Institution
Shriners Hospitals for Children - Galveston
Healthcare•Galveston, Texas, United States•
About: Shriners Hospitals for Children - Galveston is a healthcare organization based out in Galveston, Texas, United States. It is known for research contribution in the topics: Burn injury & Lean body mass. The organization has 249 authors who have published 420 publications receiving 15311 citations.
Papers published on a yearly basis
Papers
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TL;DR: An in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns and how this response to severe burns can be enhanced is reviewed.
Abstract: Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced. Besides the increased morbidity and mortality compared to burn patients with normal weight, obese patients present a challenge in fluid resuscitation, perioperative management, and difficulties in wound healing. The present work is an in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns.
10 citations
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TL;DR: Pruitt et al. as discussed by the authors were among the first to recognize and define alterations in the basal metabolic rate and thermoregulation consequent to burn injury, and their investigations prompted groundbreaking insights into the coordinated nervous, autonomic, endocrine, immune, and metabolic outflows that a severely burned patient uses to remain alive and restore homeostasis.
Abstract: Dr. Basil A. Pruitt Jr., a consummate clinical and translational surgeon-scientist, has spent over half a century at the forefront of an advancing standard of burn care. Commanding the US Army Institute for Surgical Research in San Antonio, he trained generations of leading burn clinicians and allied scientists. At his direction, there were forged discoveries in resuscitation from shock, treatment of inhalation injury, control of burn-related infections, prevention of iatrogenic complications, and understanding the sympathetic, endocrine, and immune responses to burn injury. Most consequentially, this team was among the first to recognize and define alterations in the basal metabolic rate and thermoregulation consequent to burn injury. These investigations prompted groundbreaking insights into the coordinated nervous, autonomic, endocrine, immune, and metabolic outflows that a severely burned patient uses to remain alive and restore homeostasis. Marking his scientific consequence, many of his reports continue to bear fruit when viewed through a contemporary lens. This article summarizes some of the major findings of his career thus far and is intended to complement a Festschrift recently held in his honor.
9 citations
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TL;DR: Although it has low incidence, acute pancreatitis is associated with increased mortality in severely burned pediatric patients, which underlines the importance of increased vigilance in the evaluation and treatment of pancreatitis in burned children.
9 citations
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TL;DR: Modulation of RNS may be considered an effective adjunct therapy for septic shock, in the case of hypo-responsiveness to norepinephrine, with significant improvement in survival rate and Modified sheep organ failure assessment scores in PDC.
Abstract: Vascular hypo-responsiveness to vasopressors during septic shock is a challenging problem. This study is to test the hypothesis that reactive nitrogen species (RNS), such as peroxynitrite, are major contributing factors to vascular hypo-responsiveness in septic shock. We hypothesized that adjunct therapy with peroxynitrite decomposition catalyst (PDC) would reduce norepinephrine requirements in sepsis resuscitation. Fourteen female Merino sheep were subjected to a "two-hit" injury (smoke inhalation and endobronchial instillation of live methicillin-resistant Staphylococcus aureus [1.6-2.5 × 10 CFUs]). The animals were randomly allocated to control: injured, fluid resuscitated, and titrated norepinephrine, n = 7; or PDC: injured, fluid resuscitated, titrated norepinephrine, and treated with PDC, n = 7. One-hour postinjury, an intravenous injection of PDC (0.1 mg/kg) was followed by a continuous infusion (0.04 mg/kg/h). Titration of norepinephrine started at 0.05 mcg/kg/min based on their mean arterial pressure. All animals were mechanically ventilated and monitored in the conscious state for 24 h. The mean arterial pressure was well maintained in the PDC with significantly less norepinephrine requirement from 7 to 23 h after injury compared with control. Total norepinephrine dose, the highest norepinephrine rate, and time on norepinephrine support were also significantly lower in PDC. Modified sheep organ failure assessment scores at 6 to 18 h postinjury were significantly lower in PDC compared with control. PDC improved survival rate at 24 h (71.4% vs. 28.6%). PDC treatment had no adverse effects. In conclusion, the modulation of RNS may be considered an effective adjunct therapy for septic shock, in the case of hypo-responsiveness to norepinephrine.
9 citations
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TL;DR: Intensive physical exercise may be useful for reducing the need for contracture release in children with extensive burns when used as an adjunct therapy in postburn rehabilitation.
Abstract: BACKGROUND Intensive physical exercise (IPE) increases strength, lean body mass, aerobic capacity, and range of motion in children with extensive burns However, whether IPE decreases the frequency of burn scar contracture-releasing procedures in children with extensive burns is unknown MATERIALS AND METHODS Prospectively collected surgical records of 184 children who had undergone axilla, elbow, and/or wrist contracture-releasing procedures were reviewed All children were 7 years or older and had sustained burns of at least 40% of the total body surface area Eighty-two children completed an IPE program, and 102 children did not For both groups, the axilla, elbow, and wrist were examined for tightness and restricted movement Children with contractural difficulty were prescribed a releasing procedure Logistic regression was used to model the relationship between multiple release surgeries and group RESULTS Patients in both groups had comparable injury severity A total of 120 releases were carried out in the 82 IPE patients In contrast, 211 releases were needed in the 102 non-IPE patients An approximately 60% decrease in the frequency of rerelease operations was noted in IPE patients (125% for the IPE group and 318% for non-IPE group; P < 005) CONCLUSIONS When used as an adjunct therapy in postburn rehabilitation, IPE may be useful for reducing the need for contracture release The mechanisms underlying the beneficial effects of exercise remain undefined and should be investigated
9 citations
Authors
Showing all 250 results
Name | H-index | Papers | Citations |
---|---|---|---|
Robert R. Wolfe | 124 | 566 | 54000 |
Csaba Szabó | 123 | 958 | 61791 |
David N. Herndon | 108 | 1227 | 54888 |
Steven E. Wolf | 74 | 419 | 21329 |
Blake B. Rasmussen | 65 | 152 | 18951 |
Marc G. Jeschke | 64 | 174 | 13903 |
Daniel L. Traber | 62 | 629 | 14801 |
Nicole S. Gibran | 60 | 273 | 14304 |
Donald S. Prough | 58 | 508 | 11644 |
David L. Chinkes | 56 | 151 | 11871 |
Labros S. Sidossis | 53 | 224 | 11636 |
Robert E. Barrow | 51 | 130 | 7114 |
Ashok K. Chopra | 49 | 199 | 7568 |
James A. Carson | 49 | 157 | 7554 |
Celeste C. Finnerty | 48 | 172 | 10647 |