52 research outputs found
Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury
Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions.
Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05.
Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for severely burned patients for a much more prolonged time
Elevations in growth hormone and glucagon-like peptide-2 levels on admission are associated with increased mortality in trauma patients
Knee osteoarthritis: pathophysiology and current treatment modalities
Juan C Mora,1 Rene Przkora,1 Yenisel Cruz-Almeida2 1Department of Anesthesiology, Division of Pain Medicine, University of Florida, Gainesville, FL, USA; 2Department of Aging and Geriatric Research, Institute on Aging, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA Abstract: For decades, multiple attempts to fully understand knee osteoarthritis pathophysiology and natural history have been attempted. Despite the extensive amount of research regarding this topic, there are still marked controversies. This multifactorial condition gets influenced by local, systemic, and external factors and its progression and/or response to treatments widely varies from patient to patient. Multiple therapies have been studied in the past, low impact physical activity seems to be supported by all the current medical societies while other interventions have shown conflicting findings. Newer therapies and routes of administration are under investigation and some of them have shown promising preliminary reports. This review intends to give an overview of the current knowledge of pathophysiology and non-surgical therapies available for knee osteoarthritis. Keywords: knee osteoarthritis, cartilage degeneration, non-inflammatory arthritis, intra-articular injections, corticosteroid
Korporektomie und Wirbelkörperersatz bei Metastasen der thorakolumbalen Wirbelsäule über den dorsalen Zugang
Protektion und Regulation von Hepatozytenmembranproteinen durch Hitzestress bei LPS-induzierter Endotoxinämie
The Effects of Oxandrolone and Exercise on Muscle Mass and Function in Children With Severe Burns
Der Einfluß von Wachstumshormon, HGF und IGF-I/BP-3 auf die intestinale Mukosa nach schwerem Trauma
Regression von inoperablen inflammatorischen myofibroblastären Tumoren unter der Therapie mit nichtsteroidalen Antiphlogistika
- …