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Burns management

Anne Argenta, Latha Satish, Phillip Gallo, Fang Liu, Sandeep Kathju
OBJECTIVE: To determine if local prophylactic application of probiotic bacteria to burn wounds will prevent death in a mouse model of burn wound sepsis. BACKGROUND: Infection remains the most common complication after burn injury and can result in sepsis and death, despite the use of topical and systemic antibiotics. Pseudomonas aeruginosa is a frequently implicated pathogen. Local application of probiotics directly to burn wounds is an attractive novel intervention that avoids the pitfalls of standard antibiotic therapies...
2016: PloS One
H Karimi, S A Motevalian, M Momeni, M Ghadarjani
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...
December 31, 2015: Annals of Burns and Fire Disasters
D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
Sindhu Doppalapudi, Anjali Jain, Dhiraj Kumar Chopra, Wahid Khan
Psoralen in combination with ultraviolet A radiation (PUVA) is an FDA recommended therapy for clinical application in the management of severe recalcitrant psoriasis. Psoralen acts by intercalation of DNA and upon exposure to UV-A, it forms monoadducts which inturn induce apoptosis. Poor skin deposition, weak percutaneous permeability of psoralen and adverse effects of severe burning, blisters, pigmentation associated with conventional topical psoralen vehicles hinders the therapeutic efficacy and safety of topical PUVA...
October 21, 2016: European Journal of Pharmaceutical Sciences
O M Aboyade, R Beauclair, O N Mbamalu, T R Puoane, G D Hughes
BACKGROUND: Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE). METHOD: A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250)...
October 24, 2016: BMC Complementary and Alternative Medicine
Belinda Goodenough, Richard Fleming, Michael Young, Kim Burns, Cindy Jones, Fallon Forbes
Providing information about latest research via educational sessions to health professionals caring for people with dementia may be insufficient to drive change. This project explored self-reported impacts on practice change of adding information about knowledge translation (KT) to a national dementia education program. Six national workshop days were held. Each provided the option of participating in a Principles of KT and innovation implementation seminar in addition to a clinical topic update (sexualities and dementia, or managing behavioural and psychological symptoms of dementia)...
October 24, 2016: Gerontology & Geriatrics Education
Ruohollah Seddigh, Esmat Abdollahpour, Somayeh Azarnik, Behnam Shariati, Amir-Abbas Keshavarz-Akhlaghi
Objectives: To explore the experiences of general practitioners who continue to sit a highly-competitive residency entrance examination, despite repeated failure. Methods: This qualitative, exploratory study employed semi-structured, in-depth interviews with 35 candidates of a residency entrance exam who had failed the examination at least twice and were preparing to sit it again. Interview questions addressed the challenges they faced and how they managed these challenges...
October 22, 2016: International Journal of Medical Education
Nehemiah T Liu, José Salinas, Craig A Fenrich, Maria L Serio-Melvin, George C Kramer, Ian R Driscoll, Martin A Schreiber, Leopoldo C Cancio, Kevin K Chung
INTRODUCTION: The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full-thickness (FT) involvement affected overall 24-hour burn resuscitation volumes. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns that required resuscitation using our computerized decision support system for burn fluid resuscitation...
November 2016: Journal of Trauma and Acute Care Surgery
Timothy D Girard, Waleed Alhazzani, John P Kress, Daniel R Ouellette, Gregory A Schmidt, Jonathon D Truwit, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Peter E Morris
BACKGROUND: Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST), provides evidence-based recommendations to optimize liberation from mechanical ventilation in critically ill adults. METHODS: Two methodologists performed evidence syntheses to summarize available evidence relevant to key questions about liberation from mechanical ventilation...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
Minoru Hayashi, Hideyuki Muramatsu, Minoru Nakano, Naoto Yamamoto, Ryohei Tokunaka, Kazuya Umezawa, Akito Hamajima, Natsue Araki, Shinya Yoshimoto
: The use of cultured epithelial autografts for the treatment of extensive burn wounds has become popular in recent years. We examined extensive burn wounds in 14 patients by using a combination of autograft and cultured epithelial autografts developed in Japan (JACE). METHODS: We undertook a skin biopsy at 2, 4, and 6 weeks after transplantation with JACE. By using electron microscopy we observed the engraftment process. RESULTS: In transmission electron microscope findings, we recognized the engraftment process of JACE...
September 2016: Plastic and Reconstructive Surgery. Global Open
So Young Joo, Yoon Soo Cho, Sung-Rae Cho, Dohern Kym, Cheong Hoon Seo
PURPOSE: Pain Scrambler therapy is a patient-specific electrocutaneous nerve stimulation device. Burn pruritus is a common form of chronic and disabling neuropathic pain that is often difficult to treat effectively. Pruritus is mediated by histamines, which are effector molecules stored in mast cells and released locally during injury or inflammation. Burn pruritus may be accompanied by peripheral neuropathic pain, which may result from injury to sensory nerves that hampers conductance of neuronal messages along the large A and small C afferent fibers to the spinal cord...
October 15, 2016: Burns: Journal of the International Society for Burn Injuries
Michael S Toce, Michele M Burns, Katherine A O'Donnell
CONTEXT: Exploratory buprenorphine ingestions in young children have been associated with clinically significant toxicity. However, detailed data on the clinical presentation and management of these patients are lacking. In an attempt to obtain more comprehensive data, we sought to examine a single center cohort of patients with report of buprenorphine exposure and provide descriptive analysis of rates of respiratory depression, time to respiratory depression, interventions, disposition, and outcomes...
October 19, 2016: Clinical Toxicology
Peter W Ganzlin, Michael J Gundale, Rachel E Becknell, Cory C Cleveland
Decades of fire suppression following extensive timber harvesting have left much of the forest in the intermountain western United States exceedingly dense, and forest restoration techniques (i.e., thinning and prescribed fire) are increasingly being used in an attempt to mitigate the effects of severe wildfire, to enhance tree growth and regeneration, and to stimulate soil nutrient cycling. While many of the short-term effects of forest restoration have been established, the long-term effects on soil biogeochemical and ecosystem processes are largely unknown...
July 2016: Ecological Applications: a Publication of the Ecological Society of America
David P Blair, Lachlan M McBurney, Wade Blanchard, Sam C Banks, David B Lindenmayer
Understanding the impacts of natural and human disturbances on forest biota is critical for improving forest management. Many studies have examined the separate impacts on fauna and flora of wildfire, conventional logging, and salvage logging, but empirical comparisons across a broad gradient of simultaneous disturbances are lacking. We quantified species richness and frequency of occurrence of vascular plants, and functional group responses, across a gradient of disturbances that occurred concurrently in 2009 in the mountain ash forests of southeastern Australia...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
Patricia M Alexandre, Susan I Stewart, Nicholas S Keuler, Murray K Clayton, Miranda H Mockrin, Avi Bar-Massada, Alexandra D Syphard, Volker C Radeloff
Wildfire is globally an important ecological disturbance affecting biochemical cycles and vegetation composition, but also puts people and their homes at risk. Suppressing wildfires has detrimental ecological effects and can promote larger and more intense wildfires when fuels accumulate, which increases the threat to buildings in the wildland-urban interface (WUI). Yet, when wildfires occur, typically only a small proportion of the buildings within the fire perimeter are lost, and the question is what determines which buildings burn...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
Ayesha I T Tulloch, Jean-Baptiste Pichancourt, Carl R Gosper, Angela Sanders, Iadine Chadès
Changed fire regimes have led to declines of fire-regime-adapted species and loss of biodiversity globally. Fire affects population processes of growth, reproduction, and dispersal in different ways, but there is little guidance about the best fire regime(s) to maintain species population processes in fire-prone ecosystems. We use a process-based approach to determine the best range of fire intervals for keystone plant species in a highly modified Mediterranean ecosystem in southwestern Australia where current fire regimes vary...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
David B Lindenmayer, Steven G Candy, Christopher I MacGregor, Sam C Banks, Martin Westgate, Karen Ikin, Jennifer Pierson, Ayesha Tulloch, Philip Barton
Fire is a major ecological process in ecosystems globally. Its impacts on fauna can be both direct (e.g., mortality) and indirect (e.g., altered habitat), resulting in population recovery being driven by several possible mechanisms. Separating direct from indirect impacts of fire on faunal population recovery can be valuable in guiding management of biodiversity in fire-prone environments. However, resolving the influence of direct and indirect processes remains a key challenge because many processes affecting fauna can change concomitantly with time since fire...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
Andres Fuentes-Ramirez, Joseph W Veldman, Claus Holzapfel, Kirk A Moloney
Novel fire regimes are an important cause and consequence of global environmental change that involve interactions among biotic, climatic, and human components of ecosystems. Plant flammability is key to these interactions, yet few studies directly measure flammability or consider how multiple species with different flammabilities interact to produce novel fire regimes. Deserts of the southwestern United States are an ideal system for exploring how novel fire regimes can emerge when fire-promoting species invade ecosystems comprised of species that did not evolve with fire...
October 2016: Ecological Applications: a Publication of the Ecological Society of America
Camille Stevens-Rumann, Penelope Morgan
Most models project warmer and drier climates that will contribute to larger and more frequent wildfires. However, it remains unknown how repeated wildfires alter post-fire successional patterns and forest structure. Here, we test the hypothesis that the number of wildfires, as well as the order and severity of wildfire events interact to alter forest structure and vegetation recovery and implications for vegetation management. In 2014, we examined forest structure, composition, and tree regeneration in stands that burned 1-18 yr before a subsequent 2007 wildfire...
September 2016: Ecological Applications: a Publication of the Ecological Society of America
Bernadette M Lynch, Edward P Stern, Voon Ong, Mark Harber, Aine Burns, Christopher P Denton
The UK Scleroderma Study Group developed guidelines on the diagnosis and management of scleroderma renal crisis (SRC) based on best available evidence and clinical experience. SRC is characterised by the acute onset of severe hypertension and acute kidney injury. Current strategies to reduce the associated morbidity and mortality include identifying at risk patients to aid early diagnosis. ACE inhibitor therapy should be lifelong in all patients, regardless of whether they require renal replacement therapy...
September 2016: Clinical and Experimental Rheumatology
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