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Quemaduras

Iniciación de la resucitación de los quemados A primer on burn resuscitation. Bacomo FK, Chung KK. U.S. Army Institute of Surgical Research, 3400 Rawley E. Chambers Avenue, Fort Sam Houston, TX 78234, USA. J Emerg Trauma Shock. 2011 Jan;4(1):109-13. Abstract Since the early 1900s, the scope of burn resuscitation has evolved dramatically. Due to various advances in pre-hospital care and training, under-resuscitation of patients with severe burns is now relatively uncommon. Over-resuscitation, otherwise known as "fluid creep", has emerged as one of the most important problems during the initial phases of burn care over the past decade. To avoid the complications of over-resuscitation, careful hourly titration of fluid rates based on compilation of various clinical end points by a bedside provider is vital. The aim of this review is to provide a practical approach to the resuscitation of severely burned patients http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097558/?tool=pubmed   Protección temprana de las lesiones pulmonares inducidas por  quemaduras mediante supresión de Gen preprotakinina-A Early Protection from Burn-induced Acute Lung Injury by Deletion of Preprotachykinin-A Gene Selena W. S. Sio1, Shabbir Moochhala1, Jia Lu, and Madhav Bhatia1 Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and 2Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore Am J Respir Crit Care Med Vol 181. pp 36-46, 2010  Rationale: Burn-induced acute lung injury (ALI) is a common clinical disorder associated with high mortality even in the absence of inhalational injury. Identification of endogenous triggers that mediate the early onset of remote ALI after burn represents an important goal but remains poorly defined. Objectives: We investigated the role of proinflammatory neuropeptide, substance P (SP), in instigating remote ALI and its effects on respiratory function early after severe local burn injury. Methods: A 30% total body surface area full-thickness burn was induced in wild-type (WT) mice, preprotachykinin-A (PPT-A) gene deficient mice, which encodes for SP, and PPT-A2/2 mice challenged with exogenous SP, followed by ALI and lung function analysis. Measurements and Main Results: Endogenous SP production was heightened in burn-injured WT mice, which induced significant elevation of proinflammatory cytokines, chemokines, and endothelial adhesion molecules concurrent with disruption of pulmonary permeability barrier, excessive e neutrophil infiltration, and severe ALI. Additionally, decreased neutral endopeptidase and elevated matrix metalloproteinase-9 were evident. Notably, disruption of respiratory function demonstrates a critical role of SP in lungs after burn. These effects were significantly attenuated in PPT-A2/2 mice, whereas the exogenous administration of SP to PPT-A2/2 mice restored the inflammatory response and ALI. Furthermore, analysis of neurokinin-1-receptor (NK1R), to which SP binds preferentially, revealed that SP in conjunction with burn injury regulates NK1R expression. Conclusions: We show that the absence of a single endogenous factor, SP, significantly provides early protection against burninduced ALI in mice with marked improvement in respiratory function. Thereby, the blockade of SP may be beneficial in preventing early inflammation and ALI in patients with critical burn injuries. Keywords: neuropeptide; respiratory function; substance P; thermal http://ajrccm.atsjournals.org/cgi/reprint/181/1/36    Guía Básica para el Tratamiento del Paciente quemado Carlos De los Santos En el siguiente enlace puede leer una herramienta comprensiva y sencilla para encarar el manejo de los pacientes quemados. Son datos y rutinas de manejo ya bien conocidas y que fueron recopiladas en 2002. http://www.quemados.com/

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En este día..

ON THIS DAY

On This Day: August 23

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On Aug. 23, 1927, Italian-born anarchists Nicola Sacco and Bartolomeo Vanzetti were executed in Boston for the murders of two men during a 1920 robbery.

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On Aug. 23, 1912, Gene Kelly, the American dancer and choreographer, was born. Following his death on Feb. 2, 1996, his obituary appeared in The Times.

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On This Date

1754	France's King Louis XVI was born at Versailles.
1775	Britain's King George III proclaimed the American colonies in a state of open rebellion.
1926	Silent film star Rudolph Valentino died at age 31.
1927	Italian-born anarchists Nicola Sacco and Bartolomeo Vanzetti were executed in Boston for the murders of two men during a 1920 robbery.
1960	Broadway librettist Oscar Hammerstein II died at age 65.
1979	Soviet dancer Alexander Godunov defected while the Bolshoi Ballet was on tour in New York.
1989	Yusuf Hawkins, an African-American teenager, was shot dead by white youths in Brooklyn.
2000	The first season finale of the reality show "Survivor" aired on CBS, with contestant Richard Hatch winning the $1 million prize.
2003	Former Roman Catholic priest John Geoghan, a convicted child molester, was killed by a fellow inmate in a Massachusetts prison.
2005	Israeli forces evicted militant holdouts from two Jewish settlements, completing a historic withdrawal from the Gaza Strip and part of the West Bank.
2008	Democratic presidential candidate Barack Obama introduced his choice of running mate, Sen. Joe Biden of Delaware.
2010	Golfer Tiger Woods and his wife, Elin Nordegren, divorced.

Current Birthdays

Los Angeles Lakers guard Kobe Bryant turns 33 years old today.

AP Photo/Reed Saxon

Actress Marian Seldes turns 60 years old today.

AP Photo/Jonathan Short

1928	Marian Seldes, Actress, turns 83
1930	Vera Miles, Actress, turns 81
1932	Mark Russell, Comedian, turns 79
1933	Pete Wilson, Former California governor, U.S. senator, turns 78
1934	Barbara Eden, Actress ("I Dream of Jeannie"), turns 77
1934	Sonny Jurgensen, Football Hall of Famer, turns 77
1940	Richard Sanders, Actor ("WKRP in Cincinnati"), turns 71
1947	Linda Thompson, Rock singer, turns 64
1949	Shelley Long, Actress ("Cheers"), turns 62
1949	Rick Springfield, Actor, singer, turns 62
1970	Jay Mohr, Actor, turns 41

Historic Birthdays

Gene Kelly8/23/1912 - 2/2/1996American dancer, actor, choreographer and director.Go to obituary »

65	Francois Hotman 8/23/1524 - 2/12/1590 French jurist and humanist scholar
38	Louis XVI 8/23/1754 - 1/21/1793 French king; guillotined in French Revolution
62	Georges, Baron Cuvier 8/23/1769 - 5/13/1832 French zoologist and statesman
53	William Ernest Henley 8/23/1849 - 7/11/1903 English poet, critic and editor
30	Arnold Toynbee 8/23/1852 - 3/9/1883 English economist and social reformer
80	Edgar Lee Masters 8/23/1868 - 3/5/1950 American poet and novelist
85	Jack Butler Yeats 8/23/1871 - 3/28/1957 Irish painter
70	Jonathan Wainwright 8/23/1883 - 9/2/1953 American army general and World War II hero
45	Constant Lambert 8/23/1905 - 8/21/1951 English composer, conductor and critic