Burns : journal of the International Society for Burn Injuries
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Determining the amount of analgesics required will help burn centers improve their ability to plan for a burn mass casualty incident (BMCI). We sought to quantify the amount of analgesics needed in an inpatient burn population. We hoped that assessing the analgesic use in daily burn care practice will potentially help estimate opioid needs in a burn mass casualty incident (BMCI). ⋯ Our study quantified opioid requirements in an inpatient burn population and identified TBSA (positively) and age (negatively) as significant predictors.
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Knowledge of thermally induced skin injury has increased, but its pathophysiology remains unclear. Although it is assumed that local cooling may protect tissue, little is known about the impact of local heating on human skin. This study aimed to evaluate acute skin perfusion dynamics following thermal stimuli in healthy human volunteers. ⋯ Local cooling may protect damaged tissue due to increased SO2 (lower oxygen consumption). However, reduced blood flow and velocity in response to local cooling limit nutrient requirements and the transport of metabolites. Despite higher oxygen consumption of tissue at higher temperatures, both blood flow and SO2 increase. Thus, we hypothesize that not only hypothermia but also hyperthermia may provide tissue protection.
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In burn patients, vitamin D has been studied primarily in the pediatric population and focused mainly on the correlation with bone marker measurements and incidence of fractures. There is an association between vitamin D deficiency and the development of sepsis in non-burn critically-ill patients. However, there is limited data on vitamin D concentrations and clinical outcomes in burn patients, such as sepsis. The objective of this study is to evaluate the impact of vitamin D concentrations on the incidence of sepsis in adult burn patients. ⋯ Patients with adequate vitamin D concentrations on admission had a reduction in the incidence of sepsis as compared to patients with insufficient vitamin D concentrations. Insufficient vitamin D concentrations may contribute to other worsened clinical outcomes in burn patients. Our findings set the stage for future, multicenter studies to determine the role of vitamin D supplementation in burn patients.
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Type 2 diabetes mellitus (T2DM) is an important reason to cause chronic wound healing or even amputation to patients. A common characteristic of T2DM is the presence of hyperglycemia. Autophagy, a cellular pathway which related to protein and organelle degradation, is relevant to many types of cellular homeostasis change and human diseases including diabetes. ⋯ Then we examined the expression levels of TNF-α, TLR-4 and p62 to assess inflammatory statement. High glucose induced a significant increasement in the expression of both autophagic markers and inflammatory markers and these elevated protein levels were reversed after the use of wnt7a. Therefore, these results showed that wnt7a regulates overwhelmed autophagy and inflammation promoted under high glucose condition.