Burns最新文献 - Book学术

Selenoprotein P as a prognostic biomarker of burn sepsis: A prospective cohort study 作为烧伤败血症预后生物标志物的硒蛋白 P：前瞻性队列研究。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-12 DOI: 10.1016/j.burns.2024.107314

Tabael L. Turan , Holger J. Klein , Eddy Rijntjes , Theresia Reding Graf , Kamil Demircan , Jan A. Plock , Lutz Schomburg

Introduction

Severely burned patients exhibit increased nutritional requirements and are at high risk of developing sepsis. Selenium is an essential trace element supporting antioxidant and anti-inflammatory pathways, mediated by incorporation into selenoproteins. The selenium status may affect sepsis risk in burn injury.

Methods

This prospective cohort study included 90 adult patients admitted to Zurich Burn Center, Switzerland. All patients received a continuous intravenous infusion of 1000 μg sodium selenite per day during the first week as part of local standard of care. Three complementary biomarkers of serum selenium status were determined at nine time-points up to six months postburn, namely total selenium, selenoprotein P, and glutathione peroxidase 3. The resulting data were correlated to clinical parameters and outcomes, with sepsis as the primary end point.

Results

A high fraction of the patients displayed selenium deficiency already at admission, and developed sepsis during hospitalization (n = 55; 61 %). Selenium status at admission was inversely related to burn severity. Low baseline selenoprotein P was associated with sepsis incidence, irrespective of trauma severity (adjusted HR, 1.94; 95 % CI, 1.05–3.63; p = 0.035). Burn severity and baseline concentrations of selenoprotein P and white blood cells together predicted sepsis with an area under the curve of 0.84 (95 % CI, 0.75–0.93; p < 0.0001). Supplemental selenium was associated with a transient normalization of selenium status.

Conclusion

Considering its rapid decline following severe burn injury, the assessment of serum selenoprotein P upon admission may contribute to an early prediction of sepsis risk.

导言：严重烧伤患者对营养的需求增加，患败血症的风险也很高。硒是一种重要的微量元素，通过与硒蛋白结合，支持抗氧化和抗炎途径。硒的状况可能会影响烧伤患者的败血症风险：这项前瞻性队列研究包括瑞士苏黎世烧伤中心收治的 90 名成年患者。作为当地标准护理的一部分，所有患者在第一周都接受了每天 1000 微克亚硒酸钠的持续静脉输注。在烧伤后六个月内的九个时间点测定了血清硒状态的三个互补生物标志物，即总硒、硒蛋白 P 和谷胱甘肽过氧化物酶 3。所得数据与临床参数和结果相关联，败血症是主要终点：结果：大部分患者在入院时就已经缺硒，并在住院期间出现败血症（55 人；61%）。入院时的硒状况与烧伤严重程度成反比。无论创伤严重程度如何，基线硒蛋白 P 低与败血症发病率相关（调整后 HR，1.94；95 % CI，1.05-3.63；p = 0.035）。烧伤严重程度与硒蛋白 P 和白细胞的基线浓度共同预测脓毒症的发生，曲线下面积为 0.84（95 % CI，0.75-0.93；p 结论：硒蛋白 P 和白细胞的基线浓度与脓毒症的发生有密切关系：考虑到严重烧伤后血清硒蛋白 P 的快速下降，入院时评估血清硒蛋白 P 可能有助于早期预测脓毒症风险。

{"title":"Selenoprotein P as a prognostic biomarker of burn sepsis: A prospective cohort study","authors":"Tabael L. Turan , Holger J. Klein , Eddy Rijntjes , Theresia Reding Graf , Kamil Demircan , Jan A. Plock , Lutz Schomburg","doi":"10.1016/j.burns.2024.107314","DOIUrl":"10.1016/j.burns.2024.107314","url":null,"abstract":"<div><h3>Introduction</h3><div>Severely burned patients exhibit increased nutritional requirements and are at high risk of developing sepsis. Selenium is an essential trace element supporting antioxidant and anti-inflammatory pathways, mediated by incorporation into selenoproteins. The selenium status may affect sepsis risk in burn injury.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 90 adult patients admitted to Zurich Burn Center, Switzerland. All patients received a continuous intravenous infusion of 1000 μg sodium selenite per day during the first week as part of local standard of care. Three complementary biomarkers of serum selenium status were determined at nine time-points up to six months postburn, namely total selenium, selenoprotein P, and glutathione peroxidase 3. The resulting data were correlated to clinical parameters and outcomes, with sepsis as the primary end point.</div></div><div><h3>Results</h3><div>A high fraction of the patients displayed selenium deficiency already at admission, and developed sepsis during hospitalization (<em>n</em> = 55; 61 %). Selenium status at admission was inversely related to burn severity. Low baseline selenoprotein P was associated with sepsis incidence, irrespective of trauma severity (adjusted HR, 1.94; 95 % CI, 1.05–3.63; <em>p</em> = 0.035). Burn severity and baseline concentrations of selenoprotein P and white blood cells together predicted sepsis with an area under the curve of 0.84 (95 % CI, 0.75–0.93; <em>p</em> < 0.0001). Supplemental selenium was associated with a transient normalization of selenium status.</div></div><div><h3>Conclusion</h3><div>Considering its rapid decline following severe burn injury, the assessment of serum selenoprotein P upon admission may contribute to an early prediction of sepsis risk.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107314"},"PeriodicalIF":3.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and outcomes of myocardial infarction among burn patients: A nationwide analysis. 烧伤患者心肌梗死的特征和预后：全国性分析。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-10 DOI: 10.1016/j.burns.2024.107313

Ramy Sedhom, Mohamed Khedr, Rafail Beshai, Emmanouil S Brilakis, Mir B Basir, Khaldoon Alaswad, Liset Stoletniy, Dmitry Abramov, Aditya Bharadwaj, Michael Megaly

Purpose: To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients.

Materials and methods: The Nationwide Readmissions Database was utilized to identify hospitalizations of patients with burns from 2016 to 2020. The main outcome was the difference in all-cause in-hospital mortality between burn patients with and without MI.

Results: Of 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) CONCLUSIONS: The incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality.

目的：研究烧伤患者心肌梗死（MI）的特征和预后：利用全国再入院数据库确定2016年至2020年烧伤患者的住院情况。主要结果是有心肌梗死和没有心肌梗死的烧伤患者之间全因住院死亡率的差异：在 200 130 例烧伤住院患者中，1997 例（1%）发生了急性心肌梗死。患有心肌梗死的烧伤患者年龄更大，更可能是男性，心血管风险因素的发生率更高。只有影响躯干和呼吸道的烧伤以及烧伤面积大于体表面积（BSA）20%的烧伤才会增加心肌梗死的风险。心肌梗死患者的全因院内死亡率较高（18.7% 对 3%，调整后的几率比 (aOR) 4.59，95% 置信区间 (CI) 3.66，5.76）。心肌梗死患者的心源性休克、室性心动过速和中风发生率更高。血管重建与较低的院内死亡率相关（aOR 0.33，95 % CI 0.17，0.64）：烧伤患者的心肌梗死发生率较低，但死亡率和发病率较高。涉及躯干和呼吸道的烧伤以及烧伤面积大于 20% BSA 的烧伤患者发生心肌梗死的风险较高。血管重建与较低的院内死亡率有关。

{"title":"Characteristics and outcomes of myocardial infarction among burn patients: A nationwide analysis.","authors":"Ramy Sedhom, Mohamed Khedr, Rafail Beshai, Emmanouil S Brilakis, Mir B Basir, Khaldoon Alaswad, Liset Stoletniy, Dmitry Abramov, Aditya Bharadwaj, Michael Megaly","doi":"10.1016/j.burns.2024.107313","DOIUrl":"https://doi.org/10.1016/j.burns.2024.107313","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients.</p><p><strong>Materials and methods: </strong>The Nationwide Readmissions Database was utilized to identify hospitalizations of patients with burns from 2016 to 2020. The main outcome was the difference in all-cause in-hospital mortality between burn patients with and without MI.</p><p><strong>Results: </strong>Of 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) CONCLUSIONS: The incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"107313"},"PeriodicalIF":3.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correspondence: Efficacy of a burn prevention educational program to diminish the incidence of burn injuries in the pediatric population 通讯：烧伤预防教育计划对降低儿童烧伤发病率的效果。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-07 DOI: 10.1016/j.burns.2024.107309

Dhivya Viswanathan, Rajakumar Govindasamy, Harish SL

引用次数: 0

Survey about target temperature and thermal management in intensive care for severe thermal trauma in burn centres of Germany, Austria and Switzerland 关于德国、奥地利和瑞士烧伤中心重症监护中严重热创伤的目标温度和热管理的调查。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-06 DOI: 10.1016/j.burns.2024.107308

Stefan Trojan , Friedemann Stein , Rolf Lefering , Thorsten Annecke , Frank Wappler , Ulrich Limper

Burn trauma induces hypermetabolism and alters thermoregulation resulting in elevated body temperature. Because patients with burns are prone to heat loss and hypothermia, maintaining physiologic body temperature is important. However, optimal target temperature is widely unknown because thermoregulation of burn trauma has mainly been studied in the previous century, when treatment concepts differed from current era. The aim of this study was to investigate current thermal management of burn treatment and to investigate the discrepancies between classical concepts of thermoregulation in burn trauma and current practice of temperature management. A paper-based survey was conducted in burn centres in Germany, Austria, and German-speaking Switzerland. Participants were asked for expected temperatures, temperature goals, and thermal management of severely burned patients. Results were evaluated for adults and children. 37 of 38 approached burn centres participated in this survey. 59 % expected that adults with burn trauma would develop hyperthermia (>37.5 °C) but only 27 % expected hyperthermia in children (>38 °C). The average target body temperature was 37.1 °C for adults and 36.9 °C for children. Adults below 35.7 °C and children below 36.0 °C were assessed to be hypothermic. Temperatures above 38.8 °C in adults and 38.7 °C in children raised suspicion for sepsis. Antipyretic treatment was assumed to be justified at temperatures above 39.1 °C in adults and 38.5 °C in children. Although the most common warming method was to increase ambient temperature, 89 % of all participants felt their wellbeing was affected by an increased ambient temperature and 68 % were concerned about temperature-related negative effects. Although 57 % of the responding centres had established a standard operating procedure for thermal management, only 41 % considered the available literature to be very relevant in daily practice and 89 % criticized the lack of guidelines. Limit and target temperatures in European burn centres are heterogeneous. Classic concepts of thermal management in burn care are not universally adopted. A majority of the centers expresses the need for specific guidelines. The basis for this should be multicentre clinical trials on temperature management in burn trauma.

烧伤创伤会诱发高代谢并改变体温调节，从而导致体温升高。由于烧伤患者容易失热和体温过低，因此维持生理体温非常重要。然而，由于烧伤创面的体温调节主要是在上个世纪进行研究的，当时的治疗理念与现在不同，因此最佳目标体温普遍不为人知。本研究旨在调查当前烧伤治疗的体温管理，并研究烧伤创面体温调节的经典概念与当前体温管理实践之间的差异。我们在德国、奥地利和瑞士德语区的烧伤中心进行了一项纸质调查。调查询问了严重烧伤患者的预期体温、体温目标和体温管理。调查结果针对成人和儿童进行了评估。38 家受访烧伤中心中有 37 家参与了此次调查。59% 的人认为成人烧伤患者会出现高热（>37.5 °C），但只有 27% 的人认为儿童患者会出现高热（>38 °C）。成人的平均目标体温为 37.1 °C，儿童为 36.9 °C。成人低于 35.7 °C，儿童低于 36.0 °C，则被评估为体温过低。成人体温超过 38.8 °C，儿童体温超过 38.7 °C，则需要怀疑败血症。如果成人体温超过 39.1 ℃，儿童体温超过 38.5 ℃，则有理由进行退热治疗。虽然最常见的加温方法是提高环境温度，但 89% 的参与者认为环境温度升高会影响他们的健康，68% 的参与者担心与温度有关的负面影响。虽然 57% 的受访中心已制定了热管理标准操作程序，但只有 41% 的受访者认为现有文献与日常实践非常相关，89% 的受访者批评缺乏指导方针。欧洲烧伤中心的极限温度和目标温度各不相同。烧伤护理中的热管理经典概念并未被普遍采用。大多数中心都表示需要制定具体的指南。烧伤创面温度管理的多中心临床试验应该是制定指导方针的基础。

{"title":"Survey about target temperature and thermal management in intensive care for severe thermal trauma in burn centres of Germany, Austria and Switzerland","authors":"Stefan Trojan , Friedemann Stein , Rolf Lefering , Thorsten Annecke , Frank Wappler , Ulrich Limper","doi":"10.1016/j.burns.2024.107308","DOIUrl":"10.1016/j.burns.2024.107308","url":null,"abstract":"<div><div>Burn trauma induces hypermetabolism and alters thermoregulation resulting in elevated body temperature. Because patients with burns are prone to heat loss and hypothermia, maintaining physiologic body temperature is important. However, optimal target temperature is widely unknown because thermoregulation of burn trauma has mainly been studied in the previous century, when treatment concepts differed from current era. The aim of this study was to investigate current thermal management of burn treatment and to investigate the discrepancies between classical concepts of thermoregulation in burn trauma and current practice of temperature management. A paper-based survey was conducted in burn centres in Germany, Austria, and German-speaking Switzerland. Participants were asked for expected temperatures, temperature goals, and thermal management of severely burned patients. Results were evaluated for adults and children. 37 of 38 approached burn centres participated in this survey. 59 % expected that adults with burn trauma would develop hyperthermia (>37.5 °C) but only 27 % expected hyperthermia in children (>38 °C). The average target body temperature was 37.1 °C for adults and 36.9 °C for children. Adults below 35.7 °C and children below 36.0 °C were assessed to be hypothermic. Temperatures above 38.8 °C in adults and 38.7 °C in children raised suspicion for sepsis. Antipyretic treatment was assumed to be justified at temperatures above 39.1 °C in adults and 38.5 °C in children. Although the most common warming method was to increase ambient temperature, 89 % of all participants felt their wellbeing was affected by an increased ambient temperature and 68 % were concerned about temperature-related negative effects. Although 57 % of the responding centres had established a standard operating procedure for thermal management, only 41 % considered the available literature to be very relevant in daily practice and 89 % criticized the lack of guidelines. Limit and target temperatures in European burn centres are heterogeneous. Classic concepts of thermal management in burn care are not universally adopted. A majority of the centers expresses the need for specific guidelines. The basis for this should be multicentre clinical trials on temperature management in burn trauma.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107308"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The overlooked role of cell viability in stem cell therapy for burn wound repair 细胞活力在干细胞治疗烧伤创面修复中被忽视的作用。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-06 DOI: 10.1016/j.burns.2024.107310

Chong Yao, Yu Chen, Hong Yan

引用次数: 0

Altered resting-state functional brain activity in patients with chronic post-burn pruritus 烧伤后慢性瘙痒症患者静息态大脑功能活动的改变。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-02 DOI: 10.1016/j.burns.2024.107305

Zhi-Kai Lu , Yin Huang , Bin Wang , Qian Zheng , Pei-Yi Bai , Wan-Li Guo , Wen-Jin Bian , Jin-Liang Niu

Background

Pruritus, a common symptom of burn wounds, arises from skin tissue damage and abnormal tissue healing. Chronic post-burn pruritus (CPBP) is defined as itching that persists for six weeks or more. The brain mechanisms underlying CPBP are not understood adequately. This study aims to explore abnormal brain function in CPBP patients and identify potential pathogenesis of pruritus.

Materials and methods

Twenty patients with CPBP and twenty healthy controls (HCs) participated in the study and underwent resting-state functional magnetic resonance imaging (fMRI) scans. Brain activity was evaluated using regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) measures. Preprocessing of fMRI data involved steps such as slice timing correction, motion correction, and nuisance regression to account for physiological noise and head motion. Statistical analyses included two-sample t-tests to compare ReHo, ALFF, and fALFF values between CPBP patients and HCs, with age as a covariate, and Spearman correlation analysis to explore relationships between brain activity measures and clinical characteristics.

Results

The study revealed significant differences in brain activity between CPBP patients and HCs. CPBP patients exhibited altered higher ReHo in regions including the bilateral middle frontal gyrus, medial superior frontal gyrus, precuneus, left insula, right caudate, and bilateral cerebellar tonsils, with decreased ReHo in the right precentral gyrus. ALFF analysis showed increased activity in the bilateral middle frontal gyrus, medial superior frontal gyrus, right precuneus, and right inferior frontal gyrus, and decreased ALFF in the left precentral gyrus and right postcentral gyrus. fALFF values were notably higher in the bilateral medial superior frontal gyrus and precuneus. Several brain regions with significant differences in ReHo, ALFF, and fALFF were extensively correlated with the burned area and pruritus scale scores.

Conclusion

Our data suggest that patients with CPBP show alterations in ReHo, ALFF, and fALFF values primarily in brain regions associated with the default mode network and sensorimotor areas. These results may provide valuable insights relevant to the neuropathology of CPBP.

背景：瘙痒是烧伤创面的常见症状，由皮肤组织损伤和组织异常愈合引起。烧伤后慢性瘙痒症（CPBP）是指持续六周或更长时间的瘙痒。烧伤后慢性瘙痒症的大脑机制尚未得到充分了解。本研究旨在探讨 CPBP 患者的脑功能异常，并确定瘙痒症的潜在发病机制：20 名 CPBP 患者和 20 名健康对照组（HCs）参加了研究，并接受了静息态功能磁共振成像（fMRI）扫描。采用区域同质性（ReHo）、低频波动振幅（ALFF）和分数ALFF（fALFF）测量方法对大脑活动进行评估。fMRI 数据的预处理包括切片定时校正、运动校正和干扰回归等步骤，以考虑生理噪音和头部运动。统计分析包括双样本 t 检验，以比较 CPBP 患者和 HC 之间的 ReHo、ALFF 和 fALFF 值，并将年龄作为协变量；斯皮尔曼相关分析，以探讨脑活动测量与临床特征之间的关系：研究发现，CPBP 患者和 HCs 的大脑活动存在明显差异。CPBP 患者在双侧额叶中回、内侧额叶上回、楔前回、左侧岛叶、右侧尾状核和双侧小脑扁桃体等区域表现出较高的 ReHo，而右侧中央前回的 ReHo 有所降低。ALFF分析显示，双侧额叶中回、额叶内上回、右侧楔前回和右侧额叶下回的活动增加，而左侧中央前回和右侧中央后回的ALFF降低。ReHo、ALFF和fALFF存在显著差异的几个脑区与烧伤面积和瘙痒量表评分广泛相关：我们的数据表明，CPBP 患者的 ReHo、ALFF 和 fALFF 值主要在与默认模式网络和感觉运动区相关的脑区发生改变。这些结果可为研究 CPBP 的神经病理学提供有价值的见解。

{"title":"Altered resting-state functional brain activity in patients with chronic post-burn pruritus","authors":"Zhi-Kai Lu , Yin Huang , Bin Wang , Qian Zheng , Pei-Yi Bai , Wan-Li Guo , Wen-Jin Bian , Jin-Liang Niu","doi":"10.1016/j.burns.2024.107305","DOIUrl":"10.1016/j.burns.2024.107305","url":null,"abstract":"<div><h3>Background</h3><div>Pruritus, a common symptom of burn wounds, arises from skin tissue damage and abnormal tissue healing. Chronic post-burn pruritus (CPBP) is defined as itching that persists for six weeks or more. The brain mechanisms underlying CPBP are not understood adequately. This study aims to explore abnormal brain function in CPBP patients and identify potential pathogenesis of pruritus.</div></div><div><h3>Materials and methods</h3><div>Twenty patients with CPBP and twenty healthy controls (HCs) participated in the study and underwent resting-state functional magnetic resonance imaging (fMRI) scans. Brain activity was evaluated using regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) measures. Preprocessing of fMRI data involved steps such as slice timing correction, motion correction, and nuisance regression to account for physiological noise and head motion. Statistical analyses included two-sample t-tests to compare ReHo, ALFF, and fALFF values between CPBP patients and HCs, with age as a covariate, and Spearman correlation analysis to explore relationships between brain activity measures and clinical characteristics.</div></div><div><h3>Results</h3><div>The study revealed significant differences in brain activity between CPBP patients and HCs. CPBP patients exhibited altered higher ReHo in regions including the bilateral middle frontal gyrus, medial superior frontal gyrus, precuneus, left insula, right caudate, and bilateral cerebellar tonsils, with decreased ReHo in the right precentral gyrus. ALFF analysis showed increased activity in the bilateral middle frontal gyrus, medial superior frontal gyrus, right precuneus, and right inferior frontal gyrus, and decreased ALFF in the left precentral gyrus and right postcentral gyrus. fALFF values were notably higher in the bilateral medial superior frontal gyrus and precuneus. Several brain regions with significant differences in ReHo, ALFF, and fALFF were extensively correlated with the burned area and pruritus scale scores.</div></div><div><h3>Conclusion</h3><div>Our data suggest that patients with CPBP show alterations in ReHo, ALFF, and fALFF values primarily in brain regions associated with the default mode network and sensorimotor areas. These results may provide valuable insights relevant to the neuropathology of CPBP.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107305"},"PeriodicalIF":3.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The rate of burnout, depression, and anxiety among burn care team members in a tertiary burn hospital: A descriptive cross-sectional study 一家三级烧伤医院烧伤护理团队成员的职业倦怠、抑郁和焦虑率：一项描述性横断面研究。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-11-02 DOI: 10.1016/j.burns.2024.107306

Seyed Hamid Salehi , Soodabeh Hoveidamanesh , Mahsa Moghanlou , Parviz Namazi , Tayyeb Ghadimi , Seyyed Amirhossein Salehi

Background

Working in burn units has its unique challenges and may increase the rate of depression, anxiety, and burnout in burn care staff. We aimed to estimate the rate of depression, anxiety, and burnout among the members of the burn care team.

Methods

This descriptive cross-sectional survey was conducted from 1 January 2024 to 22 February 2024 in a tertiary burn hospital. The measurement tools of study were the validated Farsi versions of Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI), and Copenhagen Burnout Inventory (CBI).

Results

We found that the rate of depression, anxiety, and burnout was 54.2%, 62.7% and 50.7% in respondents, respectively. The correlation between burnout (CBI), depression (BDI), and anxiety (BAI) scores was significantly positive (p < 0.01). The rate of burnout was significantly higher in younger staff, females, bachelor's degree holders, and burn ICU staff (P < 0.05). Female burn care providers had higher anxiety (P < 0.05). The rate of depression was significantly higher in younger participants and in those with incomes less than 300 dollars .(P < 0.05).

Conclusion

Our results indicated that a significant number of burn care team members met the criteria for anxiety, depression, and burnout. The relationship between anxiety, depression, and burnout was significantly positive. Timely and proper intervention is necessary to reduce anxiety, depression, and burnout in burn care providers.

背景：在烧伤科工作有其独特的挑战，可能会增加烧伤护理人员的抑郁、焦虑和职业倦怠率。我们旨在估计烧伤护理团队成员的抑郁、焦虑和倦怠率：这项描述性横断面调查于 2024 年 1 月 1 日至 2024 年 2 月 22 日在一家三级烧伤医院进行。研究的测量工具是经过验证的法西语版贝克抑郁量表（BDI）、贝克焦虑量表（BAI）和哥本哈根职业倦怠量表（CBI）：我们发现，受访者中抑郁、焦虑和职业倦怠的比例分别为 54.2%、62.7% 和 50.7%。职业倦怠（CBI）、抑郁（BDI）和焦虑（BAI）得分之间呈显著正相关（p 结论：我们的结果表明，有相当数量的受访者在工作中出现了职业倦怠：我们的研究结果表明，相当多的烧伤护理团队成员符合焦虑、抑郁和职业倦怠的标准。焦虑、抑郁和职业倦怠之间的关系呈显著正相关。要减少烧伤护理人员的焦虑、抑郁和职业倦怠，就必须及时采取适当的干预措施。

{"title":"The rate of burnout, depression, and anxiety among burn care team members in a tertiary burn hospital: A descriptive cross-sectional study","authors":"Seyed Hamid Salehi , Soodabeh Hoveidamanesh , Mahsa Moghanlou , Parviz Namazi , Tayyeb Ghadimi , Seyyed Amirhossein Salehi","doi":"10.1016/j.burns.2024.107306","DOIUrl":"10.1016/j.burns.2024.107306","url":null,"abstract":"<div><h3>Background</h3><div>Working in burn units has its unique challenges and may increase the rate of depression, anxiety, and burnout in burn care staff. We aimed to estimate the rate of depression, anxiety, and burnout among the members of the burn care team.</div></div><div><h3>Methods</h3><div>This descriptive cross-sectional survey was conducted from 1 January 2024 to 22 February 2024 in a tertiary burn hospital. The measurement tools of study were the validated Farsi versions of Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI), and Copenhagen Burnout Inventory (CBI).</div></div><div><h3>Results</h3><div>We found that the rate of depression, anxiety, and burnout was 54.2%, 62.7% and 50.7% in respondents, respectively. The correlation between burnout (CBI), depression (BDI), and anxiety (BAI) scores was significantly positive (p < 0.01). The rate of burnout was significantly higher in younger staff, females, bachelor's degree holders, and burn ICU staff (P < 0.05). Female burn care providers had higher anxiety (P < 0.05). The rate of depression was significantly higher in younger participants and in those with incomes less than 300 dollars .(P < 0.05).</div></div><div><h3>Conclusion</h3><div>Our results indicated that a significant number of burn care team members met the criteria for anxiety, depression, and burnout. The relationship between anxiety, depression, and burnout was significantly positive<strong>.</strong> Timely and proper intervention is necessary to reduce anxiety, depression, and burnout in burn care providers.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107306"},"PeriodicalIF":3.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility of collecting long-term patient-reported outcome data in burns patients using a centralised approach 采用集中方法收集烧伤患者长期疗效数据的可行性。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-10-28 DOI: 10.1016/j.burns.2024.107304

Lincoln M. Tracy , Elizabeth Capell , Heather J. Cleland , Dale W. Edgar , Yvonne Singer , Warwick J. Teague , Belinda J. Gabbe

Background

Collecting patient-reported outcome measures (PROMs) has been a longstanding priority for the Burns Registry of Australia and New Zealand (BRANZ). An earlier pilot of hospital-led PROM collection encountered low participation rates and high loss to follow-up, indicating consideration for an alternative model was warranted.

Aims

To establish the feasibility of implementing centralised long-term PROM collection within the BRANZ.

Methods

Two burn services participated in this prospective, longitudinal pilot. PROMs were collected from patients admitted to the services between January and December 2021 who survived to discharge. Follow-up occurred via telephone or online self-completion at three, six, and 12 months post-injury using burn-specific and generic health-related quality-of-life measures.

Results

There were 450 patients (423 adult patients [≥ 16 years] and 27 paediatric patients [< 16 years]) who could be contacted and agreed to participate in the follow-ups. Most patients initially opted for telephone rather than online self-completion (n = 305, 67.5 %). No key sociodemographic or injury event factors were associated with specifically opting for online self-completion. The follow-up rates were 81.1 % at three months, 81.9 % at six months, and 77.3 % at 12 months. Data missingness was low (i.e., < 2 %) for all instrument items, excluding the visual analogue scale scores of the 5-Level EuroQoL 5 Dimensions Questionnaire and the two paediatric burn-specific measures.

Conclusions

Collecting PROMs from burns patients in the first 12 months after injury via a centralised approach was shown to be feasible, with higher participation rates and low missingness.

背景：收集患者报告的结果指标（PROMs）一直是澳大利亚和新西兰烧伤登记处（BRANZ）的优先事项。早些时候，由医院主导的PROM收集试点工作遇到了参与率低和随访丢失率高的问题，这表明有必要考虑采用其他模式。目的：确定在BRANZ内实施集中式长期PROM收集的可行性：方法：两家烧伤医疗机构参与了这项前瞻性纵向试点项目。从 2021 年 1 月至 12 月期间入院并存活至出院的患者中收集 PROM。在伤后3、6和12个月时，通过电话或在线自我填写的方式，使用烧伤特异性和通用的健康相关生活质量测量方法进行随访：共有 450 名患者（423 名成年患者[≥ 16 岁]和 27 名儿童患者[< 16 岁]）可以联系到并同意参加随访。大多数患者最初选择电话而非在线自我填写（n = 305，67.5%）。没有关键的社会人口学或受伤事件因素与特别选择在线自我填写有关。三个月、六个月和 12 个月的随访率分别为 81.1%、81.9% 和 77.3%。所有工具项目的数据缺失率都很低（即小于 2%），但不包括欧洲生活质量 5 维度问卷的 5 级视觉模拟量表评分和两个儿科烧伤专用测量项目：通过集中方法收集烧伤患者伤后头12个月的PROMs是可行的，参与率较高，缺失率较低。

{"title":"Feasibility of collecting long-term patient-reported outcome data in burns patients using a centralised approach","authors":"Lincoln M. Tracy , Elizabeth Capell , Heather J. Cleland , Dale W. Edgar , Yvonne Singer , Warwick J. Teague , Belinda J. Gabbe","doi":"10.1016/j.burns.2024.107304","DOIUrl":"10.1016/j.burns.2024.107304","url":null,"abstract":"<div><h3>Background</h3><div>Collecting patient-reported outcome measures (PROMs) has been a longstanding priority for the Burns Registry of Australia and New Zealand (BRANZ). An earlier pilot of hospital-led PROM collection encountered low participation rates and high loss to follow-up, indicating consideration for an alternative model was warranted.</div></div><div><h3>Aims</h3><div>To establish the feasibility of implementing centralised long-term PROM collection within the BRANZ.</div></div><div><h3>Methods</h3><div>Two burn services participated in this prospective, longitudinal pilot. PROMs were collected from patients admitted to the services between January and December 2021 who survived to discharge. Follow-up occurred via telephone or online self-completion at three, six, and 12 months post-injury using burn-specific and generic health-related quality-of-life measures.</div></div><div><h3>Results</h3><div>There were 450 patients (423 adult patients [≥ 16 years] and 27 paediatric patients [< 16 years]) who could be contacted and agreed to participate in the follow-ups. Most patients initially opted for telephone rather than online self-completion (n = 305, 67.5 %). No key sociodemographic or injury event factors were associated with specifically opting for online self-completion. The follow-up rates were 81.1 % at three months, 81.9 % at six months, and 77.3 % at 12 months. Data missingness was low (i.e., < 2 %) for all instrument items, excluding the visual analogue scale scores of the 5-Level EuroQoL 5 Dimensions Questionnaire and the two paediatric burn-specific measures.</div></div><div><h3>Conclusions</h3><div>Collecting PROMs from burns patients in the first 12 months after injury via a centralised approach was shown to be feasible, with higher participation rates and low missingness.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107304"},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recovery in patients undergoing ablative fractional carbon dioxide laser for adult hypertrophic burn scars: A longitudinal cohort study 接受二氧化碳点阵消融激光治疗成人增生性烧伤疤痕患者的恢复情况：纵向队列研究。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-10-28 DOI: 10.1016/j.burns.2024.107300

Noah Betar , Michelle Donovan , Zephanie Tyack , Jacelle Warren , Steven M. McPhail , Elizabeth Vujcich , Jason Brown

Introduction

Ablative fractional carbon dioxide laser (AFCO2L) is widely used as a treatment for hypertrophic burn scars. This study aimed to evaluate clinician and patient-reported outcomes after AFCO2L treatment, safety, and identify factors influencing outcomes.

Methods

This longitudinal study recruited adult patients with hypertrophic burn scars treated with AFCO2L at a single Australian burn unit. Patients received up to four AFCO2L treatments over approximately 12 months. Outcomes were ultrasound scar thickness, the Patient and Observer Scar Assessment Scale (POSAS), and the Brisbane Burn Scar Impact Scale (BBSIP), measured at baseline and 3, 6, and 12 months after the first AFCO2L treatment. Analysis used mixed effects linear models.

Results

47 patients were included with median age 32 years (IQR: 24, 53) and median burn TBSA of 35 % (IQR: 7.5 %, 48 %). Statistically significant improvements between baseline and 12-month follow-up occurred in scar thickness, and all POSAS and BBSIP subscores. Most improvements remained when accounting for TBSA, Fitzpatrick skin type, scar maturity, and body area treated. Patients reported transient symptoms after 61 of 89 (69 %) AFCO2L treatments, but infection or delayed wound healing occurred after only 4 of 89 (4 %) treatments.

Conclusion

This study supports safety and improved clinician and patient-reported outcomes in patients undergoing AFCO2L for hypertrophic burn scars.

简介消融点阵二氧化碳激光（AFCO2L）被广泛用于治疗增生性烧伤疤痕。本研究旨在评估AFCO2L治疗后临床医生和患者报告的疗效、安全性，并确定影响疗效的因素：这项纵向研究招募了在澳大利亚一家烧伤科接受 AFCO2L 治疗的成年增生性烧伤疤痕患者。患者在大约 12 个月的时间内接受了最多四次 AFCO2L 治疗。研究结果包括超声疤痕厚度、患者和观察者疤痕评估量表（POSAS）以及布里斯班烧伤疤痕影响量表（BBSIP），分别在基线和首次 AFCO2L 治疗后 3、6 和 12 个月进行测量。分析采用混合效应线性模型：47名患者的中位年龄为32岁（IQR：24岁至53岁），中位烧伤总面积为35%（IQR：7.5%至48%）。从基线到 12 个月随访期间，疤痕厚度、所有 POSAS 和 BBSIP 子分数均有明显改善。在考虑到总热辐射面积、菲茨帕特里克皮肤类型、疤痕成熟度和治疗面积的情况下，大部分改善仍然存在。在 89 次 AFCO2L 治疗中，有 61 次（69%）治疗后患者出现短暂症状，但 89 次治疗中仅有 4 次（4%）治疗后出现感染或伤口延迟愈合：本研究支持对肥厚性烧伤疤痕患者进行 AFCO2L 治疗的安全性，并改善了临床医生和患者报告的治疗效果。

{"title":"Recovery in patients undergoing ablative fractional carbon dioxide laser for adult hypertrophic burn scars: A longitudinal cohort study","authors":"Noah Betar , Michelle Donovan , Zephanie Tyack , Jacelle Warren , Steven M. McPhail , Elizabeth Vujcich , Jason Brown","doi":"10.1016/j.burns.2024.107300","DOIUrl":"10.1016/j.burns.2024.107300","url":null,"abstract":"<div><h3>Introduction</h3><div>Ablative fractional carbon dioxide laser (AFCO2L) is widely used as a treatment for hypertrophic burn scars. This study aimed to evaluate clinician and patient-reported outcomes after AFCO2L treatment, safety, and identify factors influencing outcomes.</div></div><div><h3>Methods</h3><div>This longitudinal study recruited adult patients with hypertrophic burn scars treated with AFCO2L at a single Australian burn unit. Patients received up to four AFCO2L treatments over approximately 12 months. Outcomes were ultrasound scar thickness, the Patient and Observer Scar Assessment Scale (POSAS), and the Brisbane Burn Scar Impact Scale (BBSIP), measured at baseline and 3, 6, and 12 months after the first AFCO2L treatment. Analysis used mixed effects linear models.</div></div><div><h3>Results</h3><div>47 patients were included with median age 32 years (IQR: 24, 53) and median burn TBSA of 35 % (IQR: 7.5 %, 48 %). Statistically significant improvements between baseline and 12-month follow-up occurred in scar thickness, and all POSAS and BBSIP subscores. Most improvements remained when accounting for TBSA, Fitzpatrick skin type, scar maturity, and body area treated. Patients reported transient symptoms after 61 of 89 (69 %) AFCO2L treatments, but infection or delayed wound healing occurred after only 4 of 89 (4 %) treatments.</div></div><div><h3>Conclusion</h3><div>This study supports safety and improved clinician and patient-reported outcomes in patients undergoing AFCO2L for hypertrophic burn scars.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107300"},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commentary on Promising anti-inflammatory activity of a novel designed anti-microbial peptide for wound healing 评论：一种用于伤口愈合的新型设计抗微生物肽具有良好的抗炎活性。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns

Pub Date : 2024-10-24 DOI: 10.1016/j.burns.2024.107301

Chunfu Wei, Wenhao Wang, Xuejuan Zhang

引用次数: 0