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https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#1
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28448295/the-role-of-mitochondrial-stress-in-muscle-wasting-following-severe-burn-trauma
#2
John O Ogunbileje, David N Herndon, Andrew J Murton, Craig Porter
Increased resting metabolic rate (hypermetabolism) and skeletal muscle wasting are hallmarks of the pathophysiological stress response to severe burn trauma. However, whether these two responses occur independently in burn patients or are in fact related remains unclear. In light of recent evidence demonstrating that increased proteolysis in skeletal muscle of burned patients is accompanied by mitochondrial hypermetabolism, oxidative stress, and protein damage; in this article, we discuss the evidence for a role for the mitochondrion in skeletal muscle wasting following severe burn trauma...
April 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#3
Mary Claire B Manske, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy)...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28438352/burns-to-the-genitalia-perineum-and-buttocks-increase-the-risk-of-death-among-u-s-service-members-sustaining-combat-related-burns-in-iraq-and-afghanistan
#4
Michael S Clemens, Judson C Janak, Julie A Rizzo, John C Graybill, Michelle F Buehner, Steven J Hudak, Charles K Thompson, Kevin K Chung
PURPOSE: Among service members injured in Iraq and Afghanistan, to determine the risk of mortality associated with combat-related burns to the genitalia, perineum, and buttocks. MATERIALS AND METHODS: The prospectively maintained burn registry from the United States Army Institute of Surgical Research was retrospectively reviewed to identify all service members with combat-related burns sustained in Iraq and Afghanistan from March 2003 to October 2013. The two primary risk factors of interest were (1) any burn to the genitals, perineum, and/or buttocks (PB) and (2) burns involving the entire perineal, genital, and buttock region (complete PB)...
April 21, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28438334/understanding-patterns-of-injury-in-kenya-analysis-of-a-trauma-registry-data-from-a-national-referral-hospital
#5
Isaac M Botchey, Yuen Wai Hung, Abdulgafoor M Bachani, Hassan Saidi, Fatima Paruk, Adnan A Hyder
BACKGROUND: Injuries contribute to a substantial proportion of the burden of disease in Kenya. Trauma registries can be a very useful source of data to understand patterns of injuries and serve to provide information about potential improvements in the care of injured patients. In Kenya, health facility-based injury data has been largely administrative. Our aim was to develop and implement a prospective trauma registry at the largest trauma hospital in Kenya, the Kenyatta National Hospital, and to understand the nature of injuries presenting to the hospital, their treatment and care, and their outcomes...
April 21, 2017: Surgery
https://www.readbyqxmd.com/read/28435572/does-excision-of-heterotopic-ossification-of-the-elbow-result-in-satisfactory-patient-rated-outcomes
#6
K N Sandeep, G Suresh, B Gopisankar, N Abhishek, A Sujiv
INTRODUCTION: Treatment of heterotopic ossification (HO) of the elbow is challenging and fraught with complications. Patients who sustain direct trauma to the elbow joint, the central nervous system, and thermal burns are at increased risk for development of HO. There is a paucity of studies and reports on patient's self-evaluation after the excision of the heterotopic ossification. MATERIALS AND METHODS: This retrospective study assessed outcomes after excision of heterotopic ossification around the elbow in a cohort of ten patients operated from 2012 to 2015...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28431991/molecular-mechanisms-of-trauma-induced-acute-kidney-injury-inflammatory-and-metabolic-insights-from-animal-models
#7
David M Burmeister, Belinda I Gómez, Michael A Dubick
Trauma-induced acute kidney injury (AKI), such as after hemorrhagic shock (HS) or burn, remains a significant problem in the intensive care unit and is associated with increased mortality. The pathophysiology that drives AKI post-trauma is multi factorial, and includes both inflammatory and metabolic alterations. Identifying the systemic profile that contributes to AKI is crucial not only for early diagnosis, but also for identifying treatments that improve kidney function and maintaining long-term patient health...
April 18, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28426688/vancomycin-associated-acute-kidney-injury-a-cross-sectional-study-from-a-single-center-in-china
#8
Kunming Pan, Lingyun Ma, Qian Xiang, Xueying Li, Haixia Li, Ying Zhou, Li Yang, Yimin Cui
OBJECTIVE: The objective of this study was to investigate the current situation of vancomycin (VAN)-associated acute kidney injury (VA-AKI) in China and identify the risk factors for VA-AKI, as well as to comprehensively examine the risk related to concurrent drug use. Further, we assessed the outcomes of patients who developed VA-AKI and the risk factors for these outcomes. Finally, we aimed to provide suggestions for improving the prevention and treatment of VA-AKI in China. METHODS: We conducted a retrospective observational study of inpatients who had been treated with VAN between January 2013 and December 2013 at Peking University First Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28422699/hemorrhage-prediction-models-in-surgical-intensive-care-bedside-monitoring-data-adds-information-to-lab-values
#9
Marco De Pasquale, Travis Moss, Sergio Cerutti, James Calland, Douglas Lake, Randall Moorman, Manuela Ferrario
Hemorrhage is a frequent complication in surgery patients; its identification and management have received increasing attention as a target for quality improvement in patient care in the Intensive Care Unit (ICU). The purposes of this work were i) to find an early detection model for hemorrhage by exploring the range of data mining methods that are currently available, and ii) to compare prediction models utilizing continuously measured physiological data from bedside monitors to those using commonly obtained laboratory tests...
April 12, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28420571/assessing-guidelines-for-burn-referrals-in-a-resource-constrained-setting-demographic-and-clinical-factors-associated-with-inter-facility-transfer
#10
A Klingberg, L Wallis, H Rode, T Stenberg, L Laflamme, M Hasselberg
AIM: The aim was to assess demographic and clinical factors associated with inter-facility referrals for patients with burns in a resource-constrained setting. METHODS: This was a cross-sectional case review of patients presenting with a burn at the trauma unit at the Red Cross War Memorial Children's Hospital (RXH) in Cape Town, South Africa. RESULTS: Six hundred and eleven-(71%) children were referred to the burns or the intensive care unit and 253 children were treated and discharged from the trauma unit...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28414985/sharp-and-blunt-force-trauma-concealment-by-thermal-alteration-in-homicides-an-in-vitro-experiment-for-methodology-and-protocol-development-in-forensic-anthropological-analysis-of-burnt-bones
#11
Ioana Macoveciuc, Nicholas Márquez-Grant, Ian Horsfall, Peter Zioupos
Burning of human remains is one method used by perpetrators to conceal fatal trauma and expert opinions regarding the degree of skeletal evidence concealment are often disparate. This experiment aimed to reduce this incongruence in forensic anthropological interpretation of burned human remains and implicitly contribute to the development of research methodologies sufficiently robust to withstand forensic scrutiny in the courtroom. We have tested the influence of thermal alteration on pre-existing sharp and blunt trauma on twenty juvenile sheep radii in the laboratory using an automated impact testing system and an electric furnace...
March 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28410933/the-role-of-complement-in-the-acute-phase-response-after-burns
#12
REVIEW
H Ibrahim Korkmaz, Paul A J Krijnen, Magda M W Ulrich, E de Jong, Paul P M van Zuijlen, Hans W M Niessen
Severe burns induce a complex systemic inflammatory response characterized by a typical prolonged acute phase response (APR) that starts approximately 4-8h after-burn and persists for months up to a year after the initial burn trauma. During this APR, acute phase proteins (APPs), including C-reactive protein (CRP) and complement (e.g. C3, C4 and C5) are released in the blood, resulting amongst others, in the recruitment and migration of inflammatory cells. Although the APR is necessary for proper wound healing, a prolonged APR can induce local tissue damage, hamper the healing process and cause negative systemic effects in several organs, including the heart, lungs, kidney and the central nervous system...
April 11, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28408082/injury-factors-associated-with-discharge-status-from-emergency-room-at-two-major-trauma-hospitals-in-the-gambia-africa
#13
REVIEW
Edrisa Sanyang, Corinne Peek-Asa, Paul Bass, Tracy L Young, Abubacarr Jagne, Baba Njie
INTRODUCTION: Injuries are the leading cause of disability across all ages and gender. In this study, we identified predictors of discharge status and disability at discharge among patients who seek emergency room treatment. MATERIALS AND METHODS: The study was conducted in two major trauma hospitals in urban Gambia. 1905 patients participated in the study. 74.9% were males, and 25.1% were females. The study includes injured patients from all mechanisms. However, patients' records without age, gender, injury mechanism, and deposition from the emergency room were considered incomplete and excluded...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#14
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28394879/early-diagnosis-and-prevention-of-ischemic-enterocolitis-in-massive-burns
#15
Jennwood Chen, Giavonni M Lewis
To summarize the most salient literature regarding the pathogenesis, diagnosis, and prevention of ischemic enterocolitis (IE) in thermal injury. IE is a poorly characterized gastrointestinal complication associated with large burns. This entity occurs irrespective of abdominal trauma. The diagnostic challenges, paucity of treatment options and related complications make IE particularly lethal. Herein we present a case of profound IE in a 40-year-old male who sustained 80% total body surface area (TBSA) burns...
April 3, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28385178/epidemiology-and-outcomes-of-injuries-in-kenya-a-multisite-surveillance-study
#16
Isaac M Botchey, Yuen W Hung, Abdulgafoor M Bachani, Fatima Paruk, Amber Mehmood, Hassan Saidi, Adnan A Hyder
BACKGROUND: Injury is a leading cause of disability and death worldwide, accounting for over 5 million deaths each year. The injury burden is higher in low- and middle-income countries where more than 90% of injury-related deaths occur. Despite this burden, the use of prospective trauma registries to describe injury epidemiology and outcomes is limited in low- and middle-income countries. Kenya lacks robust data to describe injury epidemiology and care. The objective of this study was to investigate the epidemiology and outcomes of injuries at 4 referral hospitals in Kenya using hospital-based trauma registries...
April 3, 2017: Surgery
https://www.readbyqxmd.com/read/28382156/theranostic-nucleic-acid-binding-nanoprobe-exerts-anti-inflammatory-and-cytoprotective-effects-in-ischemic-injury
#17
Howard H Chen, Hushan Yuan, Hoonsung Cho, Yan Feng, Soeun Ngoy, Anand T N Kumar, Ronglih Liao, Wei Chao, Lee Josephson, David E Sosnovik
Extracellular nucleic acids are proinflammatory molecules that have been implicated in a diverse range of diseases. We report here the development of a multivalent nucleic acid scavenging nanoprobe, where the fluorochrome thiazole orange (TO) is conjugated to a polymeric 40 kDa dextran carrier. Dextran-TO (Dex-TO) has nanomolar affinity for mammalian and bacterial nucleic acids and attenuates the production of inflammatory cytokines from activated macrophages exposed to DNA and RNA. Mice with myocardial ischemia reperfusion that were treated with Dex-TO showed a decrease in myocardial macrophage infiltration at 24 hours (p<0...
2017: Theranostics
https://www.readbyqxmd.com/read/28380152/incontinence-associated-dermatitis-a-cohort-study-in-critically-ill-patients
#18
Tânia Couto Machado Chianca, Paula Caroline Gonçales, Patrícia Oliveira Salgado, Beatriz de Oliveira Machado, Gilmara Lopes Amorim, Carla Lúcia Goulart Constant Alcoforado
Objectives: Estimate incidence, determine risk factors and propose a prediction model for the development of incontinence- associated dermatitis critically ill adult patients. Method: Concurrent cohort study with 157 critically ill patients. Data collection was daily performed between February and July 2015, at a public teaching hospital of Belo Horizonte, Minas Gerais. Data was entered in a database and subjected to descriptive, survival and multivariate analysis...
March 30, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28374265/both-high-and-low-plasma-glutamine-levels-predict-mortality-in-critically-ill-patients
#19
Takae Tsujimoto, Kentaro Shimizu, Nobuaki Hata, Tatsuya Takagi, Etsuko Uejima, Hiroshi Ogura, Masafumi Wasa, Takeshi Shimazu
PURPOSE: Plasma amino acids are important indicators for understanding human kinetics and amino acid dynamics. We aimed to investigate the association between the plasma glutamine levels and the mortality rates and determine whether plasma glutamine can predict the prognosis of critically ill patients. METHODS: The clinical records of adult patients who were admitted to an ICU were retrospectively evaluated to investigate the plasma levels of amino acids, including glutamine...
April 3, 2017: Surgery Today
https://www.readbyqxmd.com/read/28372834/-methods-of-data-selection-from-the-french-medical-information-system-program-for-trauma-patient-s-analysis-burns-and-traumatic-brain-injuries
#20
L-M Paget, A Dupont, G Pédrono, L Lasbeur, B Thélot
BACKGROUND: Data from the French medical information system program in medicine, surgery, obstetrics and dentistry can be adapted in some cases and under certain conditions, to account for hospitalizations for injuries. Two areas have been explored: burn and traumatic brain injury victims. METHODS: An algorithm selecting data from the Medical information system program was established and implemented for several years for the study of burn victims. The methods of selection of stays for traumatic brain injuries, which are the subject of a more recent exploration, are described...
March 31, 2017: Revue D'épidémiologie et de Santé Publique
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