1
|
Daouda M, Seyram K, Amankwah GO, Seidu I, Kar A, Abubakari S, Malagutti F, Awuni S, Razak A, Apraku E, Peprah P, Lee AG, Mehta S, Jack D, Asante KP. Beyond air pollution: a national assessment of cooking-related burns in Ghana. Inj Prev 2024:ip-2023-045191. [PMID: 39107102 DOI: 10.1136/ip-2023-045191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 07/18/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Household energy transitions have the potential to reduce the burden of several health outcomes but have narrowly focused on those mediated by reduced exposure to air pollution, despite concerns about the burden of injury outcomes. Here, we aimed to describe the country-level incidence of severe cooking-related burns in Ghana and identify household-level risk factors for adults and children. METHODS We conducted a national household energy use survey including 7389 households across 370 enumeration areas in Ghana in 2020. In each household, a pretested version of the Clean Cooking Alliance Burns Surveillance Module was administered to the primary cook. We computed incidence rates of severe cooking-related burns and conducted bivariate logistic regression to identify potential risk factors. RESULTS We documented 129 severe cooking-related burns that had occurred in the previous year. The incidence rate (95% CI) of cooking-related burns among working-age females was 17 (13 to 21) per 1000 person-years or 8.5 times higher than that of working-age males. Among adults, the odds of experiencing a cooking-related burn were 2.29 (95% CI 1.02 to 5.14) and 2.40 (95% CI 1.04 to 5.55) times higher among primary wood and charcoal users respectively compared with primary liquified petroleum gas users. No child burns were documented in households where liquified petroleum gas was primarily used. CONCLUSION Using a nationally representative sample, we found that solid fuel use doubled the odds of cooking-related burns compared with liquified petroleum gas. Ghana's efforts to expand access to liquified petroleum gas should focus on safe use.
Collapse
Affiliation(s)
- Misbath Daouda
- Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Environmental Health Sciences, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Kaali Seyram
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Georgette Owusu Amankwah
- Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Iddrisu Seidu
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Abhishek Kar
- Council on Energy Environment and Water, New Delhi, India
| | - Sulemana Abubakari
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Flavio Malagutti
- University of California Santa Barbara, Santa Barbara, California, USA
| | - Sule Awuni
- Ghana Health Service, Accra, Bono East Region, Ghana
| | - Abdul Razak
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | - Edward Apraku
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sumi Mehta
- Vital Strategies, New York, New York, USA
| | - Darby Jack
- Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Divisin, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
| |
Collapse
|
2
|
Baraka SM, Kiswezi A, Olasinde AA, Edyedu I, Molen SF, Muhumuza J, Zawadi GV, Okedi FX. Role of the revised Baux score in predicting mortality among burn patients in an African low-income country: a multicentre prospective cohort. Ann Med Surg (Lond) 2024; 86:4364-4367. [PMID: 39118688 PMCID: PMC11305736 DOI: 10.1097/ms9.0000000000001774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/21/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Burn injury is a major cause of mortality. Majority of the burns occur in low and middle-income countries like Uganda. Uganda has a limited number of burn centres and medical resources, making a predictor of mortality necessary in allocation of the limited resources. Although the revised Baux (r-Baux) score has been validated and used in many high income countries, no study has assessed its role in an African low-income country; the reason this study was done. Methods This was a prospective multicentre cohort that enroled 101 burn patients with moderate and severe burns admitted in three tertiary hospitals in western Uganda. Follow-up was done until discharge, documenting mortality. A receiver operator characteristic curve was used to determine the role of r-Baux score in predicting mortality. Results This study included 101 patients, with a mean age of 21.3 (SD=16.8) years. The majority of the participants were male (69.3%). The area under the curved for r-Baux score's prediction of mortality was 0.943 (P<0.001). The most appropriate cut-off was determined to be 74.5. At this cut-off, r-Baux score predicted mortality with a sensitivity of 100% and specificity of 83.5%. After controlling for burn severity using Poisson regression, a patient with r-Baux score greater than 74.5 was 1.358 times more likely to die (adjusted risk ratio=1.358, 95% CI=1.195-1.543, P<0.001). Conclusion The r-Baux score was found to be excellent at predicting mortality among burn patients in Uganda and therefore should be done for all patients at admission, in order to predict mortality and do proper planning.
Collapse
Affiliation(s)
| | - Ahmed Kiswezi
- Faculty of Clinical Medicine and Dentistry, Department of Surgery
| | | | - Isaac Edyedu
- Faculty of Clinical Medicine and Dentistry, Department of Surgery
| | | | - Joshua Muhumuza
- Faculty of Clinical Medicine and Dentistry, Department of Surgery
| | - Gift Vulwaghe Zawadi
- Faculty of Clinical Medicine and Dentistry, Department of Pediatrics and Child Health, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | | |
Collapse
|
3
|
Yang Y, Zeng Q, Hu G, Wang Z, Chen Z, Zhou L, He A, Qian W, Luo Y, Li G. Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis. Infect Dis Ther 2024; 13:1291-1313. [PMID: 38720132 PMCID: PMC11128432 DOI: 10.1007/s40121-024-00983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION Over the past decade, numerous studies have described the types of pathogens and their antibiotic resistance patterns in patients with burn injuries in China; however, the findings have generally been inconsistent. We conducted a literature search and meta-analysis to summarize the infection spectra and antimicrobial resistance patterns in patients with burn injuries. METHODS We searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature, Wanfang, and Weipu databases for relevant articles published between January 2010 and December 2023. The DerSimonian-Laird random-effects model was used to estimate the proportions and 95% confidence intervals (CIs) of pathogens among Chinese patients with burn injuries. Meta-regression analyses were performed to explore differences in the proportions of pathogens among different subgroups and their resistance patterns. This study was registered with PROSPERO (CRD42024514386). RESULTS The database searches yielded 2017 records; after removing duplicates and conducting initial screening, 219 articles underwent full-text screening. Ultimately, 60 studies comprising a total of 62,819 isolated strains reported the proportions of pathogens in patients with burn injuries and were included in this meta-analysis. Meta-analyses were conducted on 18 types of pathogens. The most common pathogens causing infections in Chinese patients with burn injuries were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis. Similar results were observed in the subgroup analysis focusing on wound infections. Since 2015, there has been a significant decrease in the proportion of Pseudomonas aeruginosa (R2 = 4.89%) and a significant increase in the proportion of Klebsiella pneumoniae (R2 = 9.60%). In terms of antibiotic resistance, there has been a significant decrease in the resistance of Staphylococcus aureus to multiple antibiotics and an increasing trend in the resistance of Klebsiella pneumoniae. CONCLUSIONS We systematically summarized the epidemiological characteristics and antibiotic resistance patterns of pathogens among individuals suffering from burns in China, thus providing guidance for controlling wound infections and promoting optimal empirical antimicrobial therapy. The observed high levels of antibiotic resistance underscore the need for ongoing monitoring of antibiotic usage trends.
Collapse
Affiliation(s)
- Yuhui Yang
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - Qingling Zeng
- Department of Nursing, The Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China
| | - Guangyun Hu
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - Zhenkun Wang
- Center for Disease Control and Prevention of the Central Theater Command of Chinese People's Liberation Army, Beijing, 100042, China
| | - Zongyue Chen
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - Lang Zhou
- Center for Disease Control and Prevention of the Central Theater Command of Chinese People's Liberation Army, Beijing, 100042, China
| | - Aibo He
- Center for Disease Control and Prevention of the Central Theater Command of Chinese People's Liberation Army, Beijing, 100042, China
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, Chongqing, 400038, China.
| | - Yu Luo
- School of Nursing, Army Medical University, Chongqing, 400038, China.
| | - Gaoming Li
- Center for Disease Control and Prevention of the Central Theater Command of Chinese People's Liberation Army, Beijing, 100042, China.
| |
Collapse
|
4
|
Farzanbakhsh S, Shahrbaf MA, Madani H, Dahmardei M, Sadri B, Vosough M. A single-center, open-labeled, randomized, 6-month, parallel-group study to assess the safety and efficacy of allogeneic cultured keratinocyte sheet transplantation for deep second-degree burn wounds: rationale and design of phase I/II clinical trial. Trials 2024; 25:226. [PMID: 38556879 PMCID: PMC10983673 DOI: 10.1186/s13063-024-08070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/20/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Burn-related injuries are a major global health issue, causing 180,000 deaths per year. Early debridement of necrotic tissue in association with a split-thickness skin graft is usually administered for some of the 2nd- and 3rd-degree injuries. However, this approach can be complicated by factors such as a lack of proper donor sites. Artificial skin substitutes have attracted much attention for burn-related injuries. Keratinocyte sheets are one of the skin substitutes that their safety and efficacy have been reported by previous studies. METHODS Two consecutive clinical trials were designed, one of them is phase I, a non-randomized, open-label trial with 5 patients, and phase II is a randomized and open-label trial with 35 patients. A total number of 40 patients diagnosed with 2nd-degree burn injury will receive allogenic keratinocyte sheet transplantation. The safety and efficacy of allogeneic skin graft with autograft skin transplantation and conventional treatments, including Vaseline dressing and topical antibiotic, will be compared in different wounds of a single patient in phase II. After the transplantation, patients will be followed up on days 3, 7, 10, 14, 21, and 28. In the 3rd and 6th months after the transplantation scar, a wound closure assessment will be conducted based on the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. DISCUSSION This study will explain the design and rationale of a cellular-based skin substitute for the first time in Iran. In addition, this work proposes this product being registered as an off-the-shelf product for burn wound management in the country. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT) IRCT20080728001031N31, 2022-04-23 for phase I and IRCT20080728001031N36, 2024-03-15 for phase II.
Collapse
Affiliation(s)
- Shayan Farzanbakhsh
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Amin Shahrbaf
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hoda Madani
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mostafa Dahmardei
- Department of Plastic & Reconstructive Surgery, School of Medicine, Stem Cell and Regenerative Medicine Research Center, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sadri
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| |
Collapse
|
5
|
An SJ, Kayange L, Davis D, Peiffer S, Gallaher J, Charles A. Predictors of mortality following electrical and lightning injuries in Malawi: A decade of experience. Burns 2024; 50:754-759. [PMID: 37945505 PMCID: PMC10999340 DOI: 10.1016/j.burns.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/31/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Electrical injuries can be devastating, and data is lacking in low-resource settings. We aimed to identify predictors of mortality following electrical and lightning injuries (ELI) in Malawi. METHODS We performed a retrospective observational study of patients presenting with ELI and burn injuries at a tertiary hospital in Malawi from 2011 to 2020. Outcomes were compared and predictors of mortality were modeled. RESULTS A total of 382 ELI and 6371 burn patients were included. The mean ages for ELI and burn groups were 24 ± 14 and 11 ± 14 years, respectively (p < 0.01). Most patients were injured at home (91% in the burn group versus 51% in the ELI group, p < 0.01). The crude mortality rate in the ELI group was 28%, compared to 12% in the burn group (p < 0.01). On multivariate logistic regression, predictors of mortality included ELI (odds ratio [OR] 13.3, 95% confidence interval [CI] 7.2-24.5) and total body surface area burned (OR 1.1, 95% CI 1.1-1.1). Predicted mortality for ELI has increased over time (p = 0.05). CONCLUSIONS ELI confers more than 13 times higher odds of mortality than burn injuries in Malawi, with mortality risk increasing over time. More efforts are needed to prevent electrical hazards and implement timely interventions for patients with ELI.
Collapse
Affiliation(s)
- Selena J An
- Department of Surgery, University of North Carolina at Chapel Hill, 4001 Burnett Womack Building, CB 7050, Chapel Hill, NC 27599, USA
| | - Linda Kayange
- Department of Surgery, Kamuzu Central Hospital, Private Bag 149, Lilongwe, Malawi
| | - Dylane Davis
- University of North Carolina at Chapel Hill, School of Medicine, 1001 Bondurant Hall, CB 9535, Chapel Hill, NC 27599, USA
| | - Sarah Peiffer
- Baylor College of Medicine, 1 Moursund St, Houston, TX 77030, USA
| | - Jared Gallaher
- Department of Surgery, University of North Carolina at Chapel Hill, 4001 Burnett Womack Building, CB 7050, Chapel Hill, NC 27599, USA
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, 4001 Burnett Womack Building, CB 7050, Chapel Hill, NC 27599, USA; Department of Surgery, Kamuzu Central Hospital, Private Bag 149, Lilongwe, Malawi.
| |
Collapse
|
6
|
Tapking C, Willkomm L, Stolle A, Harhaus L, Hundeshagen G, Bliesener B, Kneser U, Radu CA. Health-related quality of life after burn injury due to bioethanol-fueled fireplaces. Burns 2024; 50:685-690. [PMID: 38042627 DOI: 10.1016/j.burns.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/29/2023] [Accepted: 11/12/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE Commercially available bioethanol-fueled fireplaces are a potential source of burns and are commonly used for home use. The present study aimed to evaluate the quality of life following burn injuries that were caused by bioethanol-related accidents. METHODS Burned patients who were admitted to our burn unit with burn injury due to bio-ethanol fueled fire places between January 2010 and December 2021 were contacted to ask for their willingness to participate in this study. They were asked to answer questions regarding the circumstances of the accident and three questionnaires to capture burn specific and general health related quality of life (Burn Specific Health Scale-Brief (BSHS-B), Short-Form Health Survey 36 (SF-36)) and general information about the accident. Patients were matched and compared to a group of patients suffering comparable burns from other burn mechanisms, which were also admitted to our burn unit at the same time. RESULTS Of 35 patients that met the inclusion criteria, 19 answered the questionnaire and were compared to 38 patients with other burn mechanisms. There were no statistical differences regarding age (bioethanol: 37.4 ± 14.7 years vs. control: 36.2 ± 14.3 years, p = 0.777), TBSA (9.9 ± 6.8% vs. 8.9 ± 10.4, p = 0.715), and sex (42.1% females vs. 36.8% females, p = 0.882). Most patients in the bioethanol-group reported that they did not follow the manual instructions (68.4%) and that the accident happened during the refilling process (52.6%). There was no significant difference in any subscale of the BSHS-B or the SF-36. DISCUSSION Burns related to bioethanol-fueled fireplaces are rare compared to other typical burn mechanisms. However, as they are used for personal pleasure and interior design, psychological impairment following burn may be even more critical. Detailed education on the use of these fireplaces needs to take place in order to reduce the risk of accidents.
Collapse
Affiliation(s)
- C Tapking
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - L Willkomm
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - A Stolle
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - L Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - G Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - B Bliesener
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - U Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - C A Radu
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
| |
Collapse
|
7
|
Yin B, He Y, Zhang Z, Cheng X, Bao W, Li S, Wang W, Jia C. Global burden of burns and its association with socio-economic development status, 1990-2019. Burns 2024; 50:321-374. [PMID: 38102041 DOI: 10.1016/j.burns.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/06/2023] [Accepted: 02/19/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Burns represent important global health problems. Whereas many studies are limited by the difficulties in estimating the burden of burns and instead focus on the causes of burns, such as fire, heat, and hot substances. Therefore, a complete assessment of the burden of all injuries leading to burns is essential to developing reasonable global intervention strategies. METHODS Data on three classes of burns, including "< 20 % total burned surface area without lower airway burns" (Moderate injury), "> =20 % total burned surface area or > = 10 % burned surface area if head/neck or hands/wrist involved w/o lower airway burns" (Major injury), "Lower airway burns" (Inhalation injury) were collected from the Global Burden of Disease 2019 database. Age-standardized incidence rates (ASR-I) and Years Lived with Disability (ASR-YLDs) for burns has been standardized by removing the influence of population size and age structure. They were extracted and stratified by cause, year, sex, age, socio-demographic index, country, and territory. RESULTS In terms of ASR-I and ASR-YLDs, burns showed a significant decrease from 1990 to 2019, especially for moderate and major injury. In 2019, the burden of moderate injury was positively correlated with socio-demographic index while major injury was negatively correlated (P < 0.05). We found no correlation between socio-demographic index and the burden for inhalation injury (P > 0.05). Fire, heat, and hot substances were the most important cause of burns except for inhalation injury. The most common association with inhalation injury was falls, which were also a major cause of moderate and major injury. CONCLUSIONS The Global Burden of Disease 2019 database data can be used to guide the allocation of resources to reduce ASR-I and ASR-YLDs of different burn classes.
Collapse
Affiliation(s)
- Bin Yin
- School of Medicine, Xiamen University, Xiamen, China
| | - Yan He
- School of Medicine, Xiamen University, Xiamen, China
| | - Zexin Zhang
- School of Medicine, Xiamen University, Xiamen, China
| | - Xialin Cheng
- School of Medicine, Xiamen University, Xiamen, China
| | - Wu Bao
- School of Medicine, Xiamen University, Xiamen, China
| | - Shu Li
- School of Medicine, Xiamen University, Xiamen, China
| | - Wenxuan Wang
- School of Medicine, Xiamen University, Xiamen, China
| | - Chiyu Jia
- The First Affiliated Hospital, Center of Burn & Plastic and Wound Healing Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| |
Collapse
|
8
|
Pittelli C, Tapking C, Lee JO, Suman-Vejas OE. Burns due to cooking: A potential simple solution for prevention. Burns 2024; 50:524-525. [PMID: 38097446 DOI: 10.1016/j.burns.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 02/24/2024]
Affiliation(s)
- C Pittelli
- Soldados de Amor Burn Prevention Foundation, Inc, USA
| | - C Tapking
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, University of Heidelberg, Germany
| | - J O Lee
- Soldados de Amor Burn Prevention Foundation, Inc, USA; University of Texas Medical Branch, Department of Surgery, Galveston, TX, USA; Shriners Children's Texas, Galveston, TX, USA
| | - O E Suman-Vejas
- Soldados de Amor Burn Prevention Foundation, Inc, USA; University of Texas Medical Branch, Department of Surgery, Galveston, TX, USA.
| |
Collapse
|
9
|
Du AL, Yao PY, Gabriel RA, Shaw SJ. Association of race and ethnicity with pediatric burn outcomes: A population study of the Kids' Inpatient Database. Burns 2024; 50:244-251. [PMID: 37690963 DOI: 10.1016/j.burns.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/27/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND While most studies on burn outcomes have focused on adults, it is unclear if the same socioeconomic and environmental inequalities affect paediatric patients. This study aims to investigate the impact of race and ethnicity on outcomes in paediatric burn patients. METHODS The Kids' Inpatient Database is released by Agency for Healthcare Research and Quality, and is the largest publicly available database for the United States inpatient paediatric population. All paediatric burned patients in 2016 and 2019 were identified. Race and/or ethnicity was the primary exposure variable, and the primary outcome was a composite of several in-hospital morbidities. Secondary outcomes included death, non-routine disposition, and length of stay. Fine-Gray competing risks regression and multivariable logistic regression were used to analyze length of stay and all other outcomes, respectively. Analysis also isolated subgroups related to socioeconomic status and case severity. RESULTS We included12,582 pediatric burn patients in this study. No difference was found in composite morbidity between White patients and those of other race or ethnicity groups. Hispanic ethnicity was associated with longer lengths of stay and increased odds of routine (i.e. home) discharge. Black patients had increased length of stay compared to White patients only in severe burn cases. CONCLUSIONS Our study implies that race- or ethnicity-associated mechanisms driving outcome disparities in adults does not necessarily apply in paediatric burn patients.
Collapse
Affiliation(s)
- Austin L Du
- School of Medicine, University of California, San Diego, La Jolla, CA, USA; Department of Anesthesiology, Division of Perioperative Informatics, University of California, San Diego, La Jolla, CA, USA.
| | - Phil Y Yao
- Department of Anesthesiology, Division of Perioperative Informatics, University of California, San Diego, La Jolla, CA, USA
| | - Rodney A Gabriel
- Department of Anesthesiology, Division of Perioperative Informatics, University of California, San Diego, La Jolla, CA, USA; Department of Medicine, Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA, USA
| | - Susanna J Shaw
- Department of Anesthesiology, Division of Perioperative Informatics, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
10
|
Bhaumik S, Ryder C, Ivers RQ. Strengthening diversity, inclusiveness and justice in the injury community. Inj Prev 2024; 30:3-4. [PMID: 38272703 DOI: 10.1136/ip-2023-045165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 01/27/2024]
Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health India, New Delhi, Delhi, India
| | - Courtney Ryder
- Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Flinders University, Adelaide, South Australia, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
11
|
Yan Z, Li S, Gong Z. Bisacurone gel ameliorated burn wounds in experimental rats via its anti-inflammatory, antioxidant, and angiogenic properties. Acta Cir Bras 2023; 38:e382423. [PMID: 37610964 PMCID: PMC10443232 DOI: 10.1590/acb382423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/26/2023] [Indexed: 08/25/2023] Open
Abstract
PURPOSE To investigate putative mechanism of wound healing for chitosan-based bisacurone gel against secondary burn wounds in rats. METHODS A second-degree burn wound with an open flame using mixed fuel (2 mL, 20 seconds) was induced in Sprague Dawley rats (male, 180-220 g, n = 15, each) followed by topical treatments with either vehicle control (white petroleum gel, 1%), silver sulfadiazine (1%) or bisacurone gel (2.5, 5, or 10%) for 20 days. Wound contraction rate and paw withdrawal threshold were monitored on various days. Oxidative stress (superoxide dismutase, glutathione, malondialdehyde, and nitric oxide), pro-inflammatory cytokines (tumour necrosis factor-alpha, interleukins by enzyme-linked immunosorbent assay), growth factors (transforming growth factor-β, vascular endothelial growth factor C using real time polymerase chain reaction and Western blot assay) levels, and histology of wound skin were assessed at the end. RESULTS Bisacurone gel showed 98.72% drug release with a 420.90-442.70 cps viscosity. Bisacurone gel (5 and 10%) significantly (p < 0.05) improved wound contraction rate and paw withdrawal threshold. Bisacurone gel attenuated oxidative stress, pro-inflammatory cytokines, and water content. It also enhanced angiogenesis (hydroxyproline and growth factor) and granulation in wound tissue than vehicle control. CONCLUSIONS These findings suggested that bisacurone gel can be a potential candidate to treat burn wounds via its anti-inflammatory, antioxidant, and angiogenic properties.
Collapse
Affiliation(s)
- Zengqiang Yan
- Inner Mongolia Baogang Hospital – Department of Burns Surgery – Baotou, Inner Mongolia, China
| | - Shuyan Li
- Inner Mongolia Tongliao Mental Health Center – Department of Cardiology – Tongliao, Inner Mongolia, China
| | - Zhenzhong Gong
- Fifth Hospital of Harbin City – Department of Burns – Harbin, Heilongjiang Province, China
| |
Collapse
|
12
|
Lindert J, Bbaale D, Mohr C, Chamania S, Bandyopadhyay S, Boettcher J, Katabogama JB, Alliance BW, Elrod J. State of burns management in Africa: Challenges and solutions. Burns 2023; 49:1028-1038. [PMID: 36759220 DOI: 10.1016/j.burns.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Understand the availability of human resources, infrastructure and medical equipment and perceived improvement helps to address interventions to improve burn care. METHODS Online survey covering human resources, infrastructure, and medical equipment of burn centers as well as perceived challenges and points for improvement. The survey was distributed in English and French via snowball method. Descriptive statistics and AI-based technique random forest analysis was applied to identify determinants for a reduction of the reported mortality rate. RESULTS 271 questionnaires from 237 cities in 40 African countries were analyzed. 222 (81.9 %) from countries with a very low Human Development Index (HDI) (4th quartile). The majority (154, 56.8 %) of all responses were from tertiary health care facilities. In only 18.8 % (n = 51) therapy was free of charge for the patients. The majority (n = 131, 48.3 %) had between 1 and 3 specialist doctors (n = 131, 48.3 %), 1 to 3 general doctors (n = 138, 50.9 %) and more than 4 nurses (n = 175, 64.6 %). A separate burn ward was available in 94 (34.7 %) centers. Regular skin grafting was performed in 165 (39.1 %) centers. Random forest-based analysis revealed a significant association between HDI (feature importance: 0.38) and mortality. The most important reason for poor outcome was perceived late presentation (212 institutions, 78.2 %). The greatest perceived potential for improvement was introduction of intensive care units (229 institutions, 84.5 %), and prevention or education (227 institutions, 83.7 %). INTERPRETATION A variety of factors, including a low HDI, delayed hospital presentation e.g. due to prior care by non-physicians and lack of equipment seem to worsen the outcome. Introduction of an intensive care unit and communal education are perceived to be important steps in improving health care in burns.
Collapse
Affiliation(s)
- Judith Lindert
- Department of Pediatric Surgery, University Hospital Rostock, Ernst-Heydemann Str 8, 18057 Rostock, Germany; German Society of Global and Tropical Surgery e.V., Germany
| | - Dorothy Bbaale
- Department of Surgery, International Hospital Kampala, Plot 4686 Barnabas Rd, Kampala, Uganda; CURE International, 70 Ionia Ave SW, Suite 200, Grand Rapids, MI 49503, United States
| | - Christoph Mohr
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Shobha Chamania
- Choithram Hospital and Research Centre, 14, Manik Bagh Rd, Indore, India
| | - Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Headington, Oxford OX3 9DU, United Kingdom
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | | | - Bisimwa Wani Alliance
- Provincial General Reference Hospital of Bukavu, 02, avenue Michombero/Commune de Kadutu, Bukavu, Democratic Republic of the Congo
| | - Julia Elrod
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| |
Collapse
|
13
|
Muacevic A, Adler JR. Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast. Cureus 2022; 14:e32842. [PMID: 36570107 PMCID: PMC9779910 DOI: 10.7759/cureus.32842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background The cardinal area of managing fire wounds is guided by adequately evaluating the burn-induced lesion's profundity and size. Superficial second-degree burns are often treated through daily reinstating with fresh sterile bandaging with appropriate topical antimicrobials to allow rapid spontaneous epithelialization. Around the world, a wide variety of substances are used to treat these wounds, from honey to synthetic biological dressings. Objective This study intended to determine honey's therapeutic potential compared with 1% silver sulfadiazine (Ag-SD) in arsenal-caused contusion medicament fulfillment. Methods A total of 70 cases were evaluated in this research work after fulfilling the required selection criteria during the study period of January 2014 to December 2014 and January 2017 to December 2017. Purposive selection criteria were adopted in the study to select research patients. The patients in Group-1 (n = 35) relied on honey as medication, while patients in Group-2 (n = 35) relied on 1% Ag-SD. Results In Group-1, exudation (68.4%) and sloughing (82.9%) were substantially reduced by Days 3 and 5 of therapeutic intervention, respectively. However, in Group-2, a reduction of exudation (17.1%) and sloughing (22.9%) occurred after Days 3 and 5 of treatment, respectively. Completion of the epithelialization process was observed among Group-1 and Group-2 cases. It was detected after Days 7 and 10 of treatment at 36.3% and 77% (Group-1) and 27% and 67% (Group-2), respectively. Around 3 ml of 1% honey was required per body surface area per dressing in Group-1. On the other hand, in Group-2, 2 gm Ag-SD was needed per body surface area per dressing. Conclusion Patients treated with honey found better clinical outcomes in managing superficial partial-thickness burns.
Collapse
|
14
|
Gallaher J, Abid M, Kayange L, Purcell L, Charles A. The effect of COVID-19 on burn management and outcomes in a resource-limited setting. Burns 2022; 48:1584-1589. [PMID: 36038452 PMCID: PMC9375248 DOI: 10.1016/j.burns.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
Introduction Optimal burn care includes fluid resuscitation and early excision and grafting. During the COVID-19 pandemic, resource-constrained environments were susceptible to interruptions in burn care. We sought to characterize pre- and intra-pandemic burn-associated outcomes at a busy tertiary hospital in Malawi. Methods This is a retrospective analysis of burn patients that presented to Kamuzu Central Hospital Lilongwe from 2011 through December 2021. We compared patients based on whether they presented pre- or intra-pandemic, starting on March 11, 2020, the date of official WHO designation. Comparing these cohorts, we used modified Poisson modeling to estimate the adjusted risk of undergoing an operation and the risk of death. Results We included 2969 patients, with 390 presenting during the pandemic. Patient factors were similar between the cohorts. More patients underwent surgery pre-pandemic (21.1 vs 10.3 %, p < 0.001) but crude mortality was similar at 17.3 % vs. 21.2 % (p = 0.08). The RR of undergoing surgery during the pandemic was 0.45 (95 % CI 0.32, 0.64) adjusted for age, sex, % TBSA, flame burns, and time to presentation. During the pandemic, the risk ratio for in-hospital mortality was 1.23 (95 % CI 1.01, 1.50) adjusted for age, sex, % TBSA, surgical intervention, flame burns, and time to presentation. Conclusions During the pandemic, the probability of undergoing burn excision or grafting was significantly lower for patients, independent of the severity. Consequently, the adjusted risk of mortality was higher. To improve patient outcomes, efforts to preserve operative capacity for burn patients during periods of severe resource constraint are imperative.
Collapse
Affiliation(s)
- Jared Gallaher
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Mustafa Abid
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Linda Kayange
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Laura Purcell
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Anthony Charles
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
| |
Collapse
|
15
|
Fan Y, Jin G, Pan Y, Cui S, Li J, Huang N. The Trend of Burn Injury Patients in Ningbo between 2012 and 2021: A Clinical Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9969158. [PMID: 35990832 PMCID: PMC9391097 DOI: 10.1155/2022/9969158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was designed to understand the local changes of burn injuries in recent 10 years, so as to provide reliable reference data and viewpoints for prevention and vigilance of local burn injuries. Methods In this study, 184 patients with a burn injury admitted to our hospital from 2012 to 2021 were enrolled and analyzed retrospectively. According to their information in the electronic database, the number of patients with burn injuries and the location of each disaster each year were analyzed, and the age, sex, hospital stay and hospitalization expense of each patient were collected. With 5 years as the boundary, the patients were divided into a 2012-2016 group and a 2017-2021 group and the differences of the two groups in the abovementioned aspects were compared. Results During 2012-2021, the incidence rate of burn injuries in men was higher than that in women and workplaces had a higher burn injury rate than residents' homes. Compared with the period of 2012-2016, the number of fires or explosions and the number of patients with a burn injury during 2017-2028 both increased, but there was no significant change in disaster location, male-female ratio, age, average hospital stay, and average hospitalization expense. Conclusion In the face of the increasing prevalence of burn injuries, we should strengthen fire-fighting knowledge-related education and fire prevention management and actively explore post-burn injury treatment strategies and potential treatment targets to promote the development of burn injury management and treatment strategies.
Collapse
Affiliation(s)
- Youfen Fan
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| | - Guoying Jin
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| | - Yanyan Pan
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| | - Shengyong Cui
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| | - Jiliang Li
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| | - Neng Huang
- Burn Department, HwaMei Hospital, University of Chinese Academy of Sciences, No. 41 Northwest Street, Haishu District, Ningbo 315010, Zhejiang Province, China
| |
Collapse
|
16
|
Abedin M, Rahman FN, Rakhshanda S, Mashreky SR, Rahman AKMF, Hossain A. Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001412. [PMID: 36053615 PMCID: PMC9198699 DOI: 10.1136/bmjpo-2022-001412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Burn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the disability-adjusted life-years are lost from fire-related burns in children. In Bangladesh, there is a scarcity of data on childhood burn injuries. The goal of the study was to describe the epidemiology of non-fatal burns in Bangladeshi children, including incidence estimates and identify high-risk groups. METHODS Bangladesh Health and Injury Survey 2016 was a large scale cross-sectional survey. The survey was conducted among 299 216 population utilising a multistage cluster sampling method. Among the 100 842 children, there were 437 non-fatal burn cases. RESULTS Among different injury mechanisms in children, burn was ranked fifth (7.4%). The overall yearly incidence rate (IR) of burns was 866.7 per 100 000 children (95% CI 785.6 to 947.8) in Bangladesh. The incidence was highest among 1-4 years old children (IR 2028.3, 95% CI 1761.1 to 2334.7) and had a 3.5 times higher risk of burns compared with the 15-17 years age group. Females had a much higher IR of non-fatal burns than males between the ages of 10-15 years (1655.2 vs 482.2). About 70% of burns occurred in rural areas. Hot liquid (44.7%), flames (32.5%) and hot objects (20.7%) were identified as the main causes of burns. The kitchen (60.9%), yards (20.8%) and bedroom and living room (10.5%) were the three most common places for burns. According to the study, 34.8% of burn incidences occurred between the hours of 7:00 and 10:00. CONCLUSION Children in Bangladesh suffer from a high rate of non-fatal burns. The high-risk category was identified as preschool-aged boys and adolescent girls. The majority of the incidents occurred in the morning and inside the kitchen. These findings will help raise awareness and create intervention measures to reduce the high incidence of non-fatal childhood burns in Bangladesh.
Collapse
Affiliation(s)
- Minhazul Abedin
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Farah Naz Rahman
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Shagoofa Rakhshanda
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- NCD and Mental Health Division, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.,Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - A K M Fazlur Rahman
- Office of Executive Director, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.,Department of Epidemiology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh.,Global Health Institute, North South University, Dhaka, Bangladesh
| |
Collapse
|
17
|
Cai W, Shen K, Ji P, Jia Y, Han S, Zhang W, Hu X, Yang X, Han J, Hu D. The Notch pathway attenuates burn-induced acute lung injury in rats by repressing reactive oxygen species. BURNS & TRAUMA 2022; 10:tkac008. [PMID: 35441079 PMCID: PMC9014447 DOI: 10.1093/burnst/tkac008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/02/2022] [Indexed: 12/21/2022]
Abstract
Background Acute lung injury (ALI) is a common complication following severe burns. The underlying mechanisms of ALI are incompletely understood; thus, available treatments are not sufficient to repair the lung tissue after ALI. Methods To investigate the relationship between the Notch pathway and burn-induced lung injury, we established a rat burn injury model by scalding and verified lung injury via lung injury evaluations, including hematoxylin and eosin (H&E) staining, lung injury scoring, bronchoalveolar lavage fluid and wet/dry ratio analyses, myeloperoxidase immunohistochemical staining and reactive oxygen species (ROS) accumulation analysis. To explore whether burn injury affects Notch1 expression, we detected the expression of Notch1 and Hes1 after burn injury. Then, we extracted pulmonary microvascular endothelial cells (PMVECs) and conducted Notch pathway inhibition and activation experiments, via a γ-secretase inhibitor (GSI) and OP9-DLL1 coculture, respectively, to verify the regulatory effect of the Notch pathway on ROS accumulation and apoptosis in burn-serum-stimulated PMVECs. To investigate the regulatory effect of the Notch pathway on ROS accumulation, we detected the expression of oxidative-stress-related molecules such as superoxide dismutase, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) 2, NOX4 and cleaved caspase-3. NOX4-specific small interfering RNA (siRNA) and the inhibitor GKT137831 were used to verify the regulatory effect of the Notch pathway on ROS via NOX4. Results We successfully established a burn model and revealed that lung injury, excessive ROS accumulation and an inflammatory response occurred. Notch1 detection showed that the expression of Notch1 was significantly increased after burn injury. In PMVECs challenged with burn serum, ROS and cell death were elevated. Moreover, when the Notch pathway was suppressed by GSI, ROS and cell apoptosis levels were significantly increased. Conversely, these parameters were reduced when the Notch pathway was activated by OP9-DLL1. Mechanistically, the inhibition of NOX4 by siRNA and GKT137831 showed that the Notch pathway reduced ROS production and cell apoptosis by downregulating the expression of NOX4 in PMVECs. Conclusions The Notch pathway reduced ROS production and apoptosis by downregulating the expression of NOX4 in burn-stimulated PMVECs. The Notch-NOX4 pathway may be a novel therapeutic target to treat burn-induced ALI.
Collapse
Affiliation(s)
- Weixia Cai
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Kuo Shen
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Peng Ji
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Yanhui Jia
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Shichao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Wanfu Zhang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Xiaolong Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Xuekang Yang
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Juntao Han
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| |
Collapse
|