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Low-protein diet accelerates wound healing in mice post-acute injury

Burns & Trauma 2021年第1期9卷 339-350页

作者： Jonathan J.Hew Roxanne J.parungao craig p.mooney Julian K.Smyth Sarah Kim Kevin H.-Y.Tsai Huaikai Shi Cassandra Chong Renee C.F.Chan Beba Attia Caroline Nicholls Zhe Li Samantha M.Solon-Biet David G.Le Couteur Stephen J.Simpson Marc G.Jeschke peter K.Maitz Yiwei Wang Burns Research and Reconstructive Surgery ANZAC Research InstituteConcord HospitalUniversity of SydneySydneyAustralia 2139 Bone Biology Group ANZAC Research InstituteConcord HospitalUniversity of SydneySydneyAustralia 2139 Adrenal Steroids Laboratory ANZAC Research InstituteConcord HospitalUniversity of SydneySydneyAustralia 2139 Electron Microscopy Unit Anatomical PathologyConcord HospitalSydneyAustralia 2139 Burns Unit Concord Repatriation General HospitalConcordAustralia 2139 Ageing and Alzheimer Institute and ANZAC Research Institute Concord HospitalUniversity of SydneySydneyAustralia 2139 Charles perkins Centre and School of Life and Environmental Sciences University of SydneyAustralia 2006 Sunnybrook Research Institute TorontoOntarioCanadaM4N 3M5 School of pharmacy Nanjing University of Chinese MedicineNanjingPR China 210023

Background:Wound healing processes are influenced by macronutrient intake(protein,carbohydrate and fat).The most favourable diet for cutaneous wound healing is not known,although highprotein diets are currently favoured *** experimental study investigates the optimal macronutrient balance for cutaneous wound healing using a mouse model and the Geometric Framework,a nutrient modelling method,capable of analyzing the individual and interactive effects of a wide spectrum of macronutrient ***:Two adjacent and identical full-thickness skin excisions(1 cm^(2))were surgically created on the dorsal area of male C57BL/6 *** were then allocated to one of 12 high-energy diets that varied in protein,carbohydrate and fat *** select diets,wound healing processes,cytokine expression,energy expenditure,body composition,muscle and fat reserves were ***:Using the Geometric Framework,we show that a low-protein intake,coupled with a balanced intake of carbohydrate and fat is optimal for wound *** fed a low-protein diet progressed quickly through wound healing stages with favourable wound inflammatory cytokine expression and significantly accelerated collagen *** local processes were associated with an increased early systemic inflammatory response and a higher overall energy expenditure,related to metabolic changes occurring in key macronutrient reserves in lean body mass and fat ***:The results suggest that a low-protein diet may have a greater potential to accelerate wound healing than the current clinically used high-protein diets.

关键词： Wound healing Macronutrients Cutaneous Geometric Framework Mouse model Low-protein diet Nutrition

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Analysis of a ten step protocol to decrease postoperative spinal wound infections

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World Journal of Orthopedics 2018年第11期9卷 271-284页

作者： Hossein Elgafy craig J Raberding Megan L mooney Kyle A Andrews Joan M Duggan Department of Orthopedics and Infectious Diseases University of Toledo Medical Center

AIM To define a ten-step protocol that reduced the incidence of surgical site infection in the spine surgery practice of the senior author and evaluate the support for each step based on current *** In response to unexplained increased infection rates at our institution following spine surgery,a ten-step protocol was implemented:(1) preoperative glycemic management based on hemoglobin A1 c(HbA1 c);(2) skin site preoperative preparation with 2% chlorhexidine gluconate disposable cloths;(3) limit operating room traffic;(4) cut the number of personnel in the room to the minimum required;(5) absolutely no flash sterilization of equipment;(6) double-gloving with frequent changing of outer gloves;(7) local application of vancomycin powder;(8) re-dosing antibiotic every 4 h for prolonged procedures and extending postoperative coverage to 72 h for high-risk patients;(9) irrigation of subcutaneous tissue with diluted povidone-iodine solution after deep fascial closure; and(10) use of Dura prep skin preparation at the end of a case before skin closure. Through an extensive literature review,the current data available for each of the ten steps was *** Use of vancomycin powder in surgical wounds,routine irrigation of surgical site,and frequent changing of surgical gloves are strongly supported by the literature. preoperative skin preparation with chlorhexidine wipes is similarly supported. The majority of current literature supports control of HbA1 c preoperatively to reduce risk of infection. Limiting the use of flash sterilization is supported,but has not been evaluated in spine-specific surgery. Limiting OR traffic and number of personnel in the OR are supported although without level 1 evidence. prolonged use of antibiotics postoperativelyis not supported by the literature. Intraoperative use of Dura prep prior to skin closure is not yet *** The ten-step protocol defined herein has significantly helped in decreasing surgical site

关键词： Wound infections Spine Ten step protocol Surgical site infections

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Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

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World Journal of Emergency Medicine 2019年第2期10卷 75-80页

作者： Robert D.Willmore Damjan Veljanoski Feray Ozdes Bethan Stephens James mooney Seamus G.Crumley Arpan Doshi philippa Davies Shreya Badhrinarayanan Emily Day Kristian Tattam April Wilson Nathan Crang Lorna Green craig A.Mounsey Howell Fu Joseph Williams Michelle S.D'souza Dhanya Sebastian Liam A.Mcgiveron Matthew G.percy James Cohen Imogen J.John Alice Lethbridge Imogen Watkins Omar Amin Mubasher A.Qamar John Gerrard Hanrahan Emily Cramond-Wong Barts Health NHS Trust Barts & the London Medical School Queen Mary University of London Norwich Medical School University of East Anglia Lancaster Medical School Lancaster University School of Medicine Dentistry and Biomedical Sciences Queen's University Belfast Faculty of Medicine University of St Andrews Faculty of Medicine Dentistry and Health University of Sheffi eld Brighton and Sussex University Hospitals NHS Trust St George's University of London University of Liverpool School of Medicine University of Exeter medical school Faculty of Medicine University of Southampton Medical Sciences Division University of Oxford University of Edinburgh Medical School Faculty of Medicine University of Warwick University College London Medical School Cardiff University School of Medicine College of Medical and Dental Sciences University of Birmingham College of Medical Veterinary and Life Sciences University of Glasgow Guys Kings and St Thomas School of Medicine King’s College London Faculty of Life Sciences & Medicine King's College London Faculty of Health Sciences at the University of Nottingham

BACKGROUND: Healthcare professionals have a duty to maintain basic life support(BLS) skills. This study aims to evaluate medical students' factual knowledge of BLS and the training they ***: A cross-sectional, closed-response questionnaire was distributed to the fi rst-and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent's previous BLS training, factual knowledge of the BLS algorithm using five multiple choice questions(MCQs), and valuate their desire for further BLS training. Students received 1 point for each correctly identifi ed answer to the 5 MCQ'***: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent(n=2,999) of students completed a BLS course as part of their undergraduate medical studies. There was a signifi cant difference(ppercentage of the fourth-year students selecting the correct answer in all the MCQ's compared to the fi rst-year students except in identifyingthe correct depth of compressions required during CpR(p=0.095). Overall 10.3%(95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ's on BLS: 9% of the first-year students(n=194) and 12% of the fourth-year students(n=190). On an institutional level the proportion of students answering all MCQ's correctly ranged from 2% to 54% at different universities. Eighty-one percent of students(n=3,031) wished for more BLS training in their ***: Factual knowledge of BLS is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training.

关键词： Emergency Medicine Basic life support Medical education Resuscitation

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