Journal of burn care & research : official publication of the American Burn Association
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The long-term impact of burn trauma on skeletal muscle bioenergetics remains unknown. Here, the authors determined respiratory capacity and function of skeletal muscle mitochondria in healthy individuals and in burn victims for up to 2 years postinjury. Biopsies were collected from the m. vastus lateralis of 16 healthy men (26 ± 4 years) and 69 children (8 ± 5 years) with burns encompassing ≥30% of their total BSA. ⋯ Muscle mitochondrial respiratory capacity remains significantly lower in burn victims for 1-year postinjury. Mitochondrial coupling control is diminished for up to 2 years postinjury in burn victims, resulting in greater mitochondrial thermogenesis. These quantitative and qualitative derangements in skeletal muscle bioenergetics likely contribute to the long-term pathophysiological stress response to burn trauma.
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Each year, there are approximately 100 firefighter fatalities and tens of thousands of injuries in the United States. 'It Happened in Seconds' is a firefighter burn injury awareness program offered to firefighters nationwide. The course focuses on situational awareness, personal protective equipment, and burn injury prevention. In order to create more instructors, a 'Train the Trainer' instructor course was developed to prepare experienced firefighters and healthcare providers from around the United States to teach firefighters in their respective communities. ⋯ This study showed that experienced firefighters and healthcare professionals thought that the course significantly improved their awareness level of issues specific to firefighter burn injury as well as their confidence in teaching these concepts to firefighters. Based on this positive evaluation, additional instructors will be trained to provide the course to all firefighters nationwide. Additional research must be conducted to evaluate whether the 'It Happened in Seconds' course results in a decreased rate of firefighter burn injuries.
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Neuropathic pain is an enormous rehabilitation challenge that has a substantial negative effect on patient function and quality of life. Somatosensory rehabilitation is a novel, nonpharmacological intervention described by Spicher based on the neuroplasticity of the somatosensory system. The rationale for somatosensory rehabilitation is that treating hypoesthesia will decrease neuropathic pain. ⋯ The QDSA improved by 9 and 50% for the two patients who initially presented with hypoesthesia. In this case series, the majority of patients (13/17 or 76%) showed substantial improvements after somatosensory rehabilitation suggesting this is a treatment approach that should be considered with burn survivors experiencing neuropathic pain. There is a need, however, for future controlled studies to further investigate this approach and to determine if there is a subpopulation of burn survivors that are more likely than others to benefit from this approach.