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BioMed Research International 2015Severe burns result in hypercatabolic state and concomitant muscle atrophy that persists for several months, thereby limiting patient recovery. However, the effects of...
BACKGROUND
Severe burns result in hypercatabolic state and concomitant muscle atrophy that persists for several months, thereby limiting patient recovery. However, the effects of burns on the corresponding spinal dermatome remain unknown. This study aimed to investigate whether burns induce apoptosis of spinal cord ventral horn motor neurons (VHMNs) and consequently cause skeletal muscle wasting.
METHODS
Third-degree hindpaw burn injury with 1% total body surface area (TBSA) rats were euthanized 4 and 8 weeks after burn injury. The apoptosis profiles in the ventral horns of the lumbar spinal cords, sciatic nerves, and gastrocnemius muscles were examined. The Schwann cells in the sciatic nerve were marked with S100. The gastrocnemius muscles were harvested to measure the denervation atrophy.
RESULT
The VHMNs apoptosis in the spinal cord was observed after inducing third-degree burns in the hindpaw. The S100 and TUNEL double-positive cells in the sciatic nerve increased significantly after the burn injury. Gastrocnemius muscle apoptosis and denervation atrophy area increased significantly after the burn injury.
CONCLUSION
Local hindpaw burn induces apoptosis in VHMNs and Schwann cells in sciatic nerve, which causes corresponding gastrocnemius muscle denervation atrophy. Our results provided an animal model to evaluate burn-induced muscle wasting, and elucidate the underlying mechanisms.
Topics: Animals; Anterior Horn Cells; Apoptosis; Burns; Hindlimb; In Situ Nick-End Labeling; Male; Muscle, Skeletal; Muscular Atrophy; Rats; Rats, Sprague-Dawley; Schwann Cells; Sciatic Nerve; Spinal Cord Ventral Horn
PubMed: 25695065
DOI: 10.1155/2015/372819 -
International Wound Journal Feb 2020Paediatric burn wounds are challenging conditions to manage for both the doctors and patients and can cause several complications entailing a complicated treatment and... (Comparative Study)
Comparative Study
Paediatric burn wounds are challenging conditions to manage for both the doctors and patients and can cause several complications entailing a complicated treatment and recovery process. This study aims to evaluate sociodemographic conditions and antibiogram culture results of paediatric burn wounds. Our study retrospectively evaluated 419 paediatric patients with burns regarding age, gender, burn area and degree, total days spent in hospital, surgical history, final condition, additional disease history, previous attempts, and culture results with their antibiotic resistances, haemogram results, C-reactive protein results, sociocultural conditions, burned region of the body, and structure of the burn. The prominent observations were an increased rate of incidence in male patients and patients with low socioeconomic conditions, the highest incidence of burns from scalding and domestic accidents, and the highest incidence of third-degree burns. Furthermore, even though the most encountered burn types were extremity burns, the burn types with the highest culture growth ratio were the perineum burns. The dominant culture growth bacterial group was coagulase-negative staphylococcus, and the ratio of medication resistance was 67.8%. It is imperative to raise awareness regarding domestic accidents to prevent paediatric burn wounds. The mortality risk can be reduced by carefully monitoring multiple organ involvement and providing timely treatment. Moreover, appropriate wound care is warranted to avoid infection from skin flora.
Topics: Age Factors; Anti-Bacterial Agents; Burns, Electric; Child; Child, Preschool; Female; Humans; Incidence; Infant; Length of Stay; Male; Retrospective Studies; Sex Factors; Socioeconomic Factors; Turkey; Wound Infection
PubMed: 31680429
DOI: 10.1111/iwj.13244 -
JNMA; Journal of the Nepal Medical... 2018Globally, eleven million people sustain burn injuries every year enough to require medical attention. WHO has estimated Disability associated limited years of 84,000 per...
INTRODUCTION
Globally, eleven million people sustain burn injuries every year enough to require medical attention. WHO has estimated Disability associated limited years of 84,000 per year just due to deformities and 2100 people die every year due to burn injuries in Nepal. The overall objective of the study is to explore the effectiveness of burn injuries treatment and management approach of hospitals.
METHODS
This qualitative study approached to 40 Health Personnel for Key Informants Interviews and 18 Focus Group Discussions with community people at the ten referral hospitals of eight district from May-June 2016. Qualitative data were analyzed using AtLas.ti software.
RESULTS
Female burn victims are brought late to the hospital compared to male patients and false reporting about incident is usually done by her attendants. More than three-fourth (80%) of the hospitals and about one-third male and female from FGD reported that the community people seek home remedy first rather than medical treatment. Majority of the medical doctors and nursing chiefs reported that first degree cases accounts for 50% of the total burn cases with a success rate of 80%. Medical and Nursing staff reported that deformities like hypertrophic scar, keloids, joint stiffness and compartment syndrome are mostly observed during the treatment. Hypothermia and sepsis were the major causes of death in most of the burn patients.
CONCLUSIONS
Usually, people who engaged in house and agriculture works, have visited public health posts/hospitals more frequently due to financial constraints and transportation issues where quality of burn care services are unavailable.
Topics: Burns; Cicatrix, Hypertrophic; Clinical Competence; Compartment Syndromes; Cross-Sectional Studies; Female; Focus Groups; Health Knowledge, Attitudes, Practice; Humans; Interviews as Topic; Keloid; Male; Medical Staff; Nursing Staff; Patient Acceptance of Health Care; Patient Satisfaction; Perception; Qualitative Research; Self Care; Sex Factors; Survival Rate; Time-to-Treatment; Treatment Outcome
PubMed: 31065136
DOI: 10.31729/jnma.3889 -
European Archives of... Sep 2021To evaluate the impact of tracheostomy on complications, dysphagia and outcome in second and third degree burned patients.
PURPOSE
To evaluate the impact of tracheostomy on complications, dysphagia and outcome in second and third degree burned patients.
METHODS
Inpatient mortality, dysphagia, severity of burn injury (ABSI, TBSA) and complications in tracheotomized burn patients were compared to (I) non-tracheotomized burn patients and (II) matched tracheotomized non-burn patients.
RESULTS
134 (30.9%) out of 433 patients who underwent tracheostomy, had a significantly higher percentage of inhalation injury (26.1% vs. 7.0%; p < 0.001), higher ABSI (8.9 ± 2.1 vs. 6.0 ± 2.7; p < 0.001) and TBSA score (41.4 ± 19.7% vs. 18.6 ± 18.8%; p < 0.001) compared to 299 non-tracheotomized burn patients. However, complications occurred equally in tracheotomized burn patients and matched controls and tracheostomy was neither linked to dysphagia nor to inpatient mortality at multivariate analysis. In particular, dysphagia occurred in 6.2% of cases and was significantly linked to length of ICU stay (OR 6.2; p = 0.021), preexisting neurocognitive impairments (OR 5.2; p = 0.001) and patients' age (OR 3.4; p = 0.046). A nomogram was calculated based on age, TBSA and inhalation injury predicting the need for a tracheostomy in severely burned patients.
CONCLUSION
Using the new nomogram we were able to predict with significantly higher accuracy the need for tracheostomy in severely burned patients. Moreover, tracheostomy is safe and is not associated with higher incidenc of complications, dysphagia or worse outcome.
Topics: Burns; Humans; Length of Stay; Multivariate Analysis; Nomograms; Retrospective Studies; Tracheostomy
PubMed: 33346855
DOI: 10.1007/s00405-020-06541-3 -
Annals of Burns and Fire Disasters Sep 2018Third-degree burns of the lower extremities are among the most difficult burn injuries to treat as they frequently expose bone, tendons or articular surfaces. Coverage...
Third-degree burns of the lower extremities are among the most difficult burn injuries to treat as they frequently expose bone, tendons or articular surfaces. Coverage with a flap is the ideal treatment, but local tissue is often unavailable, and free flaps require sophisticated equipment and perfect microsurgical technique. We demonstrate a treatment option to obtain a stable cutaneous coverage for this kind of injury, consisting in an association of skin grafts, amniotic membrane and bilaminar dermal matrix templates. This combined treatment proved to be an excellent option to cover a wide area of tibial exposure with low donor site morbidity and good functional and aesthetic results. This shows that artificial dermis is a good alternative for treating bone exposure, especially in patients for whom a classic flap reconstruction is not suitable.
PubMed: 30863258
DOI: No ID Found -
International Journal of Molecular... Oct 2020Burn-related neuropathy is common and often involves pain, paresthesia, or muscle weakness. Irisin, an exercise-induced myokine after cleavage from its membrane...
Burn-related neuropathy is common and often involves pain, paresthesia, or muscle weakness. Irisin, an exercise-induced myokine after cleavage from its membrane precursor fibronectin type III domain-containing 5 (FNDC5), exhibits neuroprotective and anti-inflammatory activities. A rat model of third-degree burn on the right hind paw was used to investigate the therapeutic role of irisin/FNDC5. Rats received burn injury and were treated with intrathecal recombinant adenovirus containing the irisin sequence (Ad-irisin) at 3 weeks postburn. One week later, mechanical allodynia was examined. The expression of irisin in cerebrospinal fluid (CSF) was detected. Ipsilateral gastrocnemius muscle and lumbar spinal cord were also obtained for further investigation. Furthermore, the anti-apoptotic effect of recombinant irisin in SH-SY5Y cells was evaluated through tumor necrosis factor alpha (TNFα) stimulus to mimic burn injury. We noted intrathecal Ad-irisin attenuated pain sensitization and gastrocnemius muscle atrophy by modulating the level of irisin in CSF, and the expression of neuronal FNDC5/irisin and TNFα in the spinal cord. Ad-irisin also ameliorated neuronal apoptosis in both dorsal and ventral horns. Furthermore, recombinant irisin attenuated TNFα-induced SH-SY5Y cell apoptosis. In summary, irisin attenuated allodynia and muscle wasting by ameliorating neuroinflammation-induced neuronal apoptosis.
Topics: Adenoviridae; Animals; Burns; Fibronectins; Gene Transfer Techniques; Genetic Therapy; Genetic Vectors; Humans; Hyperalgesia; Injections, Spinal; Male; Motor Neurons; Muscular Atrophy; Polyneuropathies; Rats, Sprague-Dawley; Recombinant Proteins; Spinal Cord
PubMed: 33096842
DOI: 10.3390/ijms21207798 -
Wound Management & Prevention Dec 2021Many patients who have diabetes and peripheral neuropathy wear compression socks, which are widely available and may be purchased with a copper component. There is also...
BACKGROUND
Many patients who have diabetes and peripheral neuropathy wear compression socks, which are widely available and may be purchased with a copper component. There is also a well-documented history of patients with neuropathy developing thermal burns from heat sources. Patients with diabetes are at an increased risk of complications when they sustain burns.
PURPOSE
To describe a patient with diabetes and neuropathy who developed third-degree burns while wearing a copper-containing compression sock.
CASE REPORT
A 68-year-old man with type 2 diabetes and peripheral neuropathy wore a copper-containing compression sock while sitting in the sun for several hours. Afterward, he noted severe blistering and was ultimately diagnosed with several areas of second- and third-degree burns. Wound treatment included sharp debridement, dressing management, and tubular compression. All wounds were healing well when the patient was lost to follow-up.
CONCLUSION
This case report illustrates the risk of burn injury when wearing compression socks infused with copper in a situation in which the sock could absorb heat, especially in persons with neuropathy. This report and previous studies showing the increased risk of burn injury complications in persons with diabetes underscore the importance of burn prevention education in this population. Future research to examine the thermal conductivity of metal-containing clothing is recommended.
Topics: Aged; Burns; Copper; Diabetes Mellitus, Type 2; Humans; Lower Extremity; Male; Peripheral Nervous System Diseases
PubMed: 35030541
DOI: No ID Found -
Frontiers in Neurology 2021Aneurysmal subarachnoid hemorrhage (SAH) is one of the special stroke subtypes with high mortality and mobility. Although the mortality of SAH has decreased by 50% over... (Review)
Review
Aneurysmal subarachnoid hemorrhage (SAH) is one of the special stroke subtypes with high mortality and mobility. Although the mortality of SAH has decreased by 50% over the past two decades due to advances in neurosurgery and management of neurocritical care, more than 70% of survivors suffer from varying degrees of neurological deficits and cognitive impairments, leaving a heavy burden on individuals, families, and the society. Recent studies have shown that white matter is vulnerable to SAH, and white matter injuries may be one of the causes of long-term neurological deficits caused by SAH. Attention has recently focused on the pivotal role of white matter injury in the pathophysiological processes after SAH, mainly related to mechanical damage caused by increased intracerebral pressure and the metabolic damage induced by blood degradation and hypoxia. In the present review, we sought to summarize the pathophysiology processes and mechanisms of white matter injury after SAH, with a view to providing new strategies for the prevention and treatment of long-term cognitive dysfunction after SAH.
PubMed: 34335439
DOI: 10.3389/fneur.2021.659740 -
Journal of Functional Biomaterials Jul 2015Skin protects the body from exogenous substances and functions as a barrier to fluid loss and trauma. The skin comprises of epidermal, dermal and hypodermal layers,... (Review)
Review
Skin protects the body from exogenous substances and functions as a barrier to fluid loss and trauma. The skin comprises of epidermal, dermal and hypodermal layers, which mainly contain keratinocytes, fibroblasts and adipocytes, respectively, typically embedded on extracellular matrix made up of glycosaminoglycans and fibrous proteins. When the integrity of skin is compromised due to injury as in burns the coverage of skin has to be restored to facilitate repair and regeneration. Skin substitutes are preferred for wound coverage when the loss of skin is extensive especially in the case of second or third degree burns. Different kinds of skin substitutes with different features are commercially available; they can be classified into acellular skin substitutes, those with cultured epidermal cells and no dermal components, those with only dermal components, and tissue engineered substitutes that contain both epidermal and dermal components. Typically, adult wounds heal by fibrosis. Most organs are affected by fibrosis, with chronic fibrotic diseases estimated to be a leading cause of morbidity and mortality. In the skin, fibroproliferative disorders such as hypertrophic scars and keloid formation cause cosmetic and functional problems. Dermal fibroblasts are understood to be heterogeneous; this may have implications on post-burn wound healing since studies have shown that superficial and deep dermal fibroblasts are anti-fibrotic and pro-fibrotic, respectively. Selective use of superficial dermal fibroblasts rather than the conventional heterogeneous dermal fibroblasts may prove beneficial for post-burn wound healing.
PubMed: 26184327
DOI: 10.3390/jfb6030547 -
Journal of Fungi (Basel, Switzerland) Mar 2022The mortality and disability-adjusted life years (DALYs) of burn patients are decreasing over time. However, finding novel effective treatment approaches using natural...
The mortality and disability-adjusted life years (DALYs) of burn patients are decreasing over time. However, finding novel effective treatment approaches using natural agents is highly considered to reduce the burden of burn injuries. One of the recent agents used in wound healing is β-glucan, mainly extracted from fungi cell walls. This study aimed to evaluate the effect of 5% (m/m) of yeast β-glucan ointment on burn wound healing and to assess the impact of β-glucan on cytokines during the treatment. Thirty-three patients with second or third-degree burns were enrolled in this study. Two groups of twenty-three and ten patients used yeast 5% (m/m) β-glucan ointment (study group) and Stratamed ointment (control), respectively, on a daily basis, for a maximum of four weeks. The size of the burn wounds was measured before and at the end of the treatment. Blood samples of 14 and 10 patients in the β-glucan and control groups, respectively, were obtained before and after the treatment, and the enzyme-linked immunosorbent assay (ELISA) was performed to measure the serum concentration of the IL-4, IL-17, and IFN-γ cytokines. The log-binomial model was used to assess the efficacy of the β-glucan ointment on burn wound healing. ANOVA/ANCOVA was employed to assess the effects of β-glucan on the serum concentration of cytokines. After adjusting for potential confounders/covariates, patients receiving β-glucan had better wound healing (RR = 4.34; 95% CI: 0.73 to 25.67; = 0.11). There was a significant difference in IL-4 secretion between the β-glucan and control groups after adjusting for potential confounders/covariates (MD = 77.27; 95% CI: 44.73 to 109.82; = 2.21; 95% CI: 1.16 to 3.24; = 0.0001). The results indicate that 5% (m/m) of β-glucan has efficacy in burn wound healing, and a significant difference was found in the level of IL-4 after receiving β-glucan. Further studies with a two-arm design and long-term use of ointment are needed to confirm the effect of β-glucan on wound healing and cytokine secretion.
PubMed: 35330265
DOI: 10.3390/jof8030263