Shriners Hospitals for Children - Galveston

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.

Pig Model to Test Tissue-Engineered Skin.

Abstract: Tissue engineering of skin is a field with high research activities and major importance for wound healing, especially following burn injuries. Animal models enable to test tissue-engineered skin as well as different types of cells in a realistic setting. Although there are several challenges in working with pigs, it is a good model because of its similarity to the human skin and a comparable wound regeneration. Here, we explain our routinely used methods for using pig models to test tissue-engineered skin in burn injuries.

Impact of obesity on body image dissatisfaction and social integration difficulty in adolescent and young adult burn injury survivors

Abstract: Burn injury deformities and obesity have been associated with social integration difficulty and body image dissatisfaction. However, the combined effects of obesity and burn injury on social integration difficulty and body image dissatisfaction are unknown. Adolescent and young adult burn injury survivors were categorized as normal weight (n = 47) or overweight and obese (n = 21). Burn-related and anthropometric information were obtained from patients’ medical records, and validated questionnaires were used to assess the main outcomes and possible confounders. Analysis of covariance and multiple linear regressions were performed to evaluate the objectives of this study. Obese and overweight burn injury survivors did not experience increased body image dissatisfaction (12 ± 4.3 vs 13.1 ± 4.4; P = .57) or social integration difficulty (17.5 ± 6.9 vs 15.5 ± 5.7; P = .16) compared with normal weight burn injury survivors. Weight status was not a significant predictor of social integration difficulty or body image dissatisfaction (P = .19 and P = .24, respectively). However, mobility limitations predicted greater social integration difficulty (P = .005) and body image dissatisfaction (P < .001), whereas higher weight status at burn was a borderline significant predictor of body image dissatisfaction (P = .05). Obese and overweight adolescents and young adults, who sustained major burn injury as children, do not experience greater social integration difficulty and body image dissatisfaction compared with normal weight burn injury survivors. Mobility limitations and higher weight status at burn are likely more important factors affecting the long-term social integration difficulty and body image dissatisfaction of these young people. (J Burn Care Res 2013;34:102–108)

Neonate twin with staphylococcal scalded skin syndrome from a renal source.

Abstract: Objective: To understand the underlying mechanism of exfoliative toxins causing staphylococcal scalded skin syndrome or Ritter's Disease that predominantly affects newborns and infants, although it is sometimes found in adults. Staphylococcal scalded skin syndrome is typically diagnosed by the characteristic fluid-filled bullae together with superficial skin loss. A histopathological diagnosis may be made by looking for subcorneal acantholytic cleavage with minimal inflammation on biopsy, although this is not normally required. Exfoliative toxin A and B are both responsible for the “acantholytic” infection of Staphylococcus aureus as they target desmoglein-1 leading to loss of cell-to-cell cohesion and subsequent spread of infection. Other factors produced by S. aureus can cause a myriad of other problems including neutralization of antimicrobial peptides, inactivation of neutrophils, proteolysis, T-cell anergy, and immunosuppression. Design: Individual care report. Setting: Pediatric intensive care unit. Patient: We describe a normal male infant who was born at term and developed 100% total body surface area staphylococcal scalded skin syndrome on the 14th day of life with associated renal sepsis. Interventions: After cultures from the lesions, bloodstream, and urine were obtained, intravenous Vancomycin and Ceftriaxone were commenced. The initial lesions increased in size over a 36-hr period to cover the entire body surface; this was associated with a decline in hemodynamic status. Measurements and Main Results: Cultures from the urine and blood grew coagulase-positive S. aureus. An ultrasound scan revealed bilateral pyonephroses, which necessitated the placement of percutaneous nephrostomies with subsequent decompression of the collecting system. Conclusions: After the decompression hemodynamic status stabilized and over the ensuing 10 days, the patient made a full recovery with no scarring. No similar lesions were noticed on the infant's twin brother. We discuss the recent developments in understanding the underlying mechanism of exfoliative toxins causing staphylococcal scalded skin syndrome, review current treatment guidelines, and outline the need for new therapeutic options.

Time course of the inflammatory and oxidative stress response to pulmonary infection in mice

Abstract: The pathophysiological response to pulmonary infection includes a surge of proinflammatory cytokines and excessive production of nitric oxide (NO), but the time changes are not sufficiently defined The current study was designed to assess the time course of proinflammatory cytokines and NO production in a murine model of pulmonary infection The injury was induced by intranasal administration of live Pseudomonas aeruginosa (32 × 10(7) colony-forming units) in C57BL/6 wild-type mice The animals were euthanized at 3, 6, 9, 12, and 15 hours postinjury Additional mice received sham injury (0 hours; control) Lung tissue and plasma samples were harvested at the respective time points The injury induced an early increase in interleukin (IL)-1 β protein in lung tissue that persisted during the entire study period with a peak at the 9-hour time point The increases in TNF-α and IL-6 proteins in lung tissue were less intense, but showed a peak about 9 hours postinjury The plasma levels of IL-1 β and tumor necrosis factor (TNF)-α protein were not elevated during the experimental period, but only an increase in plasma levels of IL-6 plasma protein was detected These findings compensate for the limitations of previous experiments with similar infection models and improve the understanding of pathophysiologic alterations in response to pulmonary infection In addition, the identification of the time changes of the described pathogenetic factors may enhance the timing of innovate therapeutic approaches in future experiments