bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Burn Nursing Units on Burn Wound Infections
Authors: Thompson James T. , Meredith J. Wayne , Molnar Joseph A. 
Published: November 2003

Abstract
Temporary closure of our burn unit allowed evaluation of the effect of a closed unit on infection rates. During renovations, burned patients were treated either in private ward rooms or in the intensive care unit by burn unit nursing staff using the same wound care practices as used in the burn unit. Data regarding burn severity and outcome were collected and compared for all patients treated before (Group A), during (Group B), and after (Group C) renovations. Burned surface area, average age, and hospital stay were statistically similar for each group. Incidence of infection differed significantly (P &lt; 0.005) with 47% of Group B developing infection compared with 11 and 23% for Groups A and C respectively. Mortality rates were not significantly different. Despite consistent wound care the incidence of infection increased nearly two-fold to four-fold when patients were treated out of the unit. We recommend a temporary isolation unit during renovations if possible.
Early Tracheostomy Does Not Improve Outcome in Burn Patients
Authors: Saffle Jeffrey R. , Morris Stephen E. , Edelman Linda 
Published: November 2003

Abstract
Early tracheostomy (ET) has been claimed to reduce ventilator support or intensive care unit or hospital length of stay in intensive care unit patients. This study was performed to assess the potential benefits of ET in burn patients. From October 1996 to July 2001, we evaluated all intubated and acutely burned adults using a formula to predict the probability of prolonged ventilator dependence. We randomized each patient with a probability of prolonged ventilator dependence more than 0.5 to ET, performed on the next operative day, or to conventional therapy (CON), which consisted of continued endotracheal intubation as needed, with tracheostomy (TRACH) performed on postburn day (PBD) 14 if necessary. During this period, 44 patients were randomized, 23 to CON and 21 to ET. Groups did not differ in age, total burn size, or inhalation injury, although ET patients had larger full-thickness burns. ET patients underwent TRACH at a mean of PBD 4 vs PBD 14.8 for CON patients (P &lt; .01). ET patients had a significant improvement in PaO2/FiO2 ratios within 24 hours following TRACH (139 ± 15 vs 190 ± 12;P &lt; .01). There were no differences in ventilator support, length of stay, incidence of pneumonia, or survival. However, six CON patients (26%) were successfully extubated by PBD 14 compared with one ET patient (P &lt; .01). Although tracheostomy offers some advantages in terms of patient comfort and security, routine performance of ET in burn patients does not improve outcomes, nor does it result in earlier extubation. This may be partly caused by the comfort and convenience of tracheostomy.
A Prospective, Randomized Comparison of the Volume Diffusive Respirator® vs Conventional Ventilation for Ventilation of Burned Children
Authors: Carman B. , Cahill T. , Warden G. , McCall J. 
Published: November 2003

Abstract
The Volume Diffusive Respirator® (VDR) is a high-frequency time cycled pressure ventilator that can ventilate, oxygenate, and promote secretion removal. The VDR provides ventilation at lower airway pressures than those required for conventional ventilation in the pressure control mode (PCV). A prospective, randomized, institutional review board–approved study was conducted comparing the VDR to PCV in burned children with respiratory failure from all causes. Methods: Pediatric burn patients requiring ventilation were stratified by presence of inhalation injury and ventilated by VDR or PCV to achieve predefined arterial blood gases. Results: Sixty-four patients were prospectively assigned ventilator type; 32 to VDR, 32 to PCV. Data are reported as mean + SEM. Patient age was 7.4 + 0.7 years, TBSA was 56 + 3%, and number of patients with inhalation injuries was 55 (86%). Maximum peak inspiratory pressure with the VDR was significantly less than with PCV (30.9 + 0.8 cm H2O vs 39.5 + 1.8 cm H2O, P &lt; 0.05) and the best PaO2/FIO2 ratio was significantly higher with the VDR compared with PCV (563 + 15 vs 507 + 13, P &lt; 0.05). No patient in the VDR group had evidence of barotrauma compared with two in the PCV group. Five patients in the PCV group died compared with two in the VDR group. Conclusion: Patients ventilated with the VDR required significantly lower peak inspiratory pressure and achieved a significantly higher PaO2/FIO2 ratio compared with PCV. This demonstrates the VDR is a safe and effective method of ventilation for pediatric burn patients and it offers advantages when compared with conventional ventilation.
Comparison of Patient Satisfaction and Self-Reports of Pain in Adult Burn-Injured Patients
Authors: Carrougher Gretchen J. , Ptacek J. T. , Sharar Sam R. , Wiechman Shelley , Honari Shari , Patterson David R. , Heimbach David M. 
Published: November 2003

Abstract
Procedural and background pain scores were assessed prospectively and compared with treatment goals and satisfaction scores in 84 adult (67 men and 17 women) burn-injured patients treated at a single, tertiary care medical center. We hypothesized that patient satisfaction with pain management plans would be highest among those patients who were experiencing the least pain and also among patients whose experiences most closely matched their treatment analgesic goals. Twice-weekly patient self-reports of worst and average procedural pain, background pain, treatment goals (the level of procedural pain and background pain patients reported that they would be satisfied as experiencing), and overall satisfaction with pain management plans were assessed using 10-point Graphic Rating Scales. Data concerning adjunctive treatments were also obtained. Opioid equivalents, representing pain medications administered, were compared. The majority of patients perceived that “no pain” during burn wound care was an unrealistic goal, a perception that was consistent throughout hospitalization. As hypothesized, average procedural pain levels demonstrated a negative association with patient satisfaction, indicating that patients with the highest levels of procedural pain also reported the lowest level of satisfaction. Opioid analgesic dosing was not significantly associated with ratings of procedural pain or treatment goals. Our findings support the hypothesis that patient satisfaction with pain management is highest in those who experience the least amount of burn care pain and do not support the hypothesis that satisfaction is highest in those whose pain experiences most closely match treatment analgesic goals.
Iatrogenic Burns by Warming Bottles in the Neonatal Period
Authors: Möhrenschlager Matthias , Weigl Lorenz B. , Haug Susanne , Schnopp Christina , Cremer Hansjörg , Ring Johannes , Abeck Dietrich 
Published: November 2003

Abstract
The cases presented in this article highlight the dangers of applying warming bottles to neonates. Warming devices as cool as 42°C (107.6°F) can burn an infant.
Personality, Coping, Chronic Stress, Social Support and PTSD Symptoms Among Adult Burn Survivors
Authors: Lawrence John W. , Fauerbach James A. 
Published: November 2003

Abstract
This paper presents a longitudinal study of the relationship between personality, coping, chronic stress, social support and posttraumatic stress disorder (PTSD). A hypothesized model of the relationship between the predictor variables and PTSD symptoms was proposed. Path analyses was completed to test the model. One hundred fifty-eight adult burn survivors completed questionnaires measuring each of the variables in the hospital. Of those 124 and 94 completed the PTSD measure at 1 month and 6 months postdischarge, respectively. The hypothesized model fit the data at each time point with slight variations. The model accounted for 46 and 29% of the variance of PTSD symptoms at hospitalization and 1 month. Neuroticism was the most important personality dimension in predicting PTSD. Avoidant Coping and Social Support mediated a high percentage of the relationship between Neuroticism and PTSD. The best predictor of PTSD symptoms at 1 and 6 months was PTSD symptoms at hospitalization.
Anoxic and Ischemic Injury of Myelinated Axons in CNS White Matter: From Mechanistic Concepts to Therapeutics
Authors: Stys Peter K. 
Published: November 2003

White matter of the brain and spinal cord is susceptible to anoxia and ischemia. Irreversible injury to this tissue can have serious consequences for the overall function of the CNS through disruption of signal transmission. Myelinated axons of the CNS are critically dependent on a continuous supply of energy largely generated through oxidative phosphorylation. Anoxia and ischemia cause rapid energy depletion, failure of the Na+−K+-ATPase, and accumulation of axoplasmic Na+ through noninactivating Na+ channels, with concentrations approaching 100 mmol/L after 60 minutes of anoxia. Coupled with severe K+ depletion that results in large membrane depolarization, high [Na+]i stimulates reverse Na+–Ca2+ exchange and axonal Ca2+ overload. A component of Ca2+ entry occurs directly through Na+ channels. The excessive accumulation of Ca2+ in turn activates various Ca2+-dependent enzymes, such as calpain, phospholipases, and protein kinase C, resulting in irreversible injury. The latter enzyme may be involved in “autoprotection,” triggered by release of endogenous γ-aminobutyric acid and adenosine, by modulation of certain elements responsible for deregulation of ion homeostasis. Glycolytic block, in contrast to anoxia alone, appears to preferentially mobilize internal Ca2+ stores; as control of internal Ca2+ pools is lost, excessive release from this compartment may itself contribute to axonal damage. Reoxygenation paradoxically accelerates injury in many axons, possibly as a result of severe mitochondrial Ca2+ overload leading to a secondary failure of respiration. Although glia are relatively resistant to anoxia, oligodendrocytes and the myelin sheath may be damaged by glutamate released by reverse Na+–glutamate transport. Use-dependent Na+ channel blockers, particularly charged compounds such as QX-314, are highly neuroprotective in vitro, but only agents that exist partially in a neutral form, such as mexiletine and tocainide, are effective after systemic administration, because charged species cannot penetrate the blood–brain barrier easily. These concepts may also apply to other white matter disorders, such as spinal cord injury or diffuse axonal injury in brain trauma. Moreover, whereas many events are unique to white matter injury, a number of steps are common to both gray and white matter anoxia and ischemia. Optimal protection of the CNS as a whole will therefore require combination therapy aimed at unique steps in gray and white matter regions, or intervention at common points in the injury cascades.
Modeling Dynamic PET-SPECT Studies in the Wavelet Domain
Authors: Turkheimer Federico E. , Banati Richard B. , Visvikis Dimitris , Aston John A. D. , Gunn Roger N. , Cunningham Vincent J. 
Published: November 2003

This work develops a theoretical framework and corresponding algorithms for the modeling of dynamic PET-SPECT studies both in time and space. The problem of estimating the spatial dimension is solved by applying the wavelet transform to each scan of the dynamic sequence and then performing the kinetic modeling and statistical analysis in the wavelet domain. On reconstruction through the inverse wavelet transform, one obtains parametric images that are consistent estimates of the spatial patterns of the kinetic parameter of interest. The theoretical setup allows the use of linear techniques currently used in PET-SPECT for kinetic analysis. The method is applied to artificial and real data sets. The application to dynamic PET-SPECT studies was performed both for validation purposes, when the spatial patterns are known, and for illustration of the advantages offered by the technique in case of tracers with an unknown pattern of distribution.
Apomorphine-Induced Changes in Synaptic Dopamine Levels: Positron Emission Tomography Evidence for Presynaptic Inhibition
Authors: de la Fuente-Fernández Raúl , Lim Andrew S. , Sossi Vesna , Holden James E. , Calne Donald B. , Ruth Thomas J. , Stoessl A. Jon 
Published: November 2003

The authors developed a novel positron emission tomography method to estimate changes in the synaptic level of dopamine ([DA]) induced by direct dopamine agonists (for example, apomorphine) in patients with Parkinson disease. The method is based on the typical asymmetry of the nigrostriatal lesion that often occurs in Parkinson disease. Using the between-side difference (ipsilateral (I) and contralateral (C) putamen to the more affected body side) of the inverse of the putamen [11C]raclopride binding potential (BP), the authors obtained [Formula: see text] at baseline (that is, before apomorphine administration) and [Formula: see text] after apomorphine administration (assuming the concentration of apomorphine is equal in both putamina). The between-side difference in the estimated synaptic concentration of dopamine (diff[DA]) should remain constant unless apomorphine affects dopamine release differently between the two sides. The authors found that apomorphine given subcutaneously at doses of 0.03 and 0.06 mg/kg induced significant changes in their estimate of diff[DA] (P < 0.05). Such changes were more pronounced when only patients with a stable response to levodopa were considered ( P < 0.01). These findings provide in vivo evidence that direct dopamine agonists can inhibit the release of endogenous dopamine. The authors propose that this effect is mainly mediated by the activation of presynaptic D2 /D3 dopamine receptors.
Silver-Sulfadiazine Eschar Pigmentation Mimics Invasive Wound Infection
Authors: Eldad A. , Icekson M. , Zur T. , Slosser D. , Maly A. , Arielli D. , Burvin R. , Ad-El D. , Neuman A. 
Published: November 2003

Abstract
A 3-year-old girl with 52% TBSA scalds, mostly partial thickness, was treated topically with 5% mafenide acetate solution and 1% silver sulfadiazine cream. All blood cultures and wound swabs were negative for the first 5 days. On day 6 gram-negative bacteria and yeast forms were isolated from her wounds. High fever and leukocytosis were present and the child was treated with intravenous ampicillin and gentamicin according to sensitivity bacteriogram. The bacteria were identified as Pseudomonas aeruginosa and the yeast was Candida tropicalis. On day 7, Escherichia coli was identified in blood cultures and intravenous cefixime was added. Amphotericin B was added on day 9 when blood cultures grew Candida tropicalis and Burkholderia cepacia. On day 13 dark pigmentation foci developed on some areas of partial-thickness burns in the back, resembling invasive wound infection. White blood cell count was 14,300 cells/mm3, and her body temperature reached 39.7°C. Cultures from the pigmented areas were negative, and biopsies revealed deposits of silver. Most of the areas healed uneventfully, and only about 8% TBSA needed grafting, including some of the pigmented areas. No residual pigmentation remained on discharge.
What Are the Acute Cardiovascular Effects of Subcutaneous and Topical Epinephrine for Hemostasis During Burn Surgery?
Authors: Cartotto Robert , Kadikar Nisha , Musgrave Melinda A. , Gomez Manuel , Cooper Andrew B. 
Published: November 2003

Abstract
Although subcutaneous and topical epinephrine are widely used for hemostasis during burn surgery, the acute systemic cardiovascular effects of the epinephrine are neither well documented nor completely understood. The purpose of this work was to prospectively study the acute cardiovascular responses to epinephrine (epi) administered subcutaneously and topically during burn surgery. Consecutive patients who received subcutaneous and topical epi during burn surgery were monitored prior to the administration of epi, at 2-minute intervals during subcutaneous epi infiltration, and then after epi infiltration (during which time, topical epi was applied). This period of monitoring lasted up to 20 minutes and was referred to as an epinephrine event (EE). A total of 100 EEs from 38 operations in 24 patients (mean ± SD: age 43 ± 16 years, mean % TBSA burn 23 ± 17%) were studied. The mean dose of subcutaneous epi was 30 ± 30 μg/kg. Although all patients received topical epi, it was impossible to document the topical dose. There was no significant increase in heart rate from baseline, and no arrhythmias occurred. Mean arterial pressure (MAP) did acutely increase significantly by 17.0 ± 14.1% from baseline (P = .009) and increased more than 10% from baseline in 64/100 EEs. However, the increase in MAP was independent of the dose of epi (r = .053). The increase in MAP was not clinically significant, did not require intervention, and did not appear to be related to the type of wound that received epi (donor site vs burn wound), or the depth of anesthesia, analgesia, or sedation. On the basis of these findings, the use of subcutaneous and topical epi appears to be safe and produces minimal acute cardiovascular effects.
Alternative Splinting Methods for the Prevention and Correction of Burn Scar Torticollis
Authors: Serghiou Michael A. , McLaughlin Alex , Herndon David N. 
Published: November 2003

Abstract
Significant neck burns may lead to deforming lateral flexion and rotation contractures. A two-device splinting regimen has been designed to prevent such contractures. In the acute phase, the Dynamic Antitorticollis Strap is applied while the patient is in bed to gently rotate the head and neck toward the neutral position. This dynamic strap includes a Velfoam® headband attached to Thera-Band® secured to the patient's bed. The antitorticollis neck splint is used in the rehabilitation phase and can be serially adjusted to correct lateral flexion contractures of the neck. Thermoplastic material is cut from a modified neck splint pattern and draped over the temporaloccipital region and anterior/posterior shoulder ipsilateral to the contracture and the anterior and contralateral aspect of the neck. The combined use of these devices during the scar maturation phase provides therapists with alternatives in preventing burn scar torticollis.
Noncontact Electrosurgical Grounding Is Useful in Burn Surgery
Authors: Sheridan Robert L. , Wilson Norman C. , O'Connell Mark F. , Fabri Judith A. 
Published: November 2003

Abstract
Grounding patients with large burns to facilitate the use of electrocautery devices during surgery is commonly difficult because of the paucity of available grounding sites. The Mega 2000 Patient Return Electrode System (Megadyne Medical Products, Draper, UT) is an electrode designed to provide electrical return to facilitate function of electrocautery devices without direct patient contact. It accomplishes this by having a very large surface area (720 square inches) in the form of a reusable pad placed on the operating table that is covered by an impermeable drape and clean sheet beneath the patient. We used this noncontact device in 25 operations of 17 children with large burns and limited availability of traditional grounding sites. The patients had an average age of 8.8 + 4.6 years (range, 14 months–14 years), average burn size of 55 + 33% of the body surface (range, 10–95%), and average weight of 33.0 + 17.9 kg (range, 9–75 kg). Operations included 22 excision and grafting operations, an axillary release, a neck release, and bilateral groin releases. The device functioned well in all cases. There were no cutaneous burns observed. No additional traditional devices required placement. We found the device useful in burn surgery in those cases where there is a paucity of traditional grounding sites available.
Overexpression of Rat Heat Shock Protein 70 is Associated with Reduction of Early Mitochondrial Cytochrome c Release and Subsequent DNA Fragmentation after Permanent Focal Ischemia
Authors: Tsuchiya Daisuke , Hong Shwuhuey , Matsumori Yasuhiko , Shiina Hiroaki , Kayama Takamasa , Swanson Raymond A. , Dillman Wolfgang H. , Liu Jialing , Panter S. Scott , Weinstein Philip R. 
Published: November 2003

Although protective effects of heat shock protein 70 (HSP70) overproduction after ischemic injury have been shown both in vitro and in vivo in neurons, the mechanisms are not fully understood. The hypothesis of this study is that transgenic mice overexpressing HSP70 (HSP70 Tg) show reduced mitochondrial cytochrome c release into cytosol and diminished apoptotic cell death after permanent focal ischemia in comparison to wild-type (Wt) mice. Permanent middle cerebral artery occlusion (pMCAO) was produced by intraluminal suture cannulation in HSP70 Tg and Wt mice. DNA fragmentation was evaluated with DNA gel electrophoresis and terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling (TUNEL) 24 h after pMCAO. Mitochondrial cytochrome c release into cytosol was assessed with Western blotting and immunohistochemistry 4 h after pMCAO. Cytochrome c levels in the cytosolic fraction were significantly reduced and immunoreactivity of cytochrome c in both cortex and striatum was significantly less in HSP70 Tg mice compared with Wt mice after 4-h pMCAO. DNA laddering, which was clearly observed in Wt mice, was markedly attenuated in HSP70 Tg mice 24 h after pMCAO. The number of TUNEL-positive cells was significantly reduced in HSP70 Tg mice compared with Wt mice. Results are consistent with an association between overexpression of HSP70 and reduction of cytochrome c release with subsequent DNA fragmentation. This may contribute to the HSP70-mediated neuroprotective effect observed after cerebral ischemia.
IL-7–dependent human leukemia T-cell line as a valuable tool for drug discovery in T-ALL
Authors: Barata Joao T. , Boussiotis Vassiliki A. , Yunes Jose A. , Ferrando Adolfo A. , Moreau Lisa A. , Veiga J. Pedro , Sallan Stephen E. , Look A. Thomas , Nadler Lee M. , Cardoso Angelo A. 
Published: November 2003

AbstractThe specific targeting of critical signaling molecules may provide efficient therapies for T-cell acute lymphoblastic leukemia (T-ALL). However, target identification and drug development are limited by insufficient numbers of primary T-ALL cells and by their high rate of spontaneous apoptosis. We established a human interleukin-7 (IL-7)–dependent T-ALL cell line, TAIL7, that maintains several biologic and signaling properties of its parental leukemia cells. TAIL7 cells are pre–T-ALL cells that proliferate in response to IL-7 and IL-4. IL-7 stimulation of TAIL7 cells prevents spontaneous in vitro apoptosis and induces cell activation and cell cycle progression. The signaling events triggered by IL-7 include down-regulation of p27kip1 and hyperphosphorylation of retinoblastoma protein (Rb). Stimulation of TAIL7 cells by IL-7 leads to phosphorylation of Janus kinase 3 (JAK3), signal transducer and activator of transcription 5 (STAT5), Akt/PKB (protein kinase B), and extracellular-regulated kinase 1 and 2 (Erk1/2). Importantly, specific blockade of JAK3 by its inhibitor WHI-P131 abrogates the IL-7–mediated proliferation and survival of TAIL7 cells, suggesting that activation of JAK3 is critical for IL-7 responsiveness by these cells. Because TAIL7 cells seem to be a biologic surrogate for primary leukemia T cells, this cell line constitutes a valuable tool for the study of the signaling pathways implicated in T-ALL. Exploitation of this cell line should allow the identification of molecular targets and promote the rational design and validation of antileukemia signaling inhibitors.