Medicine and Health Sciences Commons^™

Pharmacological Efficacy Of Aloe Vera In Wound Healing: A Narrative Review, Sandra Viviana Aparicio Salcedo, Brian Steven Carranza Aldana, Sayuri Anayca Chávez Salas, Leslie Solanth Quispe Tinco, Carlos Abel Palomino Zevallos, Ariana Nicole Peralta Medina, Juana Mónica Robles Esquerre

Revista de la Facultad de Medicina Humana

Aloe Vera has different therapeutic effects, including wound healing. The aim of this review is to determine the potential efficacy of topical use of Aloe Vera in skin wound healing. A bibliographic search of preclinical and clinical studies from 1999 to 2020 was carried out, which included the therapeutic use of Aloe vera in the healing of: burns, surgical wounds, lactation disorders, anal fissure and anal fistula; in the databases of the VHL Regional Portal, PubMed and Google Scholar. It was obtained that the topical administration of Aloe vera was effective in the healing of the mentioned wounds by mainly …

Degradable Staples And Delivery Device, Meha Elango, Jessica Cabrera, Makayla Scarpitti, Kareemat Melaiye

Williams Honors College, Honors Research Projects

The scope of this project is to design a method to secure skin grafts to healthy tissue. The ultimate goal for the proposed method is to be dissolvable in some form. Currently, skin grafts procedures utilize staples in most cases to hold a skin graft in place, but there are disadvantages that come with it. Staples are easy to place, but time consuming during the removal procedure. They also cause a lot of pain and discomfort for the patient. The goal of this project is to determine a way a secure skin grafts to healthy skin in order to reduce …

Maximizing Wound Coverage In Full-Thickness Skin Defects: A Randomized-Controlled Trial Of Autologous Skin Cell Suspension And Widely Meshed Autograft Versus Standard Autografting, Sharon Henry, Steven Mapula, Mark Grevious, Kevin N. Foster, Herbert Phelan, Jeffrey Shupp, Rodney Chan, David Harrington, Neil Mashruwala, David A. Brown, Haaris Mir, George Singer, Alfredo Cordova, Lisa Rae, Theresa Chin, Lourdes Castanon, Derek Bell, William Hughes, Joseph A. Molnar

Department of Surgery Faculty Papers

BACKGROUND: Traumatic insults, infection, and surgical procedures can leave skin defects that are not amenable to primary closure. Split-thickness skin grafting (STSG) is frequently used to achieve closure of these wounds. Although effective, STSG can be associated with donor site morbidity, compounding the burden of illness in patients undergoing soft tissue reconstruction procedures. With an expansion ratio of 1:80, autologous skin cell suspension (ASCS) has been demonstrated to significantly decrease donor skin requirements compared with traditional STSG in burn injuries. We hypothesized that the clinical performance of ASCS would be similar for soft tissue reconstruction of nonburn wounds.

METHODS: A …

Meta-Analysis Of Prognostic Indicators In Burned Patients, Fawzy Ahmed Hamza, Khallad Mohamed Abd Elfattah Sholkamy, Omar Mohamed Saad Abd Elfattah

Al-Azhar International Medical Journal

Background: The chance of death after a burn injury is considerable.There is a dearth of recent epidemiological data on burn injury and mortality rates in Egypt. Objective: This study used meta-analysis to look at the prognostic markers in burn victims. Materials and Methods: This was a meta-analysis, and articles from PubMed, PLOS, and Clarivate - Scopus were searched for relevant material.To retrieve articles from the previous ten years, we used a variety of search engines, including EKB. A total of 20 studies were included 6 were retrospective studies, 1 case series, 1 case control, 1 cross sectional and 1 prospective …

Seasonal Impact In Admissions And Burn Profiles In A Desert Burn Unit, Syed F. Saquib, Joseph T. Carroll, Paul J. Chestovich

Surgery Faculty Publications

In much of the world, pattern of burn injuries can vary depending on the season. This study examines the seasonal impact of admissions, acuity, mortality, and resource utilization at an accredited burn center located in a desert climate. It is a retrospective analysis of patients admitted from March 1, 2014 to February 28, 2019 for acute burns. Patients were categorized into four groups according to each season based on their date of admission: Spring (March, April, May), Summer (June, July, August), Fall (September, October, November), and Winter (December, January, February).

A total of 1519 patients were included. 1016 were male …

Special Considerations In Pediatric Burn Patients Regarding Drug Dosage And Administration, Kelsey Lindsley, Maureen Moynihan, Angela Chu, Kristen Yaeger, Karen L. Kier

Pharmacy and Wellness Review

Pediatric burn patients are a high-risk patient population to treat. These patients have altered physiologic function as a result of the burn injury, in addition to their smaller size and developing bodies. This creates unique challenges during treatment. Accommodations for these patients are made through unique drug dosages and routes of administration. When treating pediatric burn patients, properly assessing and treating pain promptly and effectively is of utmost importance. Nurses who utilize accurate and appropriate pain assessment scales will provide the best treatment of pain. Proper assessment allows the patient to receive the correct analgesic regime, ensuring a faster and …

Is Music Therapy Intervention Effective In Decreasing Pain After Standard Wound Care In Hospitalized Burn Patients?, Lindsay King

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not music therapy intervention is effective in decreasing pain after standard wound care in hospitalized burn patients.

STUDY DESIGN: Systematic review compiling data from three randomized controlled trials in 2016, all in the English language.

DATA SOURCES: After a thorough search of PubMed and Cochrane, three pertinent studies were found to include in this review. The selected studies were evaluated to assess the effectiveness of music therapy in decreasing pain after wound care in hospitalized burn patients.

OUTCOMES MEASURED: Decrease in pain symptoms were measured …

Cold Burn Injury After Treatment At Whole-Body Cryotherapy Facility, Mackenzie O'Connor, Jordan V. Wang, Anthony Gaspari

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Safety And Effectiveness Of Propranolol In Severely Burned Patients: Systematic Review And Meta-Analysis, Ramiro Manzano-Nunez, Herney Andrés García-Perdomo, Paula Ferrada, Carlos Alberto Ordoñez Delgado, Diego Andrés Gomez, Jorge Esteban Foianini

Surgery Publications

Background

The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).

Methods

Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We …

Evidence Based Nutritional Management Of Adult Patients With Severe Burns, Ashley Lazarz, Samantha Waller

Interprofessional Research and Innovations Council

Clinical Scholars Abstract 2017

Title: Evidence based nutritional management of adult patients with severe burns.

Presenters: Ashley Lazarz RD, LD and Samantha Waller MS, RD, LD

Background/Literature: It is estimated that more than 2 million people suffer burns in the United States annually, resulting in approximately 3400 deaths. Burns cause pathological alterations in nearly every system of the body and changes in both metabolism and immunity in the burned patient contribute to adverse outcomes. (1) Hyper-metabolism leads to severe catabolism and loss of lean body mass in the severely burned patient making nutrition intervention critical. (2) Literature indicates that enteral …

Uchunguzi (Journal Watch/Montre De Journal) June 2016, Benjamin Wachira

Emergency Medicine, East Africa

When someone telephones for an ambulance, an interaction ensues which should be efficient and effective to facilitate a speedy dispatch of the appropriate level of vehicle, equipment and personnel to where it is needed. The process in South Africa begins with a three-part opening sequence which typically identifies the organisation, introduces the call-taker (CT) and invites the caller to proceed with the business of the call. In a recent project conducted in a South African emergency service, the researchers aimed to ascertain the impact of the CT’s identification sequence on the progression of the call and to determine whether there …

Medical Student Competency In Wound Care Guidelines, Sophia Akhiyat, Sean Mcnish, Kara S. Couch, Victoria K. Shanmugam

GW Research Days 2016 - 2020

Chronic wounds that have failed to heal after 3 months of appropriate wound care affect approximately 6.5 million people in the US with a prevalence of 1% and costs estimated at $25 billion per year. Medical students currently receive limited wound care training, yet to effectively manage chronic wounds, providers must both understand the biology of healing, and also remain up-to-date with wound care guidelines published by the Agency for Healthcare Research and Quality (AHRQ). The purpose of this student-led project was to investigate medical students' knowledge and comfort with wound care guidelines.

The Evidence-Based Topical Therapies For Management Of Minor Burns In Outpatient Clinic, Siphora Dien, Eliza Miranda, Erdina Hardiono D Pusponegoro, Aditya Wardhana

Journal of General - Procedural Dermatology & Venereology Indonesia

Burns are often seen in clinics or hospitals. Majority of burns are minor burns, which can be managed in outpatient setting with satisfactory result. The healing outcome depends on physician’s knowledge and competencies in burn pathogenesis and basic principles of burn care. Initial treatment of burns consists of emergency evaluation, assessment of depth and severity of burns and considerations for referral. The principles of minor wound therapy include cooling, cleansing, pain management, and topical therapy. Recently, many topical agents are available and indicated for first to second degree burn. Silver sulfadiazine (SSD) is the standard treatment; however, it has some …

Burn Injury Alters The Intestinal Microbiome And Increases Gut Permeability And Bacterial Translocation, Zachary M. Earley, Suhail Akhtar, Stefan J. Green, Ankur Naqib, Omair Khan '15, Abigail R. Cannon, Adam M. Hammer, Niya L. Morris, Xiaoling Li, Joshua M. Eberhardt, Richard L. Gamelli, Richard H. Kennedy, Mashkoor A. Choudhry

Student Publications & Research

Sepsis remains one of the leading causes of death in burn patients who survive the initial insult of injury. Disruption of the intestinal epithelial barrier has been shown after burn injury; this can lead to the translocation of bacteria or their products (e.g., endotoxin) from the intestinal lumen to the circulation, thereby increasing the risk for sepsis in immunocompromised individuals. Since the maintenance of the epithelial barrier is largely dependent on the intestinal microbiota, we examined the diversity of the intestinal microbiome of severely burned patients and a controlled mouse model of burn injury. We show that burn injury induces …

Brother, Have You Got A Light? Assessing The Need For Intubation In Patients Sustaining Burn Injury Secondary To Home Oxygen Therapy., Hamed Amani, Daniel Lozano, Sigrid Blome-Eberwein

Sigrid A Blome-Eberwein MD

Home oxygen therapy use has steadily increased for the past 30 years. A majority of these patients suffer from chronic obstructive pulmonary disease secondary to smoking. Although warned of the danger of smoking while on oxygen, patients continue to do so, potentially resulting in cutaneous burns and suspected inhalation injury. Those suspected of inhalation injury are intubated for airway control. In the English literature, there is a paucity of data discussing the need for intubation. To date, this is the largest study to determine whether intubated patients had inhalation injury as observed by bronchoscopy and whether intubation was necessary. All …

Pediatric Medical Traumatic Stress : The Impact On Children, Parents And Staff, Sarah Mcgarry

Theses: Doctorates and Masters

Burns are one of the most painful and traumatising injuries an individual can sustain and constitute a serious global health threat to children. Despite the magnitude of this public health problem, little research has examined the psychological burden of these injuries. This study used a mixed-methods approach to investigate the effect of paediatric medical trauma on children who have sustained a burn, their parents and the healthcare professionals caring for these patients. The paediatric medical traumatic stress model provided a theoretical framework for this study.

Firstly, this study aimed to gain an understanding of the lived experience of children who …

Aberrations In Post-Trauma Monocyte (Mo) Subpopulation: Role In Septic Shock Syndrome, Carol Miller-Graziano, Gyongyi Szabo, Karen Kodys, Katherine Griffey

Gyongyi Szabo

Appearance of increased proportions of monocytes bearing the 72kd(FcRI) receptor for IgG correlated to aberrant monocyte (MO) functions, depressed immune functions, and poor clinical outcome. The trauma patients' FcRI+ MO subpopulation produced the majority of their elevated IL-6, TNF alpha, TGF beta, and PGE2. IgG stimulation of patients' MO through FcRI not only stimulated TNF alpha, IL-6, and PGE2 levels, but also greatly augmented the levels of these monokines produced after subsequent bacterial challenge. Post-trauma increased IL-6 levels can lead to polyclonal B-cell activation and high levels of circulating, nonspecific IgG as seen in trauma patients. This nonspecific IgG triggers …

Role Of Elevated Monocyte Transforming Growth Factor Beta (Tgf Beta) Production In Posttrauma Immunosuppression, Carol Miller-Graziano, Gyongyi Szabo, Katherine Griffey, Bela Mehta, Karen Kodys, Donna Catalano

Gyongyi Szabo

We previously reported that increased production of prostaglandin E2 by monocytes is a pivotal mechanism in posttrauma immunopathology. Here we characterize monocyte levels of transforming growth factor beta and examine the effects of elevated transforming growth factor beta on prostaglandin E2 release by patients' monocytes. Trauma patients' and normals' monocyte supernates (+/- stimulation with muramyl dipeptide) were acid treated and assayed for transforming growth factor beta using the mink lung-cell bioassay. Alternatively, human transforming growth factor beta was added to patients' and normals' monocytes and prostaglandin E2 production assayed. Significantly elevated transforming growth factor beta levels (median = 181.7 pmol/10(6) …

Elevated Tumor Necrosis Factor Alpha Production Concomitant To Elevated Prostaglandin E2 Production By Trauma Patients' Monocytes, Thomas Takayama, Carol Miller-Graziano, Gyongyi Szabo

Gyongyi Szabo

The level of tumor necrosis factor alpha (TNF alpha), a monokine implicated in mediating septic shock, is elevated in the blood of some patients with sepsis. Monocytes from 11 trauma patients and 11 burn patients were suboptimally stimulated with interferon gamma and muramyl dipeptide, an analogue of bacterial wall products. The patients with sepsis showed significantly greater total TNF alpha levels (secreted in combination with cell-associated) 3 days before septic episodes, as compared with normal controls (32.38 to 2231.76 ng/10(6) monocytes per milliliter, median = 121.03 ng/10(6) monocytes per milliliter; normal control: 0.00 to 18.20 ng/10(6) monocytes per milliliter, median …

Mechanisms Of Altered Monocyte Prostaglandin E2 Production In Severely Injured Patients, Carol Miller-Graziano, Mitchell Fink, Jia-Yan Wu, Gyongyi Szabo, Karen Kodys

Gyongyi Szabo

Monocytes from immunosuppressed trauma (11 patients) and burn (12 patients) patients stimulated with muramyl dipeptide, a potent prostaglandin E2 (PGE2) secretagogue, showed twofold greater PGE2 production compared with normal controls or immunocompetent patients. Monocyte plasminogen activator production was markedly depressed and inversely correlated to patients' monocyte hyper PGE2 production. Levels of the PGE2-producing monocyte subset (selected as high-affinity Fc+ receptors) were progressively elevated after injury in immunosuppressed patients, reaching 65% to 80% of the total monocyte population (39% for normal controls). Although early T-suppressor (Ts) lymphocytes did not augment monocyte PGE2 secretion, Ts lymphocytes that appeared late (greater than 12 …

Elevated Monocyte Interleukin-6 (Il-6) Production In Immunosuppressed Trauma Patients. I. Role Of Fc Gamma Ri Cross-Linking Stimulation, Gyongyi Szabo, Karen Kodys, Carol Miller-Graziano

Gyongyi Szabo

This study demonstrates that immunodepressed trauma patients' monocytes produce elevated interleukin-6 to adherence, bacterial, and cytokine stimulation compared to immunocompetent trauma patients' or normals' monocytes, suggesting their in vivo preactivation possibly mediated by the hyperimmunoglobulinemia which characterizes these patients. Furthermore, stimulation of monocytes through cross-linking their Fc gamma RI induces and augments interleukin-6 (IL-6) production to subsequent stimulation both in trauma patients' (P less than 0.001) and in normals' (P less than 0.001) monocytes. As we reported earlier, immunodepressed trauma patients have an increased proportion of Fc gamma RI-bearing monocytes in their total monocyte population and here we show that …

Causes, Magnitude And Management Of Burns In Under-Fives In District Hospitals In Dar Es Salaam, Tanzania., M. Justin-Temu, G. Rimoy, Zul Premji, G. Matemu

Pathology, East Africa

Objectives: To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania.

Methods: In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns …

Mercy's Messenger September 1929, Katharine B. Richardson

Archives

Mercy's Messenger was a newsletter describing the work of The Children's Mercy Hospital and soliciting donations, frequently including stories of young patients. This issue features Dr. Richardson's appeal for funding for a research laboratory to seek cures or better diagnosis and treatment of childhood diseases.

The September 1929 issue is marked Vol. 1, no. 2 although many earlier issues of Mercy's Messenger exist.