ABSTRACT
INTRODUCTION: Nutritional support is essential in burn care. There are few studies investigating the effect of nutrition on burn healing. The purpose of this study was to determine the relationship between perioperative serum prealbumin levels and the probability of autologous skin graft take in burned patients. MATERIALS AND METHODS: A prospective observational study was carried out with burned adults recruited consecutively from April 2019 until September 2021. Serum prealbumin was determined perioperatively. The percentage of graft take was evaluated over the first 5 postoperative dressing changes. Time until full epithelialization (absence of wounds) was also registered. RESULTS: A total of 60 patients were recruited, mostly middle-aged people with moderate flame burns. Serum prealbumin levels and graft take had a weak-moderate, nonlinear, statistically significant correlation. They were also an independent predictor of full epithelialization on the fifth dressing change, together with burn depth. Higher perioperative serum prealbumin levels were significantly associated with a reduction in time until full epithelialization. CONCLUSIONS: Perioperative serum prealbumin levels are significantly correlated with the probability of split-thickness skin autograft take in burned patients and with a reduced time to achieve complete epithelialization. They were an independent predictor of full graft take.
Subject(s)
Burns , Prealbumin , Skin Transplantation , Wound Healing , Humans , Burns/surgery , Burns/blood , Burns/metabolism , Prealbumin/metabolism , Prealbumin/analysis , Male , Female , Prospective Studies , Middle Aged , Skin Transplantation/methods , Adult , Wound Healing/physiology , Aged , Graft Survival , Re-Epithelialization , Transplantation, Autologous , Young AdultABSTRACT
This study investigated the use of endonasal infiltrative anesthesia for the management of pain associated with nasal bone fracture reduction. Fifty-two patients with nasal bone fractures were distributed in 2 groups. In the first group, topical endonasal anesthesia and external transcutaneous infiltrative anesthesia were employed. In the second group, endonasal infiltrative anesthesia was also added. Visual analog scale pain scores related to the different steps of the procedure were registered. The addition of endonasal infiltrative anesthesia was associated with a significant decrease (p < .05) in pain during reduction maneuvers (6.71 vs. 4.83) and nasal packing (5.18 vs. 3.46). Addition of endonasal infiltrative anesthesia is an effective method of pain reduction during nasal bone fracture treatment.
Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Nasal Bone/injuries , Pain, Procedural/drug therapy , Skull Fractures/surgery , Administration, Intranasal/methods , Closed Fracture Reduction/methods , Female , Humans , Injections , Male , Nasal Bone/surgery , Random Allocation , Skull Fractures/classification , Visual Analog ScaleABSTRACT
Diabetic nephropathy is associated with increased risk of cardiovascular disease. B-type natriuretic peptide (BNP) plays an important role in cardiovascular pathophysiology and therapeutics. The aim of the present study was to investigate the influence of experimental diabetes on the mechanisms that regulate the relaxant response of the rabbit renal artery to BNP. Arterial relaxations to BNP were enhanced in diabetic rabbits. Indomethacin enhanced BNP-induced relaxation in control rabbits but showed no effect in diabetic rabbits. BNP-induced release of thromboxane A2 or prostacyclin was not different in both groups of animals. Iberiotoxin had no effect on relaxations to BNP in both groups of animals. Charybdotoxin displaced to the right the concentration-response curve to BNP in both group of animals, and inhibited BNP-induced relaxation only in diabetic rabbits. Glibenclamide did not modify the BNP-induced relaxations in control rabbits, but inhibited it in diabetic rabbits. These results suggest that diabetes induces hypereactivity of the rabbit renal artery to BNP by mechanisms that at least include (1) a reduced vasoconstrictor influence of arachidonic acid metabolites via cyclooxygenase 2, which is not related with changes in thromboxane A2 and prostacyclin release from the arterial wall and (2) a selectively increased modulatory activity of KATP and endothelial IKCa channels.
Subject(s)
Diabetes Mellitus, Experimental/physiopathology , Natriuretic Peptide, Brain/physiology , Potassium Channels/physiology , Prostaglandins/physiology , Renal Artery/physiology , Animals , Male , Rabbits , VasodilationABSTRACT
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