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https://www.readbyqxmd.com/read/28941987/burn-injury-challenges-and-advances-in-burn-wound-healing-infection-pain-and-scarring
#1
Yiwei Wang, Joanneke Beekman, Jonathan Hew, Stuart Jackson, Andrea C Issler-Fisher, Roxanne Parungao, Sepher S Lajevardi, Zhe Li, Peter K M Maitz
Severe burn injuries are the most traumatic and physically debilitating injuries affecting nearly every organ system and leading to significant morbidity and mortality. Early burn wound excision and skin grafting are common clinical practices that have significantly improved the outcomes for severe burn injured patients by reducing mortality rate and days of hospital stay. However, slow wound healing, infection, pain, and hypertrophic scarring continue to remain a major challenge in burn research and management...
September 20, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28941929/minimizing-variance-in-care-of-pediatric-blunt-solid-organ-injury-through-utilization-of-a-hemodynamic-driven-protocol-a-multi-institution-study
#2
Aaron J Cunningham, Katrine M Lofberg, Sanjay Krishnaswami, Marilyn W Butler, Kenneth S Azarow, Nicholas A Hamilton, Elizabeth A Fialkowski, Pamela Bilyeu, Erika Ohm, Erin C Burns, Margo Hendrickson, Preetha Krishnan, Cynthia Gingalewski, Mubeen A Jafri
BACKGROUND: An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. METHODS: Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28940527/prioritizing-forest-fuels-treatments-based-on-the-probability-of-high-severity-fire-restores-adaptive-capacity-in-sierran-forests
#3
Daniel J Krofcheck, Matthew D Hurteau, Robert M Scheller, E Louise Loudermilk
In frequent fire forests of the western US a legacy of fire suppression coupled with increases in fire weather severity have altered fire regimes and vegetation dynamics. When coupled with projected climate change, these conditions have the potential to lead to vegetation type change and altered carbon (C) dynamics. In the Sierra Nevada, fuels reduction approaches that include mechanical thinning followed by regular prescribed fire are one approach to restore the ability of the ecosystem to tolerate episodic fire and still sequester C...
September 23, 2017: Global Change Biology
https://www.readbyqxmd.com/read/28940292/different-patients-different-outcomes-a-case-control-study-of-spontaneous-coronary-artery-dissection-versus-acute-coronary-syndrome
#4
Heath Adams, Elizabeth Paratz, Jithendra Somaratne, Jamie Layland, Andrew Burns, Sonny Palmer, Andrew MacIsaac, Robert Whitbourn
INTRODUCTION: There is progressive interest worldwide in spontaneous coronary artery dissection (SCAD). To identify a SCAD cohort and compare risk factors, presentation, and management outcomes compared to acute coronary syndrome (ACS) matched controls. METHODS: Retrospective analysis was performed from 2000 to 2015. Clinical data included a neuropsychiatric history, with management and clinical outcomes assessed at 12 months. Patients were matched on a 1:3 case-control basis according to type of ACS...
September 20, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#5
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28935210/office-based-procedures-for-the-diagnosis-and-treatment-of-laryngeal-pathology
#6
REVIEW
David J Wellenstein, Henrieke W Schutte, Robert P Takes, Jimmie Honings, Henri A M Marres, James A Burns, Guido B van den Broek
INTRODUCTION: Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. MATERIAL AND METHODS: Review of literature on office-based procedures in laryngology and head and neck oncology. RESULTS: Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia...
September 18, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#7
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28930963/role-of-autophagy-and-its-molecular-mechanisms-in-mice-intestinal-tract-after-severe-burn
#8
Duan Y Zhang, Wei Qiu, PeiS Jin, Peng Wang, Yong Sun
BACKGROUND: Severe burn can lead to hypoxia/ischemia of intestinal mucosa. Autophagy is the process of intracellular degradation, which is essential for cell survival under stresses, such as hypoxia/ischemia and nutrient deprivation. The present study was designed to investigate whether there were changes in intestinal autophagy after severe burn in mice and further to explore the effect and molecular mechanisms of autophagy on intestinal injury. METHODS: This study includes three experiments...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#9
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#10
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#11
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28918904/comparison-of-laser-doppler-imaging-ldi-and-clinical-assessment-in-differentiating-between-superficial-and-deep-partial-thickness-burn-wounds
#12
Saadia Nosheen Jan, Farid Ahmed Khan, Muhammad Mustehsan Bashir, Muneeb Nasir, Hamid Hussain Ansari, Hussan Birkhez Shami, Umer Nazir, Asif Hanif, Muhammad Sohail
PURPOSE OF PRESENTATION/STUDY: To compare the accuracy of Laser Doppler Imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burns to decide whether early tangential excision and grafting or conservative management should be employed to optimize burn and patient management. STUDY PERIOD: March 2015 to November 2016. METHODS/PROCEDURE DETAILS: Ninety two wounds in 34 patients reporting within 5days of less than 40% burn surface area were included...
September 14, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28916849/1000-consecutive-cases-of-laser-assisted-liposuction-utilizing-the-1440%C3%A2-nm-wavelength-nd-yag-laser-assessing-the-safety-and-efficacy
#13
Christopher T Chia, Mark G Albert, Sharon Del Vecchio, Spero J Theodorou
BACKGROUND: Liposuction remains one of the most popular aesthetic surgery procedures performed today, and it has undergone continuous refinements over the past four decades. Advancements in anesthesia, improvements in instrumentation, better understanding of fluid dynamics and the addition of energy to liposuction have led to better outcomes with improved safety and efficacy. OBJECTIVES: The purpose of this study is to review 1000 consecutive laser-assisted liposuction (LAL) cases utilizing the 1440 nm wavelength...
September 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28905128/women-s-subjective-experiences-of-living-with-vulvodynia-a-systematic-review-and-meta-ethnography
#14
Rebekah Shallcross, Joanne M Dickson, David Nunns, Catharine Mackenzie, Gundi Kiemle
Vulvodynia, the experience of an idiopathic pain in the form of burning, soreness, or throbbing in the vulval area, affects around 4-16% of the population. The current review used systematic search strategies and meta-ethnography as a means of identifying, analyzing, and synthesizing the existing literature pertaining to women's subjective experiences of living with vulvodynia. Four key concepts were identified: (1) Social Constructions: Sex, Women, and Femininity: Women experienced negative consequences of social narratives around womanhood, sexuality, and femininity, including the prioritization of penetrative sex, the belief that it is the role of women to provide sex for men, and media portrayals of sex as easy and natural...
September 13, 2017: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/28902702/assessment-and-management-of-burn-pain-at-the-komfo-anokye-teaching-hospital-a-best-practice-implementation-project
#15
Jonathan Bayuo, Zachary Munn, Jared Campbell
BACKGROUND: Pain management is a significant issue in health facilities in Ghana. For burn patients, this is even more challenging as burn pain has varied facets. Despite the existence of pharmacological agents for pain management, complaints of pain still persist. OBJECTIVES: The aim of this project was to identify pain management practices in the burns units of Komfo Anokye Teaching Hospital, compare these approaches to best practice, and implement strategies to enhance compliance to standards...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28902290/effect-of-secondary-infection-on-epithelialisation-and-total-healing-of-cutaneous-leishmaniasis-lesions
#16
Liliane de Fátima Antonio, Marcelo Rosandiski Lyra, Maurício Naoto Saheki, Armando de Oliveira Schubach, Luciana de Freitas Campos Miranda, Maria de Fátima Madeira, Maria Cristina da Silva Lourenço, Aline Fagundes, Érica Aparecida Dos Santos Ribeiro, Leonardo Barreto, Maria Inês Fernandes Pimentel
BACKGROUND: Cutaneous leishmaniasis (CL) generally presents with a single or several localised cutaneous ulcers without involvement of mucous membranes. Ulcerated lesions are susceptible to secondary contamination that may slow the healing process. OBJECTIVE: This study verified the influence of non-parasitic wound infection on wound closure (epithelialisation) and total healing. METHODS: Twenty-five patients with a confirmed diagnosis of CL and ulcerated lesions underwent biopsy of ulcer borders...
September 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28898193/molecular-breast-imaging-in-breast-cancer-screening-and-problem-solving
#17
Robin B Shermis, Roberta E Redfern, Jessica Burns, Haris Kudrolli
In the United States, legislative actions in over 28 states require radiologists to notify women who undergo breast screening mammography of their breast density. This has led to increased public interest in supplemental screening, but radiologists have not come to a consensus on a supplemental screening modality. In choosing between the most common options, whole-breast ultrasonography (US) and magnetic resonance (MR) imaging, one must weigh the benefits and drawbacks of each modality, as increased cancer detection may be accompanied by increased examination costs and biopsy rates...
September 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28894374/predicting-and-managing-sepsis-in-burn-patients-current-perspectives
#18
Omar Nunez Lopez, Janos Cambiaso-Daniel, Ludwik K Branski, William B Norbury, David N Herndon
Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#19
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28888319/systems-based-practice-in-burn-care-prevention-management-and-economic-impact-of-health-care-associated-infections
#20
REVIEW
Charles Scott Hultman, David van Duin, Emily Sickbert-Bennett, Lauren M DiBiase, Samuel W Jones, Bruce A Cairns, David J Weber
Health care-associated infections in burn patients, from ventilator-associated pneumonia to skin and soft tissue infections, can substantially compromise outcomes, because these complications are associated with longer lengths of stay, increased morbidity and mortality, and greater direct medical costs. Health care-associated infections are largely preventable, through surveillance, education, appropriate hand hygiene, and culture change, especially for device-related infections. Systems-based practice, which allows individuals and clinical microsystems to navigate and improve the macro health care system, may be one of the most powerful skill sets to effect change, permitting a shift in culture toward patient safety and quality improvement...
October 2017: Clinics in Plastic Surgery
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