Burn Disease Research Articles

Burns, Sepsis and Procalcitonin

The basis of the pathogenesis of burn disease is a systemic inflammatory response syndrome with episodes of bacteremia and the development of sepsis. An analysis of the literature showed that the existing clinical diagnostic scales for sepsis do not allow a confident diagnosis. The interest in changes in the concentration of procalcitonin in the blood serum is justified by the fact that this prohormone is one of the proinflammatory mediators, the concentration of which quickly increases during local and systemic bacterial and fungal infections. It seems important to consider the possibilities of various scales for determining the criteria for sepsis, analyze the values of procalcitonin and its monitoring for more effective diagnosis and procalcitonin-controlled antibiotic therapy in patients with burns.CONCLUSION. The problem of clinical diagnosis of sepsis in patients with burns has not yet been solved. Procalcitonin is an effective biomarker of bacterial infection, and its monitoring reflects the dynamics of the burn disease, predicts the outcome, indicates the effectiveness of antibiotic therapy and allows for its correction.

Optimizing light intensity and airflow for improved lettuce growth and reduced tip burn disease in a plant factory

In practical plant factory production, light intensity and airflow were major environmental factors that significantly impacted lettuce growth and tip burn disease. This study investigated the effects of light intensity (100, 200, and 300 μmol·m-2·s-1) and airflow rate (100, 200, and 300 m³/h) on the comprehensive quality of lettuce. The Analytic Hierarchy Process (AHP) was employed to determine the weight of various growth and physiological indices of lettuce, while fuzzy mathematics principles were used to evaluate its comprehensive indices. The findings revealed that higher light intensity increased Ca2+ demand and decreased stomatal conductance, exacerbating tip burn disease. In contrast, increasing the airflow rate reduced leaf temperature, promoted transpiration, and facilitated calcium ion transport, thereby alleviating the occurrence of tip burn. Increasing the airflow rate to 300 m³/h effectively improved plant transpiration and Ca²⁺ transport, which further reduced tip burn. The comprehensive results indicated that under the conditions of a light intensity of 200 μmol·m-2·s-1 and an airflow rate of 300 m³/h, lettuce achieved the best comprehensive quality score of 0.6490, with a Ca2+ content of 21.83 mg/100 g, and tip burn was effectively suppressed. The study provided valuable scientific support for the precise control of environmental conditions in plant factories.

Experience of practical use of enterosorbents in the treatment of HIV-infected children with diarrhea syndrome

Despite advances in antiretroviral therapy (ART), diarrhea is common among people living with HIV (PLHIV) and negatively impacts quality of life. Although diarrheal diseases caused by opportunistic infections have decreased in the ART era, the overall prevalence of diarrhea remains unchanged, estimated at 28% to 60% of PLHIV.The aim of the study: to conduct a comparative assessment of the clinical efficacy of enterosorbents in the treatment of diarrheal syndrome in children with HIV infection.Materials and methods. The study material included 80 HIV-infected children who experienced acute infectious diarrhea aged 5 to 14 years. The main group included 40 children who received enterosgel, 2 times 1 tablespoon included in the traditional treatment regimen, and the control group included 40 children who received the drug lactofiltrum against the background of traditional therapy, 1 tablet 3 times a day. The duration of treatment was 10 days.Results and discussion. During the treatment of acute diarrhea in children with HIV infection with Enterosgel, a significant decrease in the daily amount and in the duration of diarrhea was observed, which leads to a noticeable loss of signs of dehydration (P<0.05). Elimination of acute diarrhea in children with HIV infection may also have eliminated the underlying intoxication syndrome due to the underlying and burning disease, which may lead to a reduction in health care costs and socioeconomic burden.Conclusion. During the treatment of acute diarrhea in children with HIV infection with Enterosgel, a decrease in the daily amount and in the duration of diarrhea is reliably observed, which leads to a significant disappearance of signs of dehydration (р<0.05).

Illusory movements for immobile patients with extensive burns (IMMOBILE): A randomized, controlled, cross-over trial

IntroductionPatients who have sustained extensive burns frequently exhibit substantial damage to skeletal muscle and associated complications. The rehabilitation of these patients can be challenging due to the nature of the injury and the subsequent complications. Nevertheless, there is a possibility that functional proprioceptive stimulation (illusory movements) may facilitate effective rehabilitation in patients with limited physiotherapy options. Nevertheless, this approach has yet to be tested in patients with burn injuries. Material and methodologyA prospective, randomised, crossover trial was conducted at a burn centre in a tertiary teaching hospital. The objective was to assess the effects of illusory movements on energy metabolism, insulin sensitivity, and skeletal muscle biology in adult critically ill patients with deep burns covering 30 % or more of the total body surface area. Two 30-minute daily sessions of functional proprioceptive stimulation were administered in addition to the standard physical therapy or physical activity regimen. Subsequently, the patients proceeded to the next stage of the trial, which involved a two-week crossover period. Measurements and main resultsDaily indirect calorimetry and calculation of nitrogen balance. Skeletal muscle biopsies from vastus lateralis for high resolution respirometry and euglycemic clamps to assess whole body glucose disposal were performed three times: at baseline and then fortnightly after each intervention period. The intervention was feasible and well tolerated in both early and late stages of burn disease. It did not change energy expenditure (mean change −33 [95 % CI: −292;+227] kcal .24 h−1, p = 0.79), nitrogen balance (+2.0 [95 % CI: −3.1;+7.1] g N .1.73 m−2 BSA .24 h−1), or insulin sensitivity (mean change of insulin-mediated glucose disposal −0.33 [95 % CI: −1.18;+0.53] mmol.h−1). At the cellular level, the intervention increased the capacity of mitochondria to synthesize ATP by aerobic phosphorylation and tended to increase mitochondrial coupling. Functional capacities of fatty acid oxidation and electron transfer chain complexes I, II, and IV were unaffected. ConclusionsCompared to physical therapy alone, two daily sessions of functional proprioceptive stimulation in addition to usual physical therapy in patients with extensive burns did not change energy expenditure, insulin sensitivity, nitrogen balance, or energy substrate oxidation. At cellular level, the intervention improved the capacity of aerobic phosphorylation in skeletal muscle mitochondria. Clinical effects remain to be demonstrated in adequately powered trials.

Pathophysiology of the gastrointestinal tract in burn disease

The review of foreign publications resulted in a generalisation of medical reports on the pathological changes of the gastrointestinal tract in burn disease. Burn disease produces an immediate reaction in all organs and systems, which are not always able to maintain homeostasis and frequently suffer pathophysiological and morphological damage. One of those target systems is the gastrointestinal tract. Only in very rare cases do severe (mainly electrical) burns cause direct injury to the abdominal cavity organs, thus resulting in a very severe clinical course and high mortality. Patients of all ages who have experienced a burn injury have an increased overall risk of developing gastrointestinal diseases, which include pathology of the esophagus, stomach, and intestines, as well as lesions of the gallbladder, biliary tract, and pancreas. With a burn area of 40—95%, 5.7% of the victims were diagnosed with pathology of the abdominal organs. Among them, 26.0% had an abdominal catastrophe (infarction or perforation), 37.0% had bleeding from the upper parts of the gastrointestinal tract, 32.0% had paralytic intestinal obstruction, and 5.0% developed pancreatitis and acute necrotizing cholecystitis. Large burns are usually associated with a significant decrease in splanchnic perfusion. After severe burns, intestinal ischemia and hypoxia disrupt the intestinal epithelial barrier and enteric bacterial translocation, leading to serious complications such as systemic inflammatory response syndrome, sepsis, and multiple organ failure. Peritonitis or gastrointestinal bleeding accounted for 88.2% of deaths among patients with gastrointestinal dysfunction. In general, gastrointestinal dysfunction was more common in patients with inhalation injuries, burn shock, large burn areas, and high analgesic requirements.

MORPHOLOGICAL CHANGES IN RAT SKIN AFTER THERMAL BURNS

Every day around the world, children and adults suffer from burn injuries. Burn injury is one of the global health problems due to its high prevalence and mortality. The skin is the largest multifunctional human organ. The area of the entire skin is on average 1.7-1.9 square meters. The skin has a wide variety of functions from protective to energy-saving and tactile. Burns have a long history, but new methods of study are needed, this is due to the increase in the frequency of burns in everyday life, production, as well as the complexity of the pathogenesis and treatment of burn disease. Pathological changes that occur in the body of burned animals lead to the fact that in the first hours with extensive burn injury, circulatory disorders occur in parenchymal organs, especially in the liver, lungs and adrenal glands. In the future, with severe intoxication, severe dystrophic processes occur in the muscles of the heart and other internal organs. Recently, the main areas of research into the pathogenesis of inflammation have become immunological, at the morphological level it has not been sufficiently studied. The article shows the morphological features of the study in thermal burns of the skin of rats during treatment with a different mechanism of action. Rats in the amount of 15 pieces were divided into 3 groups: the first control group with a burn without treatment, the second group with a thermal burn, to which levomekol gel was applied to the burn area, the third group was treated with powder from the medicinal plant yarrow Achillea millefolium L. On the 3rd, 7th, 14th, and 21st days, the rats were taken out of the experiment, after which the skin pieces were fixed in 10% formalin for further histological examination.

Features of Erythro- and Thrombopoiesis in Patients with Burn Disease, Depending on the Clinical Outcome

Features of Erythro- and Thrombopoiesis in Patients with Burn Disease, Depending on the Clinical Outcome

Kidney damage in burn disease. Part 2. Biochemical markers (literature review)

Recently discovered specific markers open up new possibilities for the diagnosis of acute kidney injury (AKI) in burn disease in order to optimize the treatment of such patients. Early diagnosis with the involvement of biomarkers prevents the sudden death of burn patients and allows predicting the course of the pathological condition. There are several characteristics that an “ideal” AKI biomarker should conform to: being non-invasive, locally specific, highly sensitive, being a stable molecule at different temperatures and pH values, having the ability to rapidly increase in response to kidney injury (quantify it), remaining at high levels during the episode and decreasing during the recovery period. There is a difference between the biomarkers that can be freely filtered in the glomerulus, so any increase in their plasma concentration (due to damage to other renal tissues) can lead to a high concentration of indicators in the urine (loss of specificity), and high-molecular-weight markers that are not freely filtered and therefore are more specific when measured in urine. Renal function in burn patients is usually determined by blood and urine tests, as biopsy can cause iatrogenic damage and is not commonly used in this cohort. After the onset of AKI, the level of biomarkers remains elevated for a certain period. None of the described indicators is monospecific for AKI; this makes estimating the time of AKI quite difficult. It has been proven that the combination of three biomarkers at two different time points in adults and the combination of two indicators at two time intervals in children allows to increase the reliability of determining AKI up to 0.78

Analysis of cases of suicide by self-immolation in the post-mortem material of the Department of Forensic Medicine in Cracow.

Analysis of self-immolation cases and distribution of the resulting burns and their degree. The study included 16 cases from the Department of Forensic Medicine, Jagiellonian University Medical College in Cracow from 2000-2022 in which the cause of death was self-immolation. Based on the analysis of photographs and autopsy reports, drawings were made showing the exact distribution and nature of the injuries, moreover, the approximate percentage of body surface area affected was determined as well as the frequency of involvement of specific areas of the body, and the presence of previous diseases and mental disorders including previous suicide attempts. 81% of victims were male. Two age groups were predominant among the cases analyzed, namely, individuals around the age of 20, and those between 50 and 60 years of age. 44% of the deceased had burns exceeding 80% of total body surface. The most frequently involved body areas were the extremities and chest as well as head and neck. Fourth-degree burns were most prevalent on the head and neck, third-degree burns prevailed on the upper and lower extremities, second-degree burns were mostly found on the chest, and first-degree burns - on the lower extremities. There were no cases of fourth-degree burns of the buttocks. 38% of the subjects had a history of substance abuse, 56% suffered from mental illnesses, whereas 31% attempted suicide in the past. The distribution of burns in self-immolation cases is inhomogeneous. The most frequently affected area was the head, neck, chest and extremities, most likely due to victims dousing themselves with a flammable substance from the top of the head through the chest. In all cases, the immediate cause of death was burn disease, regardless of the size of the body surface area affected by the burns. The majority of victims had a history of mental illness, substance abuse or suicide attempts.

Physical and Chemical Parameters in Assessment of Metabolic Profiles of Patients With B

Objective: To study catalytic properties of lactate dehydrogenase (LDH) and some physical and chemical characteristics of blood in patients with thermal injuries.Materials and methods: We examined blood samples from 24 patients with contact burns involving 10%-40% of the body surface area and studied erythrocyte LDH activity in forward and reverse reactions, kinetic characteristics of this process, and protein concentration. We used teziocrystalloscopy to evaluate crystallogenic properties of blood serum of the examined patients with thermal injuries.Results: Thermal injuries were shown to cause a 2-fold decrease in LDH activity in the reverse reaction. Analysis of crystallogenic properties of blood serum of the patients with contact burns revealed that development of a complex response to a burn injury is accompanied by a moderate decrease in the structure index and crystallizability and a signifi decrease in the clearity of the marginal protein zone. In case of burn disease, we also observed a decrease in the initiative potential of the biological fl In addition, microscope slides of the dried blood serum revealed a tendency to randomization of the sample similar to that found in crystalloscopic facies.Conclusions: The local thermal effect leading to a complex response to a burn injury was found to cause significant transformation of physical and chemical characteristics of blood. Thermal injuries cause a decrease in LDH activity in the reverse reaction leading to a disturbance of the lactate-to-pyruvate ratio in the cell and significant shifts in the blood serum composition and properties, which are manifested in a significant change in blood serum crystallogenic and initiating properties.

TREATMENT TACTICS OF CONSERVATIVE AND OPERATIVE METHODS OF TREATMENT DEPENDING ON CHANGES IN BLOOD COAGULATION FACTORS IN PATIENTS WITH DEEP BURNS

In order to increase the volume of surgery in burn units, it is necessary to improve the process of preparing burn patients for surgery. Necrectomy and autodermoplasty are observed at blood loss of 0.5-1.5 cm2/mL of wound surface. At this time, the volume of adequate infusion and hemotransfusion at all stages of burn disease is determined empirically. The existing methods of necrectomy in burns are considered to be a preparatory stage for necrectomy and autodermoplasty, the time of their performance is observed in case of such complications as bleeding, hemostasis, microcirculation disturbance, removal of the scar from the skin surface for autograft preparation leads to increased bleeding. We have developed a technique of application of polycomposite polymer based on cellulose derivatives in thermal lesions.

Phage therapy for burn wound infections in the era of antibiotic resistance

Infection of burn wounds caused by antibiotic-resistant pathogens is the leading cause of systemic infectious complications in burned patients and a key link in the pathogenesis of burn disease, causing its course and outcome. The use of phage therapy to overcome antibiotic resistance of infection agents is a promising direction, the development of which can improve the results of treatment of burned. The article discusses: 1) features of the infectious process in burned; 2) the effect of antibacterial chemotherapy of burn wound infection on the microbiome and the processes of reparative regeneration; 3) principles of phage therapy; 4) ways of delivering bacteriophages; 5) development of resistance to bacteriophages 6) personalization of phage therapy.

Regenerative Activity of the Skin and Burn Wound Healing in Adults and Children With Second Degree Burns

Improving the regenerative activity of the skin is necessary for the timely healing of burn wounds. The regenerative activity of the skin epithelium varies in patients of different ages. To investigate age-related features of the regenerative activity of the skin epithelium and healing of burn wounds in adults and children with second-degree burns and to determine the effectiveness of silver nanoparticles in the healing and treatment of burn wounds. Patients of the Osh Interregional United Clinical Hospital with second-degree burn disease were studied. A literary review of the results of modern scientific, domestic and foreign literature and clinical recommendations for burn wound regeneration was carried out. Results showed that burn wound healing occurs faster in younger patients due to the sufficient content of immune cells fibroblasts, mast cells, macrophages and antigen presenting cells that influence wound healing. Conclusions: Improvement of the treatment results of patients with local burns can be achieved through the development and implementation of new methods of wound healing local therapy using silver nanoparticles. To develop a new method of local treatment of patients with superficial I-II degree burns and evaluate its therapeutic effectiveness.

Morphine concentrations in fatalities after palliative treatment of acute burn injury

The evaluation of a morphine concentration in postmortem blood is routine for a forensic toxicologist. We here report three fatal cases where we found high morphine concentrations with 7.96, 4.30, and 5.82 mg/l in femoral blood that have to be estimated as unusually high. All these individuals died due to severe burn injuries and obtained morphine in the context of their palliative care in the last hours of their lives. According to the autopsy results, the cause of death in case 1 was burn disease with burns of about 90% of the body surface area (BSA), case 2 burn trauma, and case 3 burn shock. Besides morphine, propofol, fentanyl, sufentanil, midazolam, diazepam, lorazepam, cefazolin, and rocuronium were detected in femoral blood. The findings fitted well with the detailed clinical documentation. Further evidence of therapeutic concentrations of quetiapine, duloxetine, and melperone could be matched to preexisting medication of the individuals. Physiologically based pharmacokinetic modelling (PBPK) was applied, developed for the intravenous administration of morphine, to find an explanation for the high morphine concentrations in femoral blood. Quantification of morphine in body fluids and tissue was performed to calculate morphine tissue concentration ratios to the morphine concentration in femoral blood. The presented cases show that pharmacokinetic simulations can reflect decreased renal clearance and decreased hepatic metabolism in general. However, this prediction is not sufficient to explain the high morphine concentrations in femoral blood measured here. It can be assumed that burn shock in particular leads to altered pharmacokinetics, namely decreased distribution of morphine.

Prognostication of the development of septic complications in children with burn injuries.

Aim: To determine the prognostic criteria for the development of septic complications in children with thermal injury. Materials and Methods: A single-center retrospective-prospective cohort study included a retrospective analysis of 98 medical histories of children of different ages with severe burns who were treated from 2007 to 2017. A prospective study was conducted among children (n=63) from 1 to 5 years old, who received various degrees severity burn injury, according to an open comparative method in the period from 2018 to 2021. Results: Indicators of a high risk of developing sepsis were burns by flames of any etiology, damage severity index ≥75 units, total burn surface ≥25 %, deep burn area ≥ 5%. The threshold value of procalcitonin (PCT) ≥ 0.86 ng/ml on the 1st-3rd day and PCT > 0.51 ng/ml on the 7th day of burn disease, had a prognostic value for assessing the probability of sepsis. On the 1st day of hospitalization, the development of sepsis was predicted if the C-reactive protein (CRP) value was higher than 6.98 ng/ml, on the 3rd - the CRP level was above 7.43 ng/ml, on the 7th day - above 7.28 ng/ml. Conclusions: Based on the obtained data, we selected the criteria with the best prognostic characteristics, which allows us to predict and prevent the development of sepsis in the early stages of burn disease in children.

Kidney damage in burn disease. Part 1. Pathomorphophysiology (literature review)

Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with serious adverse outcomes, including increased length of hospital stay, development of chronic kidney disease, and increased risk of mortality. The incidence of AKI among burn patients in the intensive care units is 38 (30–46) %. A high percentage of the total burn surface area and a number of individual predisposing factors are considered to be the leading risk factors for AKI. Pathophysiological and morphological changes in the body under the combination of burn disease and kidney damage have certain discrepancies with the classical course of the pathological process in some nosological forms. Despite significant progress in the technologies of fluid resuscitation, intensive care and renal replacement therapy in recent years, the morbidity and mortality rate in such patients remain quite significant. A better understanding of clinical characteristics, early detection and prevention of risk factors for kidney damage in burns, as well as timely medical intervention can effectively reduce morbidity and progression of the pathological process, and also optimize the prognosis in the long run.

Endocrine disorders in burn disease. Literature review

The purpose of the review is to highlight clinically hidden variants of hormonal dysfunctions in burn disease, which strongly determine the peculiarities of the course of the pathological condition but are often overlooked by clinicians. Based on available literary sources, this study provides a comprehensive analysis of specialised medical reports from both domestic and foreign researchers. The focus of this analysis was on compensatory and pathological shifts in hormonal regulation of the body in individuals suffering from local heat injury. The collected scientific data is expected to be useful to practitioners in the field of combustiology in their practical activities. Damage to the endocrine glands is one of the key pathogenetic factors of local thermal injury, but the intracellular mechanisms of the influence of burn disease on these processes remain poorly understood. The criticality of burn injuries often leads to hypodiagnosis of endocrine disorders, which are indeed typical and rapidly developing. The neuroendocrine response to severe burns is a multisystem coordinated response of the body, which can not only maintain homeostasis and play a protective role in critical conditions but also cause tissue damage, realising the properties of a «double‑edged sword». Burns covering more than 40% of the total surface area of the body are accompanied by a stress reaction and hyperinflammation with a steady increase in the secretion of catecholamines, glucocorticoids, and cytokines. Classic studies confirm that a sharp post‑burn increase in stress hormones (adrenaline, norepinephrine, glucagon, and cortisol) contributes to the development of hyperglycemia, a systemic catabolic state, and multiple organ dysfunction. It has been established that the hypothalamic‑pituitary axis is responsible for fluctuations in the content of pituitary hormones in the blood serum of patients with local thermal lesions. After severe burns, the plasma renin‑angiotensin‑aldosterone system is activated, and the level of some hormones increases for more than 2 months after the injury.

A Cross-Sectional Study of Sex, Race, and Ethnic Representation in Burn Registered Clinical Trials.

The demographic proportions of plastic surgery trials approximating real-world disease have not well been studied. Judicious trial representation is essential in evaluation of treatments across diverse patient populations. Herein, we investigate sex, racial, and ethnic disparities in patient enrollment across burn trials. Cross-sectional analysis of participants enrolled in high-quality, with reduced risk of bias, randomized controlled trials (RCT) on burns registered on clinicaltrials.gov under the query "burn." Completed RCTs reporting at least two demographic groups, employing double masking or greater, and with results accessible through the registry or publications were included. Trial characteristics (sponsor country, site location, initiation year, study phase, masking) and demographic data (sex, race, ethnicity per US reporting guidelines) were collected. The Global Burden of Disease database provided sex-based burn disease burdens. The primary outcome was the population-to-prevalence ratio of enrolled female participants. Secondary outcomes included representation of racial and ethnic populations as related to study blinding, phase, and study/sponsor locations. Of 546 records, 39 trials met the inclusion criteria (2919 participants). All trials reported sex demographics, with females comprising 37.02% of all participants (PPR = 0.71, 95% CI [0.59, 0.82], likely indicating underrepresentation against their empiric disease burden). Only 7 and 9 trials reported ethnicity and race, respectively, although not comprehensively. Among trials reporting race or ethnicity, Caucasians and Black persons comprised 57.52% and 21.80% of participants, respectively, while only 9.80% had Hispanic/Latino ethnicity. Severe underreporting of race and ethnicity precluded much of secondary significance testing across study variables. Females are likely underrepresented in high-quality, US-registered burn trials, unreflective of their real-world disease burden. Further, severe underreporting of race and ethnicity was noted. Future trials should enroll diverse demographics and equitable populations for promotion of study generalizability.

RATS’ THYROID GLAND HISTOLOGICAL AND ULTRASTRUCTURAL CHANGES THROUGHOUT THE EXPERIMENTAL THERMAL INJURY DYNAMICS ON THE BACKGROUND OF HAES-LX 5 % COLLOID-HYPEROSMOLAR SOLUTION INJECTION

The urgency of the burn injury problem is determined by frequent thermal injuries of patients of different ages, the complexity and duration of treatment, long-term disability and relatively high mortality. Depending on the area and depth of the lesion, a burn wound causes multiple and long-lasting disturbances in homeostasis, which cause organs and systems dysfunction. We are interested in the intrathyroid changes that occur during thermal burns, as thyroid gland plays one of the leading roles in the endocrine regulation of organisms’ majority functions. When researching the issue of pharmacological correction of thyroid gland damage after a burn injury, we proceed from the classical fundamental concept regarding its pathogenetic validity. Taking into account the known pathogenetic mechanisms of burn disease with consecutive (and sometimes simultaneous) hypoproteinemia and haemoconcentration manifestations, intoxication formation, inflammatory and autoimmune reaction, we came to a conclusion regarding the reasonability of colloid solutions efficacy testing to attempt the pharmacocorrection in case of thyroid gland both structure and function burning. The purpose of the work is to establish histological and ultrastructural changes in the thyroid gland of experimental rats that were injected with colloidal hyperosmolar solution HAES-LX 5 % in the dynamics of skin thermal damage. Experimental studies were conducted on 90 white male rats. Skin thermal burns were simulated using four copper plates application to previously depilated lateral surfaces of the rats’ body for 10 s. Rats were injected with colloidal hyperosmolar solution HAES-LX 5 % into the vena cava inferior during the first 7 days of the post-burn period. Thyroid gland pieces were fixed in a 10 % neutral formalin solution, dehydrated in alcohols of increasing concentration and embedded in paraffin blocks. The prepared sections of 5-6 μm thickness were stained with hematoxylin-eosin. For electron microscopic studies, pieces of the thyroid gland were taken, fixed in a 2.5% glutaraldehyde solution, and postfixed with a 1% osmium tetroxide solution in a phosphate buffer. Semi-thin sections were stained with methylene blue. Ultrathin sections were contrasted with uranyl acetate, lead citrate according to the Reynolds method and studied in a PEM-125K electron microscope. Colloidal hyperosmolar solution HAES-LX 5 % administration within 7 days of the post-burn period to correct the thermal injury effects has an expressed positive effect on burned animals thyroid gland histo- and ultrastructure. A significant improvement of the structural state of the stromal and parenchymal components of the organ and their relative normalization in the late period under the influence of the applied solution was established in the dynamics of the experiment. The colloidal hyperosmolar solution HAES-LX 5 % positive effects were expressed by cellular walls of the vessels and follicles dystrophic and destructive changes reduction the structural components of the organ restoration during the entire period of the study up to the 30th day of the trial. The first signs of the intraglandular environment recovery after colloidal hyperosmolar solution HAES-LX 5 % use were proved to start registered from the 7th day of the post-burn period and were maximally expressed from the 21st day until the end of the experiment. The authors are sure that colloidal hyperosmolar HAES-LX 5 % solution protective action possible mechanism is the generalized catabolic reaction inhibition and the membrane-protective effect development. A complex of colloidal hyperosmolar solution HAES-LX 5 % protective, adaptive, adaptive, compensatory and regenerative effects were realized throughout the 30 days of the post-burn period, which efficacy exceeds the thyroid gland parenchyma and surrounding tissues destructive, decompensatory and necrotic changes. The authors consider the use of colloidal hyperosmolar solution HAES-LX 5 % to be one of the burn treatment regimen components as a restorative therapy drug and secondary cytoprotection aimed at the vascular wall and tissue defects integrity restoring.

Lecture: "First Aid to the Population in Case of Thermal Burns during Accidents, Catastrophes, Natural Disasters and Terrorist Attacks" of the Subject "Life Safety" for Humanitarian and Technical Universities

To prepare the population to provide first aid for thermal burns in emergency situations, algorithms for modern didactics of the educational topic “Thermal burns” are proposed. The following educational issues are highlighted: 1) Local exposure to high temperature. Burns. Kinds. Classification according to the depth of the lesion; 2) Rules for determining the area of burns; 3) Signs of thermal burns; 4) The concept of burn disease; 5) First (pre-hospital emergency) aid to burnt people; 6). Domestic burns from boiling water; 7) Features of burns in children; 8) Treatment of burns; 9) Prevention of thermal burns.