Johns Hopkins Burn Center

Baltimore, MD, United States

Johns Hopkins Burn Center

Baltimore, MD, United States
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PubMed | Loyola University, Johns Hopkins Burn Center, Arizona Burn Center, University of Utah and 3 more.
Type: | Journal: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition | Year: 2016

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe exfoliative diseases treated in burn centers due to large skin losses. Literature on SJS/TEN refers to parenteral nutrition (PN) as the preferred route of nutrition support. This study describes nutrition support interventions in SJS/TEN patients admitted to burn centers.Seven burn centers participated in this Institutional Review Board-exempted retrospective chart review of adults with SJS/TEN admitted from 2000-2012.This analysis included 171 patients with SJS/TEN. Median total body surface area involvement was 35% (n = 145; interquartile range [IQR], 16%-62%). The majority required mechanical ventilation (n = 105). Based on indirect calorimetry, measured energy needs were 24.2 kcal/kg of admit weight (n = 58; IQR, 19.4-29.9). Thirty-one patients did not require enteral nutrition (EN) and started oral intake on hospital day 1 (IQR, 1-2), and 81% required EN support due to inadequate oral intake and remained on EN until day 16 (median hospital day, 16; IQR, 9-25). High-protein enteral formulas predominated. PN was rarely used (n = 12, 7%). Most patients were discharged home (57%), with 14% still requiring EN.Nutrition support should be considered in patients with SJS/TEN due to increased metabolic needs and an inability to meet these needs orally. Most SJS/TEN patients continued on EN and did not require escalation to PN.

News Article | December 14, 2016

SOUTH PLAINFIELD, NJ--(Marketwired - Dec 14, 2016) - Following Majesco Entertainment, Inc.'s ( : COOL) ("Majesco") announcement on 12/8/16 that it had signed a definitive merger agreement with PolarityTE™, Inc. ("Polarity"), Polarity has revealed the first wave of their World Class Clinical Advisory Board, as Drs. Michael Grant, Stephen Milner, and Anand Kumar. Chairman and CEO, Denver Lough MD, PhD elaborated, "Our goal is to build an entirely new type of regenerative medicine company with PolarityTE™. The PolarityTE™ Clinical Advisory Board will play a critical role in translating our regenerative technology into pragmatic clinical practice, helping us address the realities of the field on a real-time basis. It is this tangible feedback that allows PolarityTE™ technology to evolve quickly under the guidance of thought leaders in reconstructive surgery and regenerative medicine, while permitting our platform to break into new markets and develop new integrative technologies. We are extremely excited to announce the first tier of our world class clinical advisory board" as: Michael P Grant MD, PhD, FACS Paul N. Manson Distinguished Professor and Chief Plastic, Reconstructive and Maxillofacial Surgery R Adams Cowley Shock Trauma Center University of Maryland Medical Center Stephen Milner MD, DDS, DSc, FRCSE, FACS Professor of Plastic and Reconstructive Surgery and Pediatrics at Johns Hopkins School of Medicine, Director of the Johns Hopkins Burn Center, Professor at the Bloomberg School of Public Health, Director of the Michael D Hendrix Burn Research Center, Adjunct Professor Uniformed Services University of the Health Sciences, Honorary Civilian Consultant Advisor to the British Army in Plastic Surgery and Burns Anand Kumar MD, FACS Associate Professor of Plastic and Reconstructive Surgery Director, Center for Pediatric Craniofacial Surgery Johns Hopkins School of Medicine About PolarityTE PolarityTE, Inc. is the owner of a novel regenerative medicine and tissue engineering platform developed and patented by Denver Lough MD, PhD. This radical and proprietary technology employs a patients' own cells for the healing of full-thickness functionally-polarized tissues. If clinically successful, the PolarityTE platform will be able to provide medical professionals with a truly new paradigm in wound healing and reconstructive surgery by utilizing a patient's own tissue substrates for the regeneration of skin, bone, muscle, cartilage, fat, blood vessels and nerves. It is because PolarityTE uses a natural and biologically sound platform technology, which is readily adaptable to a wide spectrum of organ and tissue systems, that the company and its world-renowned clinical advisory board, are poised to drastically change the field and future of translational regenerative medicine. More info can be found online at Welcome to the Shift™ Forward Looking Statements Certain statements contained in this release are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Forward looking statements contained in this release relate to, among other things, the Company's ongoing compliance with the requirements of The NASDAQ Stock Market and the Company's ability to maintain the closing bid price requirements of The NASDAQ Stock Market on a post reverse split basis. They are generally identified by words such as "believes," "may," "expects," "anticipates," "should'" and similar expressions. Readers should not place undue reliance on such forward-looking statements, which are based upon the Company's beliefs and assumptions as of the date of this release. The Company's actual results could differ materially due to risk factors and other items described in more detail in the "Risk Factors" section of the Company's Annual Reports filed with the SEC (copies of which may be obtained at Subsequent events and developments may cause these forward-looking statements to change. The Company specifically disclaims any obligation or intention to update or revise these forward-looking statements as a result of changed events or circumstances that occur after the date of this release, except as required by applicable law.

Blome-Eberwein S.,Lehigh Valley Hospital | Johnson R.M.,Miami Valley Hospital Burn Center | Miller S.F.,Miami Valley Hospital Burn Center | Caruso D.M.,Arizona Burn Center | And 5 more authors.
Burns | Year: 2010

Background: This randomized, open-label study evaluated Aquacel Ag® Hydrofiber® dressing with silver (HDS; ConvaTec, Skillman, NJ, USA) with an adherent or gelled protocol in the management of split-thickness donor sites. Methods: HDS was the primary dressing in the adherent group (gauze as secondary covering) and gelled group (transparent film as secondary covering). Dressings were changed on study day 1 or 2 and study days 5 (optional), 10 (optional), and 14. The primary outcome was healing (≥90% re-epithelialization) at study day 14. Results: Seventy subjects were treated (36 adherent, 34 gelled). By study day 14, 77% of donor sites had healed (67% adherent, 88% gelled). Pain scores decreased over time in both treatment groups. Investigators were "very satisfied" or "satisfied" with (adherent, gelled) time required to manage dressing change (89%, 79% of subjects), minimization of donor-site pain (64%, 82%), ease of application (97%, 94%), management of drainage (92%, 82%), ease of removal (77%, 85%), and ability of dressing to remain in place (69%, 76%). Thirty-nine (56%) subjects had adverse events, most commonly non-donor-site infection (11%) and gastrointestinal events (11%). Conclusion: In this randomized, open-label study, HDS was well-tolerated, versatile, and effective in the management of split-thickness donor sites. © 2009 Elsevier Ltd and ISBI.

Andrikopoulou E.,Johns Hopkins University | Andrikopoulou E.,Johns Hopkins Burn Center | Zhang X.,Johns Hopkins University | Zhang X.,Johns Hopkins Burn Center | And 10 more authors.
Current Molecular Medicine | Year: 2011

Hypoxia Inducible Factor-1 (HIF-1) is considered the major coordinator of the cellular adaptive response to hypoxia. Over recent years, its activity in the context of wound healing has been the object of increasing investigation. On the molecular level, HIF-1 transcriptional target products have been shown to regulate the process of endothelial cell survival, migration and proliferation (VEGF, ANGPT-1, ANGPT-2, ANGPT-4, FGF-2, PlGF, PDGF-B, RGC-32), vascular smooth muscle cell migration and proliferation (FGF-2, EGF, PDGF, thrombospondin) and mobilization of Circulating Angiogenic Cells to the periphery (SFD-1/CXCR4). Studies on the effect of HIF-1 on the expression and activity of extracellular cell matrix modifying enzymes, such as MMPs and prolidase, have been conducted in the context of tumor angiogenesis and metastasis, and have resulted in controversial findings. A growing body of evidence suggests that HIF-1 also affects reepithelialization of the wound bed, through increasing keratinocyte migration, but decreasing their proliferation. Diminished HIF-1 levels and activity have been documented in conditions of impaired wound healing, such as wound healing in aged and in diabetic mice. The increasing number of studies on the role of HIF-1 in wound healing, apart from answering certain questions, has also raised an equal number, if not more. Clarifying the topics that still remain unclear could introduce a new era of HIF-1 targeted management of a wide range of problematic wounds. © 2011 Bentham Science Publishers Ltd.

Curinga G.,Civico and Benfratelli Hospital | Jain A.,Johns Hopkins University | Feldman M.,Johns Hopkins Burn Center | Prosciak M.,Johns Hopkins Burn Center | And 2 more authors.
Burns | Year: 2011

A severe burn will significantly alter haematologic parameters, and manifest as anaemia, which is commonly found in patients with greater than 10% total body surface area (TBSA) involvement. Maintaining haemoglobin and haematocrit levels with blood transfusion has been the gold standard for the treatment of anaemia for many years. While there is no consensus on when to transfuse, an increasing number of authors have expressed that less blood products should be transfused. Current transfusion protocols use a specific level of haemoglobin or haematocrit, which dictates when to transfuse packed red blood cells (PRBCs). This level is known as the trigger. There is no one 'common trigger' as values range from 6 g dl-1 to 8 g dl-1 of haemoglobin. The aim of this study was to analyse the current status of red blood cell (RBC) transfusions in the treatment of burn patients, and address new information regarding burn and blood transfusion management. Analysis of existing transfusion literature confirms that individual burn centres transfuse at a lower trigger than in previous years. The quest for a universal transfusion trigger should be abandoned. All RBC transfusions should be tailored to the patient's blood volume status, acuity of blood loss and ongoing perfusion requirements. We also focus on the prevention of unnecessary transfusion as well as techniques to minimise blood loss, optimise red cell production and determine when transfusion is appropriate. © 2011 Elsevier Ltd and ISBI. All rights reserved.

Klein M.B.,University of Washington | Lezotte D.C.,University of Colorado at Denver | Heltshe S.,University of Colorado at Denver | Fauerbach J.,Johns Hopkins Burn Center | And 4 more authors.
Journal of Burn Care and Research | Year: 2011

A number of factors increase the susceptibility of older adults to burn injury. The majority of studies of older adults have focused on patient and injury factors related to mortality risk. However, little is known about the long-term functional and psychological outcomes of older adults after severe burn. The purpose of this study is to examine the long-term outcomes of older adults after burn injury. The authors performed an analysis of the outcomes of older adults (age 55 years or older) enrolled in a prospective study of burn injury outcomes. Change in living situation as well as distress, functional impairment, and quality of life were examined at discharge and at 6, 12, and 24 months after hospital discharge. Mixed effects modeling was performed to compare differences across age groups and time as well as to account for missing data. A total of 737 patients aged 55 years or older were enrolled and followed in the National Institute on Disability and Rehabilitation Research burn program. Patients in all age groups had significant deficits in Short Form-36, Functional Independence Measure, and Brief Symptom Inventory scores at time of discharge. Recovery of physical and psychosocial functioning was greatest from discharge to 6 months in patients aged 55 to 74 years and greatest at 1 year for patients aged 75 years or older. This study confirms that severe burn injury significantly impacts both functional outcome and psychosocial quality of life in older adults. However, the impact seems to be age related as are recovery trajectories. Rehabilitation programs lasting up to 1 year after injury could be of tremendous benefit in helping older adults achieve maximal potential recovery. Copyright © 2011 by the American Burn Association.

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