research into the role of EPO in hepatic IRI. This study aimed to explore the role of EPO in hepatic IRI and its possible mechanism of action. METHODS: Thirty male Sprague-Dawley rats were divided into three groups: (1) ten rats in the experimental group were given 1000 IU/kg EPO one day before the operation; (2) ten rats in a control group were given normal saline preoperatively as a placebo; and (3) ten rats served as a sham-operated group. Hepatic IRI was induced by occluding the hepatic arteries of the three cephalad hepatic segments and the portal vein for about 45 minutes, while in the sham-operated group only laparotomy was performed. The levels of ALT and AST were tested 24 hours pre- and post-operation. All rats were sacriifced 24 hours after the operation to assess the pathologic changes in the liver and measure the expression of heme oxygenase-1 (HO-1) through Western blotting and RT-PCR. RESULTS: Hepatic IRI was markedly mitigated in the experimental group as compared with the control group. Moreover, the expression of HO-1 at the level of both transcription and protein increased prominently (P<0.05) in the experimental group. CONCLUSION: These results demonstrate that EPO can up-regulate HO-1 in liver tissues and accordingly decrease hepatic injury through its anti-inlfammatory property.

  16. 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


    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.

  17. Burns and epilepsy--review and case report. (United States)

    Gragnani, Alfredo; Müller, Bruno Rafael; Oliveira, Andrea Fernandes; Ferreira, Lydia Masako


    Decompensation of epilepsy in burned patients may be caused by several factors. Burn is a classic etiology of systemic inflammatory response syndrome, and evolves into two physiological phases. The first 48h after injury corresponds to the first phase involving severe hypovolemic shock. The second phase corresponds to the hypermetabolic response to burns. Altered pharmacokinetics of anticonvulsant drugs is observed. Albumin and other plasma proteins are reduced, leading to increased free fraction of phenytoin, resulting in greater clearance and a lower total drug concentration. Associated with metabolic changes of burned patient, this fact predisposes to seizures in epileptic burned patients. The authors present the case of an epileptic 36-year-old-woman who developed recurrent seizures after a thermal injury, despite using the same medications and doses of anticonvulsant drugs of last 12 years, with controlled epilepsy.

  18. 特殊部位和特殊原因烧伤需要个性化治疗%Treatment should be individualized for burn injury in extraordinary regions or caused by uncommon agents

    Institute of Scientific and Technical Information of China (English)



    Burn wounds in extraordinary regions or caused by uncommon agents need individualized treatment according to their individual particularity.A perusal of papers to be published in this issue showed that most of burn units have paid attention to burn injuries pertaining to this category in their regular performance,and individualized treatment has been advocated.Accordingly,the treatment result of burns of this category has been improved.Furtbermore,aesthetic and functional recovery has also been emphasized,thus the quality of life of the victim has been improved evidently,and they are able to return to family and society early.

  19. Antecedent thermal injury worsens split-thickness skin graft quality: A clinically relevant porcine model of full-thickness burn, excision and grafting. (United States)

    Carlsson, Anders H; Rose, Lloyd F; Fletcher, John L; Wu, Jesse C; Leung, Kai P; Chan, Rodney K


    Current standard of care for full-thickness burn is excision followed by autologous split-thickness skin graft placement. Skin grafts are also frequently used to cover surgical wounds not amenable to linear closure. While all grafts have potential to contract, clinical observation suggests that antecedent thermal injury worsens contraction and impairs functional and aesthetic outcomes. This study evaluates the impact of antecedent full-thickness burn on split-thickness skin graft scar outcomes and the potential mediating factors. Full-thickness contact burns (100°C, 30s) were created on the backs of anesthetized female Yorkshire Pigs. After seven days, burn eschar was tangentially excised and covered with 12/1000th inch (300μm) split-thickness skin graft. For comparison, unburned wounds were created by sharp excision to fat before graft application. From 7 to 120days post-grafting, planimetric measurements, digital imaging and biopsies for histology, immunohistochemistry and gene expression were obtained. At 120days post-grafting, the Observer Scar Assessment Scale, colorimetry, contour analysis and optical graft height assessments were performed. Twenty-nine porcine wounds were analyzed. All measured metrics of clinical skin quality were significantly worse (pskin graft quality, likely by multiple mechanisms including burn-related inflammation, microscopically inadequate excision, and dysregulation of tissue remodeling. A valid, reliable, clinically relevant model of full-thickness burn, excision and skin replacement therapy has been demonstrated. Future research to enhance quality of skin replacement therapies should be directed toward modulation of inflammation and assessments for complete excision.

  20. Oral Administration of Escin Inhibits Acute Inflammation and Reduces Intestinal Mucosal Injury in Animal Models

    Directory of Open Access Journals (Sweden)

    Minmin Li


    Full Text Available The present study aimed to investigate the effects of oral administration of escin on acute inflammation and intestinal mucosal injury in animal models. The effects of escin on carrageenan-induced paw edema in a rat model of acute inflammation, cecal ligation and puncture (CLP induced intestinal mucosal injury in a mouse model, were observed. It was shown that oral administration of escin inhibits carrageenan-induced paw edema and decreases the production of prostaglandin E2 (PGE2 and cyclooxygenase- (COX- 2. In CLP model, low dose of escin ameliorates endotoxin induced liver injury and intestinal mucosal injury and increases the expression of tight junction protein claudin-5 in mice. These findings suggest that escin effectively inhibits acute inflammation and reduces intestinal mucosal injury in animal models.

  1. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram


    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  2. Effects of fluid resuscitation methods on the pro- and anti-inflammatory cytokines and expression of adhesion molecules after burn injury. (United States)

    Foldi, Viktor; Lantos, Janos; Bogar, Lajos; Roth, Elizabeth; Weber, Gyorgy; Csontos, Csaba


    Fluid resuscitation management can influence inflammatory response after burn injury. The aim of this study was to analyze the effects of two fluid resuscitation methods on the cytokine production and on the expression of the leukocyte surface markers. Thirty patients were included in this prospective randomized study with burn injury affecting more than 20% of the body surface area. Fluid resuscitation was guided by hourly urine output (HUO, n = 15) or by intrathoracic blood volume index (ITBVI, n = 15). Blood samples were taken on admission and on the next five consecutive mornings. Concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha were measured in phorbol myristate acetate-stimulated and -nonstimulated samples. Leukocyte surface marker expressions (CD11a, CD11b, CD14, CD18, CD49d, and CD97) were also determined. In the ITBVI group, IL-6 levels on days 2 to 3 and IL-6/IL-10 ratios on days 2 to 3, and the IL-8/IL-10 ratios on days 3 to 5 were significantly higher than those in HUO group (P burned patients suppresses the shift toward anti-inflammatory imbalance and the expression of leukocyte surface markers more than HUO-guided resuscitation.

  3. Systematic care management: a comprehensive approach to catastrophic injury management applied to a catastrophic burn injury population--clinical, utilization, economic, and outcome data in support of the model. (United States)

    Kucan, John; Bryant, Ernest; Dimick, Alan; Sundance, Paula; Cope, Nathan; Richards, Reginald; Anderson, Chris


    The new standard for successful burn care encompasses both patient survival and the burn patient's long-term quality of life. To provide optimal long-term recovery from catastrophic injuries, including catastrophic burns, an outcome-based model using a new technology called systematic care management (SCM) has been developed. SCM provides a highly organized system of management throughout the spectrum of care that provides access to outcome data, consistent oversight, broader access to expert providers, appropriate allocation of resources, and greater understanding of total costs. Data from a population of 209 workers' compensation catastrophic burn cases with a mean TBSA of 27.9% who were managed under the SCM model of care were analyzed. The data include treatment type, cost, return to work, and outcomes achieved. Mean duration of management to achieve all guaranteed outcomes was 20 months. Of the 209 injured workers, 152 (72.7%) achieved sufficient recovery to be released to return to work, of which 97 (46.8%) were both released and competitively employed. Assessment of 10 domains of functional independence indicated that 47.2% of injured workers required total assistance at initiation of SCM. However, at termination of SCM, 84% of those injured workers were fully independent in the 10 functional activities. When compared with other burn research outcome data, the results support the value of the SCM model of care.

  4. Critical issues in burn care. (United States)

    Holmes, James H


    Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation.

  5. Thalidomide decreases the plasma levels of IL-1 and TNF following burn injury: is it a new drug for modulation of systemic inflammatory response. (United States)

    Eski, Muhitdin; Sahin, Ismail; Sengezer, Mustafa; Serdar, Muhittin; Ifran, Ahmet


    TNF and IL-1, which are produced from phagocytic cells, can produce a significant systemic inflammatory response independently by inducing systemic leukocyte and endothelial cell activation. These cytokines play a pivotal role in development of systemic inflammatory response after severe burn. Thalidomide has been shown to decrease the secretion of TNF from phagocytic cells, therefore suppression of TNF and IL-1 production from activated phagocytic cells might be a successful treatment modality for prevention of systemic inflammatory response following severe burn. To address this issue, we aimed to show whether thalidomide treatment decreased or suppressed plasma levels of TNF and IL-1 following burn in rats. Following the injury, 36 rats were randomly separated into two experimental groups at the third and seventh days. Rats in the experimental group had oral thalidomide (10mg/kg day) treatment for three and seven consecutive days whereas animals in control groups had no treatment. Thalidomide treatment decreased TNF and IL-1 significantly in both experimental groups at both the points (PTNF and IL-1, we speculate that thalidomide may have modulatory effect on the systemic inflammatory response after burn by decreasing plasma levels of TNF and IL-1.

  6. 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


    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.

  7. Virtual Reality Pain Control During Burn Wound Debridement of Combat-Related Burn Injuries Using Robot-Like Arm Mounted VR Goggles (United States)


    sessions as part of their recovery. For patients with severe burns, wound care/debridement typically involves cleaning the wound and scrubbing dead skin... Surgical Research (C.V.M., M.M., A.M., K.G., L.L.M., P.A.D.), Brooke Army Medical Center, Fort Sam, Houston, Texas; and University of Washington (H.G.H...Seattle, Washington. Supported by U.S. Army Institute of Surgical Research. Hoffman’s time was funded with help from the Gustavus and Louise Pfieffer

  8. 吸入性损伤气管切开问题的临床讨论%Clinical Discussion on Tracheotomy in Burn Patients with Inhalation Injury

    Institute of Scientific and Technical Information of China (English)

    孙志刚; 李占军


    Purpose: The opportunity and indication of tracheotomy in burn patients with complicated inhalation injury were discussed. Method: 173 patients with inhalation injury treated during 1981~1998 were reviewed. The severity of injury were 94 minor, 53 moderate and 27 severe. Tracheotomy was performed on 57 patients. Result: 56 patients died. Though mortality had close correlation with burn severity, the main reason for death was attributable to severity of inhalation injury. For patients being performed with tracheotomy within 24 hours postburn, the mortality was relatively low. Conclusion: The earliest tracheotomy is recommended for moderate and severe inhalation injuries.%目的:为了进一步探讨吸入性损伤病人的气管切开时机与指征。方法:回顾性总结分析了1981~1998年173例吸入性损伤的处理方法。他们中轻、中、重度吸入性损伤分别为94.53和27例,行气管切开者57例。结果:全组死亡56例,病死率与烧伤伤情有一定关系,但主要死因仍为吸入性损伤程度,24小时之内行气管切开者病死率偏低。结论:中、重度吸入性损伤宜尽早实行气管切开治疗,并有预防意义。

  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


    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. Reducing ventilator-induced lung injury and other organ injury by the prone position (United States)

    Suter, Peter M


    Mechanical ventilation can cause structural and functional disturbances in the lung, as well as other vital organ dysfunctions. Apoptosis is thought to be a histological sign of distant organ damage in ventilator-induced lung injury (VILI). Nakos and colleagues observed a protective effect of prone positioning against VILI in normal sheep. Less alteration in the lung architecture and function and in liver transaminases, and lower indices for apoptosis in the liver, the diaphragm and the lung were noted in the prone position compared with the supine position. If confirmed, these data open a new hypothesis for pathogenesis and prevention of VILI and its extrapulmonary complications. PMID:16677405

  11. Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches. (United States)

    Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves


    After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

  12. [Treatment of burns in infants]. (United States)

    Foyatier, J L; Latarjet, J; Comparin, J P; Zaragori, M; Robert, A; Braye, F; Weill, E; Masson, C L


    Because of the potential severity of their residual deformities, burn injuries in infants justify an early management in specialized centres when they cover more than 5% of body surface and in every case when hands, face, or external genitalia are concerned. Cooling with cold water is the first aid treatment to be performed as early as possible after the injury. The treatment in specialized centres must be both general and surgical. General treatment includes fluid and electrolyte therapy, temperature control, appropriate nutrition and pain suppression. Pain suppression is a major part of the treatment and morphine must be largely used. Surgical treatment starts as soon as the patient arrives in the centre and is eventually performed under general anesthesia: all the burned areas are covered with occlusive dressings. Infections are prevented by systematic cultures and adjusted antibiotic therapy. A vigorous rehabilitation program must be instituted as soon as possible: massages, compressive clothes, splints, physical therapy, plastic surgery. Primary prevention by sustained parental education is important in order to reduce the frequency of burn injuries in infants.

  13. S-Nitrosoglutathione reduces oxidative injury and promotes mechanisms of neurorepair following traumatic brain injury in rats

    Directory of Open Access Journals (Sweden)

    Gilg Anne G


    Full Text Available Abstract Background Traumatic brain injury (TBI induces primary and secondary damage in both the endothelium and the brain parenchyma, collectively termed the neurovascular unit. While neurons die quickly by necrosis, a vicious cycle of secondary injury in endothelial cells exacerbates the initial injury in the neurovascular unit following TBI. In activated endothelial cells, excessive superoxide reacts with nitric oxide (NO to form peroxynitrite. Peroxynitrite has been implicated in blood brain barrier (BBB leakage, altered metabolic function, and neurobehavioral impairment. S-nitrosoglutathione (GSNO, a nitrosylation-based signaling molecule, was reported not only to reduce brain levels of peroxynitrite and oxidative metabolites but also to improve neurological function in TBI, stroke, and spinal cord injury. Therefore, we investigated whether GSNO promotes the neurorepair process by reducing the levels of peroxynitrite and the degree of oxidative injury. Methods TBI was induced by controlled cortical impact (CCI in adult male rats. GSNO or 3-Morpholino-sydnonimine (SIN-1 (50 μg/kg body weight was administered orally two hours following CCI. The same dose was repeated daily until endpoints. GSNO-treated (GSNO group or SIN-1-treated (SIN-1 group injured animals were compared with vehicle-treated injured animals (TBI group and vehicle-treated sham-operated animals (Sham group in terms of peroxynitrite, NO, glutathione (GSH, lipid peroxidation, blood brain barrier (BBB leakage, edema, inflammation, tissue structure, axon/myelin integrity, and neurotrophic factors. Results SIN-1 treatment of TBI increased whereas GSNO treatment decreased peroxynitrite, lipid peroxides/aldehydes, BBB leakage, inflammation and edema in a short-term treatment (4-48 hours. GSNO also reduced brain infarctions and enhanced the levels of NO and GSH. In a long-term treatment (14 days, GSNO protected axonal integrity, maintained myelin levels, promoted synaptic plasticity

  14. Is the Target of 1 Day of Stay per 1% Total Body Surface Area Burned Achieved in Chemical Burns? (United States)

    Tan, Teresa; Wong, David S Y


    The length of hospital stay (LOS) is a standard parameter used to reflect quality and evaluate outcomes in acute burn care. This study aims to assess whether the target of 1 day of stay per 1% total body surface area (TBSA) burned was achieved in acute chemical burns management and factors affecting the LOS. A retrospective analysis of the records of patients who suffered from chemical burn injuries admitted to a university burn center over a continuous 14-year period was performed.A total of 118 patients were admitted over the period for chemical burns. Only 14% of cases achieved the target stated. Factors associated with lengthening of the hospital stay included TBSA, ocular involvement, the cause of injury, and the need for surgery during the same admission.The LOS in chemical burns frequently exceeds 1 day of stay per 1% TBSA burned. Many factors can contribute to a patient's LOS and are worth exploring in order to see if the impact of these factors could be minimized. Early surgical intervention should help to reduce the LOS if reliable methods of burn wound depth assessment are available.

  15. 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: [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: [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)


    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.


    Directory of Open Access Journals (Sweden)

    Jangpreet Singh


    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

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

    LENUS (Irish Health Repository)

    Yates, J


    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\\

  18. Telemedicine and burns: an overview. (United States)

    Atiyeh, B; Dibo, S A; Janom, H H


    Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

  19. The year in burns 2011. (United States)

    Wolf, Steven E; Arnoldo, Brett D


    For 2011, approximately 1746 original research articles in burns were published in English in scientific journals. This article reviews those with the most potential impact on for burn therapeutics and outcomes according to the Editor of one of the major journals (Burns) and his colleague. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterisation, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.

  20. Boric acid reduces axonal and myelin damage in experimental sciatic nerve injury

    Institute of Scientific and Technical Information of China (English)

    Zahir Kzlay; Haydar Ali Erken; Nesibe Kahraman etin; Serdar Akta; Burin rem Abas; Ali Ylmaz


    hTe aim of this study was to investigate the effects of boric acid in experimental acute sciatic nerve injury. Twenty-eight adult male rats were randomly divided into four equal groups (n = 7): control (C), boric acid (BA), sciatic nerve injury (I) , and sciatic nerve injury + boric acid treatment (BAI). Sciatic nerve injury was generated using a Yasargil aneurysm clip in the groups I and BAI. Boric acid was given four times at 100 mg/kg to rats in the groups BA and BAI atfer injury (by gavage at 0, 24, 48 and 72 hours) but no injury was made in the group BA.In vivo electrophysiological tests were performed at the end of the day 4 and sciatic nerve tissue samples were taken for histopathological examination. The amplitude of compound action potential, the nerve conduction velocity and the number of axons were signiifcantly lower and the myelin structure was found to be broken in group I compared with those in groups C and BA. However, the amplitude of the compound action potential, the nerve conduction velocity and the number of axons were signiifcantly greater in group BAI than in group I. Moreover, myelin injury was signiifcantly milder and the intensity of nuclear factor kappa B immunostaining was signiifcantly weaker in group BAI than in group I. hTe results of this study show that administration of boric acid at 100 mg/kg atfer sciatic nerve injury in rats markedly reduces myelin and axonal injury and improves the electrophysiological function of injured sciatic nerve possibly through alleviating oxidative stress reactions.

  1. Boric acid reduces axonal and myelin damage in experimental sciatic nerve injury (United States)

    Kızılay, Zahir; Erken, Haydar Ali; Çetin, Nesibe Kahraman; Aktaş, Serdar; Abas, Burçin İrem; Yılmaz, Ali


    The aim of this study was to investigate the effects of boric acid in experimental acute sciatic nerve injury. Twenty-eight adult male rats were randomly divided into four equal groups (n = 7): control (C), boric acid (BA), sciatic nerve injury (I), and sciatic nerve injury + boric acid treatment (BAI). Sciatic nerve injury was generated using a Yasargil aneurysm clip in the groups I and BAI. Boric acid was given four times at 100 mg/kg to rats in the groups BA and BAI after injury (by gavage at 0, 24, 48 and 72 hours) but no injury was made in the group BA. In vivo electrophysiological tests were performed at the end of the day 4 and sciatic nerve tissue samples were taken for histopathological examination. The amplitude of compound action potential, the nerve conduction velocity and the number of axons were significantly lower and the myelin structure was found to be broken in group I compared with those in groups C and BA. However, the amplitude of the compound action potential, the nerve conduction velocity and the number of axons were significantly greater in group BAI than in group I. Moreover, myelin injury was significantly milder and the intensity of nuclear factor kappa B immunostaining was significantly weaker in group BAI than in group I. The results of this study show that administration of boric acid at 100 mg/kg after sciatic nerve injury in rats markedly reduces myelin and axonal injury and improves the electrophysiological function of injured sciatic nerve possibly through alleviating oxidative stress reactions. PMID:27904499

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

    Directory of Open Access Journals (Sweden)

    Ai-Jiao Xiao


    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.

  3. Effect of Extracorporeal Shock Wave Treatment on Deep Partial-Thickness Burn Injury in Rats: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gabriel Djedovic


    Full Text Available Extracorporeal shock wave therapy (ESWT enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N=15, but not to group 2 (N=15. On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P<0.05. The reepithelialization rate was improved significantly on day 15 (P<0.05. The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.

  4. Hand chemical burns. (United States)

    Robinson, Elliot P; Chhabra, A Bobby


    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  5. Evaluating the effectiveness of a participatory ergonomics approach in reducing the risk and severity of injuries from manual handling. (United States)

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


    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.

  6. 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


    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.

  7. Epoetin Alpha and Epoetin Zeta: A Comparative Study on Stimulation of Angiogenesis and Wound Repair in an Experimental Model of Burn Injury. (United States)

    Irrera, Natasha; Bitto, Alessandra; Pizzino, Gabriele; Vaccaro, Mario; Squadrito, Francesco; Galeano, Mariarosaria; Stagno d'Alcontres, Francesco; Stagno d'Alcontres, Ferdinando; Buemi, Michele; Minutoli, Letteria; Colonna, Michele Rosario; Altavilla, Domenica


    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.

  8. Burn Pits (United States)

    ... Enter ZIP code here Enter ZIP code here Burn Pits Burn Pits Registry Studies Photo: U.S. Department ... the health of deployed Veterans. Health effects from burn pit smoke Toxins in burn pit smoke may ...

  9. The global burden of child burn injuries in light of country level economic development and income inequality. (United States)

    Sengoelge, Mathilde; El-Khatib, Ziad; Laflamme, Lucie


    Child burn mortality differs widely between regions and is closely related to material deprivation, but reports on their global distribution are few. Investigating their country level distribution in light of economic level and income inequality will help assess the potential for macro-level improvements. We extracted data for child burn mortality from the Global Burden of Disease study 2013 and combined data into 1-14 years to calculate rates at country, region and income levels. We also compiled potential lives saved. Then we examined the relationship between country level gross domestic product per capita from the World Bank and income inequality (Gini Index) from the Standardized World Income Inequality Database and child burn mortality using Spearman coefficient correlations. Worldwide, the burden of child burn deaths is 2.5 per 100,000 across 103 countries with the largest burden in Sub-Saharan Africa (4.5 per 100,000). Thirty-four thousand lives could be saved yearly if all countries in the world had the same rates as the best performing group of high-income countries; the majority in low-income countries. There was a negative graded association between economic level and child burns for all countries aggregated and at regional level, but no consistent pattern existed for income inequality at regional level. The burden of child burn mortality varies by region and income level with prevention efforts needed most urgently in middle-income countries and Sub-Saharan Africa. Investment in safe living conditions and access to medical care are paramount to achieving further reductions in the global burden of preventable child burn deaths.

  10. Update on the critical care management of severe burns. (United States)

    Kasten, Kevin R; Makley, Amy T; Kagan, Richard J


    Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population.

  11. Riboflavin (vitamin B-2) reduces hepatocellular injury following liver ischaemia and reperfusion in mice. (United States)

    Sanches, Sheila Cristina; Ramalho, Leandra Naira Z; Mendes-Braz, Mariana; Terra, Vânia Aparecida; Cecchini, Rubens; Augusto, Marlei Josiele; Ramalho, Fernando Silva


    Riboflavin has been shown to exhibit anti-inflammatory and antioxidant properties in the settings of experimental sepsis and ischaemia/reperfusion (I/R) injury. We investigated the effect of riboflavin on normothermic liver I/R injury. Mice were submitted to 60 min of ischaemia plus saline or riboflavin treatment (30 μmoles/kg BW) followed by 6 h of reperfusion. Hepatocellular injury was evaluated by aminotransferase levels, reduced glutathione (GSH) content and the histological damage score. Hepatic neutrophil accumulation was assessed using the naphthol method and by measuring myeloperoxidase activity. Hepatic oxidative/nitrosative stress was estimated by immunohistochemistry. Liver endothelial and inducible nitric oxide synthase (eNOS/iNOS) and nitric oxide (NO) amounts were assessed by immunoblotting and a chemiluminescence assay. Riboflavin significantly reduced serum and histological parameters of hepatocellular damage, neutrophil infiltration and oxidative/nitrosative stress. Furthermore, riboflavin infusion partially recovered hepatic GSH reserves and decreased the liver contents of eNOS/iNOS and NO. These data indicate that riboflavin exerts antioxidant and anti-inflammatory effects in the ischaemic liver, protecting hepatocytes against I/R injury. The mechanism of these effects appears to be related to the intrinsic antioxidant potential of riboflavin/dihydroriboflavin and to reduced hepatic expression of eNOS/iNOS and reduced NO levels, culminating in attenuation of oxidative/nitrosative stress and the acute inflammatory response.

  12. The year in burns 2008. (United States)

    Wolf, Steven E


    For 2008, approximately 1200 original burn research articles were published in scientific journals using the English language. This article reviews those with the most impact on burn treatment according to the Editor of one of the major journals (Burns). As in the previous year's review, articles were divided into the following topic areas: epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.

  13. Is a cognitive-behavioural biofeedback intervention useful to reduce injury risk in junior football players? (United States)

    Edvardsson, Arne; Ivarsson, Andreas; Johnson, Urban


    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

  14. 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


    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.

  15. Insulin Reduces Cerebral Ischemia/Reperfusion Injury in the Hippocampus of Diabetic Rats


    Collino, Massimo; Aragno, Manuela; Castiglia, Sara; Tomasinelli, Chiara; Thiemermann, Christoph; Boccuzzi, Giuseppe; Fantozzi, Roberto


    OBJECTIVE—There is evidence that insulin reduces brain injury evoked by ischemia/reperfusion (I/R). However, the molecular mechanisms underlying the protective effects of insulin remain unknown. Insulin is a well-known inhibitor of glycogen synthase kinase-3β (GSK-3β). Here, we investigate the role of GSK-3β inhibition on I/R-induced cerebral injury in a rat model of insulinopenic diabetes. RESEARCH DESIGN AND METHODS—Rats with streptozotocin-induced diabetes were subjected to 30-min occlusio...

  16. History of burns: The past, present and the future. (United States)

    Lee, Kwang Chear; Joory, Kavita; Moiemen, Naiem S


    Burn injuries are one of the most common and devastating afflictions on the human body. In this article we look back at how the treatment of burns has evolved over the centuries from a primarily topical therapy consisting of weird and wonderful topical concoctions in ancient times to one that spans multiple scientific fields of topical therapy, antibiotics, fluid resuscitation, skin excision and grafting, respiratory and metabolic care and nutrition. Most major advances in burn care occurred in the last 50 years, spurred on by wars and great fires. The use of systemic antibiotics and topical silver therapy greatly reduced sepsis related mortality. This along with the advent of antiseptic surgical techniques, burn depth classification and skin grafting allowed the excision and coverage of full-thickness burns which resulted in greatly improved survival rates. Advancements in the methods of assessing the surface area of burns paved way for more accurate fluid resuscitation, minimising the effects of shock and avoiding fluid over-loading. The introduction of metabolic care, nutritional support and care of inhalational injuries further improved the outcome of burn patients. We also briefly discuss some future directions in burn care such as the use of cell and pharmalogical therapies.

  17. History of burns: The past, present and the future

    Directory of Open Access Journals (Sweden)

    Kwang Chear Lee


    Full Text Available Burn injuries are one of the most common and devastating afflictions on the human body. In this article we look back at how the treatment of burns has evolved over the centuries from a primarily topical therapy consisting of weird and wonderful topical concoctions in ancient times to one that spans multiple scientific fields of topical therapy, antibiotics, fluid resuscitation, skin excision and grafting, respiratory and metabolic care and nutrition. Most major advances in burn care occurred in the last 50 years, spurred on by wars and great fires. The use of systemic antibiotics and topical silver therapy greatly reduced sepsis related mortality. This along with the advent of antiseptic surgical techniques, burn depth classification and skin grafting allowed the excision and coverage of full-thickness burns which resulted in greatly improved survival rates. Advancements in the methods of assessing the surface area of burns paved way for more accurate fluid resuscitation, minimising the effects of shock and avoiding fluid over-loading. The introduction of metabolic care, nutritional support and care of inhalational injuries further improved the outcome of burn patients. We also briefly discuss some future directions in burn care such as the use of cell and pharmalogical therapies.

  18. 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)


    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.

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

    LENUS (Irish Health Repository)

    Donnelly, J


    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. Normothermic machine perfusion reduces bile duct injury and improves biliary epithelial function in rat donor livers. (United States)

    Op den Dries, Sanna; Karimian, Negin; Westerkamp, Andrie C; Sutton, Michael E; Kuipers, Michiel; Wiersema-Buist, Janneke; Ottens, Petra J; Kuipers, Jeroen; Giepmans, Ben N; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J


    Bile duct injury may occur during liver procurement and transplantation, especially in livers from donation after circulatory death (DCD) donors. Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury compared to static cold storage (SCS). However, it is unknown whether NMP provides better preservation of bile ducts. The aim of this study was to determine the impact of NMP on bile duct preservation in both DCD and non-DCD livers. DCD and non-DCD livers obtained from Lewis rats were preserved for 3 hours using either SCS or NMP, followed by 2 hours ex vivo reperfusion. Biomarkers of bile duct injury (gamma-glutamyltransferase and lactate dehydrogenase in bile) were lower in NMP-preserved livers compared to SCS-preserved livers. Biliary bicarbonate concentration, reflecting biliary epithelial function, was 2-fold higher in NMP-preserved livers (P < 0.01). In parallel with this, the pH of the bile was significantly higher in NMP-preserved livers (7.63 ± 0.02 and 7.74 ± 0.05 for non-DCD and DCD livers, respectively) compared with SCS-preserved livers (7.46 ± 0.02 and 7.49 ± 0.04 for non-DCD and DCD livers, respectively). Scanning and transmission electron microscopy of donor extrahepatic bile ducts demonstrated significantly decreased injury of the biliary epithelium of NMP-preserved donor livers (including the loss of lateral interdigitations and mitochondrial injury). Differences between NMP and SCS were most prominent in DCD livers. Compared to conventional SCS, NMP provides superior preservation of bile duct epithelial cell function and morphology, especially in DCD donor livers. By reducing biliary injury, NMP could have an important impact on the utilization of DCD livers and outcome after transplantation. Liver Transplantation 22 994-1005 2016 AASLD.

  1. Strength Training Reduces Injury Rate in Elite Young Soccer Players During One Season. (United States)

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


    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.

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

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    Oludiran O


    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.

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

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    Juliann G. Kiang


    Full Text Available 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.

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

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    Jude-Kennedy C Emejulu


    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.

  5. Effect of exercise on burn induced changes in tissue specific glucose metabolism


    Carter, Edward A.; Paul, Kasie; Bonab, Ali A.; TOMPKINS, RONALD G.; Fischman, Alan J.


    Exercise is a component of the clinical management for the burn patients to help reduce muscle wasting associated with prolonged hospitalization. In the present studies we examined 18FDG uptake in mice subjected burn injury with and without exercise. Mice had their the dorsums shaven, the animals were placed in molds and the exposed area was immersed in 90° water for 9 sec followed by resuscitation with saline (2 ml) to produce a 30% full thickness burn injury. 24 hrs later, the mice were sub...

  6. Protect the Ones You Love: Burns Safety (United States)

    ... Child Abuse and Neglect Prevention Youth Violence Prevention Burn Prevention Recommend on Facebook Tweet Share Compartir We ... to prevent leading causes of child injury, like burns, is a step toward this goal. Every day, ...

  7. Calcium antagonists and converting enzyme inhibitors reduce renal injury by different mechanisms. (United States)

    Dworkin, L D; Benstein, J A; Parker, M; Tolbert, E; Feiner, H D


    Both glomerular hypertension and hypertrophy have been associated with the development of glomerular injury in models of hypertension and reduced renal mass. The purpose of this study was to examine the effects of antihypertensive therapy on these parameters in the remnant kidney model of progressive glomerular sclerosis. Rats underwent 5/6 nephrectomy and were randomly assigned to receive either no therapy, the calcium entry blocker (CEB), nifedipine, or the angiotensin converting enzyme inhibitor (CEI), enalapril. Administration of either drug was associated with a reduction in systemic blood pressure and in the severity of glomerular injury assessed eight weeks after renal ablation. Micropuncture studies four weeks after ablation revealed that systemic and glomerular capillary pressure were high in untreated remnant kidney rats and reduced by enalapril. Administration of nifedipine was associated with a decline in systemic pressure, however, plasma renin levels increased, causing efferent arteriolar vasoconstriction and persistence of glomerular hypertension. Morphometric analysis showed that kidney weight, glomerular volume and glomerular capillary radius were lower in nifedipine treated rats than in the other two groups, indicating that the CEB, but not enalapril, inhibited the hypertrophic response to ablation of renal mass. Therefore, both CEIs and CEBs reduce glomerular injury in rats with remnant kidneys but they may act by different mechanisms. CEI reduce glomerular capillary pressure while CEBs inhibit compensatory kidney growth.

  8. Management of burn wounds. (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin


    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  9. Differential reinforcement of other behavior (DRO) to reduce aggressive behavior following traumatic brain injury. (United States)

    Hegel, M T; Ferguson, R J


    Severe brain injury can result in significant neurobehavioral and social functioning impairment. In rehabilitation settings, behavioral problems of aggression and nonadherence to therapeutic activities can pose barriers to maximal recovery of function. Behavioral interventions seem to be effective in reducing problem behavior among individuals recovering from severe brain trauma, but well-controlled studies examining the efficacy of such interventions are sparse. This article presents a single-case, multiple-baseline study of a differential reinforcement of other behavior (DRO) procedure in a 28-year-old, brain-injured male with aggressive behavior problems. The procedure successfully reduced the frequency of problem behavior by up to 74%, maintained at 1-month follow-up. Implications of this intervention for individuals with brain injury are discussed, and testing of this procedure using a between-group design seems indicated.

  10. Melatonin Reduces Inflammatory Injury Through Inhibiting NF-κB Activation in Rats With Colitis

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    Jun-Hua Li


    Full Text Available Proinflammatory mediators are important in the pathogenesis of IBD, which are regulated by activation of NF-κB. The aim of this study was to investigate whether melatonin reduces inflammatory injury and inhibits proinflammatory molecule and NF-κB in rats with colitis. Rat colitis model was established by TNBS enema. NF-κB p65, TNF-α, ICAM-1, and IκBα in colon tissue were examined by immunohistochemistry, EMSA, RT-PCR, and Western blot analysis. Expression of proinflammatory molecule and activation of NF-κB were upregulated and IκB level decreased in rats with colitis. Melatonin reduces colonic inflammatory injury through downregulating proinflammatory molecule mediated by NF-κB inhibition and blockade of IκBα degradation.

  11. Hepatic injury following reduced intensity unrelated cord blood transplantation for adult patients with hematological diseases. (United States)

    Kusumi, Eiji; Kami, Masahiro; Kanda, Yoshinobu; Murashige, Naoko; Seki, Kunihiko; Fujiwara, Masayo; Koyama, Rikako; Komatsu, Tsunehiko; Hori, Akiko; Tanaka, Yuji; Yuji, Koichiro; Matsumura, Tomoko; Masuoka, Kazuhiro; Wake, Atsushi; Miyakoshi, Shigesaburo; Taniguchi, Shuichi


    Liver injury is a common complication in allogeneic hematopoietic stem cell transplantation. Its major causes comprise graft-versus-host disease (GVHD), infection, and toxicities of preparative regimens and immunosuppressants; however, we have little information on liver injuries after reduced intensity cord blood transplantation (RICBT). We reviewed medical records of 104 recipients who underwent RICBT between March 2002 and May 2004 at Toranomon Hospital. Preparative regimen and GVHD prophylaxis comprised fludarabine/melphalan/total body irradiation and cyclosporine or tacrolimus. We assessed the etiology of liver injuries based on the clinical presentation, laboratory results, comorbid events, and imaging studies in 85 patients who achieved primary engraftment. The severity of liver dysfunction was assessed according to the National Cancer Institute Common Toxicity Criteria version 2.0. Hyperbilirubinemia was graded according to a report by Hogan et al (Blood. 2004;103:78-84). Moderate to very severe liver injuries were observed in 36 patients. Their causes included cholestatic liver disease (CLD) related to GVHD or sepsis (n = 15), GVHD (n = 7), cholangitis lenta (n = 5), and others (n = 9). Median onsets of CLD, GVHD, and cholangitis lenta were days 37, 40, and 22, respectively. Frequencies of grade 3-4 alanine aminotransferase elevation were comparable across the 3 types of hepatic injuries. Serum gamma-glutamil transpeptidase was not elevated in any patients with cholangitis lenta, whereas 27% and 40% of patients with CLD and GVHD, respectively, developed grade 3-4 gamma-glutamil transpeptidase elevation. Multivariate analysis identified 2 risk factors for hyperbilirubinemia; grade II-IV acute GVHD (relative risk, 2.23; 95% confidential interval, 1.11-4.47; P = .024) and blood stream infection (relative risk, 3.77; 95% confidential interval, 1.91-7.44; P = .00013). In conclusion, the present study has demonstrated that the hepatic injuries are significant

  12. Rapamycin increases neuronal survival, reduces inflammation and astrocyte proliferation after spinal cord injury. (United States)

    Goldshmit, Yona; Kanner, Sivan; Zacs, Maria; Frisca, Frisca; Pinto, Alexander R; Currie, Peter D; Pinkas-Kramarski, Ronit


    Spinal cord injury (SCI) frequently leads to a permanent functional impairment as a result of the initial injury followed by secondary injury mechanism, which is characterised by increased inflammation, glial scarring and neuronal cell death. Finding drugs that may reduce inflammatory cell invasion and activation to reduce glial scarring and increase neuronal survival is of major importance for improving the outcome after SCI. In the present study, we examined the effect of rapamycin, an mTORC1 inhibitor and an inducer of autophagy, on recovery from spinal cord injury. Autophagy, a process that facilitates the degradation of cytoplasmic proteins, is also important for maintenance of neuronal homeostasis and plays a major role in neurodegeneration after neurotrauma. We examined rapamycin effects on the inflammatory response, glial scar formation, neuronal survival and regeneration in vivo using spinal cord hemisection model in mice, and in vitro using primary cortical neurons and human astrocytes. We show that a single injection of rapamycin, inhibited p62/SQSTM1, a marker of autophagy, inhibited mTORC1 downstream effector p70S6K, reduced macrophage/neutrophil infiltration into the lesion site, microglia activation and secretion of TNFα. Rapamycin inhibited astrocyte proliferation and reduced the number of GFAP expressing cells at the lesion site. Finally, it increased neuronal survival and axonogenesis towards the lesion site. Our study shows that rapamycin treatment increased significantly p-Akt levels at the lesion site following SCI. Similarly, rapamycin treatment of neurons and astrocytes induced p-Akt elevation under stress conditions. Together, these findings indicate that rapamycin is a promising candidate for treatment of acute SCI condition and may be a useful therapeutic agent.

  13. Psychiatric aspects of burn

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    Dalal P


    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.

  14. Femoral artery neointimal hyperplasia is reduced after wire injury in Ref-1+/- mice. (United States)

    Basi, David L; Adhikari, Neeta; Mariash, Ami; Li, Qinglu; Kao, Esther; Mullegama, Sureni V; Hall, Jennifer L


    Redox factor-1 (Ref-1) is a multifunctional protein that regulates redox, DNA repair, and the response to cell stress. We previously demonstrated that Ref-1(+/-) mice exhibit a significantly reduced Ref-1 mRNA and protein levels within the vasculature, which are associated with increased oxidative stress. The goal of this study was to test the hypothesis that partial loss of Ref-1 altered the cellular response to vascular injury. Fourteen days after femoral artery wire injury, we found that vessel intima-to-media ratio was significantly reduced in Ref-1(+/-) mice compared with that in wild-type mice (P Ref-1(+/-) mice. In vitro studies found no significant changes in either serum-induced proliferation or baseline apoptosis in Ref-1(+/-) vascular smooth muscle cells. Exposure to Fas ligand; however, did result in increased susceptibility of Ref-1(+/-) vascular smooth muscle cells to apoptosis (P Ref-1(+/-) mice exhibited an increase in circulating baseline levels of IL-10, IL-1alpha, and VEGF compared with those in wild-type mice but a marked impairment in these pathways in response to injury. In sum, loss of a single allele of Ref-1 is sufficient to reduce intimal lesion formation and to alter circulating cytokine and growth factor expression.

  15. Ischemic preconditioning reduces ischemic brain injury by suppressing nuclear factor kappa B expression and neuronal apoptosis

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    Songsheng Shi; Weizhong Yang; Xiankun Tu; Chunmei Chen; Chunhua Wang


    Ischemic stroke induces a series of complex pathophysiological events including blood-brain barrier disruption, inflammatory response and neuronal apoptosis. Previous studies demonstrate that ischemic preconditioning attenuates ischemic brain damage via inhibiting blood-brain barrier disruption and the inflammatory response. Rats underwent transient (15 minutes) occlusion of the bilateral common carotid artery with 48 hours of reperfusion, and were subjected to permanent middle cerebral artery occlusion. This study explored whether ischemic preconditioning could reduce ischemic brain injury and relevant molecular mechanisms by inhibiting neuronal apoptosis. Results found that at 72 hours following cerebral ischemia, myeloperoxidase activity was enhanced, malondialdehyde levels increased, and neurological function was obviously damaged. Simultaneously, neuronal apoptosis increased, and nuclear factor-κB and cleaved caspase-3 expression was significantly increased in ischemic brain tissues. Ischemic preconditioning reduced the cerebral ischemia-induced inflammatory response, lipid peroxidation, and neurological function injury. In addition, ischemic preconditioning decreased nuclear factor-κB p65 and cleaved caspase-3 expression. These results suggested that ischemic preconditioning plays a protective effect against ischemic brain injury by suppressing the inflammatory response, reducing lipid peroxidation, and neuronal apoptosis via inhibition of nuclear factor-κB and cleaved caspase-3 expression.

  16. Losartan administration reduces fibrosis but hinders functional recovery after volumetric muscle loss injury. (United States)

    Garg, Koyal; Corona, Benjamin T; Walters, Thomas J


    Losartan is a Food and Drug Administration approved antihypertensive medication that is recently emerging as an antifibrotic therapy. Previously, losartan has been successfully used to reduce fibrosis and improve both muscle regeneration and function in several models of recoverable skeletal muscle injuries, such as contusion and laceration. In this study, the efficacy of losartan treatment in reducing fibrosis and improving regeneration was determined in a Lewis rat model of volumetric muscle loss (VML) injury. VML has been defined as the traumatic or surgical loss of skeletal muscle with resultant functional impairment. It is among the top 10 causes for wounded service members to be medically retired from the military. This study shows that, after several weeks of recovery, VML injury results in little to no muscle regeneration, but is marked by persistent inflammation, chronic upregulation of profibrotic markers and extracellular matrix (i.e., collagen type I), and fat deposition at the defect site, which manifest irrecoverable deficits in force production. Losartan administration at 10 mg·kg(-1)·day(-1) was able to modulate the gene expression of fibrotic markers and was also effective at reducing fibrosis (i.e., the deposition of collagen type I) in the injured muscle. However, there were no improvements in muscle regeneration, and deleterious effects on muscle function were observed instead. We propose that, in the absence of regeneration, reduction in fibrosis worsens the ability of the VML injured muscle to transmit forces, which ultimately results in decreased muscle function.

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


    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.

  18. How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns (United States)

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


    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]…


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    Terence F. McLoughlin


    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

  20. Burn mouse models

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus


    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......-degree burn injury was induced with a hot-air blower. The third-degree burn was confirmed histologically. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear...... neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization of the skin showed an increased polymorphonuclear neutrophil granulocytes dominated inflammation in the group of mice...

  1. Need for airbag and seatbelt to reduce orbital injuries from steering wheel knob. (United States)

    Hwang, Kun; Kim, Joo Ho


    The aims of this study are to report a blowout fracture of the orbital floor and medial wall caused by being struck by a steering wheel knob of an automobile and to discuss the use of airbags and seatbelts as a preventive measure for orbital injuries. A 58-year-old man was struck in the left eye by a steering wheel. His car hit a telephone pole, and he had a frontal collision injury. In this frontal impact, his left eye was hit by a Brodie knob attached to the steering wheel. At the time of injury, the speed of the car was about 65 km/h. He was not wearing a seatbelt, and the airbag had not deployed. Swelling and ecchymosis were observed at the left periorbital area, and he had diplopia on a left-side gaze. A CT revealed fractures in the medial and inferior wall of the left orbit. Entrapped soft tissues were reduced, and the medial wall and floor were reconstructed with a resorbable sheet. His diplopia disappeared 12 days after surgery. To prevent the injury from the steering wheel knob, an airbag should be installed in any vehicle, which has a steering wheel knob. Legislation mandating the use of airbags as well as seatbelts in vehicles with attached steering wheel knobs should be made.

  2. Hematogenous macrophage depletion reduces the fibrotic scar and increases axonal growth after spinal cord injury. (United States)

    Zhu, Y; Soderblom, C; Krishnan, V; Ashbaugh, J; Bethea, J R; Lee, J K


    Spinal cord injury (SCI) leads to formation of a fibrotic scar that is inhibitory to axon regeneration. Recent evidence indicates that the fibrotic scar is formed by perivascular fibroblasts, but the mechanism by which they are recruited to the injury site is unknown. Using bone marrow transplantation in mouse model of spinal cord injury, we show that fibroblasts in the fibrotic scar are associated with hematogenous macrophages rather than microglia, which are limited to the surrounding astroglial scar. Depletion of hematogenous macrophages results in reduced fibroblast density and basal lamina formation that is associated with increased axonal growth in the fibrotic scar. Cytokine gene expression analysis after macrophage depletion indicates that decreased Tnfsf8, Tnfsf13 (tumor necrosis factor superfamily members) and increased BMP1-7 (bone morphogenetic proteins) expression may serve as anti-fibrotic mechanisms. Our study demonstrates that hematogenous macrophages are necessary for fibrotic scar formation and macrophage depletion results in changes in multiple cytokines that make the injury site less fibrotic and more conducive to axonal growth.

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

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    Abdolreza Babaee


    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

  4. Neuroprotection of lipoic acid treatment promotes angiogenesis and reduces the glial scar formation after brain injury. (United States)

    Rocamonde, B; Paradells, S; Barcia, J M; Barcia, C; García Verdugo, J M; Miranda, M; Romero Gómez, F J; Soria, J M


    After trauma brain injury, a large number of cells die, releasing neurotoxic chemicals into the extracellular medium, decreasing cellular glutathione levels and increasing reactive oxygen species that affect cell survival and provoke an enlargement of the initial lesion. Alpha-lipoic acid is a potent antioxidant commonly used as a treatment of many degenerative diseases such as multiple sclerosis or diabetic neuropathy. Herein, the antioxidant effects of lipoic acid treatment after brain cryo-injury in rat have been studied, as well as cell survival, proliferation in the injured area, gliogenesis and angiogenesis. Thus, it is shown that newborn cells, mostly corresponded with blood vessels and glial cells, colonized the damaged area 15 days after the lesion. However, lipoic acid was able to stimulate the synthesis of glutathione, decrease cell death, promote angiogenesis and decrease the glial scar formation. All those facts allow the formation of new neural tissue. In view of the results herein, lipoic acid might be a plausible pharmacological treatment after brain injury, acting as a neuroprotective agent of the neural tissue, promoting angiogenesis and reducing the glial scar formation. These findings open new possibilities for restorative strategies after brain injury, stroke or related disorders.

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

    DEFF Research Database (Denmark)

    Baskys, Andrius; Bayazitov, Ildar; Fang, Liwei


    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....

  6. Polyethylene glycol reduces early and long-term cold ischemia-reperfusion and renal medulla injury. (United States)

    Faure, Jean Pierre; Hauet, Thierry; Han, Zeqiu; Goujon, Jean Michel; Petit, Isabelle; Mauco, Gerard; Eugene, Michel; Carretier, Michel; Papadopoulos, Vassilios


    Ischemia-reperfusion injury (IRI) after transplantation is a major cause of delayed graft function, which has a negative impact on early and late graft function and improve acute rejection. We have previously shown that polyethylene glycol (PEG) and particularly PEG 20M has a protective effect against cold ischemia and reperfusion injury in an isolated perfused pig and rat kidney model. We extended those observations to investigate the role of PEG using different doses (30g or 50g/l) added (ICPEG30 or ICPEG50) or not (IC) to a simplified preservation solution to reduce IRI after prolonged cold storage (48-h) of pig kidneys when compared with Euro-Collins and University of Wisconsin solutions. The study of renal function and medulla injury was performed with biochemical methods and proton NMR spectroscopy. Histological and inflammatory cell studies were performed after reperfusion (30-40 min) and on days 7 and 14 and weeks 4, 8, and 12. Peripheral-type benzodiazepine receptor (PBR), a mitochondrial protein involved in cholesterol homeostasis, was also studied. The results demonstrated that ICPEG30 improved renal function and reduced medulla injury. ICPEG30 also improved tubular function and strongly protect mitochondrial integrity. Post-IRI inflammation was strongly reduced in this group, particularly lymphocytes TCD4(+), PBR expression was influenced by IRI in the early period and during the development of chronic dysfunction. This study clearly shows that PEG has a beneficial effect in renal preservation and suggests a role of PBR as a marker IRI and repair processes.

  7. Erythropoietin-mediated tissue protection: reducing collateral damage from the primary injury response. (United States)

    Brines, M; Cerami, A


    In its classic hormonal role, erythropoietin (EPO) is produced by the kidney and regulates the number of erythrocytes within the circulation to provide adequate tissue oxygenation. EPO also mediates other effects directed towards optimizing oxygen delivery to tissues, e.g. modulating regional blood flow and reducing blood loss by promoting thrombosis within damaged vessels. Over the past 15 years, many unexpected nonhaematopoietic functions of EPO have been identified. In these more recently appreciated nonhormonal roles, locally-produced EPO signals through a different receptor isoform and is a major molecular component of the injury response, in which it counteracts the effects of pro-inflammatory cytokines. Acutely, EPO prevents programmed cell death and reduces the development of secondary, pro-inflammatory cytokine-induced injury. Within a longer time frame, EPO provides trophic support to enable regeneration and healing. As the region immediately surrounding damage is typically relatively deficient in endogenous EPO, administration of recombinant EPO can provide increased tissue protection. However, effective use of EPO as therapy for tissue injury requires higher doses than for haematopoiesis, potentially triggering serious adverse effects. The identification of a tissue-protective receptor isoform has facilitated the engineering of nonhaematopoietic, tissue-protective EPO derivatives, e.g. carbamyl EPO, that avoid these complications. Recently, regions within the EPO molecule mediating tissue protection have been identified and this has enabled the development of potent tissue-protective peptides, including some mimicking EPO's tertiary structure but unrelated in primary sequence.


    Directory of Open Access Journals (Sweden)

    Arne Edvardsson


    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

  9. Reduced Ignition Propensity cigarette regulations and decline in fires, fire injuries and fatalities in Canada

    Directory of Open Access Journals (Sweden)

    Krasovsky, Konstantin S


    Full Text Available On October 1, 2005, Canada became the first country to implement a nationwide cigarette fire-safety standard for Reduced Ignition Propensity (RIP cigarettes. The aim of the paper is to estimate the impact of the RIP cigarette regulations on the number of smoking-related fires (SRF, fire injuries (SRFI and fatalities (SRFF in Canada. METHODS: As there are no national fire statistics data, the data from Canadian provinces were studied. The data with smoking mentioned as a source of ignition were found for four provinces and grouped into two time periods: pre-implementation (2000-2004 and post-implementation (2005-2009. Average annual indicators for each period were compared. RESULTS: In Alberta, the number of home SRF and SRFF did not change much, while small (14% reduction was observed in SRFI. In British Columbia, the percentage of SRF in all fires decreased by 15% and the number of SRFI and SRFF declined by 41% and 49% respectively. In Ontario, an average number of SRF and SRFI per year slightly decreased; however, the number of SRFF increased. In Saskatchewan, fires caused by smokers’ materials decreased almost by half while the number of fatalities and injuries decreased even to a larger extent. Most prominent was the reduction of fatalities and injuries in fires with cigarettes as the source of ignition: they decreased more than three-fold in Saskatchewan. CONCLUSION: Canadian fire statistics do not allow estimating fire loss reduction as a result of the implemented RIP cigarette regulations for the whole country. Two Canadian provinces (British Columbia and Saskatchewan experienced a substantial reduction in fires ignited by manufactured cigarettes and a corresponding reduction in the associated fire fatalities and injuries. In Alberta, only the number of smoking fire injuries has shown some decrease. No substantial changes were observed in Ontario, probably due to the high level of cigarette smuggling.

  10. Agmatine induces gastric protection against ischemic injury by reducing vascular permeability in rats

    Institute of Scientific and Technical Information of China (English)

    Abeer A Al Masri; Eman El Eter


    AIM:To investigate the effect of administration of agmarine (AGM) on gastric protection against ischemia reperfusion (I/R)injury.METHODS:Three groups of rats (6/group); sham,gastric I/R injury,and gastric I/R + AGM (100 mg/kg,i.p.given 15 min prior to gastric ischemia) were recruited.Gastric injury was conducted by ligating celiac artery for 30 rmin and reperfusion for another 30 min.Gastric tissues were histologically studied and immunostained with angiopoietin 1 (Ang-1) and Ang-2.Vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) were measured in gastric tissue homogenate.To assess whether AKt/phosphatidyl inositol-3-kinase (PI3K) mediated the effect of AGM,an additional group was pretreated with Wortmannin (WM) (inhibitor of Akt/PI3K,15 μg/kg,i.p.),prior to ischemic injury and AGM treatment,and examined histologically and immunostained.Another set of experiments was run to study vascular permeability of the stomach using Evan's blue dye.RESULTS:AGM markedly reduced Evan's blue dye extravasation (3.58 ± 0.975 μg/stomach vs 1.175 ±0.374 μg/stomach,P < 0.05),and VEGF (36.87 ± 2.71 pg/100 mg protein vs 48.4 ± 6.53 pg/100 mg protein,P < 0.05) and MCP-1 tissue level (29.5 ± 7 pg/100 mg protein vs 41.17 ± 10.4 pg/100 mg protein,P < 0.01).It preserved gastric histology and reduced congestion.Ang-1 and Ang-2 immunostaining were reduced in stomach sections of AGM-treated animals.The administration of WM abolished the protective effects of AGM and extensive hemorrhage and ulcerations were seen.CONCLUSION:AGM protects the stomach against I/R injury by reducing vascular permeability and inflammation.This protection is possibly mediated by Akt/PI3K.

  11. Anticancer Drug 2-Methoxyestradiol Protects against Renal Ischemia/Reperfusion Injury by Reducing Inflammatory Cytokines Expression

    Directory of Open Access Journals (Sweden)

    Ying-Yin Chen


    -A-treated RMC and NRK52E cells. Conclusions. 2ME2 reduces renal I/R injury in mice because it inhibits the expression of ROS and proinflammatory cytokines and induces antiapoptotic proteins.

  12. Bronchoscopy-derived correlates of lung injury following inhalational injuries: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Samuel W Jones

    Full Text Available BACKGROUND: Acute lung injury (ALI is a major factor determining morbidity following burns and inhalational injury. In experimental models, factors potentially contributing to ALI risk include inhalation of toxins directly causing cell damage; inflammation; and infection. However, few studies have been done in humans. METHODS: We carried out a prospective observational study of patients admitted to the NC Jaycees Burn Center who were intubated and on mechanical ventilation for burns and suspected inhalational injury. Subjects were enrolled over an 8-month period and followed till discharge or death. Serial bronchial washings from clinically-indicated bronchoscopies were collected and analyzed for markers of cell injury and inflammation. These markers were compared with clinical markers of ALI. RESULTS: Forty-three consecutive patients were studied, with a spectrum of burn and inhalation injury severity. Visible soot at initial bronchoscopy and gram negative bacteria in the lower respiratory tract were associated with ALI in univariate analyses. Subsequent multivariate analysis also controlled for % body surface area burns, infection, and inhalation severity. Elevated IL-10 and reduced IL-12p70 in bronchial washings were statistically significantly associated with ALI. CONCLUSIONS: Independently of several factors including initial inhalational injury severity, infection, and extent of surface burns, high early levels of IL-10 and low levels of IL-12p70 in the central airways are associated with ALI in patients intubated after acute burn/inhalation injury. Lower airway secretions can be collected serially in critically ill burn/inhalation injury patients and may yield important clues to specific pathophysiologic pathways.

  13. Burning vasculitis. (United States)

    Chadha, Priyanka; Hobday, Dorian; O'Connor, Edmund Fitzgerald; D'Cruz, David


    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn.

  14. Pain in burn patients. (United States)

    Latarjet, J; Choinère, M


    While severe pain is a constant component of the burn injury, inadequate pain management has been shown to be detrimental to burn patients. Pain-generating mechanisms in burns include nociception, primary and secondary hyperalgesia and neuropathy. The clinical studies of burn pain characteristics reveal very clear-cut differences between continuous pain and pain due to therapeutic procedures which have to be treated separately. Some of the main features of burn pain are: (1) its long-lasting course, often exceeding healing time, (2) the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. Pharmaco-therapy with opioids is the mainstay for analgesia in burned patients, but non-pharmacological techniques may be useful adjuncts. Routine pain evaluation is mandatory for efficient and safe analgesia. Special attention must be given to pain in burned children which remains too often underestimated and undertreated. More educational efforts from physicians and nursing staff are necessary to improve pain management in burned patients.

  15. Hair dryer burns in children. (United States)

    Prescott, P R


    Three children with burn injuries caused by home hair dryers are described. In one patient the injury was believed to be accidental, and in the other two cases the injuries were deliberately caused by a caretaker. The lack of prior experience with hair dryer burns initially led to suspicion of other causes. The characteristics of each case aided in the final determination of accidental vs nonaccidental injury. These cases prompted testing of home hair dryers to determine their heat output. At the highest heat settings, the dryers rapidly generated temperatures in excess of 110 degrees C. After the dryers were turned off, the protective grills maintained sufficient temperatures to cause full-thickness burns for up to 2 minutes. These cases and the results of testing demonstrate that hair dryers must be added to the list of known causes of accidental and nonaccidental burns in children.

  16. A CD11d Monoclonal Antibody Treatment Reduces Tissue Injury and Improves Neurological Outcome after Fluid Percussion Brain Injury in Rats



    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 d...

  17. Utilizing pharmacotherapy and mesenchymal stem cell therapy to reduce inlfammation following traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Sherwin Mashkouri; Marci G. Crowley; Michael G. Liska; Sydney Corey; Cesar V. Borlongan


    The pathologic process of chronic phase traumatic brain injury is associated with spreading inlfamma-tion, cell death, and neural dysfunction. It is thought that sequestration of inlfammatory mediators can facilitate recovery and promote an environment that fosters cellular regeneration. Studies have targeted post-traumatic brain injury inlfammation with the use of pharmacotherapy and cell therapy. These thera-peutic options are aimed at reducing the edematous and neurodegenerative inlfammation that have been associated with compromising the integrity of the blood-brain barrier. Although studies have yielded posi-tive results from anti-inlfammatory pharmacotherapy and cell therapy individually, emerging research has begun to target inlfammation using combination therapy. The joint use of anti-inlfammatory drugs along-side stem cell transplantation may provide better clinical outcomes for traumatic brain injury patients. Despite the promising results in this ifeld of research, it is important to note that most of the studies men-tioned in this review have completed their studies using animal models. Translation of this research into a clinical setting will require additional laboratory experiments and larger preclinical trials.

  18. FeTPPS Reduces Secondary Damage and Improves Neurobehavioral Functions after Traumatic Brain Injury (United States)

    Bruschetta, Giuseppe; Impellizzeri, Daniela; Campolo, Michela; Casili, Giovanna; Di Paola, Rosanna; Paterniti, Irene; Esposito, Emanuela; Cuzzocrea, Salvatore


    Traumatic brain injury (TBI) determinate a cascade of events that rapidly lead to neuron's damage and death. We already reported that administration of FeTPPS, a 5,10,15,20-tetrakis (4-sulfonatophenyl) porphyrin iron III chloride peroxynitrite decomposition catalyst, possessed evident neuroprotective effects in a experimental model of spinal cord damage. The present study evaluated the neuroprotective property of FeTPPS in TBI, using a clinically validated model of TBI, the controlled cortical impact injury (CCI). We observe that treatment with FeTPPS (30 mg/kg, i.p.) reduced: the state of brain inflammation and the tissue hurt (histological score), myeloperoxidase activity, nitric oxide production, glial fibrillary acidic protein (GFAP) and pro-inflammatory cytokines expression and apoptosis process. Moreover, treatment with FeTPPS re-established motor-cognitive function after CCI and it resulted in a reduction of lesion volumes. Our results established that FeTPPS treatment decreases the growth of inflammatory process and the tissue injury associated with TBI. Thus our study confirmed the neuroprotective role of FeTPPS treatment on TBI.

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

    Directory of Open Access Journals (Sweden)

    Yun-Hee Lee


    Full Text Available 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.


    Directory of Open Access Journals (Sweden)

    Nuno M. L. Oliveira


    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

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


    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

  2. Irradiation induced injury reduces energy metabolism in small intestine of Tibet minipigs.

    Directory of Open Access Journals (Sweden)

    Yu-Jue Wang

    Full Text Available BACKGROUND: The radiation-induced energy metabolism dysfunction related to injury and radiation doses is largely elusive. The purpose of this study is to investigate the early response of energy metabolism in small intestinal tissue and its correlation with pathologic lesion after total body X-ray irradiation (TBI in Tibet minipigs. METHODS AND RESULTS: 30 Tibet minipigs were assigned into 6 groups including 5 experimental groups and one control group with 6 animals each group. The minipigs in these experimental groups were subjected to a TBI of 2, 5, 8, 11, and 14 Gy, respectively. Small intestine tissues were collected at 24 h following X-ray exposure and analyzed by histology and high performance liquid chromatography (HPLC. DNA contents in this tissue were also examined. Irradiation causes pathologic lesions and mitochondrial abnormalities. The Deoxyribonucleic acid (DNA content-corrected and uncorrected adenosine-triphosphate (ATP and total adenine nucleotides (TAN were significantly reduced in a dose-dependent manner by 2-8 Gy exposure, and no further reduction was observed over 8 Gy. CONCLUSION: TBI induced injury is highly dependent on the irradiation dosage in small intestine and inversely correlates with the energy metabolism, with its reduction potentially indicating the severity of injury.

  3. Resveratrol attenuates peripheral and brain inflammation and reduces ischemic brain injury in aged female mice. (United States)

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


    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.

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


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


    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...

  5. Evaluating trapping techniques to reduce potential for injury to Mexican wolves (United States)

    Turnbull, T.T.; Cain, J.W.; Roemer, G.W.


    Increased scrutiny of furbearer trapping has resulted in more regulation and even prohibition of common trapping methods in some States. Concerns regarding the potential negative impacts of regulated furbearer trapping on reintroduced Mexican gray wolves (Canis lupus baileyi) led now former Governor Bill Richardson to issue an executive order prohibiting trapping in the New Mexico portion of the Blue Range Wolf Recovery Area (BRWRA). This ban was to last for at least 6 months and required an evaluation of the risk posed to wolves by traps and snares legally permitted in New Mexico. We reviewed various threats to wolves in the BRWRA, including threats posed by regulated furbearer trapping. Seventy-eight Mexican wolf mortalities were documented during the reintroduction effort (1998-2010). More than 80 percent of documented mortalities were human-caused: illegal shooting (47.4 percent), vehicle collisions (15.4 percent), lethal removal by the U.S. Fish and Wildlife Service (USFWS) (14.1 percent), nonproject-related trapping (2.6 percent), project-related trapping (1.3 percent), and legal shooting by the public (1.3 percent). The remaining 17.9 percent of mortalities were a result of natural causes. An additional 23 wolves were permanently removed from the wild by USFWS. Of 13 trapping incidents in New Mexico that involved trappers other than USFWS project personnel, 7 incidents resulted in injuries to wolves, 2 wolves sustained injuries severe enough to result in leg amputations, and 2 wolves died as a result of injuries sustained. Rubber-padded foothold traps and properly set snares would most likely reduce trap-related injuries to Mexican wolves; however, impacts caused by trapping are outnumbered by other, human-caused impacts.

  6. Regulatory T cells reduce acute lung injury fibroproliferation by decreasing fibrocyte recruitment. (United States)

    Garibaldi, Brian T; D'Alessio, Franco R; Mock, Jason R; Files, D Clark; Chau, Eric; Eto, Yoshiki; Drummond, M Bradley; Aggarwal, Neil R; Sidhaye, Venkataramana; King, Landon S


    Acute lung injury (ALI) causes significant morbidity and mortality. Fibroproliferation in ALI results in worse outcomes, but the mechanisms governing fibroproliferation remain poorly understood. Regulatory T cells (Tregs) are important in lung injury resolution. Their role in fibroproliferation is unknown. We sought to identify the role of Tregs in ALI fibroproliferation, using a murine model of lung injury. Wild-type (WT) and lymphocyte-deficient Rag-1(-/-) mice received intratracheal LPS. Fibroproliferation was characterized by histology and the measurement of lung collagen. Lung fibrocytes were measured by flow cytometry. To dissect the role of Tregs in fibroproliferation, Rag-1(-/-) mice received CD4(+)CD25(+) (Tregs) or CD4(+)CD25(-) Tcells (non-Tregs) at the time of LPS injury. To define the role of the chemokine (C-X-C motif) ligand 12 (CXCL12)-CXCR4 pathway in ALI fibroproliferation, Rag-1(-/-) mice were treated with the CXCR4 antagonist AMD3100 to block fibrocyte recruitment. WT and Rag-1(-/-) mice demonstrated significant collagen deposition on Day 3 after LPS. WT mice exhibited the clearance of collagen, but Rag-1(-/-) mice developed persistent fibrosis. This fibrosis was mediated by the sustained epithelial expression of CXCL12 (or stromal cell-derived factor 1 [SDF-1]) that led to increased fibrocyte recruitment. The adoptive transfer of Tregs resolved fibroproliferation by decreasing CXCL12 expression and subsequent fibrocyte recruitment. Blockade of the CXCL12-CXCR4 axis with AMD3100 also decreased lung fibrocytes and fibroproliferation. These results indicate a central role for Tregs in the resolution of ALI fibroproliferation by reducing fibrocyte recruitment along the CXCL12-CXCR4 axis. A dissection of the role of Tregs in ALI fibroproliferation may inform the design of new therapeutic tools for patients with ALI.

  7. 芦荟减阻剂对烧伤休克大鼠微循环的影响%Effects of Drag-reducing polymer derived from Aloe vera on microcirculation in burn rats

    Institute of Scientific and Technical Information of China (English)

    张俊莉; 蔡淑敏; 李涛; 曾振华; 高友光; 陈仲清


    Objective To investigate the effects of drag-reducing polymers on microcirculation in 40%total body surface area burn-injured rats. Methods SD rats were randomized into control group, drag-reducing polymer (DRPs) group and normal saline (NS) group (5 minutes after scald, drag-reducing polymer or saline was injected for fluid resuscitation). Wet dry weigh ratio of lung, histopathologic changes and arterial blood gas at 24 hour were respectively measured by wet dry weigh ratio method, hematoxylin-eosin (HE) staining and arterial blood gas analysis. The velocity of flow of red cell in oblique ridge and the survival time of burn-injured rats were observed. Results Compared with control group, rats in NS group exhibit significant lung injury characterized by a high W/D (P < 0.01), accumulation of a large number of neutrophils in HE stain, low partial pressure of oxygen (PO2) and high lactate (Lac) (P<0.05 or P<0.01) in arterial blood. Compared with the NS group, DRPs treatment rats exhibit significantly reduced lung injury characterized by W/D reducing (P < 0.05), the reduction of neutrophil infiltration, increased PO2, decreased Lac (P<0.05, P<0.01). In addition, DRPs treatment obviously increases the burn-induced low velocity of flow of red cell in oblique ridge (P<0.01). Moreover, the survival time of burned rats can be improved by DRPs treatment (P < 0.05). Conclusion DRPs ameliorates burn-induced acute lung injury, the mechanism may be through improving the burn-induced microcirculation disorders.%目的:探讨芦荟减阻剂对大鼠40%体表面积深Ⅱ度烧伤休克模型微循环的影响。方法:SD大鼠随机分为3组:对照组、减阻剂组及盐水组(烫伤后5 min给予减阻剂或者盐水进行补液复苏)。检测烧伤休克后24 h肺湿干重比(W/D)、病理及动脉血气;活体微循环观测技术观察烧伤休克后脊斜肌微动脉红细胞流速;观察动物的存活时间。结果:与对照组比较,盐

  8. Burn prevention mechanisms and outcomes: pitfalls, failures and successes. (United States)

    Atiyeh, Bishara S; Costagliola, Michel; Hayek, Shady N


    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

  9. Telmisartan reduced cerebral edema by inhibiting NLRP3 inflammasome in mice with cold brain injury. (United States)

    Wei, Xin; Hu, Chen-Chen; Zhang, Ya-Li; Yao, Shang-Long; Mao, Wei-Ke


    The aim of this study was to investigate the possible beneficial role of telmisartan in cerebral edema after traumatic brain injury (TBI) and the potential mechanisms related to the nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) pyrin domain-containing 3 (NLRP3) inflammasome activation. TBI model was established by cold-induced brain injury. Male C57BL/6 mice were randomly assigned into 3, 6, 12, 24, 48 and 72 h survival groups to investigate cerebral edema development with time and received 0, 5, 10, 20 and 40 mg/kg telmisartan by oral gavage, 1 h prior to TBI to determine the efficient anti-edemic dose. The therapeutic window was identified by post-treating 30 min, 1 h, 2 h and 4 h after TBI. Blood-brain barrier (BBB) integrity, the neurological function and histological injury were assessed, at the same time, the mRNA and protein expression levels of NLRP3 inflammasome, IL-1β and IL-18 concentrations in peri-contused brain tissue were measured 24 h post TBI. The results showed that the traumatic cerebral edema occurred from 6 h, reached the peak at 24 h and recovered to the baseline 72 h after TBI. A single oral dose of 5, 10 and 20 mg/kg telmisartan could reduce cerebral edema. Post-treatment up to 2 h effectively limited the edema development. Furthermore, prophylactic administration of telmisartan markedly inhibited BBB impairment, NLRP3, apoptotic speck-containing protein (ASC) and Caspase-1 activation, as well as IL-1β and IL-18 maturation, subsequently improved the neurological outcomes. In conclusion, telmisartan can reduce traumatic cerebral edema by inhibiting the NLRP3 inflammasome-regulated IL-1β and IL-18 accumulation.

  10. 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;


    and 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...... 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...

  11. Tiotropium bromide suppresses smoke inhalation and burn injury-induced ERK 1/2 and SMAD 2/3 signaling in sheep bronchial submucosal glands. (United States)

    Jacob, Sam; Zhu, Yong; Asmussen, Sven; Ito, Hiroshi; Herndon, David N; Enkhbaatar, Perenlei; Hawkins, Hal K; Cox, Robert A


    The effects of tiotropium bromide on ERK 1/2, SMAD 2/3 and NFκB signaling in bronchial submucosal gland (SMG) cells of sheep after smoke inhalation and burn injury (S + B) were studied. We hypothesized that tiotropium would modify intracellular signaling processes within SMG cells after injury. Bronchial tissues were obtained from uninjured (sham, n = 6), S + B injured sheep 48 h after injury (n = 6), and injured sheep nebulized with tiotropium (n = 6). The percentage (mean ± SD) of cells showing nuclear localization of phosphorylated ERK 1/2, pSMAD 2/3, and NFκB (p65) was determined by immunohistochemistry. Nuclear pERK 1/2 staining was increased in injured animals as compared to sham, (66 ± 20 versus 14 ± 9), p = 0.0022, as was nuclear pSMAD, 84 ± 10 versus 20 ± 10, p = 0.0022. There was a significant decrease in pERK 1/2 labeling in the tiotropium group compared to the injured group (31 ± 20 versus 66 ± 20, p = 0.013), and also a decrease in pSMAD labeling, 62 ± 17 versus 84 ± 10, p = 0.04. A significant increase for NFκB (p65) was noted in injured animals as compared to sham (73 ± 16 versus 7 ± 6, p = 0.0022). Tiotropium-treated animals showed decreased p65 labeling as compared to injured (35 ± 17 versus 74 ± 16, p = 0.02). The decrease in nuclear expression of pERK, pSMAD and NFκB molecules in SMG cells with tiotropium treatment is suggestive that their activation after injury is mediated in part through muscarinic receptors.

  12. Losartan reduces ensuing chronic kidney disease and mortality after acute kidney injury (United States)

    Cheng, Shun-Yang; Chou, Yu-Hsiang; Liao, Fang-Ling; Lin, Chi-Chun; Chang, Fan-Chi; Liu, Chia-Hao; Huang, Tao-Min; Lai, Chun-Fu; Lin, Yu-Feng; Wu, Vin-Cent; Chu, Tzong-Shinn; Wu, Ming-Shiou; Lin, Shuei-Liong


    Acute kidney injury (AKI) is an important risk factor for incident chronic kidney disease (CKD). Clinical studies disclose that ensuing CKD progresses after functional recovery from AKI, but the underlying mechanisms remain illusive. Using a murine model representing AKI-CKD continuum, we show angiotensin II type 1a (AT1a) receptor signaling as one of the underlying mechanisms. Male adult CD-1 mice presented severe AKI with 20% mortality within 2 weeks after right nephrectomy and left renal ischemia-reperfusion injury. Despite functional recovery, focal tubular atrophy, interstitial cell infiltration and fibrosis, upregulation of genes encoding angiotensinogen and AT1a receptor were shown in kidneys 4 weeks after AKI. Thereafter mice manifested increase of blood pressure, albuminuria and azotemia progressively. Drinking water with or without losartan or hydralazine was administered to mice from 4 weeks after AKI. Increase of mortality, blood pressure, albuminuria, azotemia and kidney fibrosis was noted in mice with vehicle administration during the 5-month experimental period. On the contrary, these parameters in mice with losartan administration were reduced to the levels shown in control group. Hydralazine did not provide similar beneficial effect though blood pressure was controlled. These findings demonstrate that losartan can reduce ensuing CKD and mortality after functional recovery from AKI. PMID:27677327

  13. Sesamin Ameliorates High-Fat Diet–Induced Dyslipidemia and Kidney Injury by Reducing Oxidative Stress (United States)

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


    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

  14. Sesamin Ameliorates High-Fat Diet-Induced Dyslipidemia and Kidney Injury by Reducing Oxidative Stress. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Ruijuan Zhang


    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.

  16. 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


    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.

  17. Titanium tetrachloride burns to the eye.


    Chitkara, D K; McNeela, B. J.


    We present eight cases of chemical burns of the eyes from titanium tetrachloride, an acidic corrosive liquid. However it causes severe chemical burns which have a protracted course and features more akin to severe alkali burns. Injuries related to titanium tetrachloride should be treated seriously and accordingly appropriate management is suggested.

  18. A review of hydrofluoric acid burn management


    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel


    The clinical presentation and severity of hydrofluoric acid burns vary considerably, making management particularly challenging. Given that current knowledge of HF burns is derived from small case series, case reports, animal studies and anecdotal evidence, this narrative review discusses the current understanding of the effects associated with severe hydrofluoric acid burns, describing the mechanism of injury, systemic toxicity and treatment options.

  19. Reducir la secuela en una quemadura doméstica Reducing the effect of a domestic burn

    Directory of Open Access Journals (Sweden)

    R. Fernando García González


    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

  20. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi


    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.

  1. iNOS as a Driver of Inflammation and Apoptosis in Mouse Skeletal Muscle after Burn Injury: Possible Involvement of Sirt1 S-Nitrosylation-Mediated Acetylation of p65 NF-κB and p53 (United States)

    Yasukawa, Takashi; Ishimaru, Kazuhiro; Yasuhara, Shingo; Yu, Yong-Ming; Martyn, J. A. Jeevendra; Tompkins, Ronald. G.; Shimokado, Kentaro; Kaneki, Masao


    Inflammation and apoptosis develop in skeletal muscle after major trauma, including burn injury, and play a pivotal role in insulin resistance and muscle wasting. We and others have shown that inducible nitric oxide synthase (iNOS), a major mediator of inflammation, plays an important role in stress (e.g., burn)-induced insulin resistance. However, it remains to be determined how iNOS induces insulin resistance. Moreover, the interrelation between inflammatory response and apoptosis is poorly understood, although they often develop simultaneously. Nuclear factor (NF)-κB and p53 are key regulators of inflammation and apoptosis, respectively. Sirt1 inhibits p65 NF-κB and p53 by deacetylating these transcription factors. Recently, we have shown that iNOS induces S-nitrosylation of Sirt1, which inactivates Sirt1 and thereby increases acetylation and activity of p65 NF-κB and p53 in various cell types, including skeletal muscle cells. Here, we show that iNOS enhances burn-induced inflammatory response and apoptotic change in mouse skeletal muscle along with S-nitrosylation of Sirt1. Burn injury induced robust expression of iNOS in skeletal muscle and gene disruption of iNOS significantly inhibited burn-induced increases in inflammatory gene expression and apoptotic change. In parallel, burn increased Sirt1 S-nitrosylation and acetylation and DNA-binding capacity of p65 NF-κB and p53, all of which were reversed or ameliorated by iNOS deficiency. These results indicate that iNOS functions not only as a downstream effector but also as an upstream enhancer of burn-induced inflammatory response, at least in part, by Sirt1 S-nitrosylation-dependent activation (acetylation) of p65 NF-κB. Our data suggest that Sirt1 S-nitrosylation may play a role in iNOS-mediated enhanced inflammatory response and apoptotic change, which, in turn, contribute to muscle wasting and supposedly to insulin resistance after burn injury. PMID:28099528

  2. Experiment Study on Wound Healing Mechanisms of Jintangbao Spray for Treating Burn Injury%金烫宝烧烫伤喷雾剂治疗烧烫伤创面愈合的研究

    Institute of Scientific and Technical Information of China (English)

    罗先钦; 刘剑毅; 黄思行; 何沛霖; 梅小利; 张莉


    目的:观察金烫宝烧烫伤喷雾剂对大鼠浅Ⅱ度烫伤模型的治疗作用以及其抗炎镇痛作用.方法:采用SD大鼠浅Ⅱ度烫伤和KM小鼠足部烫伤创面模型评价其治疗烧烫伤作用;采用角叉菜胶致SD大鼠足肿胀和甲醛致KM小鼠疼痛模型来评价其抗炎镇痛作用.以上动物试验在造模同时分别皮肤涂抹不同质量浓度(0.59,0.39,0.20 g·mL-1)的金烫宝烧烫伤喷雾剂和阳性药物,模型组动物皮肤涂抹等容量的赋形剂.结果:金烫宝烧烫伤喷雾剂1.76g/只能明显促进浅Ⅱ度烫伤大鼠模型皮肤创面的愈合,病理组织检查结果显示能够促进浅Ⅱ度烫伤大鼠皮肤表皮损伤和真皮胶原纤维束排列紊乱的修复,促进真皮毛囊增生,减轻炎症细胞对烫伤皮肤的浸润,对烫伤皮肤具有明显的修复作用;金烫宝烧烫伤喷雾剂0.12g/只和0.08g/只能明显减少小鼠实验性烫伤足部组织含水量;金烫宝烧烫伤喷雾剂0.70g/只对角叉菜胶所致大鼠足肿胀有明显的抑制作用;金烫宝烧烫伤喷雾剂0.12g/只对甲醛引起的小鼠疼痛具有明显镇痛作用.结论:金烫宝烧烫伤喷雾剂具有促进烧烫伤创面愈合和抗炎镇痛作用.%Objective:To investigate the wound healing effect of Jintangbao Spray for promoting superficial second degrees burn, as well as anti-inflammatory and analgesic actions. Method: The effect of wound healing was investigated through superficial second degrees burn model in rats and feet burn model in mice. Anti-inflammatory effect was investigated through carrageenan-induced swelling of rat toes. Analgesic effect was investigated through formaldehyde-induced pain in mice. Result: Compared with the model group, Jintangbao Spray could remarkly promote healing of cutis in the trauma with superficial second degrees burn in rats. The pathomorphological evidences of hepatic tissue showed thatJintangbao Spray could remarkably repair cutaneous epidermis injury and

  3. Inhalation of hydrogen gas suppresses hepatic injury caused by ischemia/reperfusion through reducing oxidative stress. (United States)

    Fukuda, Kei-ichi; Asoh, Sadamitsu; Ishikawa, Masahiro; Yamamoto, Yasuhiro; Ohsawa, Ikuroh; Ohta, Shigeo


    We have recently showed that molecular hydrogen has great potential for selectively reducing cytotoxic reactive oxygen species, such as hydroxyl radicals, and that inhalation of hydrogen gas decreases cerebral infarction volume by reducing oxidative stress [I. Ohsawa, M. Ishikawa, K. Takahashi, M. Watanabe, K. Nishimaki, K. Yamagata, K.-I. Katsura, Y. Katayama, S. Asoh, S. Ohta, Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals, Nat. Med., 13 (2007) 688-694]. Here we show that the inhalation of hydrogen gas is applicable for hepatic injury caused by ischemia/reperfusion, using mice. The portal triad to the left lobe and the left middle lobe of the liver were completely occluded for 90min, followed by reperfusion for 180min. Inhalation of hydrogen gas (1-4%) during the last 190min suppressed hepatic cell death, and reduced levels of serum alanine aminotransferase and hepatic malondialdehyde. In contrast, helium gas showed no protective effect, suggesting that the protective effect by hydrogen gas is specific. Thus, we propose that inhalation of hydrogen gas is a widely applicable method to reduce oxidative stress.

  4. Contributions of Severe Burn and Disuse to Bone Structure and Strength in Rats (United States)


    injuries of≥40% total body surface area (TBSA) has markedly reduced bone formation in both adults and children [1]. Burn induces a systemic catabolic...the overall out come of the patients’ health and well being. Following 7 days of bed rest, adult patients with greater than 50% TBSA burn have lower...the reduction in bone formation [3,5,15] and thusmay be associated with a higher incidence of fractures and osteoporosis [3,16,17]. Using two and

  5. Pyrrolidine dithiocarbamate reduces ischemia-reperfusion injury of the small intestine

    Institute of Scientific and Technical Information of China (English)

    Ismail H Mallick; Wen-Xuan Yang; Marc C Winslet; Alexander M Seifalian


    AIM: To evaluate whether pyrrolidine dithiocarbamate (PDTC), an enhancer of HO production, attenuates intestinal IR injury.METHODS: Eighteen male rats were randomly allocated into three groups: (a) sham; (b) IR, consisting of 30 min of intestinal ischemia, followed by 2-h period of reperfusion; and (c) PDTC treatment before IR. Intestinal microvascular perfusion (IMP) was monitored continuously by laser Doppler fiowmetry. At the end of the reperfusion, serum samples for lactate dehydrogenase (LDH) levels and biopsies of ileum were obtained. HO activity in the ileum was assessed at the end of the reperfusion period.RESULTS: At the end of the reperfusion in the IR group,IMP recovered partially to 42.5% of baseline (P<0.05vs sham), whereas PDTC improved IMP to 67.3% of baseline (P<0.01 vs IR). There was a twofold increase in HO activity in PDTC group (2 062.66±106.11) as compared to IR (842.3±85.12) (P<0.001). LDH was significantly reduced (P<0.001) in PDTC group (585.6±102.4)as compared to IR group (1 973.8±306.5). Histological examination showed that the ileal mucosa was significantly less injured in PDTC group as compared with IR group.CONCLUSION: Our study demonstrates that PDTC improves the IMP and attenuates IR injury of the intestine possibly via HO production. Additional studies are warranted to evaluate the clinical efficacy of PDTC in the prevention of IR injury of the small intestine.

  6. 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


    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.

  7. The year in burns 2013. (United States)

    Wolf, Steven E; Phelan, Herbert A; Arnoldo, Brett D


    Approximately 3415 research articles were published with burns in the title, abstract, and/or keyword in 2013. We have continued to see an increase in this number; the following reviews articles selected from these by the Editor of one of the major journals (Burns) and colleagues that in their opinion are most likely to have effects on burn care treatment and understanding. As we have done before, articles were found and divided into the following topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. The articles are mentioned briefly with notes from the authors; readers are referred to the full papers for details.

  8. 脂肪间充质干细胞对烧伤脓毒症小鼠肾脏损伤的作用%Effects of adipose-derived stem cells on renal injury in burn mice with sepsis

    Institute of Scientific and Technical Information of China (English)

    李娜; 胡大海; 王耀军; 胡晓龙; 张月; 李小强; 石继红; 白晓智; 蔡维霞


    kidney tissue in group ADSC was less serious than that of normal control group at each time point.From PBH 12 to PBH 72,the levels of blood urea nitrogen and serum creatinine in saline group were significantly higher than those of normal control group and group ADSC (P values all below 0.01).Compared with those of the normal control group,the levels of TNF-α and IL-12 mRNA were higher in group ADSC and saline group at PBH 24 (P values all below 0.05).At PBH 24,the level of TNF-α mRNA in group ADSC (1.58±0.19) was lower than that of saline group (3.36 ±0.30,P <0.05).At PBH 24,the levels of IL-10 and COX2 mRNA in group ADSC (2.89 ±0.47,4.90 ±0.59) were higher than those in normal control group (1.00 ±0.15,1.00 ±0.27)and saline group (1.32 ± 0.38,1.57 ± 0.38,P values all below 0.05).Conclusions ADSC can decrease the levels of blood urea nitrogen and serum creatinine,promote the production of anti-inflammatory cytokines IL-10 and COX2,and reduce the release of the pro-inflammatory cytokines TNF-α and IL-12 to offer protective effects against renal injury in burn mice with sepsis.%目的 探讨脂肪间充质干细胞(ADSC)对烧伤脓毒症小鼠肾脏损伤的作用及相关机制. 方法 (1)取5只C57 BL/6J小鼠双侧腹股沟脂肪组织,采用酶消化法、密度梯度离心法及贴壁法分离培养纯化小鼠ADSC,取第3代细胞行形态学观察、测定细胞生长曲线,流式细胞仪检测细胞表面分子标记物,并行成骨及成脂肪细胞诱导分化鉴定.(2)另取37只C57BL/6J小鼠,按随机数字表法分为正常对照组、生理盐水组、ADSC组.正常对照组5只,其余2组各16只.生理盐水组及ADSC组小鼠造成背部15% TBSAⅢ度烫伤后,创面中心注射铜绿假单胞菌菌液制成烧伤脓毒症小鼠模型,之后分别经尾静脉注射生理盐水和ADSC,均于伤后12、24、48、72 h观察肾脏组织病理学变化、检测血肌酐和尿素氮水平,并采用实时荧光定量PCR法

  9. Quantitative long term measurements of burns in a rat model using spatial frequency domain imaging and laser speckle imaging (Conference Presentation) (United States)

    Ponticorvo, Adrien; Rowland, Rebecca A.; Baldado, Melissa L.; Kennedy, Gordon T.; Saager, Rolf B.; Choi, Bernard; Durkin, Anthony J.


    The ability to accurately assess burn wound severity in a timely manner is a critical component of wound management as it dictates the course of treatment. While full thickness and superficial burns can be easily diagnosed through visual inspection, burns that fall in between these categories are difficult to classify. Additionally, the ability to better quantify different stages of wound healing from a burn of any severity would be important for evaluating the efficacy of different treatment options. Here we present a longitudinal (28 day) study that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn wounds and healing in a murine model. Burn wounds were created using an established technique of a brass comb heated to a given temperature and applied for a set amount of time. They were imaged immediately after the initial injury and then at 2, 4, 7, 14, 21, and 28 days following the injury. Biopsies were taken on the day of the injury in order to verify the extent of the burn damage as well as at different time points after the injury in order to visualize different stages of inflammation and healing. The results of this study suggest that the reduced scattering coefficient measured using SFDI and blood flow as measured using LSI have the potential to provide useful metrics for quantifying the severity of burn injuries as well as track the different stages associated with wound healing progression.

  10. Advancement in the research of mechanism of endogenous cellular injury in visceral complications as complications after severe burn%严重烧伤脏器并发症的内源性细胞损伤机制研究进展

    Institute of Scientific and Technical Information of China (English)

    罗鹏飞; 王光毅; 夏照帆


    It is of great importance to know the endogenous mechanism in burn-induced organ injuries,not only for the understanding of pathophysiological processes after burn,but also for guiding the clinical treatment.Recent studies have widened and deepened our scope and understanding of secondary injuries to various organs.However,a unaminous understanding of molecular pathway involved in all burn-induced organ injuries has not been attained.Relatively,the mechanism of endogenous cellular injuries as a result of burn injury could be regarded as a common one to explain the causation of cellular injury,and to guide the prevention and treatment for the burn-induced complications using cytoprotection strategy. This review summarized four aspects of the mechanism of endogenous cellular injuries,including cellular injuries induced by ischemic/hypoxic-oxidative stress,excessive inflammatory factors released by inflammatory cells,immunosuppression caused by suppression of function of adaptive immune cells,and dysfunction of important supportive cells of various organs.

  11. 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


    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.

  12. Metformin attenuates hyperoxia-induced lung injury in neonatal rats by reducing the inflammatory response. (United States)

    Chen, Xueyu; Walther, Frans J; Sengers, Rozemarijn M A; Laghmani, El Houari; Salam, Asma; Folkerts, Gert; Pera, Tonio; Wagenaar, Gerry T M


    Because therapeutic options are lacking for bronchopulmonary dysplasia (BPD), there is an urgent medical need to discover novel targets/drugs to treat this neonatal chronic lung disease. Metformin, a drug commonly used to lower blood glucose in type 2 diabetes patients, may be a novel therapeutic option for BPD by reducing pulmonary inflammation and fibrosis and improving vascularization. We investigated the therapeutic potential of daily treatment with 25 and 100 mg/kg metformin, injected subcutaneously in neonatal Wistar rats with severe experimental BPD, induced by continuous exposure to 100% oxygen for 10 days. Parameters investigated included survival, lung and heart histopathology, pulmonary fibrin and collagen deposition, vascular leakage, right ventricular hypertrophy, and differential mRNA expression in the lungs of key genes involved in BPD pathogenesis, including inflammation, coagulation, and alveolar development. After daily metformin treatment rat pups with experimental BPD had reduced mortality, alveolar septum thickness, lung inflammation, and fibrosis, demonstrated by a reduced influx of macrophages and neutrophils and hyperoxia-induced collagen III and fibrin deposition (25 mg/kg), as well as improved vascularization (100 mg/kg) compared with control treatment. However, metformin did not ameliorate alveolar enlargement, small arteriole wall thickening, vascular alveolar leakage, and right ventricular hypertrophy. In conclusion metformin prolongs survival and attenuates pulmonary injury by reducing pulmonary inflammation, coagulation, and fibrosis but does not affect alveolar development or prevent pulmonary arterial hypertension and right ventricular hypertrophy in neonatal rats with severe hyperoxia-induced experimental BPD.

  13. Reduced Use of Emergency Care and Hospitalization in Patients with Traumatic Brain Injury Receiving Acupuncture Treatment

    Directory of Open Access Journals (Sweden)

    Chun-Chuan Shih


    Full Text Available Background. Little research exists on acupuncture treatment’s effect on patients with traumatic brain injury (TBI. Methods. Using Taiwan’s National Health Insurance Research Database, we conducted a cohort study to compare the use of emergency care and hospitalization in TBI patients with and without acupuncture treatment in the first year after TBI. The adjusted relative risks (RRs and 95% confidence intervals (CIs of high use of emergency care and hospitalization associated with acupuncture treatment were calculated in multivariate Poisson regression models with generalized estimating equation. Results. The means of medical visits of emergency care and hospitalization were lower in TBI patients with acupuncture treatment than in those without acupuncture treatment. After adjustment, acupuncture treatment was associated with decreased risk of high emergency care visits (beta = −0.0611, P=0.0452 and hospitalization (beta = −0.0989, P<0.0001. The RRs of high medical visits and expenditure for hospitalization associated with acupuncture treatment were 0.62 (95% CI = 0.50–0.76 and 0.66 (95% CI = 0.53–0.83, respectively. Conclusion. Patients with TBI who receive acupuncture treatment have reduced the use of emergency care and hospitalization in the first year after injury. The mechanisms of effects of acupuncture on TBI warrant further investigations.

  14. Aerodigestive tract burn from ingestion of microwaved food. (United States)

    Silberman, Michael; Jeanmonod, Rebecca


    Aerodigestive tract burns represent a rare but potentially devastating injury pattern throughout the world. Although the majority of these injuries do not require intervention, these burns have the potential for poor outcomes. Traditionally this disease has been caused by superheated gases found in explosions or fire-related injury. However, as technology advances, it brings novel methods for injury that require physician awareness of potential hazards. We describe a case of laryngeal and esophageal thermal burn caused by a microwave heated food bolus.

  15. Scald Burns (United States)

    Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

  16. Cognitive emotion regulation strategies and neuroticism in relation to depressive symptoms following burn injury: a longitudinal study with a 2-year follow-up. (United States)

    Van Loey, Nancy E; Oggel, Anne; Goemanne, Anne-Sofie; Braem, Leen; Vanbrabant, Leonard; Geenen, Rinie


    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 regulation styles as possible influencing factors. Data from 242 patients with burns were analyzed employing latent growth modeling. The level of depressive symptoms across the 2-year interval was associated with burn severity, higher levels of neuroticism and rumination, and lower levels of positive refocusing. Notably, rumination partly mediated the effect of neuroticism on the course of depressive symptoms. Correlational analysis suggested a specific effect of burn severity on rumination. The results indicate that screening for symptoms of depression, rumination, and neuroticism in burn patients is useful. Early interventions focusing on cognitive restructuring could assist in improving the cognitive emotional adaptation process following a burn event.

  17. A novel safety mechanism to reduce the risk of inadvertent electrosurgical injury. (United States)

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


    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.

  18. Beneficial effects of hydrogen-rich saline on early burn-wound progression in rats.

    Directory of Open Access Journals (Sweden)

    Song Xue Guo

    Full Text Available Deep burn wounds undergo a dynamic process known as wound progression that results in a deepening and extension of the initial burn area. The zone of stasis is more likely to develop more severe during wound progression in the presence of hypoperfusion. Hydrogen has been reported to alleviate injury triggered by ischaemia/reperfusion and burns in various organs by selectively quenching oxygen free radicals. The aim of this study was to investigate the possible protective effects of hydrogen against early burn-wound progression.Deep-burn models were established through contact with a boiled, rectangular, brass comb for 20 s. Fifty-six Sprague-Dawley rats were randomly divided into sham, burn plus saline, and burn plus hydrogen-rich saline (HS groups with sacrifice and analysis at various time windows (6 h, 24 h, 48 h post burn. Indexes of oxidative stress, apoptosis and autophagy were measured in each group. The zone of stasis was evaluated using immunofluorescence staining, ELISA, and Western blot to explore the underlying effects and mechanisms post burn.The burn-induced increase in malondialdehyde was markedly reduced with HS, while the activities of endogenous antioxidant enzymes were significantly increased. Moreover, HS treatment attenuated increases in apoptosis and autophagy postburn in wounds, according to the TUNEL staining results and the expression analysis of Bax, Bcl-2, caspase-3, Beclin-1 and Atg-5 proteins. Additionally, HS lowered the level of myeloperoxidase and expression of TNF-α, IL-1β, and IL-6 in the zone of stasis while augmenting IL-10. The elevated levels of Akt phosphorylation and NF-κB p65 expression post burn were also downregulated by HS management.Hydrogen can attenuate early wound progression following deep burn injury. The beneficial effect of hydrogen was mediated by attenuating oxidative stress, which inhibited apoptosis and inflammation, and the Akt/NF-κB signalling pathway may be involved in regulating the

  19. A Systematic Review on the Epidemiology of Pediatric Burn in Iran. (United States)

    Hashemi, Sayed Saeed; Sharhani, Asaad; Lotfi, Bahare; Ahmadi-Juibari, Toraj; Shaahmadi, Zahra; Aghaei, Abbas


    Burn is the most common pediatric injuries all over the world. The aim of this study was to study the epidemiology of burn in under 15-year-old Iranian children by applying a systematic review. The related articles published before 2016 have been gathered from international databases by using the keywords in term of pediatric burns such as ScienceDirect, PubMed, Iranmedex, Google Scholar, Embase, Magiran, and SID. The checklists of STROBE have been applied to evaluate the quality of the reviewed data. A total of 35 relevant studies were extracted and evaluated. In most studies, the incidence of pediatric burns in male patients was more than female patients by 9.5 to 50 cases in 100,000 per children. Mortality rate of pediatric burn was between 1.7 and 18.5%. The most common cause of pediatric burn was hot water or other hot liquids. Pediatric burn in urban areas was higher and the highest number of pediatric burns occurred at home. Burn is considered as one of the major incidents related to children's health that required planning to reduce its incidence, especially in the lower age groups as well as male patients who are more active and susceptible to burn.

  20. Klotho expression is reduced in COPD airway epithelial cells: effects on inflammation and oxidant injury. (United States)

    Gao, Wei; Yuan, Cheng; Zhang, Jingying; Li, Lingling; Yu, Like; Wiegman, Coen H; Barnes, Peter J; Adcock, Ian M; Huang, Mao; Yao, Xin


    COPD (chronic obstructive pulmonary disease) is associated with sustained inflammation, excessive injury, and accelerated lung aging. Human Klotho (KL) is an anti-aging protein that protects cells against inflammation and damage. In the present study, we quantified KL expression in the lungs of COPD patients and in an ozone-induced mouse model of COPD, and investigated the mechanisms that control KL expression and function in the airways. KL distribution and levels in human and mouse airways were measured by immunohistochemistry and Western blotting. The effect of CSE (cigarette smoke extract) on KL expression was detected in human bronchial epithelial cells. Moreover, the effect of KL on CSE-mediated inflammation and hydrogen peroxide-induced cellular injury/apoptosis was determined using siRNAs. KL expression was decreased in the lungs of smokers and further reduced in patients with COPD. Similarly, 6 weeks of exposure to ozone decreased KL levels in airway epithelial cells. CSE and TNFα (tumour necrosis factor α) decreased KL expression and release from airway epithelial cells, which was associated with enhanced pro-inflammatory cytokine expression. Moreover, KL depletion increased cell sensitivity to cigarette smoke-induced inflammation and oxidative stress-induced cell damage. These effects involved the NF-κB (nuclear factor κB), MAPK (mitogen-activated protein kinase) and Nrf2 (nuclear factor erythroid 2-related factor 2) pathways. Reduced KL expression in COPD airway epithelial cells was associated with increased oxidative stress, inflammation and apoptosis. These data provide new insights into the mechanisms associated with the accelerated lung aging in COPD development.

  1. Erythropoietin reduces ischemia-reperfusion injury after liver transplantation in rats. (United States)

    Schmeding, Maximilian; Hunold, Gerhard; Ariyakhagorn, Veravoorn; Rademacher, Sebastian; Boas-Knoop, Sabine; Lippert, Steffen; Neuhaus, Peter; Neumann, Ulf P


    Human recombinant Erythropoietin (rHuEpo) has recently been shown to be a potent protector of ischemia- reperfusion injury in warm-liver ischemia. Significant enhancement of hepatic regeneration and survival after large volume partial hepatic resection has also been demonstrated. It was the aim of this study to evaluate the capacities of rHuEpo in the setting of rat liver transplantation. One-hundred-and-twenty Wistar rats were used: 60 recipients received liver transplantation following donor organ treatment (60 donors) with either 1000 IU rHuEpo or saline injection (controls) into portal veins (cold ischemia 18 h, University of Wisconsin (UW) solution). Recipients were allocated to two groups, which either received 1000 IU rHuEpo at reperfusion or an equal amount of saline (control). Animals were sacrificed at defined time-points (2, 4.5, 24, 48 h and 7 days postoperatively) for analysis of liver enzymes, histology [hematoxylin-eosin (HE) staining, periodic acid Schiff staining (PAS)], immunostaining [terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), Hypoxyprobe] and real-time polymerase chain reaction (RT-PCR) of cytokine mRNA (IL-1, IL-6). Lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) values were significantly reduced among the epo-treated animals 24 and 48 h after liver transplantation (LT). The TUNEL and Hypoxyprobe analyses as well as necrotic index evaluation displayed significant reduction of apoptosis and necrosis in rHuEpo-treated graft livers. Erythropoietin reduces ischemia-reperfusion injury after orthotopic liver transplantation in rats.

  2. 昆山爆炸事故成批烧冲复合伤患者的抢救调配及护理%Rescue, allocation and nursing of multiple- patient burn- blast combined injury in Kunshan explosive accident

    Institute of Scientific and Technical Information of China (English)

    朱利红; 赵朋; 华皎; 袁琴芳; 王芳; 任颖伟; 孙丹; 周竞奋; 吕国忠


    目的:探讨突发成批烧冲复合伤患者的护理及各个环节的配合及质量控制情况。方法对35例烧冲复合伤患者在第一时间启动应急预案,其中包括人员调配、物资调配、护理质量控制、病区监控等。结果35例烧冲复合伤患者在第一时间得到了及时有效的烧伤抗休克治疗及护理。成批烧冲复合伤患者抢救成功率达77.14%(27/35),无一例护理并发症。结论护理人员及时调配到位,其数量与结构合理和组织协调有力,物资配备齐全及时,护理应急质量管理控制规范和措施得力,是确保此次突发成批烧冲复合伤危重患者救治成功的关键,是护理质量保障的体现。%Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

  3. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)


    textabstractBurn injuries arc among the worst traumas which can happen to man. The larger a burn injury, the more severe the consequences and the highcr the chance of an adverse outcome or even death. In The Netherlands each year 40,000 people visit a general practitioner for treatment of a burn wou

  4. Reducing the oxidative stress mediates the cardioprotection of bicyclol against ischemia-reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Jie CUI; Zhi LI; Ling-bo QIAN; Qin GAO; Jue WANG; Meng XUE; Xiao-e LOU


    Objective:To investigate the beneficial effect of bicyclol on rat hearts subjected to ischemia-reperfusion (IR) injuries and its possible mechanism.Methods:Male Sprague-Dawley rats were intragastrically administered with bicyclol (25,50 or 100 mg/(kg·d)) for 3 d.Myocardial IR was produced by occlusion of the coronary artery for 1 h and reperfusion for 3 h.Left ventricular hemodynamics was continuously monitored.At the end of reperfusion,myocardial infarct was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining,and serum lactate dehydrogenase (LDH) level and myocardial superoxide dismutase (SOD) activity were determined by spectrophotometry.Isolated ventricular myocytes from adult rats were exposed to 60 min anoxia and 30 min reoxygenation to simulate IR injuries.After reperfusion,cell viability was determined with trypan blue; reactive oxygen species (ROS) and mitochondrial membrane potential of the cardiomyocytes were measured with the fluorescent probe.The mitochondrial permeability transition pore (mPTP) opening induced by Ca2+ (200 μmol/L) was measured with the absorbance at 520 nm in the isolated myocardial mitochondria.Results:Low dose of bicyclol (25 mg/(kg·d)) had no significant improving effect on all cardiac parameters,whereas pretreatment with high bicyclol markedly reduced the myocardial infarct and improved the left ventricular contractility in the myocardium exposed to IR (P<0.05).Medium dose of bicyclol (50 mg/(kg·d))markedly improved the myocardial contractility,left ventricular myocyte viability,and SOD activity,as well decreased infarct size,serum LDH level,ROS production,and mitochondrial membrane potential in rat myocardium exposed to IR.The reduction of ventricular myocyte viability in IR group was inhibited by pretreatment with 50 and 100 mg/(kg.d) bicyclol (P<0.05 vs.IR),but not by 25 mg/(kg·d) bicyclol.The opening of mPTP evoked by Ca2+ was significantly inhibited by medium bicyclol.Conclusions:Bicyclol exerts

  5. Breviscapine reduces neuronal injury caused by traumatic brain injury insult: partly associated with suppression of interleukin-6 expression

    Directory of Open Access Journals (Sweden)

    Ling Jiang


    Full Text Available Breviscapine, extracted from the herb Erigeron breviscapus, is widely used for the treatment of cardiovascular diseases, cerebral infarct, and stroke, but its mechanism of action remains unclear. This study established a rat model of traumatic brain injury induced by controlled cortical impact, and injected 75 μg breviscapine via the right lateral ventricle. We found that breviscapine significantly improved neurobehavioral dysfunction at 6 and 9 days after injection. Meanwhile, interleukin-6 expression was markedly down-regulated following breviscapine treatment. Our results suggest that breviscapine is effective in promoting neurological behavior after traumatic brain injury and the underlying molecular mechanism may be associated with the suppression of interleukin-6.

  6. Ankle Injuries: Reduce the Risk by Using a Soccer-Specific Warm-up Routine (United States)

    Elliott, Steven; Ellis, Margery; Combs, Sue; Hunt Long, Lynn


    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…

  7. 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.

  8. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease. (United States)

    Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W


    Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

  9. Rehabilitation of the Burned Hand (United States)


    13 Mallet and swan-neck deformities Thermal injury to the terminal slip of the extensor tendon can result in loss of DIP joint extension or mallet...deformity. Injury to the terminal slip can be a result of direct thermal injury or tendon ischemia induced as the injured tendon is compressed between...elastic bandage or self-adherent wrap may be necessary. Cotton socks over the splint may prevent the child from removing the splint. Contact burns

  10. 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


    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.

  11. 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.


    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.


    Institute of Scientific and Technical Information of China (English)

    林建华; 吴国豪


    Objective To investigate the effects of leucine-enriched parenteral nutrion protein loss after burn injury in rabbits and its mechanism. Method Forty New Zealand white rabbits were inflicted with 15% total body surface area full thickness burn and given parenterally different nutrition supports including glucose (Glu group), basal and parenteral nutrition (BPN group), BCAA-enriched PN (BCAA group), and leucine-enriched PN (Leu group). Three parenteral nutrition flaids were infused both isonitrogenously and isocalorically 7 d later. The ratio of leucine to total amino acids was 6.9%, 12.8% and 35.9% respectively. A stable isotope tracer research with L-[1-13C]-phenylalanine was started 1h after nutrition support to determine hindquarter muscle protein metabolism. Results Compared to Glu group, protein synthesis rates of BCAA group and Leu group were both elevated significantly, and the latter group showed more significannce (+206% vs +99%) . Among the three parenteral nutrition groups, only Leu improved the muscle protein balance, and obtained a positive protein balance [0.38±0.10 g/(kg·d) vs-0.74±0.40 g/(kg·d)]. The protein metabolic parameters between Glu group and BPN group, BPN group and BCAA group did not differ significantly. Conclusion Leucine-enriched parenteral nutrition can reduce protein loss effectively in rabbits after burn injury by increasing muscle protein synthesis. [ACTA NUTRIMENTA SINICA, 2012,34(6): 549-552].%目的 观察不同浓度亮氨酸的肠外营养液对烧伤后家兔肌肉蛋白质丢失的影响,并探讨其机制.方法 40只新西兰兔,经沸水造成15%面积的Ⅲ度烧伤,7d后给予不同的静脉营养支持,分别为普通糖水(Glu组)、基础肠外营养(BPN组)、支链氨基酸肠外营养(BCAA组)、和高亮氨酸肠外营养(Leu组).其中BPN,BCAA,Leu组肠外营养液按等氮等能量配置,亮氨酸分别占总氨基酸的6.9%、12.8%、35.9%.营养支持1h后开始L-[1-13C]-苯丙氨酸同位素示

  13. Application of exercise rehabilitation therapy in 96 children with burn injury%运动康复疗法在96例烧烫伤患儿康复中的应用

    Institute of Scientific and Technical Information of China (English)

    刘锐; 郭振荣; 金明珠; 曹卫红; 李宗瑜; 苏海涛; 牟滨; 孙艳秋; 赵雁楠; 王江红


    目的::研究运动康复疗法在烧伤患儿康复治疗中的作用。方法:2014年1月-10月收治的96例烧(烫)伤患儿,均为深Ⅱ度创面、均经非手术治疗创面愈合。随机分为治疗组(n=48)和对照组(n=48),对照组采用传统康复治疗方法,外用疤痕舒均匀涂布创面(每日2次)、佩戴弹力套。治疗组在对照组治疗基础上,创面愈合后采用肢体训练器械、指法按摩的方法进行主动、被动肢体运动康复治疗8周。康复治疗8周后,分析瘢痕增生指数、疼痛评分、瘙痒评分、日常生活活动能力评价(以Barthel指数代替)、畸形发生率。结果:经过主动、被动肢体运动疗法治疗后,治疗组患儿的温哥华瘢痕评估量表(VSS)瘢痕评分、疼痛评分、瘙痒评分、畸形发生率均明显低于对照组,日常生活活动能力评分明显高于对照组(P<0.05)。结论:运动康复疗法可以明显减轻儿童烧(烫)伤患者瘢痕增生程度,降低畸形发生率。%Objective:To investigate the effect of rehabilitation therapy in form of physical exercise in children with burn injury. Methods:Ninety-six children with deep Ⅱ degree burns involving (19.0±16.5)% TBSA,were admitted from January to October in 2014 to the Fifth Hospital of Harbin,were included in this study. After heal-ing of the wound,they were randomly divided into treatment group (n=48)and control group (n=48). In the control group,children received topical drug dressing and wore elastic body suit. In the treatment group,on the bases of the treatment of the control group,they also received physical training with apparatus,massage,and ac-tive and passive joint movement therapy for 8 weeks. The Vancouver Scar Scale (VSS),pruritus degree,pain se-verity,ability of daily life activities (Barthel index),and deformity incidence were compared between the two groups. Results:After active and passive rehabilitation therapy,the VSS and scores of pruritus

  14. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı


    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

  15. Systemic bisperoxovanadium activates Akt/mTOR, reduces autophagy, and enhances recovery following cervical spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Chandler L Walker

    Full Text Available Secondary damage following primary spinal cord injury extends pathology beyond the site of initial trauma, and effective management is imperative for maximizing anatomical and functional recovery. Bisperoxovanadium compounds have proven neuroprotective effects in several central nervous system injury/disease models, however, no mechanism has been linked to such neuroprotection from bisperoxovanadium treatment following spinal trauma. The goal of this study was to assess acute bisperoxovanadium treatment effects on neuroprotection and functional recovery following cervical unilateral contusive spinal cord injury, and investigate a potential mechanism of the compound's action. Two experimental groups of rats were established to 1 assess twice-daily 7 day treatment of the compound, potassium bisperoxo (picolinato vanadium, on long-term recovery of skilled forelimb activity using a novel food manipulation test, and neuroprotection 6 weeks following injury and 2 elucidate an acute mechanistic link for the action of the drug post-injury. Immunofluorescence and Western blotting were performed to assess cellular signaling 1 day following SCI, and histochemistry and forelimb functional analysis were utilized to assess neuroprotection and recovery 6 weeks after injury. Bisperoxovanadium promoted significant neuroprotection through reduced motorneuron death, increased tissue sparing, and minimized cavity formation in rats. Enhanced forelimb functional ability during a treat-eating assessment was also observed. Additionally, bisperoxovanadium significantly enhanced downstream Akt and mammalian target of rapamycin signaling and reduced autophagic activity, suggesting inhibition of the phosphatase and tensin homologue deleted on chromosome ten as a potential mechanism of bisperoxovanadium action following traumatic spinal cord injury. Overall, this study demonstrates the efficacy of a clinically applicable pharmacological therapy for rapid initiation of

  16. Diethylcarbamazine Reduces Chronic Inflammation and Fibrosis in Carbon Tetrachloride- (CCl4- Induced Liver Injury in Mice

    Directory of Open Access Journals (Sweden)

    Sura Wanessa Santos Rocha


    Full Text Available This study investigated the anti-inflammatory effects of DEC on the CCl4-induced hepatotoxicity in C57BL/6 mice. Chronic inflammation was induced by i.p. administration of CCl4 0.5 μL/g of body weight through two injections a week for 6 weeks. DEC (50 mg/kg was administered by gavage for 12 days before finishing the CCl4 induction. Histological analyses of the DEC-treated group exhibited reduced inflammatory process and prevented liver necrosis and fibrosis. Immunohistochemical and immunofluorescence analyses of the DEC-treated group showed reduced COX-2, IL1β, MDA, TGF-β, and αSMA immunopositivity, besides exhibiting decreased IL1β, COX-2, NFκB, IFNγ, and TGFβ expressions in the western blot analysis. The DEC group enhanced significantly the IL-10 expression. The reduction of hepatic injury in the DEC-treated group was confirmed by the COX-2 and iNOS mRNA expression levels. Based on the results of the present study, DEC can be used as a potential anti-inflammatory drug for chronic hepatic inflammation.

  17. Toll-Like Receptor 4 Reduces Oxidative Injury via Glutathione Activity in Sheep

    Directory of Open Access Journals (Sweden)

    Shoulong Deng


    Full Text Available Toll-like receptor 4 (TLR4 is an important sensor of Gram-negative bacteria and can trigger activation of the innate immune system. Increased activation of TLR4 can lead to the induction of oxidative stress. Herein, the pathway whereby TLR4 affects antioxidant activity was studied. In TLR4-overexpressing sheep, TLR4 expression was found to be related to the integration copy number when monocytes were challenged with lipopolysaccharide (LPS. Consequently, production of malondialdehyde (MDA was increased, which could increase the activation of prooxidative stress enzymes. Meanwhile, activation of an antioxidative enzyme, glutathione peroxidase (GSH-Px, was increased. Real-time PCR showed that expression of activating protein-1 (AP-1 and the antioxidative-related genes was increased. By contrast, the expression levels of superoxide dismutase 1 (SOD1 and catalase (CAT were reduced. In transgenic sheep, glutathione (GSH levels were dramatically reduced. Furthermore, transgenic sheep were intradermally injected with LPS in each ear. The amounts of inflammatory infiltrates were correlated with the number of TLR4 copies that were integrated in the genome. Additionally, the translation of γ-glutamylcysteine synthetase (γ-GCS was increased. Our findings indicated that overexpression of TLR4 in sheep could ameliorate oxidative injury through GSH secretion that was induced by LPS stimulation. Furthermore, TLR4 promoted γ-GCS translation through the AP-1 pathway, which was essential for GSH synthesis.

  18. Ghrelin accelerates wound healing through GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways in combined radiation and burn injury in rats. (United States)

    Liu, Cong; Huang, Jiawei; Li, Hong; Yang, Zhangyou; Zeng, Yiping; Liu, Jing; Hao, Yuhui; Li, Rong


    The therapeutic effect of ghrelin on wound healing was assessed using a rat model of combined radiation and burn injury (CRBI). Rat ghrelin, anti-rat tumor necrosis factor (TNF) α polyclonal antibody (PcAb), or selective antagonists of p38 mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase (JNK), and growth hormone secretagogue receptor (GHS-R) 1a (SB203580, SP600125, and [D-Lys3]-GHRP-6, respectively), were administered for seven consecutive days. Levels of various signaling molecules were assessed in isolated rat peritoneal macrophages. The results showed that serum ghrelin levels and levels of macrophage glucocorticoid receptor (GR) decreased, while phosphorylation of p38MAPK, JNK, and p65 nuclear factor (NF) κB increased. Ghrelin inhibited the serum induction of proinflammatory mediators, especially TNF-α, and promoted wound healing in a dose-dependent manner. Ghrelin treatment decreased phosphorylation of p38MAPK, JNK, and p65NF-κB, and increased GR levels in the presence of GHS-R1a. SB203580 or co-administration of SB203580 and SP600125 decreased TNF-α level, which may have contributed to the inactivation of p65NF-κB and increase in GR expression, as confirmed by western blotting. In conclusion, ghrelin enhances wound recovery in CRBI rats, possibly by decreasing the induction of TNF-α or other proinflammatory mediators that are involved in the regulation of GHS-R1a-mediated MAPK-NF-κB/GR signaling pathways.

  19. Mortality rate associated with hospital acquired infections among burn patients

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    Saima Aslam Bharwana


    Full Text Available Hospital acquired infections (HAIs are the major contributors of mortality associated with burn injuries. The aim of this research was to document the antecedents affiliated with major burn injuries, hospitalization and mortality in burn patients. We performed a single center prospective study of patients admitted during 3 months period (April-June 2014 in burn wards of government hospital. There were 100 patients in this investigation which were observed weekly. The inclusion criterion was based on the shifting of patients from emergency to the wards after initial treatment of more than 24 h. Variables included were age and gender of the patient, the percent total body surface area (%TBSA burn, the cause of the burn. Mean age of patients was 30.29 years. More females (55.67% were admitted than males (44.32%. The total body surface area (%TBSA burnt were from 15%- 95% respectively moreover children were more sensitive to hospital acquired infections (HAIs and mortality rate was 34% in children with mean age of 5 years and disability of body parts were 42% among 75% were females. Whereas the most common (HAIs were primary blood stream (PBS with mean value of 30.50, wound infections (WIS were at second prevalence with mean value of 27.50, followed by sepsis (S and pneumonia (P 10.33, eye infections (EIs 4.833 and urinary tract infections (UTIs 2.667. Factors significantly (p-value= 0.000 associated with increased duration of hospitalization caught HAIs mortality include the age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt. It concluded that the mortality was very much dependent on age and gender of the patient, burn causes, affected area as well as %TBSA burnt are considerable factors in determining the relationship of HAIs and whether the patients will survive or knuckle to injuries. Better compliance techniques, stricter control over disinfection and sterilization practices and usage of

  20. Practical screening and intervention to reduce risk of ACL injury in young women



    Injury of the anterior cruciate ligament (ACL) is a relatively common knee injury amongst participants of competitive sports such as soccer, basketball, gymnastics, volleyball and handball. Its incidence amongst young females is two to six times higher than males participating in the same sports due to a number of factors including biomechanical and neuromuscular differences. ACL injury has serious consequences for affected individuals including costly rehabilitation, long recovery time and a...

  1. HGF Gene Modification in Mesenchymal Stem Cells Reduces Radiation-Induced Intestinal Injury by Modulating Immunity.

    Directory of Open Access Journals (Sweden)

    Hua Wang

    Full Text Available Effective therapeutic strategies to address intestinal complications after radiation exposure are currently lacking. Mesenchymal stem cells (MSCs, which display the ability to repair the injured intestine, have been considered as delivery vehicles for repair genes. In this study, we evaluated the therapeutic effect of hepatocyte growth factor (HGF-gene-modified MSCs on radiation-induced intestinal injury (RIII.Female 6- to 8-week-old mice were radiated locally at the abdomen with a single 13-Gy dose of radiation and then treated with saline control, Ad-HGF or Ad-Null-modified MSCs therapy. The transient engraftment of human MSCs was detected via real-time PCR and immunostaining. The therapeutic effects of non- and HGF-modified MSCs were evaluated via FACS to determine the lymphocyte immunophenotypes; via ELISA to measure cytokine expression; via immunostaining to determine tight junction protein expression; via PCNA staining to examine intestinal epithelial cell proliferation; and via TUNEL staining to detect intestinal epithelial cell apoptosis.The histopathological recovery of the radiation-injured intestine was significantly enhanced following non- or HGF-modified MSCs treatment. Importantly, the radiation-induced immunophenotypic disorders of the mesenteric lymph nodes and Peyer's patches were attenuated in both MSCs-treated groups. Treatment with HGF-modified MSCs reduced the expression and secretion of inflammatory cytokines, including tumor necrosis factor alpha (TNF-α and interferon-gamma (IFN-γ, increased the expression of the anti-inflammatory cytokine IL-10 and the tight junction protein ZO-1, and promoted the proliferation and reduced the apoptosis of intestinal epithelial cells.Treatment of RIII with HGF-gene-modified MSCs reduces local inflammation and promotes the recovery of small intestinal histopathology in a mouse model. These findings might provide an effective therapeutic strategy for RIII.

  2. Inhalation of hydrogen gas reduces liver injury during major hepatotectomy in swine

    Institute of Scientific and Technical Information of China (English)

    Lei Xiang; Jing-Wang Tan; Li-Jie Huang; Lin Jia; Ya-Qian Liu; Yu-Qiong Zhao; Kai Wang; Jia-Hong Dong


    Contrast-group (P =0.0005,P =0.0004).In Hydrogen-group,the HA level was also significantly low to Contrast-group (P =0.0005,P =0.0005) although the two groups all increased at PH 1 h and 3 h.The expression of cluster of differentiation molecule 31 molecules Hydrogen-group was low to Contrast-group.However,PCNA index (%) was not statistically significant between the two groups (P =0.802).Microphotometric evaluation of apoptotic index (AI) in terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling-stained tissue after hepatotectomy for 3h,the AI% level in the hydrogen was significantly low to Contrast-group (P =0.012).There were no significant difference between Hydrogen-group and Contrast-group at pre-operation (P =0.653,P =0.423),but after massive hepatotectomy,the TNF-α and IL-6 levels increase,and its in Hydrogen-group was significantly low compared with Contrast-group (P =0.022,P =0.013,vs P =0.016,P =0.012),respectively.Hydrogen-gas inhalation reduce levels of these markers and relieved morphological liver injury and apoptosis.CONCLUSION:H2 gas attenuates markedly ischemia and portal hyperperfusion injury in pigs with massive hepatotectomy,possibly by the reduction of inflammation and oxidative stress,maybe a potential agent for treatment in clinic.

  3. The rehabilitation of hand burns%手烧伤的康复治疗

    Institute of Scientific and Technical Information of China (English)

    郭华; 舒甜; 秦萍; 何成奇


    手烧伤是烧伤中的常见情况。手表面积占全身表面积不足5%,但手损伤后的功能影响却是巨大的。手损伤后,可能导致严重的畸形、功能障碍,并且伴有感觉减退、感觉异常、瘙痒、关节活动度减小等问题。尤其在早期,将会严重影响患者的身体、心理健康及其在生活、工作中的参与,降低其自我效能,影响生活质量。该综述旨在总结临床上对手烧伤的康复治疗,降低烧伤带来的原发和继发影响,为临床更系统全面治疗手烧伤提供参考。%Hand burns are common seen in burns injury. Although the total area of hand is less than 5% of the whole body, hand burns injury can cause severe dysfunction. Following the hand burns injury, patients may suffer from the severe deformity and dysfunction of hand, with decreased sensation, paresthesia like itch and hyperesthesia and also decreased range of motion. All of those can have bad inlfuences on patients' physical and mental health, which may lead to the decreased involvement into daily activities and work and ifnally reduce the self-efifcacy and quality of life of patients especially in the acute stage. This review provides a clear view and guidance of rehabilitation therapy to manage the hand burns injury to reduce the inlfuences of burns injury and secondary injury and to make a good outcome.

  4. Perineal burn contractures: An experience in tertiary hospital of a Himalayan state


    Thakur Jagdeep; Chauhan C. G. S; Diwana Vijay; Chuahan Dayal; Thakur Anamika


    Perineal burn contracture is a rare burn sequel. We conducted a retrospective analysis of cases with perineal burn contractures managed in a tertiary care centre of a Himalayan state. We found that all cases sustained burn injury from burning firewood and the time of presentation was two to six years after the burn injury. We analyzed our treatment method and have classified these contractures into two types.

  5. Perineal burn contractures: An experience in tertiary hospital of a Himalayan state

    Directory of Open Access Journals (Sweden)

    Thakur Jagdeep


    Full Text Available Perineal burn contracture is a rare burn sequel. We conducted a retrospective analysis of cases with perineal burn contractures managed in a tertiary care centre of a Himalayan state. We found that all cases sustained burn injury from burning firewood and the time of presentation was two to six years after the burn injury. We analyzed our treatment method and have classified these contractures into two types.

  6. 乌司他丁对吸入性损伤患者早期肺功能的保护作用%Protective effects of ulinastatin on early pulmonary function of patients with burn and smoke inhalation injury

    Institute of Scientific and Technical Information of China (English)

    丁伟; 吕大伦; 徐祥; 王合丽; 王箴


    Objective:To observe the effects of ulinastatin on inflammatory response and early pulmonary function in the patients with burn and smoke in-halation injury.Methods:Forty-three patients with severe inhalation injury were randomly allocated to the experimental group (n=21) and control group ( n=22 ) .Two groups of patients received conventional therapy of burn injury ,and the experimental group were given additional intravenous drip of ulinas-tatin in dose of 10 000 U/(kg· d) for 7 days.Before treatment and at day 1,4 and 7 after treatment,blood samples were taken from peripheral veins for determination of C-reactive protein (CRP),TNF-α,IL-6,IL-10 and SOD activities.Besides,APACHEⅡ scoring was maintained at day 1,4,7 and 14,re-spectively,for evaluation of the incidence of pulmonary infection in the two groups.Results:By comparison with the control group at day 4 and 7 after treat-ment,significantly elevated PaO2,PaO2/FiO2,IL-10 and SOD,yet markedly reduced TNF-αand IL-6 levels were observed in patients from experimental group,and the CRP level was also significantly lowed,which showed statistical difference(P<0.05).Although the APACHEⅡ scores had no significant difference between two groups, the experimental group had lower incidence rate and delayed occurrence of pneumonia within 14 days of therapy. Conclusion:Complementary therapy with ulinastatin during the early phase may effectively inhibit the inflammatory response ,improve the pulmonary func-tion and reduce the incidence of pneumonia for patients with burn and smoke-induced inhalation injury.%目的:研究乌司他丁( ulinastatin)对吸入性损伤患者早期炎症反应的影响及肺功能保护作用。方法:43例重症烧伤合并吸入性损伤患者,随机分为乌司他丁治疗组(21例)和对照组(22例),两组常规治疗一致,乌司他丁组在此基础上给予1万U/( kg· d)静脉滴注,连续用药7 d。分别于治疗开始前、治疗后第1天、第4

  7. 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.


    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

  8. Melatonin inhibits cholangiocarcinoma and reduces liver injury in Opisthorchis viverrini-infected and N-nitrosodimethylamine-treated hamsters. (United States)

    Laothong, Umawadee; Pinlaor, Porntip; Boonsiri, Patcharee; Pairojkul, Chawalit; Priprem, Aroonsri; Johns, Nutjaree Pratheepawanit; Charoensuk, Lakhanawan; Intuyod, Kitti; Pinlaor, Somchai


    The human liver fluke Opisthorchis viverrini infection and N-nitrosodimethylamine (NDMA) administration induce cholangiocarcinoma (CCA) and liver injury in hamsters. Melatonin protects against liver injury and reduces the alteration of mitochondrial structure, mitochondrial membrane potential, and mitochondrial pro- and anti-apoptotic pathways in various cancer types. To investigate the chemopreventive effect of melatonin on CCA genesis and liver injury, hamsters were treated with a combination of O. viverrini infection and NDMA concurrently administered with melatonin (10 mg/kg and 50 mg/kg) for 120 days. Melatonin treatment at 50 mg/kg caused a significant reduction in liver/body weight ratios and decreased tumor volumes leading to an increase in the survival of animals. In the tumorous tissues, the high-dose melatonin reduced DNA fragmentation and mitochondrial apoptosis by inducing anti-apoptotic protein (Bcl-2) in the mitochondrial fraction and down-regulating cytochrome c, pro-apoptotic protein (Bax), and caspase-3 in tumor cytosol. Moreover, a high-dose melatonin treatment significantly increased mitochondrial antioxidant enzymes and prevented mitochondrial ultrastructure changes in the tumor. Overall, melatonin has potent chemopreventive effects in inhibiting CCA genesis and also reduces liver injury in hamster CCA, which, in part, might involve in the suppression of CCA by reducing tumor mitochondria alteration.

  9. Hepatic and intestinal blood flow following thermal injury

    Energy Technology Data Exchange (ETDEWEB)

    Carter, E.A.; Tompkins, R.G.; Burke, J.F.


    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.

  10. Bad advice; bad burn: a new problem in burn prevention. (United States)

    Deans, L; Slater, H; Goldfarb, I W


    Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.

  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:; 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)


    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. Rapamycin upregulates autophagy by inhibiting the mTOR-ULK1 pathway, resulting in reduced podocyte injury.

    Directory of Open Access Journals (Sweden)

    Lingling Wu

    Full Text Available The podocyte functions as a glomerular filtration barrier. Autophagy of postmitotic cells is an important protective mechanism that is essential for maintaining the homeostasis of podocytes. Exploring an in vivo rat model of passive Heymann nephritis and an in vitro model of puromycin amino nucleotide (PAN-cultured podocytes, we examined the specific mechanisms underlying changing autophagy levels and podocyte injury. In the passive Heymann nephritis model rats, the mammalian target-of-rapamycin (mTOR levels were upregulated in injured podocytes while autophagy was inhibited. In PAN-treated podocytes, mTOR lowered the level of autophagy through the mTOR-ULK1 pathway resulting in damaged podocytes. Rapamycin treatment of these cells reduced podocyte injury by raising the levels of autophagy. These in vivo and in vitro experiments demonstrate that podocyte injury is associated with changes in autophagy levels, and that rapamycin can reduce podocyte injury by increasing autophagy levels via inhibition of the mTOR-ULK1 pathway. These results provide an important theoretical basis for future treatment of diseases involving podocyte injury.

  13. Outlier detection and removal improves accuracy of machine learning approach to multispectral burn diagnostic imaging. (United States)

    Li, Weizhi; Mo, Weirong; Zhang, Xu; Squiers, John J; Lu, Yang; Sellke, Eric W; Fan, Wensheng; DiMaio, J Michael; Thatcher, Jeffrey E


    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.

  14. Outlier detection and removal improves accuracy of machine learning approach to multispectral burn diagnostic imaging (United States)

    Li, Weizhi; Mo, Weirong; Zhang, Xu; Squiers, John J.; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.


    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.

  15. Hypothermic machine preservation reduces molecular markers of ischemia/reperfusion injury in human liver transplantation. (United States)

    Henry, S D; Nachber, E; Tulipan, J; Stone, J; Bae, C; Reznik, L; Kato, T; Samstein, B; Emond, J C; Guarrera, J V


    Hypothermic machine perfusion (HMP) is in its infancy in clinical liver transplantation. Potential benefits include diminished preservation injury (PI) and improved graft function. Molecular data to date has been limited to extrapolation of animal studies. We analyzed liver tissue and serum collected during our Phase 1 trial of liver HMP. Grafts preserved with HMP were compared to static cold stored (SCS) transplant controls. Reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry and transmission electron microscopy (TEM) were performed on liver biopsies. Expression of inflammatory cytokines, adhesion molecules and chemokines, oxidation markers, apoptosis and acute phase proteins and the levels of CD68 positive macrophages in tissue sections were evaluated. RT-PCR of reperfusion biopsy samples in the SCS group showed high expression of inflammatory cytokines, adhesion molecules and chemokines, oxidative markers and acute phase proteins. This upregulation was significantly attenuated in livers that were preserved by HMP. Immunofluorescence showed larger numbers of CD68 positive macrophages in the SCS group when compared to the HMP group. TEM samples also revealed ultrastructural damage in the SCS group that was not seen in the HMP group. HMP significantly reduced proinflammatory cytokine expression, relieving the downstream activation of adhesion molecules and migration of leukocytes, including neutrophils and macrophages when compared to SCS controls.

  16. Erdosteine protects rat testis tissue from hypoxic injury by reducing apoptotic cell death. (United States)

    Guven, A; Ickin, M; Uzun, O; Bakar, C; Balbay, E Gulec; Balbay, O


    The purpose of this study was to examine the effects of hypobaric hypoxia on testis morphology and the effects of erdosteine on testis tissue. Caspase-3 and hypoxia-inducible factor 1α expressions were detected by immunohistochemistry. Adult male Wistar rats were placed in a hypobaric hypoxic chamber. Rats in the erdosteine group were exposed to the same conditions and treated orally with erdosteine (20 mg kg(-1) daily) at the same time from the first day of hypoxic exposure for 2 weeks. The normoxia group was evaluated as the control. The hypoxia group showed decreased height of spermatogenic epithelium in some seminiferous tubules, vacuolisation in spermatogenic epithelial cells, deterioration and gaps in the basal membrane and an increase in blood vessels in the interstitial area. The erdosteine group showed amelioration of both epithelial cell vacuolisation and basal membrane deterioration. Numbers of hypoxia-inducible factor 1α-immunostained Sertoli and Leydig cells were significantly higher in the hypoxia group than in the erdosteine group. The number of seminiferous tubules with caspase-3-immunostained germ cells was highest in the hypoxia group and decreased in the erdosteine and normoxia groups respectively. Based on these observations, erdosteine protects testis tissue from hypoxic injury by reducing apoptotic cell death.

  17. Rosuvastatin reduces neointima formation in a rat model of balloon injury

    Directory of Open Access Journals (Sweden)

    Preusch MR


    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.

  18. Severe Calorie Restriction Reduces Cardiometabolic Risk Factors and Protects Rat Hearts from Ischemia/Reperfusion Injury (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.


    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

  19. Effects of glutamine combined with ulinastatin on inflammatory response of patients with severe burn injury%谷氨酰胺联合乌司他丁对严重烧伤患者炎症反应的影响

    Institute of Scientific and Technical Information of China (English)

    孙勇; 王良喜; 周宜芳; 孙曙光; 毛学飞; 邓向东; 张盼


    significant difference was observed in nitrogen balance and the serum levels of D-lactate,DAO between group G + U and group G (P values all above 0.05).The serum levels of LPS,TNF-α,and IL-6 in group G + U ten days after treatment were respectively (0.167 ±0.064) EU/mL,(43 ± 14) pg/mL,(139 ±23) pg/mL,which were significantly lower than those in group G [(0.240 ±0.079) EU/mL,(59 ±8) pg/mL,(195 ±31) pg/mL,respectively,P < 0.05 or P < 0.01].The would healing rate on PBD 30 and total hospital stay days in group G were respectively higher and shorter than those in group C (P values all below 0.01),but no statistically significant difference in the incidence of burn sepsis was found between them (P > 0.05).The would healing rate on PBD 30 in group G + U [(96 ±4)%] was enhanced,and total hospital stay days [(41 ±4) d] were lowered than those in group G [(88 ± 7) %,(49 ± 5) d,P values all below 0.01].The incidence of burn sepsis of patients in group G + U (5%) was significantly lower than that in group C (35%,x 2 =6.234,P <0.05).Conclusions Glutamine combined with ulinastatin treatment can alleviate damage to intestine after severe burn injury,lower the serum level of inflammatory cytokines,promote wound healing,and reduce the incidence of burn sepsis.%目的 观察谷氨酰胺联合乌司他丁对严重烧伤患者炎症反应的影响. 方法 选择笔者单位2010年1月-2011年12月收治入院且符合入选标准的60例严重烧伤患者,按照随机数字表法分为常规治疗组20例、谷氨酰胺组20例、联合用药组20例,另选10名健康志愿者作为健康对照组.3组烧伤患者于伤后2d起均给予等氮、等热量的营养支持;给予谷氨酰胺组患者的蛋白质中0.3g/kg由谷氨酰胺双肽提供,使用10 d;联合用药组患者同谷氨酰胺组处理,另在应用谷氨酰胺双肽的10 d中7d静脉注射乌司他丁100 kU,每隔8h注射1次.3组烧伤患者于治疗前ld和治疗后10 d收集24 h尿液,用微量

  20. Histomorphologic change of radiation pneumonitis in rat lungs: captopril reduces rat lung injury induced by irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee [College of Medicine, Keimhyung Univ., Taegu (Korea, Republic of)


    To assess the histomorphologic changes in the rat lung injury induced by radiation, to determine whether captopril reduces the rat lung injury and to evaluate change in TNF-{alpha} and TGF {beta} and rat lung damage by radiation and captopril. Right lungs in male Sprague-Dawley rats were divided irradiation alone (10, 20, 30 Gy) or radiation (same dose with radiation alone group) with captopril (500 mg/L). Radiation alone group were sacrificed at twelve hours and eleven weeks after radiation and radiation with captopril group (captopril group) were sacrificed at eleven weeks after radiation with captopril. We examined the light microscope and electron microscopic features in the groups. In radiation alone group, there were patch parenchymal collapse and consolidation at twelve hours after radiation. The increase of radiation dose shows more prominent the severity and broader the affected areas. Eleven weeks after radiation, the severity and areas of fibrosis had increased in proportion to radiation dose given in the radiation alone group. There was notable decrease of lung fibrosis in captopril group than in radiation alone group. The number of mast cells rapidly increased with increase of radiation dose in radiation alone group and the degree of increase of mast cell number and severity of collagen accumulation more decreased in captopril group than in radiation alone group. In radiation alone group expression of TNF-{alpha} and TGF-{beta}] increased according to increase of radiation dose at twelve hours after radiation in both group. At eleven weeks after radiation, expression of TGF- P increased according to increase of radiation dose in radiation group but somewhat decreased in captopril group. In the captopril group the collagen deposition increased but less dense than those of radiation alone group. The severity of perivascular thickening, capillary change, the number and degranulation of mast cells more decreased in the captopril group than in the radiation

  1. Ethyl pyruvate reduces myocardial ischemia and reperfusion injury by inhibiting high mobility group box 1 protein in rats. (United States)

    Hu, Xiaorong; Cui, Bo; Zhou, Xiaoya; Xu, Changwu; Lu, Zhibing; Jiang, Hong


    High mobility group box 1 protein (HMGB1) plays an important role in myocardial ischemia and reperfusion (I/R) injury. Ethyl pyruvate (EP), a potent reactive oxygen species scavenger, has been reported to inhibit myocardial apoptosis and reduce myocardial I/R injury. The aim of this study was to investigate the mechanism by which EP reduces myocardial I/R injury in rats. Anesthetized male rats were once treated with EP (50 mg/kg, i.p.) before ischemia, and then subjected to ischemia for 30 min followed by reperfusion for 4 h. Lactate dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA), superoxide dismutase (SOD) activity and infarct size were measured. HMGB1 expression was assessed by immunoblotting. The results showed that pretreatment of EP (50 mg/kg) could significantly reduce the infarct size and the levels of LDH and CK after 4 h reperfusion (all PR. The present study suggested that ethyl pyruvate could attenuate myocardial I/R injury by inhibiting HMGB1 expression.

  2. 涌泉穴烧山火针法治疗脊髓损伤临床观察%Clinical Observations on Mountain-burning Fire Acupuncture at Point Yongquan(KI1) for the Treatment of Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    余鸿斌; 于柏清; 杜振欢; 杨汉晖


    目的:观察采用涌泉穴烧山火针法治疗脊髓损伤的疗效。方法将30例脊髓损伤患者随机分为观察组和对照组,每组15例。对照组仅采用现代康复治疗,观察组采用涌泉穴烧山火针法配合运动康复治疗。结果观察组总有效率为93.3%,对照组总有效率为73.3%,观察组总有效率明显优于对照组(P<0.05)。结论涌泉穴烧山火针法治疗脊髓损伤疗效显著,有效提高患者大小便功能、性功能及肢体活动能力。%ObjectiveTo investigate the efficacy of mountain-burning fire acupunctureat point Yongquan(KI1)in treating spinal cord injury.MethodThirty patients with spinal cord injury were randomly allocated to observation and control groups, 15 cases each. The control group received modern rehabilitation therapy and the observationgroup, mountain-burning fire acupuncture at point Yongquan plus exercise rehabilitation therapy.ResultThe total efficacy rate was 93.3% in the observation group and 73.3% in the control group. The total efficacy rate increased significantly in the observation group and was significantly higher than in the control group(P<0.05).ConclusionMountain-burning fire acupuncture at point Yongquan has a marked therapeutic effect on spinal cord injury and effectively improves urinary and fecal voiding, sexual and limb motor functions in the patients.

  3. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona


    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

  4. Simvastatin Treatment Improves Survival in a Murine Model of Burn Sepsis (United States)

    Beffa, David C; Fischman, Alan J.; Fagan, Shawn P.; Hamrahi, Victoria F.; Kaneki, Masao; Yu, Yong-Ming; Tompkins, Ronald G.; Carter, Edward A.


    Infection is the most common and most serious complication of a major burn injury related to burn size. Despite improvements in antimicrobial therapies sepsis still accounts for 50–60% of deaths in burn patients. Given the acute onset and unpredictable nature of sepsis, primary prevention was rarely attempted in its management. However, recent studies have demonstrated that statin treatment can decrease mortality is a murine model of sepsis by preservation of cardiac function and reversal of inflammatory alterations. In addition, it has been shown that treatment with statins is associated with reduced incidence of sepsis in human patients. In the current study groups of CD1 male mice (n=12) were anesthetized and subjected to a dorsal 30% TBSA scald burn injury. Starting 2 hours post burn, the animals were divided into a treatment group receiving 0.2 µ/g simvastatin or a sham group receiving placebo. Simvastatin and placebo were administered by intraperitoneal injection with two dosing regimens; once daily and every 12 hours. On Post burn day 7 cecal ligation and puncture with a 21-gauge needle was performed under ketamine/xylazine anesthesia and the two different dosing schedules were continued. A simvastatin dose dependant improvement in survival was observed in the burn sepsis model. PMID:21145172

  5. 3,5-diiodo-L-thyronine powerfully reduces adiposity in rats by increasing the burning of fats. (United States)

    Lanni, Antonia; Moreno, Maria; Lombardi, Assunta; de Lange, Pieter; Silvestri, Elena; Ragni, Maurizio; Farina, Paola; Baccari, Gabriella Chieffi; Fallahi, Pupah; Antonelli, Alessandro; Goglia, Fernando


    The effect of thyroid hormones on metabolism has long supported their potential as drugs to stimulate fat reduction, but the concomitant induction of a thyrotoxic state has greatly limited their use. Recent evidence suggests that 3,5-diiodo-L-thyronine (T2), a naturally occurring iodothyronine, stimulates metabolic rate via mechanisms involving the mitochondrial apparatus. We examined whether this effect would result in reduced energy storage. Here, we show that T2 administration to rats receiving a high-fat diet (HFD) reduces both adiposity and body weight gain without inducing thyrotoxicity. Rats receiving HFD + T2 showed (when compared with rats receiving HFD alone) a 13% lower body weight, a 42% higher liver fatty acid oxidation rate, appoximately 50% less fat mass, a complete disappearance of fat from the liver, and significant reductions in the serum triglyceride and cholesterol levels (-52% and -18%, respectively). Thyroid hormones and thyroid-stimulating hormone (TSH) serum levels were not influenced by T2 administration. The biochemical mechanism underlying the effects of T2 on liver metabolism involves the carnitine palmitoyl-transferase system and mitochondrial uncoupling. If the results hold true for humans, pharmacological administration of T2 might serve to counteract the problems associated with overweight, such as accumulation of lipids in liver and serum, without inducing thyrotoxicity. However, the results reported here do not exclude deleterious effects of T2 on a longer time scale as well as do not show that T2 acts in the same way in humans.

  6. Reducing Motor Vehicle-Related Injuries at an Arizona Indian Reservation: Ten Years of Application of Evidence-Based Strategies. (United States)

    Piontkowski, Stephen R; Peabody, Jon S; Reede, Christine; Velascosoltero, José; Tsatoke, Gordon; Shelhamer, Timothy; Hicks, Kenny R


    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. BARC solution for burn injuries

    CERN Multimedia


    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).

  8. 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)


    textabstractHypertrophic scarring and poor intrinsic axon growth capacity constitute major obstacles for spinal cord repair. Thes