International journal of burns and trauma
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Sepsis can lead to multiple organ dysfunction, including the Acute Respiratory Distress Syndrome (ARDS), due to intertwined, dynamic changes in inflammation and organ physiology. We have demonstrated the efficacy of Chemically-Modified Tetracycline 3 (CMT-3) at reducing inflammation and ameliorating pathophysiology in the setting of a clinically realistic porcine model of ARDS. Here, we sought to gain insights into the derangements that characterize sepsis/ARDS and the possible impact of CMT-3 thereon, by combined experimental and computational studies. ⋯ DBN suggested a conserved network structure in both control and CMT-3 animals: a response driven by positive feedback between interleukin-6 and lung dysfunction. Resulting networks further suggested that in control animals, acute kidney injury, acidosis, and respiratory failure play an increased role in the response to insult compared to CMT-3 animals. These combined in vivo and in silico studies in a high fidelity, clinically applicable animal model suggest a dynamic interplay between inflammatory, physiologic, and blood chemistry variables in the setting of sepsis and ARDS that may be dramatically altered by pleiotropic interruption of inflammation by CMT-3.
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Pneumonia is the leading complication in the critical care of burn victims. Airway epithelial dysfunction compromises host defense against pneumonia. The aim of this study is to test the hypothesis that burn injury alters the physiology of the airway epithelium. ⋯ Burn injury altered multiple important functions in rat tracheal epithelium. The decrease in MCC and cell proliferation may be due to oxidative injury. Mechanistic studies to identify physiological processes associated with changes in airway function may help in designing therapeutic agents to reduce burn-induced airway pathogenesis.
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In Konya, Turkey, the community celebrates the traditional ceremony of Shivlilik, which occurs on the first day of the seventh month in the lunar-based Hijri calendar. In the evening, people light bonfires of tires in the streets, and children and young people attempt to jump over the flames. Flame burns regularly occur due to falling. Attention should be given to preventing injuries such as these that are caused by social and regional customs. ⋯ Serious flame burns occur because of the traditional Shivlilik ceremony. We must promote some changes in this ceremony in order to prevent these burns.
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We describe the case of a 77 year-old Japanese woman who was referred to the Department of Oral and Maxillofacial Surgery at Tokyo Women's Medical University Hospital with symptoms of spontaneous intraoral pain and dysphagia evoked by accidental alkaline (calcium oxide) ingestion. The stomach and esophagus were examined under endoscopy, but no evidence of burns or ulceration associated with the calcium oxide was apparent in the upper gastrointestinal tract. Oral care, antibacterial therapy (cefmetazole sodium) and nutritional management were performed after hospitalization. ⋯ Re-burn of the oral mucosa associated with accidental ingestion was not reported after discharge. Oral management may have potential to improve the management of intraoral chemical burns, but symptomatic treatment remains the only strategy for burn management. Accidental ingestion of chemicals by patients with impaired cognition may result in dire consequences and prevention is thus more important than burn management.
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In the past, the authors performed a comprehensive literature review to identify all randomized controlled trials assessing the impact of early tracheostomy on severe brain injury outcomes. The search produced only two trials, one by Sugerman and another by Bouderka. ⋯ For severe brain injury, analyses indicate that ventilator-associated pneumonia rates are not decreased with early tracheostomy. Further, this study implies that mechanical ventilation is reduced with early tracheostomy. Both the randomized trial and retrospective meta-analysis indicate that risk for hospital death increases with early tracheostomy. Findings imply that early tracheostomy for severe brain injury is not a prudent routine policy.