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Burn and trauma

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https://www.readbyqxmd.com/read/28224048/wound-penetration-of-cefazolin-ciprofloxacin-piperacillin-tazobactam-and-vancomycin-during-negative-pressure-wound-therapy
#1
Matthew P Rowan, Krista L Niece, Julie A Rizzo, Kevin S Akers
Objective: Negative pressure wound therapy (NPWT) uses subatmospheric pressure as a noninvasive adjunct to treat wounds and has demonstrated clinical efficacy by accelerating healing of a variety of acute and chronic wounds. NPWT may also play a role in preventing or treating wound infections, possibly by increasing wound penetration of antibiotics. However, clinical data in patients undergoing antibiotic and NPWT treatment are limited. Approach: To evaluate the wound penetration of antibiotics in NPWT patients, we conducted a prospective, observational study of burn and trauma patients treated with NPWT and systemic antibiotics...
February 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28221299/treatment-of-burn-and-surgical-wounds-with-recombinant-human-tropoelastin-produces-new-elastin-fibers-in-scars
#2
Hua Xie, Lisa Lucchesi, Bo Zheng, Elena Ladich, Teresa Pineda, Rose Merten, Cynthia Gregory, Michael Rutten, Kenton Gregory
Tropoelastin (TE), the soluble precursor of insoluble elastin fibers, is produced in minimal amounts in adults. Burn injuries result in inflexible collagen-rich scars because of lack of elastin fiber formation. We studied the feasibility of using recombinant human tropoelastin to enable elastin fiber production in burn and surgical scars to improve skin flexibility. In a swine hypertrophic burn scar model, normal skin and 3 × 3-cm partial thickness thermal burns underwent dermatome resection at 1 week post burn and randomized to four subcutaneous injections of saline or TE (either 0...
February 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28219767/the-biochemical-alterations-underlying-post-burn-hypermetabolism
#3
REVIEW
Christopher Auger, Osai Samadi, Marc G Jeschke
A severe burn can trigger a hypermetabolic state which lasts for years following the injury, to the detriment of the patient. The drastic increase in metabolic demands during this phase renders it difficult to meet the body's nutritional requirements, thus increasing muscle, bone and adipose catabolism and predisposing the patient to a host of disorders such as multi-organ dysfunction and sepsis, or even death. Despite advances in burn care over the last 50 years, due to the multifactorial nature of the hypermetabolic phenomenon it is difficult if not impossible to precisely identify and pharmacologically modulate the biological mediators contributing to this substantial metabolic derangement...
February 17, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28213997/echocardiographic-correlates-are-associated-with-in-hospital-mortality-in-trauma-and-burn-patients
#4
Duraid Younan, Russell Griffin, Donald Reiff, Jeffrey Richey, Eric Schinnerer, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: The role of echocardiographic indices of preload and contractility in predicting outcomes is unknown. We report the association of end diastolic area (EDA) and fractional area of change (FAC) with mortality in a cohort of trauma and burn patients. METHODS: Data on 86 patients admitted to a tertiary care center between July 2013 and July 2015 were reviewed. The association between abnormal EDA and FAC and adverse clinical outcomes was tested using exact logistic regression analysis...
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#5
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28196343/do-abused-young-children-feel-less-pain
#6
Marie-Hélène Drouineau, Elise Guenego, Véronique Sebille-Rivain, Bénédicte Vrignaud, Martine Balençon, Thomas Blanchais, Karine Levieux, Nathalie Vabres, Georges Picherot, Christèle Gras-le Guen
The objective of this study was to investigate whether acute pain in abused children was under recognized by doctors and nurses compared to children evaluated for accidental injuries. We hypothesize that an abused child's reaction to physical pain could be an additional symptom of this challenging diagnosis. For the observational prospective case control study in an emergency department, children were eligible when: younger than six years old, the reported trauma occurred within the previous seven days, the trauma comprised a bone injury or burn, and the child was able to express his or her pain...
February 11, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28187248/emergency-department-telemedicine-is-used-for-more-severely-injured-rural-trauma-patients-but-does-not-decrease-transfer-a-cohort-study
#7
Nicholas M Mohr, Karisa K Harland, Elizabeth A Chrischilles, Amanda Bell, Dan M Shane, Marcia M Ward
OBJECTIVES: Traumatic injury is a leading cause of death in the United States, and rural populations are at increased risk of injury and death. Rural residents have limited access to trauma care, and telemedicine has been proposed as one strategy to improve the provision of trauma care locally. The objective of this study was to describe patient-level factors associated with telemedicine consultation in North Dakota critical-access hospital (CAH) emergency departments (EDs) and to measure the association between telemedicine consultation and interhospital transfer...
February 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28185802/infection-in-burn-patients-in-a-referral-center-in-colombia
#8
Carlos Enrique Ramirez-Blanco, Carlos Enrique Ramirez-Rivero, Luis Alfonso Diaz-Martinez, Luis Miguel Sosa-Avila
INTRODUCTION: Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. OBJECTIVES: To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS)...
February 6, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28162307/-503-trauma-exposure-and-pain-severity-among-people-with-chronic-lower-back-pain-moderated-mediation-by-thought-suppression-and-social-constraints
#9
S Pegram, M Lumley, D Latsch, M Jasinski, E Schuster, J Burns
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28158149/a-systematic-review-on-the-prevalence-etiology-and-pathophysiology-of-intrinsic-pain-in-dermal-scar-tissue
#10
Eveline Bijlard, Lisa Uiterwaal, Casimir A E Kouwenberg, Marc A M Mureau, Steven E R Hovius, Frank J P M Huygen
BACKGROUND: Scars can cause pain, even without symptoms of underlying nerve damage. A lack of knowledge on intrinsic scar pain hampers effective treatment of these complaints. OBJECTIVE: Aggregate current knowledge on the prevalence, etiology, and pathophysiology of intrinsic pain in dermal scars. STUDY DESIGN: Systematic review. SETTING: University Medical Center. METHODS: We searched the Embase, Medline, Cochrane central, CINAHL, Web-of-Science, and Pubmed databases with search terms: scar, skin, pain, and etiology/pathology, adding all synonyms of these terms...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28134661/burn-injury-decreases-the-antinociceptive-effects-of-opioids
#11
Michael A Emery, M L Shawn Bates, Paul J Wellman, Shoshana Eitan
Burn victim patients are frequently prescribed opioids at doses that are significantly higher than standard analgesic dosing guidelines, and, even despite an escalation in opioid dosing, many continue to experience pain. Thus, the aim of this study was to determine the effect of burn injury on opioid antinociception. Mice were examined for their baseline pain sensitivity thresholds using the von Frey filaments test. Then, they were subjected to burn or sham injury to the dorsal surface of the hindpaw and treated orally with morphine, oxycodone, hydrocodone (20 or 40 mg/kg), or saline twice daily throughout the study...
January 27, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28117814/a-model-of-free-tissue-transfer-the-rat-epigastric-free-flap
#12
Diogo Casal, Diogo Pais, Inês Iria, Eduarda Mota-Silva, Maria-Angélica Almeida, Sara Alves, Cláudia Pen, Ana Farinho, Luís Mascarenhas-Lemos, José Ferreira-Silva, Mário Ferraz-Oliveira, Valentina Vassilenko, Paula A Videira, João Gory O'Neill
Free tissue transfer has been increasingly used in clinical practice since the 1970s, allowing reconstruction of complex and otherwise untreatable defects resulting from tumor extirpation, trauma, infections, malformations or burns. Free flaps are particularly useful for reconstructing highly complex anatomical regions, like those of the head and neck, the hand, the foot and the perineum. Moreover, basic and translational research in the area of free tissue transfer is of great clinical potential. Notwithstanding, surgical trainees and researchers are frequently deterred from using microsurgical models of tissue transfer, due to lack of information regarding the technical aspects involved in the operative procedures...
January 15, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28116225/hyperbaric-oxygen-therapy-for-the-compromised-graft-or-flap
#13
REVIEW
Ashish Francis, Richard C Baynosa
Significance: Tissue grafts and flaps are used to reconstruct wounds from trauma, chronic disease, tumor extirpation, burns, and infection. Despite careful surgical planning and execution, reconstructive failure can occur due to poor wound beds, radiation, random flap necrosis, vascular insufficiency, or ischemia-reperfusion (IR). Traumatic avulsions and amputated composite tissues-compromised tissue-may fail from crush injury and excessively large sizes. While never intended, these complications result in tissue loss, additional surgery, accrued costs, and negative psychosocial patient effects...
January 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28107388/factors-moderating-the-relationship-between-childhood-trauma-and-premorbid-adjustment-in-first-episode-schizophrenia
#14
S Kilian, J K Burns, S Seedat, L Asmal, B Chiliza, S Du Plessis, M R Olivier, M Kidd, R Emsley
Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship...
2017: PloS One
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#15
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28103991/-study-on-sweat-gland-regeneration-induced-by-microenvironment-of-three-dimensional-bioprinting
#16
B Yao, J F Xie, S Huang, X B Fu
Sweat glands are abundant in the body surface and essential for thermoregulation. Sweat glands fail to conduct self-repair in patients with large area of burn and trauma, and the body temperature of patients increases in hot climate, which may cause shock or even death. Now, co-culture system, reprogramming, and tissue engineering have made progresses in inducing sweat gland regeneration, but the inductive efficiency and duration need to be improved. Cellular microenvironment can regulate cell biological behavior, including cell migration and cell differentiation...
January 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28099528/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-%C3%AE%C2%BAb-and-p53
#17
Harumasa Nakazawa, Kyungho Chang, Shohei Shinozaki, Takashi Yasukawa, Kazuhiro Ishimaru, Shingo Yasuhara, Yong-Ming Yu, J A Jeevendra Martyn, Ronald G Tompkins, Kentaro Shimokado, Masao Kaneki
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...
2017: PloS One
https://www.readbyqxmd.com/read/28095550/the-diagnostic-role-of-optical-coherence-tomography-oct-in-measuring-the-depth-of-burn-and-traumatic-scars-for-more-accurate-laser-dosimetry-pilot-study
#18
Jill S Waibel, Ashley C Rudnick, Adam J Wulkan, Jon D Holmes
BACKGROUND: In recent decades, a number of optimal diagnostic technologies have emerged to assist in tissue visualization. Real-time monitoring of skin during laser therapies will help optimize laser parameters for more ef cient therapies. One of these technologies, optimal coherence tomography (OCT), may be used to help visualize burn and traumatic scars. When lasing severe scars, lasers have tunable pulse energies, which are made proportional to the scar thickness as estimated by palpation and the physician eye...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#19
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28069345/patients-perspectives-on-quality-of-life-after-burn
#20
Marianne B Kool, Rinie Geenen, Marthe R Egberts, Hendriët Wanders, Nancy E Van Loey
BACKGROUND: The concept quality of life (QOL) refers to both health-related outcomes and one's skills to reach these outcomes, which is not yet incorporated in the burn-related QOL conceptualisation. The aim of this study was to obtain a comprehensive overview of relevant burn-specific domains of QOL from the patient's perspective and to determine its hierarchical structure. METHODS: Concept mapping was used comprising a focus group (n=6), interviews (n=25), and a card-sorting task (n=24) in burn survivors...
January 6, 2017: Burns: Journal of the International Society for Burn Injuries
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