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Burns therapy

Pranita Sahay, Mohamed Ibrahime Asif, Prafulla Kumar Maharana, Jeewan S Titiyal
We present two cases of culture-proven fungal keratitis on natamycin treatment which developed periocular erythema, oedema, burning sensation and pruritus within 48 hours of the addition of topical voriconazole. On clinical examination, periocular erythema with induration was noted. A diagnosis of orbital cellulitis was suspected, but the absence of pain and tenderness refuted the diagnosis on clinical grounds. A dermatology consultation was sought, and a diagnosis of periocular contact dermatitis with voriconazole was made...
September 15, 2018: BMJ Case Reports
Scott A Burns, Joshua A Cleland, Darren A Rivett, Suzanne J Snodgrass
BACKGROUND: Recent evidence suggests that physical therapy interventions targeting the hips may improve outcomes, including pain and disability, for patients with low back pain (LBP). Currently, there is conflicting data in regard to whether an individual with LBP needs to have a concurrent hip impairment in order to respond to this approach. The purpose of this clinical trial will be to determine the short and long-term effectiveness of physical therapy interventions directed at the lumbar spine only, versus lumbar spine and hip(s), in individuals with a primary complaint of LBP with a concurrent hip impairment...
September 7, 2018: Brazilian Journal of Physical Therapy
Brenda J Curtis, Jill A Shults, Devin M Boe, Luis Ramirez, Elizabeth J Kovacs
Cutaneous burn injury is one of the most devastating injuries one can obtain with tissue damage extending beyond the skin wound to distal organs, including the gastrointestinal tract, liver, and lungs. Multiple organ failure is a leading cause of death after burn injury resulting in excessive systemic and localized inflammation directly contributing to end organ damage. We postulated that the gut-liver-lung inflammatory axis underscores multiple organ failure in the context of burn injury and is hyper-activated when ethanol intoxication precedes burn...
September 11, 2018: Alcohol
Maryiam Zaman, Aarnoud Huissoon, Matthew Buckland, Smita Patel, Hana Alachkar, J David Edgar, Moira Thomas, Gururaj Arumugakani, Helen Baxendale, Siobhan Burns, Anthony P Williams, Stephen Jolles, Richard Herriot, Ravishankar B Sargur, Peter D Arkwright
Good's syndrome (thymoma and hypogammaglobulinemia) is a rare secondary immunodeficiency disease, previously reported in the published literature as mainly individual cases or small case series. We use the national UK-Primary Immune Deficiency (UKPID) registry to identify a large cohort of patients in the UK with this PID to review its clinical course, natural history and prognosis. Clinical information, laboratory data, treatment and outcome were collated and analysed. Seventy-eight patients with a median age of 64 years, 59% of whom were females were reviewed...
September 14, 2018: Clinical and Experimental Immunology
Ahmad Tarhini, Sameer R Ghate, Raluca Ionescu-Ittu, Ameur M Manceur, Briana Ndife, Philippe Jacques, François Laliberté, Antonio Nakasato, Rebecca Burne, Mei Sheng Duh
Surgery is the mainstay treatment for operable nonmetastatic melanoma, but recurrences are common and limit patients' survival. This study aimed to describe real-world patterns of treatment and recurrence in patients with melanoma and to quantify healthcare resource utilization (HRU) and costs associated with episodes of locoregional/distant recurrences. Adults with nonmetastatic melanoma who underwent melanoma lymph node surgery were identified from the Truven Health MarketScan database (1 January 2008 to 31 July 2017)...
September 13, 2018: Melanoma Research
Bhagwat V Alapure, Yan Lu, Mingyu He, Chih-Chang Chu, Hongying Peng, Filipe Muhale, Yue-Liang Brewerton, Bruce A Bunnell, Song Hong
Severe burns are some of the most challenging problems in clinics and still lack ideal modalities. Mesenchymal stem cells (MSCs) incorporated with biomaterial coverage of burn wounds may offer a viable solution. In this report, we seeded MSCs to a biodegradable hybrid hydrogel, namely ACgel, that was synthesized from unsaturated arginine-based poly(ester amide) (UArg-PEA) and chitosan derivative. MSC adhered to ACgels. ACgels maintained a high viability of MSCs in culture for 6 days. MSC seeded to ACgels presented well in third-degree burn wounds of mice at 8 days post-burn (dpb) after the necrotic full-thickness skin of burn wounds was debrided and filled and covered by MSC-carrying ACgels...
September 14, 2018: Stem Cells and Development
Zhi Cheng, Minoru Nakatsugawa, Chen Hu, Scott P Robertson, Xuan Hui, Joseph A Moore, Michael R Bowers, Ana P Kiess, Brandi R Page, Laura Burns, Mariah Muse, Amanda Choflet, Kousuke Sakaue, Shinya Sugiyama, Kazuki Utsunomiya, John W Wong, Todd R McNutt, Harry Quon
Objective: We explore whether a knowledge-discovery approach building a Classification and Regression Tree (CART) prediction model for weight loss (WL) in head and neck cancer (HNC) patients treated with radiation therapy (RT) is feasible. Methods and materials: HNC patients from 2007 to 2015 were identified from a prospectively collected database Oncospace. Two prediction models at different time points were developed to predict weight loss ≥5 kg at 3 months post-RT by CART algorithm: (1) during RT planning using patient demographic, delineated dose data, planning target volume-organs at risk shape relationships data and (2) at the end of treatment (EOT) using additional on-treatment toxicities and quality of life data...
July 2018: Advances in Radiation Oncology
Ouiam El Anzi, Badreddine Hassam
Henna is used for coloring hair, but also to draw labile skin tattoo. Henna is often mixed with paraphenylenediamine (PPD). We report the case of a female patient presenting with contact eczema due to labile tattoo containing PPD. The study involved a 23-year old young woman with an aesthetic Black Henna tattoo on the back of the hand and on the forearm. This labile tattoo contained PPD. Two days later, the patient developed intensely pruritic, burning erythematovesiculosus and edematous lesions. The lesions involved the tattooed area, corresponding with the original drawing...
2018: Pan African Medical Journal
William C Miller, Irving F Hoffman, Brett S Hanscom, Tran V Ha, Kostyantyn Dumchev, Zubairi Djoerban, Scott M Rose, Carl A Latkin, David S Metzger, Kathryn E Lancaster, Vivian F Go, Sergii Dvoriak, Katie R Mollan, Sarah A Reifeis, Estelle M Piwowar-Manning, Paul Richardson, Michael G Hudgens, Erica L Hamilton, Jeremy Sugarman, Susan H Eshleman, Hepa Susami, Viet Anh Chu, Samsuridjal Djauzi, Tetiana Kiriazova, Duong D Bui, Steffanie A Strathdee, David N Burns
BACKGROUND: People who inject drugs (PWID) have a high incidence of HIV, little access to antiretroviral therapy (ART) and medication-assisted treatment (MAT), and high mortality. We aimed to assess the feasibility of a future controlled trial based on the incidence of HIV, enrolment, retention, and uptake of the intervention, and the efficacy of an integrated and flexible intervention on ART use, viral suppression, and MAT use. METHODS: This randomised, controlled vanguard study was run in Kyiv, Ukraine (one community site), Thai Nguyen, Vietnam (two district health centre sites), and Jakarta, Indonesia (one hospital site)...
September 1, 2018: Lancet
Benjamin Jevans, Conor J McCann, Nikhil Thapar, Alan J Burns
Spinal cord injury (SCI) causes paralysis, multisystem impairment and reduced life expectancy, as yet with no cure. Stem cell therapy can potentially replace lost neurons, promote axonal regeneration and limit scar formation, but an optimal stem cell source has yet to be found. Enteric neural stem cells (ENSC) isolated from the enteric nervous system (ENS) of the gastrointestinal (GI) tract are an attractive source. Here, we used the chick embryo to assess the potential of ENSC to integrate within the developing spinal cord...
September 7, 2018: Journal of Anatomy
Audra T Clark, Xilong Li, Rohan Kulangara, Beverley Adams-Huet, Sarah C Huen, Tarik D Madni, Jonathan B Imran, Herb A Phelan, Brett D Arnoldo, Orson W Moe, Steven E Wolf, Javier A Neyra
Rationale & Objective: Acute kidney injury (AKI) is a common and morbid complication in patients with severe burn. The reported incidence of AKI and mortality in this population vary widely due to inconsistent and changing definitions. We aimed to examine the incidence, severity, and hospital mortality of AKI patients after burn using consensus criteria. Study Design: Retrospective cohort study of adults with thermal injury admitted to the Parkland burn intensive care unit (ICU) from 2008 to 2015...
September 5, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Jerry Tan, Robert Bissonnette, David Gratton, Nabil Kerrouche, Juliana Machado Canosa
BACKGROUND: Combined use of a retinoid and antimicrobial is recommended for acne, however, local tolerability issues may compromise patient adherence and treatment outcome. OBJECTIVES: This multicentre, single-blinded controlled study was designed to determine whether modified adapalene/benzoyl peroxide (A/BPO, Epiduo® , Galderma, France) regimens improve local tolerability during the first four weeks of treatment without impairing efficacy at Week 12. MATERIALS & METHODS: In total, 120 subjects with mild-to-moderate acne received, during the first four weeks, A/BPO daily overnight (A/BPO-EN), A/BPO daily for three hours (A/BPO-3h), A/BPO daily overnight and a provided moisturizer lotion (A/BPO-moisturizer), or A/BPO every other night (A/BPO-EoN)...
September 6, 2018: European Journal of Dermatology: EJD
Jeanne M Marrazzo, Julia C Dombrowski, Michael R Wierzbicki, Charlotte Perlowski, Angela Pontius, Dwyn Dithmer, Jane Schwebke
Background: Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) present serious reproductive health risks and management challenges, with poor control attributed to survival of treatment-resistant biofilm communities. Boric acid is used in various regimens for non-albicans VVC and recurrent BV. We investigated safety and efficacy of a novel boric acid-based vaginal anti-infective with enhanced antibiofilm activity (TOL-463) in treating BV and VVC. Methods: In this phase 2 randomized, investigator-blinded trial conducted at 2 sexual health clinics, women with BV or VVC were randomly assigned (1:1) to 7 nights of TOL-463 vaginal gel or insert...
August 31, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jae-Seong Lee, Ye-Jin Kim, Gi-Youn Hong, Su-Kyung Nam, Tae-Eung Kim
Abdominal wall endometriosis (AWE) occurs in about 0.1% of people with endometriosis, and is often diagnosed postoperatively. Surgical resection is generally used to treat AWE. We successfully treated AWE with ultrasound-guided high-intensity focused ultrasound therapy (USgHIFU). A 37-year-old Korean female presented with a palpable subcutaneous nodule associated with cyclic pain and swelling during menstruation. She was recommended surgical excision three months ago. She had a history of laparoscopic surgery for endometriosis 4 years ago and was interested in less invasive methods of treatment...
September 5, 2018: Gynecological Endocrinology
F Riechelmann, P Kaiser, R Arora
OBJECTIVE: Debridement of soft tissue and bone in an open fracture situation to minimize infection risk and achieve primary skin closure, or to provide conditions for early soft tissue coverage. INDICATIONS: Indications are Gustilo-Anderson grade I-III A-C open fractures. CONTRAINDICATIONS: Contraindications are injuries requiring amputation, burns, and life-threatening injuries which make appropriate treatment temporarily impossible. SURGICAL TECHNIQUE: Removal of gross contamination and macroscopic contaminants; debridement of the wound; complete resection of contaminated and dirty tissue; sparse step-by-step resection of contaminated or non-vital wound and bone margins until vital, bleeding tissue begins; low-pressure irrigation with isotonic irrigation fluid; diagnostic biopsies for microbiological testing; reduction of dead space by interpositioning of muscle or cement spacers loaded with local antibiotics; primary wound closure if tension-free closure possible; otherwise, if resources and knowhow permit and satisfactory clean debridement was achieved, local flap; if flap impossible, debridement not satisfactory, secondary tissue necrosis likely, potential remaining contamination or contamination with fecal matter, then vacuum-assisted closure therapy...
September 4, 2018: Operative Orthopädie und Traumatologie
Yanru Qiao, Christina A Spivey, Junling Wang, Ya-Chen Tina Shih, Jim Y Wan, Julie Kuhle, Samuel Dagogo-Jack, William C Cushman, Marie A Chisholm-Burns
The objective of this study was to examine positive predictive value (PPV) of medication therapy management (MTM) eligibility criteria under Medicare Modernization Act (MMA) and Affordable Care Act (ACA) in identifying patients with medication utilization issues across racial and ethnic groups. The study analyzed Medicare data (2012-2013) for 2 213 594 beneficiaries. Medication utilization issues were determined based on medication utilization measures mostly developed by Pharmacy Quality Alliance. MMA was associated with higher PPV than ACA in identifying individuals with medication utilization issues among non-Hispanic blacks (blacks) and Hispanics than non-Hispanic whites (whites)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Keisuke Murata, Yasuhiko Koga, Norimitsu Kasahara, Yoshimasa Hachisu, Satoshi Nunomura, Nozomi Nakajima, Hideaki Yokoo, Kyoichi Kaira, Toshitaka Maeno, Kunio Dobashi, Kenji Izuhara, Takeshi Hisada
Periostin, an extracellular matrix molecule, is associated with idiopathic pulmonary fibrosis (IPF). It is known that the frequency of familial IPF (FIPF) ranges from 0.5% to 2.2% among IPF cases. However, the relationship between periostin and FIPF has not been previously described. We report the first case of periostin accumulation in the lungs of a patient with an acute exacerbation of FIPF. A 72-year-old woman, diagnosed with FIPF, had been followed up for 5 years. The patient experienced increased dyspnea within a 1-month period and was referred to our hospital...
July 2018: Journal of Thoracic Disease
I Tocco-Tussardi, B Presman, Z Sleem, F Huss
Post-burn infections still stand as the most common/serious complication of burn injuries: sepsis accounts for 50-60% of deaths in burn patients despite improvements in antimicrobial therapies. Among the many potential complications of sepsis/septic shock are hemodynamic instability and perfusion failure. We report the case of a patient developing massive soft tissue necrosis after an episode of acute post-burn septic shock, with possible explanation of an overdosage of vasopressors due to significant body weight increase as an effect of the burn resuscitation...
March 31, 2018: Annals of Burns and Fire Disasters
Y Moutaouakkil, S Siah, A Bennana, Y Tadlaoui, S Makram, Y Cherrah, Y Bousliman, J Lamsaouri
Bacterial resistance is a major concern and the proper use of antibiotics is a global public health priority. Inappropriate use of antibiotic therapy can have serious ecological and pharmaco-economic consequences. The objective of our work was to study the reevaluation of probabilistic antibiotherapy in the burns intensive care unit. A prospective study concerning the clinical-biological reassessment of antibiotic therapy was set up in the burns intensive care unit at the Military Hospital Instruction Mohammed V of Rabat...
March 31, 2018: Annals of Burns and Fire Disasters
Obada Hasan, Wajiha Khan, Muneeba Jessar, Aly Zaheer Pathan, Riaz Hussain Lakdawala
INTRODUCTION: Aeromonas are Gram-negative bacilli often causing necrotizing fasciitis or sepsis in immunocompromised patients. Aeromonas Hydrophila is most often found in immunocompromised patients or those with burns or aquatic trauma. When patients present with a discharge and infection on bone graft donor site and progressive sepsis, an Aeromonas hydrophila infection should be considered in the differential diagnosis. PRESENTATION OF CASE: We report here a rare case of Aeromonas hydrophila with surgical site sepsis/infection in an immunocompromised 69 years old female, with several comorbids...
August 25, 2018: International Journal of Surgery Case Reports
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