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https://www.readbyqxmd.com/read/29661381/a-review-of-the-safety-and-efficacy-of-inhaled-methoxyflurane-as-an-analgesic-for-outpatient-procedures
#1
REVIEW
C Jephcott, J Grummet, N Nguyen, O Spruyt
Methoxyflurane delivered via a hand-held inhaler is a proven analgesic which has been used in Australasia for emergency relief of trauma associated pain since the 1970s. The agent is self-administered by the patient under the supervision of trained personnel. More than 5 million patients have received inhaled methoxyflurane without significant side effects. Methoxyflurane is also licensed in Australasia for the relief of pain in monitored conscious patients requiring analgesia for minor surgical procedures...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#2
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29659947/pediatric-thoracic-trauma-in-iraq-and-afghanistan
#3
Ryan J Keneally, Cynthia H Shields, Albert Hsu, Howard I Prior, Kevin M Creamer
Introduction: The objective of this study is to review available data on pediatric thoracic trauma seen at U.S. military treatment facilities in Iraq and Afghanistan and describe the scope of injuries, patterns seen, and associated mortality. The results were compared with adults injured in Iraq and Afghanistan and other reports of pediatric thoracic trauma in the literature. Materials and Methods: The investigators received approval from the Uniformed Services University of the Health Sciences' institutional review board before the study...
April 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29657096/mother-father-and-child-traumatic-stress-reactions-after-paediatric-burn-within-family-co-occurrence-and-parent-child-discrepancies-in-appraisals-of-child-stress
#4
Marthe R Egberts, Rens van de Schoot, Rinie Geenen, Nancy E E Van Loey
AIM: The current study examined occurrence and within-family associations of traumatic stress reactions after child burn injury, while in the same model addressing the role of parents' own symptoms in their reports of child symptoms. METHODS: One-hundred children (8-18 years old), and their mothers (n=90) and fathers (n=74) were assessed within the first month (T1) and three months (T2) after burn. Parents and children rated child traumatic stress reactions on the Children's Responses to Trauma Inventory (CRTI) and parents rated their own reactions on the Impact of Event Scale (IES)...
April 12, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29656835/trauma-quality-improvement-reducing-triage-errors-by-automating-the-level-assignment-process
#5
David P Stonko, Dillon C O Neill, Bradley M Dennis, Melissa Smith, Jeffrey Gray, Oscar D Guillamondegui
BACKGROUND: Trauma patients are triaged by the severity of their injury or need for intervention while en route to the trauma center according to trauma activation protocols that are institution specific. Significant research has been aimed at improving these protocols in order to optimize patient outcomes while striving for efficiency in care. However, it is known that patients are often undertriaged or overtriaged because protocol adherence remains imperfect. The goal of this quality improvement (QI) project was to improve this adherence, and thereby reduce the triage error...
April 12, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29644541/prevalence-of-the-systemic-inflammatory-response-syndrome-in-patients-who-underwent-orthognathic-surgery
#6
Magno Liberato Silva, Andréia Ferreira Ribeiro, Fábio Ricardo Loureiro Sato, Roger William Fernandes Moreira
PURPOSE: The systemic inflammatory response syndrome (SIRS) is the body's response to an insult, such as infection, trauma, burn, and surgical stress linked to several factors deemed potential for multiple organ failure if left untreated. Thus, the aim of this paper was a prospective study to examine the incidence of SIRS in postoperative patients who underwent orthognathic surgery from June/2013 to July/2016. METHODS: The sample consisted of 80 patients who underwent bimaxillary orthognathic surgery, with data on vital signs and white blood cell count collected preoperatively, and the same data collected in the immediate postoperative period, in addition to CO2 pressure in arterial blood by blood gas analysis...
April 11, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29626545/hypoxia-selective-allosteric-destabilization-of-activin-receptor-like-kinases-a-potential-therapeutic-avenue-for-prophylaxis-of-heterotopic-ossification
#7
Guorong Lu, Mary R Tandang-Silvas, Alyssa C Dawson, Trenton J Dawson, Jay C Groppe
Heterotopic ossification (HO), the pathological extraskeletal formation of bone, can arise from blast injuries, severe burns, orthopedic procedures and gain-of-function mutations in a component of the bone morphogenetic protein (BMP) signaling pathway, the ACVR1/ALK2 receptor serine-threonine (protein) kinase, causative of Fibrodysplasia Ossificans Progressiva (FOP). All three ALKs (-2, -3, -6) that play roles in bone morphogenesis contribute to trauma-induced HO, hence are well-validated pharmacological targets...
April 4, 2018: Bone
https://www.readbyqxmd.com/read/29618862/acetic-acid-dressings-finding-the-holy-grail-for-infected-wound-management
#8
Kapil S Agrawal, Anup Vidyadhar Sarda, Raghav Shrotriya, Manoj Bachhav, Vinita Puri, Gita Nataraj
Background: Wounds have since long, contributed majorly to the health-care burden. Infected long-standing non-healing wounds place many demands on the treating surgeon and are devastating for the patients physically, nutritionally, vocationally, financially, psychologically and socially. Acetic acid has long been included among agents used in the treatment of infected wounds. In this study, we have evaluated the use of acetic acid for topical application in the treatment of infected wounds...
September 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29618839/metformin-adapts-its-cellular-effects-to-bioenergetic-status-in-a-model-of-metabolic-dysfunction
#9
Christopher Auger, Thibacg Sivayoganathan, Abdikarim Abdullahi, Alexandra Parousis, Bo Wen Pang, Marc G Jeschke
Thermal injury induces a complex immunometabolic response, characterized by hyperglycemia, extensive inflammation and persistent hypermetabolism. It has been suggested that attenuation of the hypermetabolic response is beneficial for patient wellbeing. To that effect, metformin represents an attractive therapeutic agent, as its effects on glycemia, inflammation and bioenergetics can improve outcomes in burn patients. Therefore, we studied metformin and its effects on mitochondrial bioenergetics in a murine model of thermal injury...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29614433/acquired-and-congenital-forms-of-heterotopic-ossification-new-pathogenic-insights-and-therapeutic-opportunities
#10
REVIEW
Maurizio Pacifici
Heterotopic ossification (HO) involves the formation and accumulation of extraskeletal bone tissue at the expense of local tissues including muscles and connective tissues. There are common forms of HO that are triggered by extensive trauma, burns and other bodily insults, and there are also rare congenital severe forms of HO that occur in children with Fibrodysplasia Ossificans Progressiva or Progressive Osseous Heteroplasia. Given that HO is often preceded by inflammation, current treatments usually involve anti-inflammatory drugs alone or in combination with local irradiation, but are not very effective...
March 31, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29605375/nasal-erosion-as-an-uncommon-sign-of-child-abuse
#11
Paige A Culotta, Reena Isaac, Kwabena Sarpong, Binoy Chandy, Andrea Cruz, Marcella Donaruma-Kwoh
While various forms of facial trauma, bruising, burns, and fractures are frequently seen in cases of child abuse, purposeful nasal erosion has rarely been identified as a form of abusive injury. Progressive destruction of nasal tissue in children provokes a wide differential diagnosis crossing multiple subspecialties: infectious, primary immunodeficiencies, inflammatory conditions, malignancy, and genetic disorders. Progressive nasal erosion also can be a manifestation of child abuse. The proposed mechanism is repetitive mechanical denudation of the soft tissue and cartilage resulting in chronic inflammation, bleeding, and ultimately destruction of the insulted tissue...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29601597/hmgb1-il-1%C3%AE-complexes-in-plasma-microvesicles-modulate-immune-responses-to-burn-injury
#12
Leon G Coleman, Robert Maile, Samuel W Jones, Bruce A Cairns, Fulton T Crews
Modulating immune responses to sepsis and trauma remain one of the most difficult challenges in modern medicine. Large burn injuries (LBI) are a severe form of trauma associated with sepsis, immune impairment, and mortality. Immune dysfunction after LBI is complex, involving both enhanced and impaired immune activation. The release of Damage-Associated Molecular Patterns (DAMPs), such as HMGB1, and cytokines (e.g. IL-1β) creates an environment of immune dysfunction often leading to end organ failure and death...
2018: PloS One
https://www.readbyqxmd.com/read/29596686/hypertrophic-scar-severity-at-autograft-sites-is-associated-with-increased-pain-and-itch-after-major-thermal-burn-injury
#13
Matthew C Mauck, Jeffrey W Shupp, Felicia Williams, Marie Ashley Villard, Samuel W Jones, James Hwang, Jennifer Smith, Rachel Karlnoski, David J Smith, Bruce A Cairns, Samuel A McLean
Approximately three quarters of major thermal burn injury (MThBI) survivors suffer from hypertrophic scarring (HTS) and over half experience chronic pain or itch. In survivors of MThBI, HTS and chronic pain or itch are considered one of the greatest unmet challenges of postburn injury care and psychosocial reintegration. Although scarring, itch, and pain have been clinically associated, there are no prospective, multisite studies examining tissue autograft site pain or itch and scar outcomes. The authors collected a representative cohort (n = 56) of MThBI survivors who received autografting within 14 days of injury and evaluated graft-site pain or itch severity (0-10 Numeric Rating Scale) and HTS using a validated scar photograph assessment scale 6 months following MThBI...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29596678/follow-the-blue-feet-nurse-implemented-postoperative-mobility-program
#14
E Shannon Walters, Kathryn Curtin, Melissa M McLawhorn, Katherine Lee, Jeffrey W Shupp
To establish the effectiveness of a nurse-led postoperative MOBILITY program implemented on the Burn/Surgical/Trauma unit at our facility to increase documentation of patient mobility and to develop nurse and patient understanding of the importance of movement in postoperative recovery while increasing patient satisfaction with mobility. The MOBILITY program was implemented on a 24-bed Burn/Surgical/Trauma unit. Lewin's Change Theory guided the development of the program, while the Iowa Model of Evidence-Based Practice for Quality Care was the framework for the project...
December 27, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29596386/the-role-of-serotonin-during-skin-healing-in-post-thermal-injury
#15
Alia Sadiq, Ahmed Shah, Marc G Jeschke, Cassandra Belo, Muhammad Qasim Hayat, Sheeba Murad, Saeid Amini-Nik
Post-burn trauma significantly raises tissue serotonin concentration at the initial stages of injury, which leads us to investigate its possible role in post burn wound healing. Therefore, we planned this study to examine the role of serotonin in wound healing through in vitro and in vivo models of burn injuries. Results from in vitro analysis revealed that serotonin decreased apoptosis and increased cell survival significantly in human fibroblasts and neonatal keratinocytes. Cellular proliferation also increased significantly in both cell types...
March 29, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29596291/interprofessional-simulations-promote-knowledge-retention-and-enhance-perceptions-of-teamwork-skills-in-a-surgical-trauma-burn-intensive-care-unit-setting
#16
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29587343/molecular-mechanisms-of-melatonin-protection-from-gastric-mucosal-apoptotic-injury-in-experimental-burns
#17
Minka Hristova, Maria Tzaneva, Ganka Bekyarova, Dariya Chivchibashi, Nadezhda Stefanova, Yoana Kiselova-Kaneva
Melatonin, a basic secretory pineal gland product, is a nontoxic, multifunctional molecule. It has antioxidant and anti-apoptotic activities and protects tissues from injury. The objective of the present study was to determine the molecular mechanism of melatonin anti-apoptotic effect on gastric injury in a rat burn model. We hypothesized that melatonin gastric protection may be related to the activation of transcription erythroid 2-related factor 2 (Nrf2). Using a 30% total body surface area (TBSA) rat burn model, melatonin (10 mg/kg, i...
March 24, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29581998/long-term-effect-of-critical-illness-after-severe-paediatric-burn-injury-on-cardiac-function-in-adolescent-survivors-an-observational-study
#18
Gabriel Hundeshagen, David N Herndon, Robert P Clayton, Paul Wurzer, Alexis McQuitty, Kristofer Jennings, Ludwik Branski, Vanessa N Collins, Nicole Ribeiro Marques, Celeste C Finnerty, Oscar E Suman, Michael P Kinsky
Background: Sepsis, trauma, and burn injury acutely depress systolic and diastolic cardiac function; data on long-term cardiac sequelae of pediatric critical illness are sparse. This study evaluated long-term systolic and diastolic function, myocardial fibrosis, and exercise tolerance in survivors of severe pediatric burn injury. Methods: Subjects at least 5 years after severe burn (post-burn:PB) and age-matched healthy controls (HC) underwent echocardiography to quantify systolic function (ejection fraction[EF%]), diastolic function (E/e'), and myocardial fibrosis (calibrated integrated backscatter) of the left ventricle...
December 2017: Lancet Child & Adolescent Health
https://www.readbyqxmd.com/read/29565953/unique-complications-of-percutaneous-endoscopic-lumbar-discectomy-and-percutaneous-endoscopic-interlaminar-discectomy
#19
Chuanli Zhou, Guoqing Zhang, Ripul R Panchal, Xianfeng Ren, Hongfei Xiang, Ma Xuexiao, Xiaoliang Chen, Gu Tongtong, Wang Hong, Alana D Dixson
BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, posterior neck pain, and surgical site infection, are difficult to avoid; however, more focus on these issues perioperatively may be in order...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29564197/conservative-management-of-acalculous-cholecystitis-in-a-seven-year-old-child
#20
Jessica Y Ng, Jennie Gu
Acute acalculous cholecystitis is an uncommon disease in children and is usually associated with trauma, burns, and infections. Whereas acute acalculous cholecystitis is only seen in 10% of cholecystitis in adults, it is uncommon in the paediatric population. A seven-year-old male presented to the emergency department of a regional hospital with a 36-hour history of right-upper-quadrant abdominal pain. He had associated symptoms of anorexia, nausea, and vomiting. He was septic with raised white cell count and inflammatory markers...
January 20, 2018: Curēus
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