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1.
Braz. j. biol ; 84: e250936, 2024. graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1345557

ABSTRACT

Abstract This study was carried out to evaluate the effect of Glutamine, as a dipeptide or a free amino acid form, on the progression of burn injuries in rats. Thirty male Wistar rats were burned with a comb metal plate heated in boiling water (98 °C) for three minutes, creating four rectangular full-thickness burn areas separated by three unburned interspaces (zone of stasis) in both dorsum sides. The animals were randomized into three groups (n=10): saline solution (G1-Control) and treated groups that orally received Glutamine as dipeptide (G2-Dip) or free amino acid (G3-FreeAA). Two and seven days after burn injury, lesions were photographed for unburned interspaces necrosis evolution assessment. Seven days after injury, glutathione seric was measured and histopathological analysis was performed. By photographs, there was a significant reduction in necrosis progression in G3-Free-AA between days two and seven. Histopathological analysis at day 7 showed a significantly higher stasis zone without necrosis and a higher number of fibroblasts in G2-Dip and G3-FreeAA compared with G1-Control. Also, glutathione serum dosage was higher in G2-Dip. The plasmatic glutathione levels were higher in the G2-Dip than the G1-Control, and there was a trend to higher levels in G3-FreeAA. The reduction in histological lesions, greater production of fibroblasts, and greater amounts of glutathione may have benefited the evolution of burn necrosis, which showed greater preservation of interspaces.


Resumo Este estudo foi realizado para avaliar o efeito da Glutamina, como um dipeptídeo ou forma de aminoácido livre, na progressão de queimaduras em ratos. Trinta ratos Wistar machos foram queimados com um pente de metal aquecido em água fervente (98 °C) por três minutos, criando quatro áreas retangulares queimadas separadas por três interesespaços não queimados (zona de estase) em ambos os lados do dorso. Os animais foram randomizados em três grupos (n = 10): solução salina (G1-Controle) e grupos tratados que receberam glutamina via oral como dipeptídeo (G2-Dip) ou aminoácido livre (G3-FreeAA). Dois e sete dias após a queimadura, as lesões foram fotografadas para avaliação da evolução da necrose entre os espaços não queimados. Sete dias após a lesão, foi dosada a glutationa sérica e realizada análise histopatológica. Pelas fotografias, houve uma redução significativa na progressão da necrose no G3-Free-AA entre os dias dois e sete. A análise histopatológica no dia 7 mostrou uma zona de estase significativamente maior sem necrose e número mais elevado de fibroblastos em G2-Dip e G3-FreeAA em comparação com G1-Controle. Os níveis plasmáticos de glutationa foram maiores no G2-Dip em relação ao G1-Controle, e houve tendência a níveis mais elevados no G3-FreeAA. A redução das lesões histológicas, maior produção de fibroblastos, maior quantidade de glutationa podem ter beneficiado a evolução da necrose da queimadura, que mostrou maior preservação dos interespaços.


Subject(s)
Animals , Male , Rats , Burns/drug therapy , Glutamine , Rats, Wistar , Dipeptides , Disease Models, Animal , Amino Acids
2.
Braz. j. biol ; 83: e249209, 2023.
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339360

ABSTRACT

Abstract Alo vera is a centenary remedy use for minor wounds and burns, but its mechanism of wound healing has not been know since. This article will evaluate and gather evidence of the effectiveness and safety of the use of aloe vera in the treatment of burns. A systematic review was carried out on the databases: MEDLINE, LILACS, DECS, SCIELO, in the last 7 years, with the descriptors: "Aloe", "Burns" and "treatment". 16 articles were found. After using the exclusion criteria; research in non-humans and literature review; 5 articles were selected. The article Teplick et al. (2018) performed an in vitro clinical experiment in A. Vera solution, and demonstrated that there was proliferation and cell migration of human skin fibroblasts and keratinocytes, in addition to being protective in the death of keratonocytes. That is, it accelerates the healing of wounds. Muangman et al. (2016), evaluated 50 patients with 20% of the total body surface area burned with second-degree burns, between 18-60 years old, with half of the group receiving gauze dressings with soft paraffin containing 0.5% chlorhexidine acetate and the other half receiving polyester dressings containing extracts of medicinal plants mainly Aloe Vera. It had positive results, a higher healing speed and shorter hospital stay compared to the control group. Hwang et al. (2015) investigated the antioxidant effects of different extracts from 2,4,6,8,12 months of Aloe Vera. And the 6-month concentrated extract of 0.25 mg / mL had a higher content of flavonoids (9.750 mg catechin equivalent / g extract) and polyphenols (23.375 mg gallic acid equivalent / g extract) and the greater ferric reducing antioxidant power (0.047 mM equivalent ferrous sulfate / mg extract), that is, greater potential for free radical scavenging and also a protective effect against oxidative stress induced by tert-butyl hydroperoxide (t-BHP), suggesting evidence of a bioactive potential of A. vera . However, in the article Kolacz et al. (2014) suggested as an alternative treatment the use of Aloe Vera dressing in combination with honey, lanolin, olive oil, wheat germ oil, marshmallow root, wormwood, comfrey root, white oak bark, lobelia inflata, glycerin vegetable oil, beeswax and myrrh, without obtaining significant and conclusive results that would allow the conventional treatment of burns to be subsidized. Finally, in the article by Zurita and Gallegos (2017), it carried out a descriptive cross-sectional study with 321 people, both sexes between 17-76 years of age, of an inductive nature, exploring the experience of this population and their behavioral attitudes regarding the treatment of dermatoses. Aloe vera had 13.8% cited by individuals in the treatment of acne and 33.6% in the treatment of burns. Even with evidence that suggests the efficacy in the treatment of burns with the use of Aloe Vera extract, further clinical trials with larger sample space on the use of Aloe vera dressings in medium burns are suggested for further conclusions.


Resumo Alo vera é um remédio centenário usado para pequenas feridas e queimaduras, mas seu mecanismo de cicatrização de feridas não foi conhecido desde então. Este artigo avaliará e reunirá evidências da eficácia e segurança do uso de aloe vera no tratamento de queimaduras. Realizada revisão Sistemática nas bases de dados: MEDLINE, LILACS, DECS, SCIELO, nos últimos 7 anos, com os descritores: "Aloe", "Burns" and "treatment". Foram encontrados 16 trabalhos. Após utilizarmos os critérios de exclusão; pesquisa em nao humanos e revisão da literatura ; foram selecionados 5 artigos. O artigo Teplick et al. (2018) realizou um experimento clinico in vitro em solução de A. Vera, e demonstrou que houve proliferação e migração celular de fibroblastos e queratinócitos de pele humana, além de ser protetor na morte de queratonócitos. Ou seja, acelera a cicatrização das feridas. Já Muangman et al. (2016), avaliou 50 pacientes com 20% do total da área superficial corporal queimada com queimaduras de segundo grau, entre 18-60 anos, tendo metade do grupo como controle recebendo curativos de gaze com parafina mole contendo 0,5% acetado de clorexidina e a outra metade recebendo curativos com poliéster contendo extratos de plantas medicinais principalmente Aloe Vera. Teve resultados positivos, uma maior velocidade de cicatrização e menor tempo de internação comparado ao grupo controle. Já Hwang et al. (2015) investigou os efeitos antioxidante de diferentes extratos de 2,4,6,8,12 meses da Aloe Vera. E o extrato com 6 meses concentrado de 0,25 mg/mL teve maior teor de flavanóides (9,750 mg equivalente catequina / g extrato) e polifenóis (23,375 mg equivalente ácido gálico / g extrato) e o maior poder antioxidante redutor férrico (0,047 mM de sulfato ferroso equivalente / extrato mg), ou seja, maior potencial de eliminação de radicais livres e também efeito proteror contra o estresse oxidativo induzido por hidroperóxido de terc-butila (t-BHP), sugerindo indícios de um potencial bioativo da A. vera. Porém, no artigo Kolacz et al. (2014) sugeriu como tratamento alternativo o uso do curativo com Aloe Vera em conjunto de mel, lanolina, azeite de oliva, óleo de gérmen de trigo, raiz de marshmallow, absinto, raiz de confrei, casca de carvalho branco, lobelia inflata, glicerina vegetal, cera de abelha e mirra, não obtendo resultados significativos e conclusivos que permitam subsidiar o tratamento convencional das queimaduras. Por fim, no artigo de Zurita and Gallegos (2017), realizou um estudo descritivo transversal com 321 pessoas, ambos os sexos entre 17-76 anos, de natureza indutiva, explorando a vivência dessa população e suas atitudes comportamentais quanto ao tratamento de dermatoses. Aloe vera teve 13,8% citada pelos indivíduos no tratamento de acne e 33,6% no tratamento de queimaduras. Mesmo tendo evidências que sugerem a eficácia no tratamento de queimaduras com o uso do extrato da Aloe Vera, sugere-se mais ensaios clínicos com espaço amostral maior sobre o uso de curativos de Aloe vera em médio queimados para maiores conclusões.


Subject(s)
Humans , Plants, Medicinal , Burns/drug therapy , Aloe , Wound Healing , Plant Extracts/therapeutic use , Plant Extracts/pharmacology , Cross-Sectional Studies
3.
J Nanobiotechnology ; 20(1): 291, 2022 Jun 21.
Article in English | MEDLINE | ID: mdl-35729564

ABSTRACT

BACKGROUND: The use of keratinocytes derived from induced pluripotent stem cells (iPSCs-KCs) may represent a novel cell therapy strategy for burn treatment. There is growing evidence that extracellular vesicles, including exosomes, are primary mediators of the benefits of stem cell therapy. Herein, we thus explored the effects of exosomes produced by iPSCs-derived keratinocytes (iPSCs-KCs-Exos) in a model of deep second-degree burn wound healing and evaluated the mechanistic basis for the observed activity. METHODS: iPSCs-KCs-Exos were isolated from conditioned medium of iPSCs-KCs and verified by electron micrograph and size distribution. Next, iPSCs-KCs-Exos were injected subcutaneously around wound sites, and its efficacy was evaluated by measuring wound closure areas, histological examination, and immunohistochemistry staining. The effects of iPSCs-KCs-Exos on proliferation and migration of keratinocytes and endothelial cells in vitro were assessed by EdU staining, wound healing assays, and transwell assay. Then, high-throughput microRNA sequencing was used to explore the underlying mechanisms. We assessed the roles of miR-762 in iPSCs-KCs-Exos-induced regulation of keratinocytes and endothelial cells migration. Furthermore, the target gene which mediated the biological effects of miR-762 in keratinocytes and endothelial cells was also been detected. RESULTS: The analysis revealed that iPSCs-KCs-Exos application to the burn wound drove the acceleration of wound closure, with more robust angiogenesis and re-epithelialization being evident. Such iPSCs-KCs-Exos treatment effectively enhanced endothelial cell and keratinocyte migration in vitro. Moreover, the enrichment of miR-762 was detected in iPSCs-KCs-Exos and was found to target promyelocytic leukemia (PML) as a means of regulating cell migration through a mechanism tie to integrin beta1 (ITGB1). CONCLUSION: These results thus provide a foundation for the further study of iPSCs-KCs-Exos as novel cell-free treatments for deep second-degree burns.


Subject(s)
Burns , Exosomes , Induced Pluripotent Stem Cells , MicroRNAs , Burns/therapy , Cell Movement , Cell Proliferation/physiology , Endothelial Cells , Exosomes/genetics , Humans , Keratinocytes , MicroRNAs/genetics , Wound Healing
4.
J Appl Biomed ; 20(2): 45-55, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35727122

ABSTRACT

Open wounds are easily susceptible to infection by multi-drug resistant (MDR) pathogens. The emergence of MDR super bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus spp, fungi such as Aspergillus niger and Candida spp, has been identified to significantly increase the incidence rate. Therefore, it is necessary to develop a suitable barrier to prevent infection and enhance wound healing. On the other hand, medicinal plants could represent a significant source of new antimicrobial drugs for combating MDR pathogens. Out of 60 clinical skin burn cases, 51 patients (85%) had polymicrobial infections, while the remaining had monomicrobial infections. Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumonia were identified as the most common bacterial isolates based on morphological and biochemical tests. However, Candida albicans, Candida parasitosis, Candida glabrata, Candida famata, Aspergillus niger, and Exophilia spinifera were the most common fungal isolates found in skin burn cases. MDR classification was reported in 21 of the 39 bacterial isolates and 8 of the 27 fungal isolates. The antimicrobial activity of tested acetonic plant extracts rosemary, henna, and licorice against MDR isolates was compared to the commercial antibiotic agents. Acetonic rosemary extract outperformed henna and licorice extracts in antibacterial activity, while licorice extract outperformed henna and rosemary extracts on antifungal activity. As a result, rosemary and licorice extracts were chosen to prepare a topical cream for further in vivo wound healing and histopathology. Based on the antimicrobial potential of acetonic plant extracts against MDR isolates, BI-41 and FI-17 were chosen for in vivo wound healing. BI-41 stands for the molecularly identified species Pseudomonas aeruginosa SSM-15, while FI-17 stands for molecularly identified species Aspergillus niger SSM-27. In vivo testing showed that both cream formulas had excellent healing properties when administered topically. In vivo histopathological examination revealed that acetonic rosemary and licorice extract could be promising for wound healing, combating MDR pathogens of burn wound infections.


Subject(s)
Anti-Infective Agents , Burns , Anti-Bacterial Agents/pharmacology , Burns/drug therapy , Candida , Escherichia coli , Humans , Microbial Sensitivity Tests , Plant Extracts/pharmacology , Pseudomonas aeruginosa , Staphylococcus aureus , Wound Healing
5.
Sci Rep ; 12(1): 10479, 2022 Jun 21.
Article in English | MEDLINE | ID: mdl-35729262

ABSTRACT

Determining the optimal treatment course for a dermatologic burn wound requires knowledge of the wound's severity, as quantified by the depth of thermal damage. In current clinical practice, burn depth is inferred based exclusively on superficial visual assessment, a method which is subject to substantial error rates in the classification of partial thickness (second degree) burns. Here, we present methods for direct, quantitative determination of the depth extent of injury to the dermal collagen matrix using polarization-sensitive optical coherence tomography (PS-OCT). By visualizing the depth-dependence of the degree of polarization of light in the tissue, rather than cumulative retardation, we enable direct and volumetric assessment of local collagen status. We further augment our PS-OCT measurements by visualizing adnexal structures such as hair follicles to relay overall dermal viability in the wounded region. Our methods, which we have validated ex vivo with matched histology, offer an information-rich tool for precise interrogation of burn wound severity and healing potential in both research and clinical settings.


Subject(s)
Burns , Tomography, Optical Coherence , Burns/diagnostic imaging , Burns/pathology , Collagen , Humans , Skin/pathology , Tomography, Optical Coherence/methods , Wound Healing
6.
Pak J Pharm Sci ; 35(2): 507-517, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35642407

ABSTRACT

The study aimed to investigate the constituents of the ethanolic extract of Micromeria fruticosa and evaluate its antimicrobial and burn healing activities and the isolated compound, rutin. The plant was extracted with ethanol and the active constituents were isolated. The antimicrobial activities of the extract and the isolated compounds were assessed. The burn healing potentiality was evaluated in a second-degree burn model on rats. Five compounds were isolated and identified namely, oleanolic acid 3-O-ß-D-glucopyranoside, apigenin, tectochrysin, 7,4' dihydroxyflavone7-rhamnoglucoside, and rutin. Noticeable antimicrobial activities of the extract, fractions and rutin, were obtained. These effects could be attributed to the isolated flavonoids and triterpenes compounds. The topical application of the extract or rutin significantly reduced the wound size and improved the skin histology. The molecular docking simulations predicted potential inhibitory interaction between rutin and the active site of IKKß that could be responsible for blocking NF-κB activation; this could explain the possible mechanism by which rutin enhances the burn wounds healing process. Ethanolic extract, fractions and isolated compound, rutin of M. fruticosa exhibited significant antimicrobial activities. The plant extract and rutin demonstrated high potentialities to heal burns.


Subject(s)
Anti-Infective Agents , Burns , Lamiaceae , Animals , Anti-Infective Agents/pharmacology , Burns/drug therapy , Ethanol/pharmacology , Molecular Docking Simulation , Plant Extracts , Rats , Rutin/pharmacology , Wound Healing
7.
Ann Glob Health ; 88(1): 34, 2022.
Article in English | MEDLINE | ID: mdl-35646613

ABSTRACT

Burn injuries are a major cause of death and disability globally; however, the true epidemiologic burden is underestimated given the limited and fragmented availability of high-quality burn injury data from many regions. To address this gap, the World Health Organization (WHO) Global Burn Registry (GBR)-a minimum dataset aligned with a centralized registry-was officially launched in 2018 to facilitate hospital-level collection of key prevention, care, and outcome data from burn-injured patients around the world in a standardized manner. However, uptake and use of GBR has been low and inconsistent. Therefore, we aimed to identify and understand the barriers and facilitators to the implementation of the GBR to inform the development of a web-based GBR implementation guide through the Centre for Global Burn Injury Policy and Research and Interburns. We designed and conducted web-based surveys with "GBR users" and "GBR non-users" using purposive sampling. Themes of identified barriers and facilitators focused on awareness of the GBR, stakeholder buy-in, resource constraints, process management, and utility of the registry. The lessons learned could support current and future GBR users to promote and maximize the use of the GBR. To achieve the GBR's full potential in global burn injury prevention and care, engagement with the GBR should be enhanced through education and promotion, development of a community of practice, tools for data utilization and quality improvement, and periodic re-evaluation.


Subject(s)
Burns , Burns/epidemiology , Burns/therapy , Humans , Quality Improvement , Registries , United Kingdom , World Health Organization
9.
Klin Lab Diagn ; 67(6): 330-333, 2022 Jun 20.
Article in English | MEDLINE | ID: mdl-35749596

ABSTRACT

The aim of the study was to assess the zinc content and identify the relationship between the concentration of this element and changes in the biochemical status of patients and markers of inflammation during burn shock. We examined 23 patients aged 45.3±16.1 years with burns of I-II-III degree, area of 31-80%. The serum concentrations of zinc, albumin, interleukin-6, C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined. The majority of patients (21/23) had severe hypocincemia, correlated with burn area (r=-0.53; p=0.008). A decrease in zinc levels during burn shock was associated with the development of hypoalbuminemia (r=0.52, p=0.01). The association of deviations in ALT and AST activity with changes in zinc concentration was revealed (-0.59<γ<-0.61, 0.008

Subject(s)
Burns , Hypoalbuminemia , Burns/complications , Burns/metabolism , Homeostasis , Humans , Hypoalbuminemia/complications , Inflammation/complications , Interleukin-6 , Zinc
10.
Front Endocrinol (Lausanne) ; 13: 874291, 2022.
Article in English | MEDLINE | ID: mdl-35721744

ABSTRACT

Background: We recently reported the clinical safety profile of RJX, a well-defined intravenous GMP-grade pharmaceutical formulation of anti-oxidant and anti-inflammatory vitamins as active ingredients, in a Phase 1 study in healthy volunteers (ClinicalTrials.gov Identifier: NCT03680105) (Uckun et al., Front. Pharmacol. 11, 594321. 10.3389/fphar.2020.594321). The primary objective of the present study was to examine the effects of GMP-grade RJX on wound and burn injury healing in diabetic rats. Methods: In the present study, a rat model of T2DM was used that employs HFD in combination with a single injection of STZ intraperitoneally (i.p) at a moderate dose level (45 mg/kg). Anesthetized diabetic rats underwent full-thickness skin excision on the back or were subjected to burn injury via a heated brass probe and then started on treatments with normal saline (NS = vehicle) or RJX administered via intraperitoneal injections for three weeks. Findings: Notably, diabetic rats treated with the 1.25 mL/kg or 2.5 mL/kg RJX (DM+RJX groups) rapidly healed their wounds as fast as non-diabetic control rats. Inflammatory cell infiltration in the dermis along with fibrin and cell debris on the epithelial layer persisted for up to 14 days in the DM+NS group but not in RJX-treated groups. The histopathological score of wound healing on days 7 and 14 was better in diabetic rats treated with RJX than diabetic rats treated with NS and comparable to the scores for non-diabetic healthy rats consistent with an accelerated healing process. The residual wound area of RJX-treated rats was significantly smaller than that of NS-treated diabetic rats at each evaluation time point (P<0.001). The accelerating effect of RJX on diabetic wound healing was dose-dependent. We obtained similar results in the burn injury model. Our results demonstrate that RJX - at a dose level >10-fold lower than its clinical maximum tolerated dose (MTD) - accelerates the healing of excision wounds as well burn injury in diabetic rats.


Subject(s)
Burns , Diabetes Mellitus, Experimental , Animals , Burns/complications , Burns/drug therapy , Burns/pathology , Diabetes Mellitus, Experimental/drug therapy , Humans , Rats , Wound Healing
11.
Biomed Res Int ; 2022: 5004282, 2022.
Article in English | MEDLINE | ID: mdl-35722456

ABSTRACT

Background: Burn injuries in children are a major physical and psychological trauma, often a severe condition with long-term consequences. Current methods of assessing the extent of burn injuries on admission are inaccurate. Circulating cell-free DNA (cfDNA) is a potential marker of tissue damage that may be useful in burn care. Objective: To explore the use of cfDNA admission levels as a prognostic marker of pediatric burn severity and outcome. Methods: cfDNA levels of 38 pediatric burn patients (otherwise healthy) and 12 matched pediatric controls (minor elective surgery patients) admitted to our center were quantified by a direct fluorometric assay. Results: We found significantly higher admission cfDNA levels in the patient group (median 724 ng/ml, range 44-4405), compared to the control group (median 423 ng/ml, range 206-970, Mann-Whitney, P = 0.03) and a significant difference between cfDNA levels of partial-thickness burns (median 590 ng/ml, range 44-2909) and full-thickness burns (median 2394 ng/ml, range 528-4405, Mann-Whitney, P = 0.01). We also found significant correlations between cfDNA levels and hospitalization duration (Spearman, R = 0.42, P < 0.01) and undergoing surgical procedures (Spearman, R = 0.40, P < 0.01). PICU admission did not correlate to cfDNA levels (Spearman, R = 0.14, P = NS). Discussion. Admission cfDNA levels may be a valuable objective tool for assessing the severity of pediatric burn injuries on admission, including correlations with the length of hospitalization and surgical burden. Conclusion: Admission cfDNA levels may be a promising novel pediatric burn assessment method. Further investigation of cfDNA levels in healthy children standardized to age and larger cohorts are needed to establish cfDNA as a valuable prognostic factor for pediatric burn injury.


Subject(s)
Burns , Cell-Free Nucleic Acids , Burns/diagnosis , Child , Hospitalization , Humans , Length of Stay , Prognosis , Retrospective Studies
12.
Soc Sci Med ; 305: 115037, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35662513

ABSTRACT

Burns et al.'s innovative recommendation to use social network theory to study integration will contribute to our understanding of how healthcare systems can optimally deliver high quality, coordinated, person-centered care. We discuss three enhancements to this approach. (1) In increasing our attention to social network analysis and processual perspectives, we must not "throw out the baby with the bathwater" and abandon research that includes formal organizational structure. Structure remains an important focus for researchers and healthcare managers, who spend considerable resources on reorganizing. Since there is evidence that formal structure affects social processes and coordination, future research should build on that evidence and investigate how coordination is affected by the segmentation of organizations into units and the structures and processes designed to integrate interdependent work across those units. Conducting network analysis in the context of formal structure can help us better understand how formal structure affects both social networks and coordination. (2) Using multi-level, mixed methods, and qualitative research will be critically important to fully understand how and why formal organizational structure, social networks, and processual dynamics contribute to coordination or fragmentation of care. Because the relationships among these constructs occur not only within, but also across multiple levels, multi-level research is necessary to understand their effects on coordination. In considering the individual level, patients can be studied as a role embedded in networks. In addition, however, we must not lose a focus on patients as people at the center of multi-level networks, whose attitudes, values, preferences and goals may directly affect processual dynamics and coordination of care. (3) Finally, our field lacks precision in nomenclature, specification of levels, and the constructs within them, including ambiguity around even what is meant by "structure" and its variations. Furthermore, different authors use "macro", "meso", and "micro", differently, contributing to confusion in the discourse on organizational phenomena. Greater clarity and consistency in terminology is needed to facilitate research and improve communication across the field.


Subject(s)
Burns , Delivery of Health Care, Integrated , Communication , Health Facilities , Humans , Qualitative Research
13.
PLoS One ; 17(6): e0270281, 2022.
Article in English | MEDLINE | ID: mdl-35737705

ABSTRACT

BACKGROUND: In this study, a hydrogel comprising poly (vinyl alcohol)/pectin (PVA/PET) was prepared by the addition of Melia azedarach extract for epithelial restoration. M. azedarach extract (MAE) contains volatile organic plant-derived compounds with antimicrobial properties. MAE has a variety of physiological properties, including antimicrobial, insecticidal, and anti-inflammatory activity. This study aimed to investigate whether MAE-loaded PVA/PET hydrogels have protective effects against burn wound healing. METHODS AND FINDINGS: To mix M. azedarach with the gel, nanoparticles containing M. azedarach were prepared using chitosan/maltodextrin as the wall material. A PVA/PET hydrogel containing M. azedarach was developed and its applicability as a wound dressing was evaluated. In the in vitro scratch assay, MAE treatment showed a scratch recovery-promoting effect comparable to that of the positive control TGF-ß1. The MAE-PVA/PET hydrogel was found to be non-toxic, and the antibacterial activity of the hydrogel was excellent against both gram-positive and gram-negative bacteria. Furthermore, as the formulated hydrogel demonstrated strong antimicrobial activity, its wound-healing efficacy was investigated in vivo using a rat model. CONCLUSION: MAE was found to be effective against burn wounds and to have antimicrobial activity in vitro and in vivo.


Subject(s)
Burns , Melia azedarach , Animals , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Burns/drug therapy , Gram-Negative Bacteria , Gram-Positive Bacteria , Hydrogels/pharmacology , Pectins/pharmacology , Polyvinyl Alcohol/pharmacology , Rats , Wound Healing
14.
Medicina (Kaunas) ; 58(6)2022 May 30.
Article in English | MEDLINE | ID: mdl-35743999

ABSTRACT

Backgroundand Objectives: Hypertrophic scars following surgeries or burns present a serious concern for many patients because these scars not only lead to an aesthetical but also to a functional and psychological burden. Treatment of hypertrophic scars is challenging because despite various treatment options, a low level of evidence hinders preference of any specific treatment plan. To properly identify new therapeutic approaches, the use of in vivo models remains indispensable. A gold standard for hypertrophic scars has not been established to date. This review aims at giving a comprehensive overview of the available in vivo models. Materials and Methods: PubMed and CINAHL were queried for currently existing models. Results: Models with mice, rats, rabbits, pigs, guinea pigs and dogs are used in hypertrophic scar research. Rodent models provide the advantage of ready availability and low costs, but the number of scars per animal is limited due to their relatively small body surface, leading to a high number of test animals which should be avoided according to the 3Rs. Multiple scars per animal can be created in the guinea pig and rabbit ear model; but like other rodent models, these models exhibit low transferability to human conditions. Pig models show a good transferability, but are cost-intensive and require adequate housing facilities. Further, it is not clear if a currently available pig model can deliver clinical and histological features of human hypertrophic scars concurrently. Conclusions: None of the analyzed animal models can be clearly recommended as a standard model in hypertrophic scar research because the particular research question must be considered to elect a suitable model.


Subject(s)
Burns , Cicatrix, Hypertrophic , Animals , Cicatrix, Hypertrophic/drug therapy , Cicatrix, Hypertrophic/etiology , Disease Models, Animal , Dogs , Guinea Pigs , Humans , Mice , Rabbits , Rats , Wound Healing
15.
Medicina (Kaunas) ; 58(6)2022 Jun 17.
Article in English | MEDLINE | ID: mdl-35744082

ABSTRACT

Background and Objectives: Homogeneous and xenogenic bioengineering structures are actively used as wound coatings in treatment of burns and have already shown their effectiveness. Nevertheless, the disadvantage of such dressings is their high cost. This issue is particularly challenging for developing countries in which the incidence of burns is the highest one. With such needs taken into account, the research team developed and clinically tested a new wound coating based on decellularized bovine peritoneum (DBP). Materials and Methods: A multicenter randomized clinical trial was conducted to evaluate DBP. The following variables were considered in the research study: the number of inpatient days, the number of dressing changes, the level of pain experienced during dressing changes, and the condition of wounds at the time of the follow-up examination. Results: The research involved 68 participants. It was found that the patients who were treated with a DBP experienced less pain with less changes of dressings. However, the number of inpatient days and wound healing failed to demonstrate statistically significant difference compared to the control group. Conclusions: In the given research, DBP showed efficacy in improving patients' quality of life by reducing pain and the number of dressings' changes. However, when comparing this research study with the studies of other animal-derived wound coverings, there were a number of differences and limitations in the parameters. Thus, the results requires further study for a greater comparability of data. Given the above, we expect that DBP will become an inexpensive and effective treatment for burns in developing countries.


Subject(s)
Burns , Peritoneum , Animals , Burns/therapy , Cattle , Heterografts , Humans , Pain , Quality of Life , Surgical Wound Infection/epidemiology
16.
Ulus Travma Acil Cerrahi Derg ; 28(6): 790-795, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35652868

ABSTRACT

BACKGROUND: For prediction of mortality and clinical course, various scoring systems had been developed. We choose four well known burn specific scoring systems and a general scoring system that using in Intensive Care Units. The primary outcome of this study was evaluate the predictive performances of this models and define the optimal one for our patient population. METHODS: Variables analyzed were age, gender, burn type, total burned surface area (TBSA), total partial thickness burn area, total full thickness burn area, inhalation injuries, mechanical ventilation supports, blood products usage, total scores of Abbreviated Burn Severity Index (ABSI), revised Baux, Belgian Outcome in Burn Injury, Fatality by Longevity, Acute Physiology and Chronic Health Eval-uation II (APACHE II) score, Measured Extent of burn and Sex (FLAMES) and APACHE II, and their relations with mortality. RESULTS: In our study, a statistically significant relationship was found with mortality between age, TBSA, full thickness burn percent-age, inhalation injury, burn type, and it was similar to literature. Female gender was found to be a significant risk factor for mortality. CONCLUSION: We compared several burn mortality scoring systems and their predictional mortality rates. ABSI scores of patients for estimated mortality rates were similar to our mortality rate. Consequently, it was thought that ABSI was included all mortality-re-lated parameters.


Subject(s)
Burns , Severity of Illness Index , APACHE , Age Factors , Burns/mortality , Burns, Inhalation , Female , Humans , Intensive Care Units , Retrospective Studies , Risk Factors , Sex Factors
17.
18.
Antimicrob Resist Infect Control ; 11(1): 82, 2022 Jun 13.
Article in English | MEDLINE | ID: mdl-35698209

ABSTRACT

BACKGROUND: Multidrug resistant organisms (MDROs) occur more commonly in burns patients than in other hospital patients and are an increasingly frequent cause of burn-related mortality. We examined the incidence, trends and risk factors for MDRO acquisition in a specialist burns service housed in an open general surgical ward, and general intensive care unit. METHODS: We performed a retrospective study of adult patients admitted with an acute burn injury to our specialist statewide tertiary burns service between July 2014 and October 2020. We linked patient demographics, injury, treatment, and outcome details from our prospective burns service registry to microbiology and antimicrobial prescribing data. The outcome of interest was first MDRO detection, stratified into the following groups of interest: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), two groups of Pseudomonas (carbapenem resistant, and piperacillin-tazobactam or cefepime resistant), carbapenem-resistant Acinetobacter species, Stenotrophomonas maltophilia, carbapenem-resistant Enterobacteriaceae (CRE), and extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE). We used a Cox proportional hazards model to evaluate the association between antibiotic exposure and MDRO acquisition. RESULTS: There were 2,036 acute admissions, of which 230 (11.3%) had at least one MDRO isolated from clinical specimens, most frequently wound swabs. While acquisition rates of individual MDRO groups varied over the study period, acquisition rate of any MDRO was reasonably stable over time. Carbapenem-resistant Pseudomonas was acquired at the highest rate over the study period (3.5/1000 patient days). The 12.8% (29/226) of MDROs isolated within 48 h were predominantly MRSA and Stenotrophomonas. Median (IQR) time from admission to MDRO detection was 10.9 (5.6-20.5) days, ranging from 9.8 (2.7-24.2) for MRSA to 23.6 (15.7-36.0) for carbapenem-resistant P. aeruginosa. Patients with MDROs were older, had more extensive burns, longer length of stay, and were more likely to have operative burn management. We were unable to detect a relationship between antibiotic exposure and emergence of MDROs. CONCLUSIONS: MDROs are a common and consistent presence in our burns unit. The pattern of acquisition suggests various causes, including introduction from the community and nosocomial spread. More regular surveillance of incidence and targeted interventions may decrease their prevalence, and limit the development of invasive infection.


Subject(s)
Burns , Methicillin-Resistant Staphylococcus aureus , Vancomycin-Resistant Enterococci , Adult , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Carbapenems , Drug Resistance, Multiple, Bacterial , Humans , Prospective Studies , Retrospective Studies
19.
Sci Rep ; 12(1): 10252, 2022 Jun 17.
Article in English | MEDLINE | ID: mdl-35715479

ABSTRACT

This study analyzed the effect of parental supervision of infants at age 4 to 6 months on injuries at age 4 to 12 months. Among all Korean children born during 2008-2009, 464,326 (50.6%) infant had parents who responded to a questionnaire that surveyed their safety and supervision when infant were 4 to 6 months-old. Based on questionnaire score, infant were divided into "safe" or "unsafe" group. 1:1 propensity score matching was used to balance the groups, and injury diagnosis and treatments were analyzed. After matching, we examined the records of 405,862 infant. The unsafe group had significantly increased risk ratios (RRs) for injury of head/neck (RR: 1.06), trunk/abdominopelvic region (RR: 1.12), upper extremities (RR: 1.04), and from burn and frostbite (RR: 1.10). The risks of a wound and fracture and foreign body injury were significantly greater in infant whose parents sometimes left them alone (RR: 1.15 and 1.06, respectively), and whose parents did not always keep their eyes on them (RR: 1.04 and 1.13, respectively). Infant whose parents had a hot drink when carrying them had an increased risk of burn injuries (RR: 1.21). Injuries were less common in infant whose parents provided more supervision.


Subject(s)
Burns , Parents , Child , Humans , Infant
20.
J Biomed Nanotechnol ; 18(3): 898-908, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35715909

ABSTRACT

Scars are common and intractable consequences after scalded wound healing, while monotherapy of epidermal growth factors does not solve this problem. Maintaining the stability of epidermal growth factors and promoting scarless healing of wounds is paramount. In this study, engineering cellular nanovesicles overexpressing PD-L1 proteins, biomimetic nanocarriers with immunosuppressive efficacy, were successfully prepared to encapsulate epidermal growth factors for maintaining its bioactivity. Remarkably, PD-L1 cellular nanovesicles encapsulating epidermal growth factors (EGF@PDL1 NVs) exerted desired therapeutic effect by attenuating the overactivation of T cell immune response and promoting skin cells migration and proliferation. Hence, EGF@PD-L1 NVs promoted wound healing and prevented scarring in deep second-degree scald treatment, demonstrating a better effect than using individual PD-L1 NVs or EGF. This research proved that EGF@PD-L1 NVs is considered an innovative and thorough therapy of deep second-degree scald.


Subject(s)
Burns , Epidermal Growth Factor , B7-H1 Antigen/metabolism , B7-H1 Antigen/therapeutic use , Burns/drug therapy , Cicatrix , Epidermal Growth Factor/metabolism , Epidermal Growth Factor/therapeutic use , Humans , Skin/metabolism , Wound Healing
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