Burns : journal of the International Society for Burn Injuries
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Ephrin ligand/Eph receptor signaling is important in both tissue development and homeostasis. There is increasing evidence that Ephrin/Eph signaling is important in the skin, involved in hair follicle cycling, epidermal differentiation, cutaneous innervation and skin cancer. However, there is currently limited information on the role of Ephrin/Eph signaling in cutaneous wound healing. ⋯ The loss of Ephrin-A2 and A5 ligands did not impact on the rate of wound closure or re-innervation after injury. However, changes in the gross morphology of the healed scar and in collagen histology of the scar dermis were observed in transgenic mice. Therefore Ephrin-A2 and A5 ligands may play an important role in final scar appearance associated with collagen deposition and structure.
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A high prevalence of self-inflicted burn injury is noted in severe burn injury. It remains unclear as to whether gender and past psychiatric history impact upon whether injury is self-inflicted and the outcomes. ⋯ Psychiatric clinicians should assertively screen the psychiatric history of patients with severe burn injury, and participate in the acute and longer-term management of persons admitted with a self-inflicted burn.
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The prevalence of acute respiratory distress syndrome (ARDS) in mechanically ventilated burn patients is 33%, with mortality varying from 11-46% depending on ARDS severity. Despite the new Berlin definition for ARDS, prompt bedside diagnosis is lacking. We developed and tested a bedside technique of fiberoptic-bronchoscopy-based optical coherence tomography (OCT) measurement of airway mucosal thickness (MT) for diagnosis of ARDS following smoke inhalation injury (SII) and burns. ⋯ OCT is a useful tool to quantify MT changes in the airway following SII and burns. OCT may be effective as a diagnostic tool in the early stages of SII-induced ARDS and should be tested in humans.
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Burn injury induces an acute hyperactive immune response followed by a chronic immune dysregulation that leaves those afflicted susceptible to multiple secondary infections. Many murine models are able to recapitulate the acute immune response to burn injury, yet few models are able to recapitulate long-term immune suppression and thus chronic susceptibility to bacterial infections seen in burn patients. This has hindered the field, making evaluation of the mechanisms responsible for these susceptibilities difficult to study. Herein we describe a novel mouse model of burn injury that promotes chronic immune suppression allowing for susceptibility to primary and secondary infections and thus allows for the evaluation of associated mechanisms. ⋯ Burn-mediated protection from infection is transient, with a secondary infection inducing immune protection to collapse. Repeated infection leads to increased neutrophil and macrophage numbers in the lungs late after burn injury, with diminished innate immune cell function and an increased anti-inflammatory cytokine environment.
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This was a methodological study whose objective was to culturally adapt the 5-D itch scale for Brazilian Portuguese and verify its practicability, acceptability and reliability for burn survivors. This study followed the five internationally recommended steps for the adaptation process: translation, synthesis, back translation, assessment by an expert committee and pretesting process; besides, an evaluation of its practicability, acceptability and reliability was conducted. The pretest was carried out with thirty burn survivors - hospitalized or on outpatient follow-up - from two public hospitals in the state of São Paulo. ⋯ The Brazilian version had semantic and idiomatic, conceptual and cultural equivalences, with a satisfactory content validity index for each item (CVI-I). Mean application time was 3.5minutes, acceptability was good, and there was evidence of reliability for the total score (0.793). The Brazilian version of the 5-D itch scale showed equivalence and evidence of reliability for assessing pruritus and its impact in burn survivors.