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Current understanding of the chronic stress response to burn injury from human studies

burns & Trauma 2023年第1期11卷 289-299页

作者： Tyler Osborne Bradley Wall Dale WEdgar Timothy Fairchild Fiona Wood Discipline of Exercise Science Murdoch UniversityMurdoch 6150Western Australia Centre for Healthy Ageing Health Futures InstituteMurdoch UniversityMurdoch 6150Western Australia State Adult burns Unit Govern-ment of Western Australia South Metropolitan Health ServiceFiona Stanley HospitalMurdoch 6150Western Australia FionaWood Foundation Fiona Stanley HospitalMurdoch 6150Western Australia burn injury research node Institute for Health ResearchThe University of Notre Dame AustraliaMurdoch 6160Western Australia burn injury research Unit University of Western AustraliaMurdoch 6009Western Australia The Centre for Molecular Medicine and Innovative Therapeutics Health Futures InstituteMurdoch UniversityMurdoch 6150Western Australia

There is a marked inflammatory and hypermetabolic response following a burn *** inter-linked responses are more pronounced than for other forms of trauma and can persist for≥3 years post-injury in burned *** a burn,patients have an increased risk of diseases of ageing including cancer,diabetes and cardiovascular disease,highlighting the need for effective long-term strategies to ameliorate the stress response *** therapeutic strategies for post-burn recovery include removal of damaged tissue with surgical excision and wound repair,nutritional supplementation and rehabilitative *** strategies aim to minimize the hypermetabolic and inflammatory responses,as well as reducing the loss of lean body *** review briefly summarises the inflammatory and hypermetabolic responses and provides an update on the current therapeutic strategies for burned *** review examines the persistent nutritional challenge of ensuring sufficient energy intake of each macronutrient to fuel the hypermetabolic and counteract the catabolic response of burn injury,whilst reducing periods of hyperglycaemia and *** require individualized treatment options tailored to unique systemic responses following a burn,facilitated by a precision medicine approach to improve clinical and physiological outcomes in burned ***,this review discusses the utility of metabolic flexibility assessment to aid clinical decision making and prescription relating to nutritional supplementation and rehabilitative exercise in the burned patient.

关键词： burns Metabolism Inflammation Metabolic flexibility Exercise Nutrition Clinical care

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Demonstration of the test-retest reliability and sensitivity of the Lower Limb Functional Index-10 as a measure of functional recovery post burn injury:a cross-sectional repeated measures study design

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burns & Trauma 2016年第2期4卷 153-159页

作者： Margaret E.Ryland Tiffany L.Grisbrook Fiona M.Wood Michael Phillips Dale W.Edgar School of Physiotherapy and Exercise Science Curtin UniversityBentley 6102WAAustralia School of Physiotherapy and Exercise Science Curtin UniversityBentley 6102WAAustralia Fiona Wood Foundation of Western Australia Fiona Stanley Hospital11 Warren DriveMurdoch 6150WAAustralia Fiona Wood Foundation of Western Australia Fiona Stanley Hospital11 Warren DriveMurdoch 6150WAAustralia State Adult burn Unit Fiona Stanley HospitalLevel 411 Warren Smith DriveMurdoch 6150WAAustralia burn injury research Unit The University of Western AustraliaCrawley 6009WAAustralia Harry Perkins Institute of Medical research The University of Western AustraliaCrawley 6009WAAustralia Fiona Wood Foundation of Western Australia Fiona Stanley Hospital11 Warren DriveMurdoch 6150WAAustralia State Adult burn Unit Fiona Stanley HospitalLevel 411 Warren Smith DriveMurdoch 6150WAAustralia burn injury research Unit The University of Western AustraliaCrawley 6009WAAustralia burn injury research node The University of Notre Dame Australia19 Mouat StFremantle 6160WAAustralia

Background:Lower limb burns can significantly delay recovery of *** lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid *** aims of this study were to examine the test-retest reliability,sensitivity,and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10(LLFI-10)questionnaire for measuring functional ability in patients with lower limb burns over ***:Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the *** addition,the minimal detectable change(MDC)was calculated for Section 1 and 3 of the *** 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury ***:Section 1 of the LLFI-10 demonstrated excellent test-retest reliability(intra-class correlation coefficient(ICC)0.98,95%CI 0.96–0.99)whilst Section 3 demonstrated high test-retest reliability(ICC 0.88,95%CI 0.79–0.94).MDC scores for Sections 1 and 3 were 1.27 points and 30.22%,*** consistency was demonstrated with a significant negative association(rs=?0.83)between Sections 1 and 3 of the LLFI-10(pburns in the previous 12 months,and furthermore,Section 1 is sensitive to changes in patient function over time.

关键词： Outcome measure Questionnaire Lower limb function Internal consistency Minimal detectable change burn

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An objective measure for the assessment and management of fluid shifts in acute major burns

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burns & Trauma 2018年第1期6卷 21-32页

作者： Pippa Kenworthy Michael Phillips Tiffany L.Grisbrook William Gibson Fiona M.Wood Dale W.Edgar Fiona Wood Foundation Fiona Stanley HospitalPerthWestern AustraliaAustralia School of Physiotherapy and Exercise Science Curtin UniversityPerthWestern AustraliaAustralia burns Service of Western Australia Fiona Stanley HospitalPerthWestern AustraliaAustralia burn injury research node Notre Dame UniversityFremantleWestern AustraliaAustralia Harry Perkins Institute of Medical research The University of Western AustraliaPerthWestern AustraliaAustralia School of Physiotherapy Notre Dame UniversityFremantleWestern AustraliaAustralia Adult State burns Service Fiona Stanley HospitalMurdoch DriveMurdochWestern Australia 6150Australia.

Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat?on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns. Methods: An observational longitudinal cohort study was conducted from December 2014 to February 2016. Patients with over 15% total body surface area (TBSA) burns and injury less than 48 h were enrolled in the study. BIS triplicate measures were collected in an open wound and with an ActicoatTMdressing (at 5 half hour intervals). Standard and alternate electrode placements were utilised for the reliability analysis and standard placement only for determining the validity of BIS in moderate to major burns. The ImpediMde SFB7 was used to collect whole-body and segmental BIS measures. Stata statistical software, release 14 was utilised to analyse all results. Descriptive analyses were performed and were reported using the means and standard deviations (SD). Results: BIS-repeated measures established BIS raw resistance (R), and predicted volume variables were reliable in any condition (intra-class correlation coefficient (ICC) 0.996-0.999, 95% confidence intervals (CI) 0.996-0.999) without a systematic difference. Acticoat?dressings significantly influenced all BIS-predicted volumes (p≤0.01) as determined by multilevel mixed effects (MLME) linear regression analysis. Validity of BIS was demonstrated by resistance variables significantly decreasing with increasing net ionic fluid shift and increased TBSA (severity of injury) and calculated fluid volumes increasing with increasing net f

关键词： Bioelectrical impedance Oedema Wounds Fluid resuscitation Dressings

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Establishment of Modified Chronic Lung Lymph Fistula in Chongqing Goats

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Journal of Medical Colleges of PLA 1986年第3期 253-258页

作者：王成忠黎鳌杨宗城朱佩芳王敦 burn Center First Teaching Hospital Third Military Medical College Chongqing

A method,which was a modification of that of Stothert et al,was adopted to establish chronic lung lymph fistula in goats fromChongqing *** procedure consisted mainly that a segment ofthe thoracic duct was isolated to serve as the efferent of the caudalmediastinal lymph node to collect lung lymph,and an irrigationtube was inserted for the periodic administration of heparin solutionto prevent the sanguinous lymph from clotting in the early post-operative days.A series of difficulties including high surgical morta-lity,stoppage of lymph flow,and chyle contamination of the lunglymph were overcome.A trial of the operated goats on steaminhalation injury precipitated instant increase of lung lymph flowand an elevation of lymph/plasma ratio of total protein concentration,which suggested that our animal model was suitable and effective inthe study of the exchanges of fluid and protein in the *** of technique were described and discussed.

关键词： lung lymph fistula goat

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Treatment of invasive fungal disease: A case report

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World Journal of Clinical Cases 2019年第16期7卷 2374-2383页

作者： Xue-Fei Xiao Jiong-Xing Wu Yang-Cheng Xu Department of Emergency and Intensive Medicine The Third Xiangya HospitalCentral South UniversityChangsha 410013Hunan ProvinceChina Department of burn Plastic Surgery The Third Xiangya HospitalCentral South UniversityChangsha 410013Hunan ProvinceChina

BACKGROUND In recent years,the incidence of fungal infection has been increasing,often invading one or more systems of the ***,it is rare for lymph nodes to be invaded without the involvement of other *** SUMMARY A 21-year-old man was admitted to hospital for repeated cough for 2 mo and abdominal pain for 1 *** examination revealed multiple lymph nodes enlargement,especially those in the left neck and *** scan showed multiple lymph nodes enlargement in the chest,especially left lung,abdominal cavity,and *** first lymph node biopsy revealed granulomatous lesions of lymph nodes,so intravenous infusion of Cefoperazone tazobactam combined with anti-tuberculosis drugs were *** fever and respiratory failure occurred 4 d after admission,mechanical ventilation was given,and Caspofungin and Voriconazole were used ***,the disease still could not be *** the 11th day of admission,the body temperature reached 40° *** mycosis of lymph nodes was confirmed by the second lymph node biopsy,Amphotericin B was given,and the patient recovered and was discharged from the *** No fixed target organ was identified in this case,and only lymph node involvement was ***,a new antifungal drug,and the conventional first choice drug,Voriconazole,were ineffective,while Amphotericin B was effective.

关键词： Invasive fungal disease Case report Lymphadenectasis Lymph node biopsy Mycosis of lymph nodes Amphotericin B

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烧伤后12个月内瘙痒和疼痛的预测因子:来自澳大利亚和新西兰烧伤登记处长期预后项目的结果

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中华烧伤杂志 2021年第1期37卷 355-355页

作者：黄卓(编译) 谢卫国(审校) Tracy LM Edgar DW Schrale R School of Public Health and Preventive Medicine Monash University 553 St Kilda Road Melbourne Victoria 3004 Australia. State Adult burn Unit Fiona Stanley Hospital 11 Warren Drive Murdoch Western Australia 6150 Australia. burn injury research node The University of Notre Dame 19 Mouat Street Fremantle Western Australia 6959 Australia. Tasmanian burns Unit Burns & Surgical Specialties Unit 5A Royal Hobart Hospital GPO Box 1061 Hobart Tasmania 7001 Australia. Victorian Adult burns Service The Alfred Commercial Road Melbourne Victoria 3004 Australia. Health Data research UK Swansea University Medical School Swansea University Singleton Park Swansea Wales SA28PP United Kingdom.

澳大利亚Monash大学Dale W Edgar教授团队近期在《burns & Trauma》发文《Predictors of itch and pain in the 12 months following burn injury: results from the burns Registry of Australia and New Zealand (BRANZ) Long-Term Outcomes Project》,该研究旨在分析烧伤后12个月内瘙痒以及中度和重度疼痛的发生率和预测因素,并确定其对患者烧伤后生活质量的影响。

关键词：烧伤后预测因素澳大利亚预测因子

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Diagnostic Power of Diffusion-weighted Magnetic Resonance Imaging for the Presence of Lymph node Metastasis:A Meta-analysis

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2017年第4期37卷 469-474页

作者：孔祥闯熊凌云 Emre Gazyakan Holger Engel Ulrich Kneser Andreas K.Nüssler Christoph Hirche 孔祥泉 Department of Radiology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Department of Plastic and Reconstructive Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Department of Hand-Plastic and Reconstructive Surgery Burn CenterBG Trauma Center LudwigshafenUniversity of Heidelberg Department of Hand-Plastic and Reconstructive Surgery Medical Center Kassel Eberhard-Karls-University Tuebingen BG Trauma CenterSiegfried Weller Institut

Present work was designed to quantitatively evaluate the performance of diffusion-weighted magnetic resonance imaging（DWI） in the diagnosis of the presence of metastasis in lymph nodes（LNs）. Eligible studies were identified from systematical Pub Med and EMBASE searches. Data were extracted. Meta-analyses were performed to generate pooled sensitivity and specificity on the basis of per-node, per-lesion and per-patient, respectively. Fourteen publications（2458 LNs, 404 lesions and 334 patients） were eligible. Per-node basis demonstrated the pooled sensitivity and specificity was 0.82（P〈0.0001） and 0.90（P〈0.0001）, respectively. Per-lesion basis illustrated the pooled sensitivity and specificity was 0.73（P=0.0036） and 0.85（P〈0.0001）, respectively. Per-patient basis indicated the pooled sensitivity and specificity was 0.67（P=0.0909） and 0.86（P〈0.0001）, respectively. In conclusion, DWI has rather a negative predictive value for the diagnosis of LN metastasis presence. The difference of the mean apparent diffusion coefficients between benign and malignant LNs is not yet stable. Therefore, the DWI technique has to be further improved.

关键词： Meta-analysis magnetic resonance imaging lymph node metastasis diffusion-weighted

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New reference trajectory optimization algorithm for a flight management system inspired in beam search

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Chinese Journal of Aeronautics 2017年第4期30卷 1459-1472页

作者： Alejandro MURRIETA-MENDOZA Bruce BEUZE Laurane TERNISIEN Ruxandra Mihaela BOTEZ research Laboratory in Active Control Avionics and Aeroservoelasticity (LARCASE) Universitd du Quebec (Ecole deTechnologie Superieure - ETS) Montreal H3C 1K3 Canada

With the objective of reducing the flight cost and the amount of polluting emissions released in the atmosphere, a new optimization algorithm considering the climb, cruise and descent phases is presented for the reference vertical flight trajectory. The selection of the reference vertical navigation speeds and altitudes was solved as a discrete combinatory problem by means of a graphtree passing through nodes using the beam search optimization technique. To achieve a compromise between the execution time and the algorithm＇s ability to find the global optimal solution, a heuristic methodology introducing a parameter called ‘‘optimism coefficient was used in order to estimate the trajectory＇s flight cost at every node. The optimal trajectory cost obtained with the developed algorithm was compared with the cost of the optimal trajectory provided by a commercial flight management system（FMS）. The global optimal solution was validated against an exhaustive search algorithm（ESA）, other than the proposed algorithm. The developed algorithm takes into account weather effects, step climbs during cruise and air traffic management constraints such as constant altitude segments, constant cruise Mach, and a pre-defined reference lateral navigation route. The aircraft fuel burn was computed using a numerical performance model which was created and validated using flight test experimental data.

关键词： Beam search Commercial aircraft Flight time Flight management system Fuel burn FMS Trajectory optimization

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