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pathophysiology of burn

C M Han
The wound healing includes non-healing and overhealing of the wounds. The results of wound healing are well known by people such as non-healing of the diabetic ulcer or hypertrophic scar after deep burn. In this issue, three papers involve in wound healing, one about autologous adipose-derived mesenchymal stem cells injected into wound or scar of rabbit ear, one about severe hypoxia and hypoalbuminemia inducing human hypertrophic scar derived fibroblast apoptosis in vitro, and another about the dysfunction of protein kinase B/mammalian target of rapamycin signaling pathway contributing to the pathophysiological characteristics of diabetic skin and non-healing wound...
October 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Kevin D Burns, Yuliya Lytvyn, Farid H Mahmud, Denis Daneman, Livia Deda, David B Dunger, John E Deanfield, R Neil Dalton, Yesmino Elia, Ronnie Har, Julie A D Van, Timothy J Bradley, Cameron Slorach, Wei Hui, Fengxia Xiao, Joseph Zimpelmann, Luc Mertens, Rahim Moineddin, Heather N Reich, Etienne B Sochett, James W Scholey, David Z I Cherney
AIMS: The relationship between the renal renin-angiotensin aldosterone system (RAAS) and cardiorenal pathophysiology is unclear. Our aims were to assess (1) levels of urinary RAAS components and (2) the association between RAAS components and HbA1c, urine albumin/creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and blood pressure in otherwise healthy adolescents with type 1 diabetes mellitus (TID) vs. healthy controls (HC). METHODS: Urinary angiotensinogen and ACE2 levels, activity of ACE and ACE2, blood pressure (BP), HbA1c, ACR and eGFR were measured in 65 HC and 194 T1D from the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)...
October 12, 2016: American Journal of Physiology. Renal Physiology
Fumio Tanaka, Kazunari Tominaga, Yoshiko Fujikawa, Yasuaki Nagami, Noriko Kamata, Hirokazu Yamagami, Tetsuya Tanigawa, Masatsugu Shiba, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
BACKGROUND: In patients with functional dyspepsia (FD), mild duodenal inflammation correlates with increased mucosal permeability. Enteric glial cells can produce glial cell line-derived neurotrophic factor (GDNF) to repair disrupted epithelial barrier function. AIMS: We examined the role of duodenal GDNF in FD pathophysiology and its association with dyspeptic symptoms. METHODS: Duodenal biopsies taken from FD patients and control subjects were used for analysis...
October 7, 2016: Digestive Diseases and Sciences
Perenlei Enkhbaatar, Basil A Pruitt, Oscar Suman, Ronald Mlcak, Steven E Wolf, Hiroyuki Sakurai, David N Herndon
Smoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns. However, relatively little attention has been paid to this devastating condition, and the bulk of research is limited to preclinical basic science studies. Moreover, no worldwide consensus criteria exist for its diagnosis, severity grading, and prognosis. Therapeutic approaches are highly variable depending on the country and burn centre or hospital. In this Series paper, we discuss understanding of the pathophysiology of smoke inhalation injury, the best evidence-based treatments, and challenges and future directions in diagnostics and management...
October 1, 2016: Lancet
Craig Porter, Ronald G Tompkins, Celeste C Finnerty, Labros S Sidossis, Oscar E Suman, David N Herndon
Major burns provoke a profound stress response, which is unrivalled in terms of its magnitude and duration. Evidence suggests that the pathophysiological stress response to severe burn trauma persists for several years after injury. Thus, there is a pressing need for novel strategies that mitigate this response and restore normal metabolic function in patients with burns. This is the first in a Series of three papers about the care of people with burns. In this paper, we review the current knowledge of the stress response to burn trauma, with a focus on hypermetabolism, muscle wasting, and stress-induced diabetes...
October 1, 2016: Lancet
Geoffrey N Hendy, Lucie Canaff
The human calcium-sensing receptor gene (CASR) has 8 exons, and localizes to chromosome 3q. Exons 1A and 1B encode alternative 5'-untranslated regions (UTRs) that splice to exon 2 encoding the AUG initiation codon. Exons 2-7 encode the CaSR protein of 1078 amino acids. Promoter P1 has TATA and CCAAT boxes upstream of exon 1A, and promoter P2 has Sp1/3 motifs at the start site of exon 1B. Exon 1A transcripts from the P1 promoter are reduced in parathyroid tumors and colon carcinomas. Studies of colon carcinomas and neuroblastomas have emphasized the importance of epigenetic changes-promoter methylation of the GC-rich P2 promoter, histone acetylation-as well as involvement of microRNAs in bringing about CASR gene silencing and reduced CaSR expression...
2016: Frontiers in Physiology
Barth L Wilsey, Reena Deutsch, Emil Samara, Thomas D Marcotte, Allan J Barnes, Marilyn A Huestis, Danny Le
A randomized, placebo-controlled crossover trial utilizing vaporized cannabis containing placebo and 6.7% and 2.9% delta-9-tetrahydrocannabinol (THC) was performed in 42 subjects with central neuropathic pain related to spinal cord injury and disease. Subjects received two administrations of the study medication in a 4-hour interval. Blood samples for pharmacokinetic evaluation were collected, and pain assessment tests were performed immediately after the second administration and 3 hours later. Pharmacokinetic data, although limited, were consistent with literature reports, namely dose-dependent increase in systemic exposure followed by rapid disappearance of THC...
2016: Journal of Pain Research
Christine J Andrews, Margit Kempf, Roy Kimble, Leila Cuttle
There are very few porcine burn models that replicate scald injuries similar to those encountered by children. We have developed a robust porcine burn model capable of creating reproducible scald burns for a wide range of burn conditions. The study was conducted with juvenile Large White pigs, creating replicates of burn combinations; 50°C for 1, 2, 5 and 10 minutes and 60°C, 70°C, 80°C and 90°C for 5 seconds. Visual wound examination, biopsies and Laser Doppler Imaging were performed at 1, 24 hours and at 3 and 7 days post-burn...
2016: PloS One
Lisa Rae, Philip Fidler, Nicole Gibran
Burn trauma in the current age of medical care still portends a 3% to 8% mortality. Of patients who die from their burn injuries, 58% of deaths occur in the first 72 hours after injury, indicating death from the initial burn shock is still a major cause of burn mortality. Significant thermal injury incites an inflammatory response, which distinguishes burns from other trauma. This article focuses on the current understanding of the pathophysiology of burn shock, the inflammatory response, and the direction of research and targeted therapies to improve resuscitation, morbidity, and mortality...
October 2016: Critical Care Clinics
Zhang Haijun, Yu Yonghui, Chai Jiake
BACKGROUND: Severe thermal trauma covering more than 30% of the total body surface area (TBSA) triggers a sustained pathophysiological response, which includes, but is not limited to, hypermetabolism, chronic inflammation, and severe skeletal muscle wasting. Long non-coding RNAs (lncRNAs) are an important class of pervasive genes involved in a variety of biological functions. However, the functions of lncRNAs in the regulation of responses of skeletal muscle wasting after severe burn have remained untested...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Kwang Chear Lee, Janine Dretzke, Liam Grover, Ann Logan, Naiem Moiemen
BACKGROUND: Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients...
2016: Burns and trauma
Kathleen Yin, Jennifer R Deuis, Richard J Lewis, Irina Vetter
Burn injury is a cause of significant mortality and morbidity worldwide and is frequently associated with severe and long-lasting pain that remains difficult to manage throughout recovery. We characterised a mouse model of burn-induced pain using pharmacological and transcriptomic approaches. Mechanical allodynia elicited by burn injury was partially reversed by meloxicam (5 mg/kg), gabapentin (100 mg/kg) and oxycodone (3 and 10 mg/kg), while thermal allodynia and gait abnormalities were only significantly improved by amitriptyline (3 mg/kg) and oxycodone (10 mg/kg)...
2016: Molecular Pain
S X Guo, H L Zhou, C G You, C M Han
Acute kidney injury (AKI), one of the common and important complications post burn, shows a high incidence and mortality in severely burned patients. The common etiologic factors involved in the development of AKI post burn include hypovolaemia, denatured proteins, nephrotoxic agents, etc., while the molecular mechanisms include oxidative stress injury, systematic or local inflammation, apoptosis, and so on. Furthermore, quite a few signaling pathways participate in the regulation of the occurrence and development of AKI post burn...
August 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Katalin Módis, YoungJun Ju, Akbar Ahmad, Ashley A Untereiner, Zaid Altaany, Lingyun Wu, Csaba Szabo, Rui Wang
Mammalian cells can utilize hydrogen sulfide (H2S) to support mitochondrial respiration. The aim of our study was to explore the potential role of S-sulfhydration (a H2S-induced posttranslational modification, also known as S-persulfidation) of the mitochondrial inner membrane protein ATP synthase (F1F0 ATP synthase/Complex V) in the regulation of mitochondrial bioenergetics. Using a biotin switch assay, we have detected S-sulfhydration of the α subunit (ATP5A1) of ATP synthase in response to exposure to H2S in vitro...
August 20, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Mostafa Khafaei, Shahram Samie, Seyed Javad Mowla, Akbar Ghorbani Alvanegh, Behnaz Mirzaei, Somaye Chavoshei, Ghamar Soltan Dorraj, Mostafa Esmailnejad, Mahmood Tavallaie, Mohammadreza Nourani
Sulfur mustard (SM) or mustard gas is a chemical alkylating agent that causes blisters in the skin (blister gas), burns the eyes and causes lung injury. Some major cellular pathways are involved in the damage caused by mustard gas such as NF-κb signaling, TGF-β signaling, WNT pathway, inflammation, DNA repair and apoptosis. MicroRNAs are non-coding small RNAs (19-25 nucleotides) that are involved in the regulation of gene expression and are found in two forms, extracellular and intracellular. Changes in the levels of extracellular microRNAs are directly associated with many diseases, it is thus common to study the level of extracellular microRNAs as a biomarker to determine the pathophysiologic status...
December 2015: Interdisciplinary Toxicology
H-G Struck
Background: This review gives a therapeutic approach for the early treatment of chemical and thermal burns of the ocular surface (CTOS). Method: Based on a review of international literature, the experiences of University Hospital Aachen and Halle/Saale, Eye Clinic Cologne as well as experimental data of the research institute (An-Institut) at RWTH Aachen University are considered and discussed. Results: As the risk depends on the stage of CTOS, recommendations are given for acute treatment for different stages...
July 25, 2016: Klinische Monatsblätter Für Augenheilkunde
Y H Sun
Burn is a common trauma in peace time and war. Burn care was not designated as a specific discipline but a subspecialty of general surgery in China until the 1950s. In 1958, along with the development of metallurgical industry in China, the number of burn patients was increased remarkably, followed by establishment of modern burn departments. A steel worker sustaining a burn injury with size of 89% total burn surface area (TBSA) and full-thickness wound size of 23% TBSA was successfully cured by burn experts of Shanghai Guangci Hospital (renamed Ruijin Hospital Affiliated to the School of Medicine of Shanghai Jiao Tong University)...
January 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
L Van Oudenhove, F Jasper, M Walentynowicz, M Witthöft, O Van den Bergh, J Tack
OBJECTIVES: Rome III introduced a subdivision of functional dyspepsia (FD) into postprandial distress syndrome and epigastric pain syndrome, characterized by early satiation/postprandial fullness, and epigastric pain/burning, respectively. However, evidence on their degree of overlap is mixed. We aimed to investigate the latent structure of FD to test whether distinguishable symptom-based subgroups exist. METHODS: Consecutive tertiary care Rome II FD patients completed the dyspepsia symptom severity scale...
July 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
T Shinozaki, Y Imamura, R Kohashi, K Dezawa, Y Nakaya, Y Sato, K Watanabe, Y Morimoto, T Shizukuishi, O Abe, T Haji, K Tabei, M Taira
Burning mouth syndrome (BMS) is an idiopathic orofacial pain condition. Although the pathophysiology of BMS is not clearly understood, central and peripheral neuropathic mechanisms are thought to be involved. The authors compared brain response to noxious heat stimuli in 16 right-handed women with primary BMS and 15 sex- and age-matched right-handed healthy female controls. A thermal stimulus sequence of 32 °C to 40 °C to 32 °C to 49 °C was repeated 4 times in a cycle. Warm and noxious heat stimuli were delivered with a Peltier thermode placed on the right palm or right lower lip for 32 s each in a session...
September 2016: Journal of Dental Research
Julie A Rizzo, Matthew P Rowan, Ian R Driscoll, Rodney K Chan, Kevin K Chung
Major physiologic alterations following a severe thermal injury disrupt thermal homeostasis and predispose burn patients to hypothermia. An important recommendation in many clinical practice guidelines is to increase the ambient temperature during the care of severely burned patients in the operating room and intensive care unit to mitigate the loss of thermoregulation, prevent hypothermia, and minimize the impact of hypermetabolism. However, the scientific support for this recommendation remains unclear. This review summarizes the current knowledge regarding the pathophysiology and treatment of thermal injury-induced hypermetabolism and hypothermia, with special emphasis on alterations in ambient temperature...
June 2, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
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