Vasoactive and/or inotropic drugs in initial resuscitation of burn injuries: A systematic review

Background According to current guidelines, initial burn resuscitation should be performed with fluids alone. The aims of the study were to review the frequency of use of vasoactive and/or inotropic drugs in initial burn resuscitation, and assess the benefits and harms of adding such drugs to fluids. Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, UpToDate, and SveMed+ through 3 December 2021. The search included studies on critically ill burn patients receiving vasoactive and/or inotropic drugs in addition to fluids within 48 h after burn injury. Results The literature search identified 1058 unique publications that were screened for inclusion. After assessing 115 publications in full text, only two retrospective cohort studies were included. One study found that 16 out of 52 (31%) patients received vasopressor(s). Factors associated with vasopressor use were increasing age, burn depth, and % total body surface area (TBSA) burnt. Another study observed that 20 out of 111 (18%) patients received vasopressor(s). Vasopressor use was associated with increasing age, Baux score, and %TBSA burnt in addition to more frequent dialysis treatment and increased mortality. Study quality assessed by the Newcastle-Ottawa quality assessment scale was considered good in one study, but uncertain due to limited description of methods in the other. Conclusion This systematic review revealed that there is a lack of evidence regarding the benefits and harms of using vasoactive and/or inotropic drugs in addition to fluids during early resuscitation of patients with major burns.publishedVersio

Psykologen og den fremmedkulturelle klienten - en kvalitativ studie

The present study attempts to provide a better understanding of the psychologists experience and expectations when meeting clients from foreign cultures in therapy. A qualitative approach was used. Six private psychologist specialists in Bergen were interviewed about their experiences with multicultural clients. The interviews were analyzed, and three main points were identified: How do the informants experience the conductance of therapy with clients from other cultures? To what degree is the concept of therapeutic alliance experienced as applicable cross-culturally? How is the level of experienced uncertainty affected by the therapist's knowledge of, versus his or her expectations of cultural differences? The informants emphasize the work as time-consuming with many challenges. Informants in its approach to the multicultural client show culturally sensitiveness, but also see its limitations in being trained in a psychology based in the western culture

Lykkelige foreldre. Lykkelige barn?: voksne barn og foreldrenes skilsmisse

Emnet for oppgaven er "voksne barn" som opplever at foreldrene skiller seg. Det blir presenter fire informanter som er i alderen fra 24 til 28 år, som opplevde dette for ca. 1 til 5 år siden. Formålet er å belyse deres opplevelse av denne hendelsen, gjennom å legge vekt på familiens betydning for individene som tilhører gruppen, og hvilke konsekvenser dette har for individene, spesielt barnet, når familien blir oppløst. Metoden som har blitt benyttet er kvalitative dybdeintervju spilt inn på bånd. Disse intervjuene er blitt analysert og satt i sammenheng og forklart med et tidligere forskningsprosjekt av J. Wallerstein, og S. Blakeslee, samt E. Goffmans gruppeteori. Konklusjonen som følger er at når en familie går i oppløsning, og rollene som en konsekvens av dette må omdefineres, kommer enkeltindividene i en anomisk tilstand, denne vil vare over en tid, til de igjen har klart å skape en ramme rundt livene sine igjen

Vasoactive and/or inotropic drugs in initial resuscitation of burn injuries: A systematic review

Background According to current guidelines, initial burn resuscitation should be performed with fluids alone. The aims of the study were to review the frequency of use of vasoactive and/or inotropic drugs in initial burn resuscitation, and assess the benefits and harms of adding such drugs to fluids. Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, UpToDate, and SveMed+ through 3 December 2021. The search included studies on critically ill burn patients receiving vasoactive and/or inotropic drugs in addition to fluids within 48 h after burn injury. Results The literature search identified 1058 unique publications that were screened for inclusion. After assessing 115 publications in full text, only two retrospective cohort studies were included. One study found that 16 out of 52 (31%) patients received vasopressor(s). Factors associated with vasopressor use were increasing age, burn depth, and % total body surface area (TBSA) burnt. Another study observed that 20 out of 111 (18%) patients received vasopressor(s). Vasopressor use was associated with increasing age, Baux score, and %TBSA burnt in addition to more frequent dialysis treatment and increased mortality. Study quality assessed by the Newcastle-Ottawa quality assessment scale was considered good in one study, but uncertain due to limited description of methods in the other. Conclusion This systematic review revealed that there is a lack of evidence regarding the benefits and harms of using vasoactive and/or inotropic drugs in addition to fluids during early resuscitation of patients with major burns

Epithelial to mesenchymal transition (EMT) is associated with attenuation of succinate dehydrogenase (SDH) in breast cancer through reduced expression of SDHC

Background: Epithelial to mesenchymal transition (EMT) is a well-characterized process of cell plasticity that may involve metabolic rewiring. In cancer, EMT is associated with malignant progression, tumor heterogeneity, and therapy resistance. In this study, we investigated the role of succinate dehydrogenase (SDH) as a potential key regulator of EMT. Methods: Associations between SDH subunits and EMT were explored in gene expression data from breast cancer patient cohorts, followed by in-depth studies of SDH suppression as a potential mediator of EMT in cultured cells. Results: We found an overall inverse association between EMT and the SDH subunit C (SDHC) when analyzing gene expression in breast tumors. This was particularly evident in carcinomas of basal-like molecular subtype compared to non-basal-like tumors, and a low SDHC expression level tended to have a prognostic impact in those patients. Studies in cultured cells revealed that EMT was induced by SDH inhibition through SDHC CRISPR/Cas9 knockdown or by the enzymatic inhibitor malonate. Conversely, overexpression of EMT-promoting transcription factors TWIST and SNAI2 caused decreased levels of SDHB and C and reduced rates of SDH-linked mitochondrial respiration. Cells overexpressing TWIST had reduced mitochondrial mass, and the organelles were thinner and more fragmented compared to controls. Conclusions: Our findings suggest that downregulation of SDHC promotes EMT and that this is accompanied by structural remodeling of the mitochondrial organelles. This may confer survival benefits upon exposure to hostile microenvironment including oxidative stress and hypoxia during cancer progression