Hydrotherapy in burn care: Pros, cons and suggestions

Hydrotherapy represents the use of water for medical purpose, being involved in burn wound care since the 17th century. Burn wound cleansing, performed daily, twice a day, or as needed, as part of standard care, should be scheduled by a burn surgeon and supervised by proper specialists. It can be performed by various methods, like shower, immersion, bedside irrigation or wiping. Due to the high risk of cross-contamination, immersion is no longer recommended. Tap water seems to be superior to saline solution in burn wound care, and adjuvants can be added, especially chlorhexidine, povidone-iodine, or special detergents. Disposable plastic sheets use during showering and the following of cleaning protocols for washing areas have decreased the risk of infection. Apart from the wound-cleansing role, hydrotherapy reduces itching and pain, improves wound healing, favours early mobilization and increases patients’ comfort. Controversy persists around the optimal method and appropriate solutions for cleaning burn injuries and clinical studies are further required to solve this matter. In the absence of standardized recommendations, most burn centers are guided by experience

Nebulized heparin for burned patients with inhalation injury: a review

The presence of inhalation injury has a negative impact on the evolution of burned patients, being associated with increased mortality. It occurs as a direct consequence of thermal action, or secondary to the presence of respiratory irritants or absorption of toxins, and actual therapeutic management is mainly supportive. Several clinical findings are relevant to raising suspicion and guiding further examinations, fiberoptic bronchoscopy being the gold standard of diagnosis and staging. In burned patients with inhalation injuries, various reports showed that nebulized heparin (5,000 or 10,000 units) with a 4-hour administration regimen leads to improved outcome, reduces the days of mechanical ventilation and consequently the length of hospital stay, reduces pulmonary complications and improves lung function, having a safe profile, with fewer side effects

Big Data Components for Business Process Optimization

In these days, more and more people talk about Big Data, Hadoop, noSQL and so on, but very few technical people have the necessary expertise and knowledge to work with those concepts and technologies. The present issue explains one of the concept that stand behind two of those keywords, and this is the map reduce concept. MapReduce model is the one that makes the Big Data and Hadoop so powerful, fast, and diverse for business process optimization. MapReduce is a programming model with an implementation built to process and generate large data sets. In addition, it is presented the benefits of integrating Hadoop in the context of Business Intelligence and Data Warehousing applications. The concepts and technologies behind big data let organizations to reach a variety of objectives. Like other new information technologies, the main important objective of big data technology is to bring dramatic cost reduction

Big Data: present and future

The paper explains the importance of the Big Data concept, a concept that even now, after years of development, is for the most companies just a cool keyword. The paper also describes the level of the actual big data development and the things it can do, and also the things that can be done in the near future. The paper focuses on explaining to nontechnical and non-database related technical specialists what basically is big data, presents the three most important V's, as well as the new ones, the most important solutions used by companies like Google or Amazon, as well as some interesting perceptions based on this subject

Collision risk assessment between aircraft and obstacles in the areas surrounding airports

The topographical features of a site and the anthropogenic artefacts inside and outside the airport boundaries influence the infrastructure use. Objects penetrating the obstacle limitation surfaces (OLS) or standing outside those surfaces have to be mapped and risk-assessed because they could be a hazard to air navigation. This study aims to quantify the risk of collision between aircraft and obstacles in the airspace. There are no available procedures in the literature: the authors supposed that the obstacle type and the examined OLS affect the collision risk. The proposed risk values and amplification factors derive from interviews with technicians. The methodology has been implemented in an existing airport with 589 penetrating obstacles: the results highlight that 69.8% of obstacles imply a negligible risk, and 3.7% require further analyses by the competent aviation authority. In this study, buildings and pylons penetrating the Transitional Surface are the most hazardous obstacles

Platelet Rich Plasma- mechanism of action and clinical applications

Platelet-rich plasma (PRP) is a blood-derived fraction containing high level of platelets, a high concentration of leukocytes and growth factors. PRP therapy has been growing as a viable treatment alternative for a number of clinical applications and has a potential benefit for use in wound healing. Nowadays platelet rich plasma is used in stimulating wound healing in skin and soft tissue ulcerations, accelerating wound healing in diabetic patients and facilitating bone proliferation in orthopedic and trauma surgery. It has also applications in maxillofacial surgery, spinal surgery, plastic and esthetic surgery, heart surgery and burns. This review of the literature shows a limited number of studies realized on humans that sustain PRP applications in orthopedic and plastic surgery. As the use of PRP increases, more properly structured clinical studies are necessary to confirm the results and to establish clearly the techniques of preparing, the conditions and the clinical indications of applying this therapy

Inmunolocalización en la retina humana de POMT1 y POMT2, dos O-manosil transferasas de proteínas asociadas al síndrome de Walker-Warburg

Resumen del póster presentado al XXXIV Congreso de la Sociedad Española de Bioquímica y Biología Molecular, celebrado en Barcelona del 5 al 8 de septiembre de 2011.Las distroglicanopatías son un grupo de distrofias musculares recesivas raras que afectan con mayor o menor gravedad al músculo, ojo y cerebro. Se caracterizan por una hipoglicosilación del α-distroglicano (α-DG), una proteína implicada en el anclaje celular a la lámina basal y el establecimiento de sinapsis en el SNC. La más severa es el síndrome de Walker-Warburg, que conlleva graves defectos cerebrales y oculares y está causado principalmente por mutaciones en el gen POMT1, y con menor frecuencia en POMT2. Estos genes codifican las proteína O-manosil transferasas-1 y -2 responsables de glicosilar el α-DG. Hasta la fecha no se ha estudiado su expresión en la retina de mamíferos adultos. En este trabajo describimos que el gen POMT1 se expresa a nivel de mRNA y proteína en la retina adulta de todos los mamíferos estudiados, desde roedores hasta la especie humana. Hemos detectado asimismo diversas isoformas putativas de POMT1. También hemos investigado el patrón de inmunolocalización de POMT1 y POMT2 en los distintos tipos neuronales y gliales de la retina humana. Hemos determinado que ambas proteínas se colocalizan en las células gliales de Müller. POMT1 y POMT2 también se observan en fotorreceptores (segmentos externos e internos), así como en algunas células bipolares, amacrinas y ganglionares. Dado el amplio patrón de expresión de POMT1 y POMT2, proponemos que estas proteínas podrían desempeñar otras funciones en la retina adulta humana adicionales a su papel descrito en la Oglicosilación del α-DG.Instituto de Salud Carlos III PI09/1623 (J.M.N.) y PI09/0343 (J.C.).Peer Reviewe

Surgical treatment of distal biceps tendon rupture: a case report

Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons

INFECTIONS MANAGEMENT IN VENOUS LEG ULCERS: A SINGLE CENTER EXPERIENCE

Objectives. Chronic wounds have a prolonged period of healing due to numerous factors, including infections. Venous ulcers represent almost 80% of the lower extremity ulcerations, having a great impact on the patient's quality of life. The objective of this study was to evaluate the presence of bacteria and the proper management in treating venous leg ulcers. Material and methods. The study enrolled ten patients with chronic venous leg ulcers hospitalized in the Plastic Surgery Department of the Emergency Clinical Hospital “Prof. Dr. Agrippa Ionescu”, during a period of six months. For each patient included in the study, we assessed the wounds culture and we started an antibiotic treatment, according to the antibiogram, which was completed by the surgical treatment of the wound. Outcomes. Venous leg ulcers had a favorable outcome after the administration of antibiotic therapy, surgical debridement of the wound and coverage with a skin graft. Conclusions. Venous ulcers may evolve over an extended period of time (weeks or years) and may also be associated with severe complications, such as cellulites or malignant transformation. Infections affect the healing process. Surgical debridement associated with systemic administration of antibiotics has a favorable outcome in the epithelialization of venous ulcers

ASSESSING THE ADEQUACY OF HEMODIALYSIS AS RENAL REPLACEMENT THERAPY

Following the increase in incidence and prevalence of the risk factors responsible for the occurence of renal impairment is the increase of patients suffering from chronic kidney disease (CKD). As the renal function declines and the end stage of the chronic kidney disease is reached, it is necessary to start one of the following methods for substituting the renal function: renal transplantation, hemodialysis or peritoneal dialysis. The treatment of choice for most patients is hemodialysis, both in Romania and abroad in the international medical centers. According to official data, the number of patients undergoing hemodialysis is constantly growing. Hemodialysis adequacy evaluation instruments must be familiar among clinicians in order to provide a treatment that meets the quality standards