Thermal Trauma Research Articles

Dynamics of Burn Wound Healing in Children: Dependence on Anthropometric Parameters

Thermal trauma among pediatric patients has remained the leading cause of hospitalization in pediatric surgery departments in recent decades. Anthropometric parameters are often used by doctors when performing a comprehensive assessment of the child's physical development, and can also be used as essential factors in predicting the course of the disease. The aim of the study was to assess the dynamics of burn wound healing and its relationship with anthropometric parameters in individuals of the first period of childhood. Material and methods. The study involved investigation of the wound healing process in 125 male children, aged 4–6, having different levels of physical development. The patients' height, body weight (with calculation of the body mass index), head, chest and waist circumferences were measured on the day of admission using a standard set of anthropometric instruments, the WHtR index (waist to height ratio), and the head to chest ratio was calculated. Based on the BMI parameters, patients were divided into two groups: with normal weight and overweight. The wound area was measured on the 1st, 3rd, 5th, 7th and 9th days using the stereometric technique, applying a polyethylene antiseptic-processed film to the wound surface; this followed by outlining the edges of the wound defect. The results were processed using nonparametric statistics. Results It was found that in overweight patients, all the studied parameters, except for the ratio of head circumference to chest circumference, were higher than in children with the normal body weight. Correlations were detected between a number of anthropometric parameters in patients of both groups. On the 7th day, 73.9% of children with the normal body weight demonstrated epithelialization of the wound defect over the entire surface area of the wound, while in overweight children this was observed only in 34% of cases. Conclusion. As demonstrated, we obtained anthropometric measurements in boys of the first period of childhood having normal and overweight body weight. In children with the normal body weight, the process of wound epithelialization was completed mainly on the 7th day, while in patients with excess body weight, the wound defect closed by the 9th day. Excess body weight in children has a statistically significant relationship with an increased healing time of burn wounds.

Thermal Evaluation of Bone Drilling: Assessing Drill Bits and Sequential Drilling.

Sequential drilling is a common practice in dental implant surgery aimed at minimizing thermal damage to bone. This study evaluates the thermal effects of sequential drilling and assesses modifications to drilling protocols to manage heat generation. We utilized a custom drill press and artificial bone models to test five drill bits under various protocols, including sequential drilling with different loads, spindle speeds, and peck drilling. Infrared thermography recorded temperature changes during the drilling process, with temperatures monitored at various depths around the osteotomy. The results reveal sequential drilling does not eliminate the thermal damage zone it creates (well over 70 °C). It creates harmful heat to surrounding bone that can spread up to 10 mm from the osteotomy. The first drill used in sequential drilling produces the highest temperatures (over 100 °C), and subsequent drill bits cannot remove the thermal trauma incurred; rather, they add to it. Modifying drill bit design and employing proper drilling techniques, such as reducing drilling RPM and load, can reduce thermal trauma by reducing friction. Inadequate management of heat can lead to prolonged recovery, increased patient discomfort, and potential long-term complications such as impaired bone-to-implant integration and chronic conditions like peri-implantitis. Ensuring healthy bone conditions is critical for successful implant outcomes.

Epidemiology of Neurosurgical and Orthopedic Trauma in Children: A Study in the West of Iran

Background: Trauma can be categorized based on the characteristics of its cause into penetrating, blunt, thermal, or compressive trauma. Another type of classification is based on anatomical location, as trauma may occur at any anatomical site of the body. Objectives: This study aimed to determine the epidemiology of neurosurgical and orthopedic trauma among children in the city of Ilam. Methods: In this retrospective study, the health records of all patients aged 6 to 18 years with orthopedic and neurosurgical trauma who were referred to the hospital in Ilam were investigated. Since Imam Khomeini Hospital is the only public hospital for trauma patients in this city, only the records of patients who were referred to this hospital were reviewed. Results: Results showed that in the neurosurgical trauma group, out of 145 reviewed cases, 96 (66.2%) patients were male and 49 (33.8%) were female. In relation to orthopedic traumas, out of 570 investigated cases, 386 (67.7%) were male and 184 (32.2%) were female. Additionally, results showed that 224 (39.3%) patients had fractures in the right hand, 255 (44.7%) had fractures in the left hand, and 91 (16%) had fractures in both hands. Furthermore, 21 (14.5%) patients had cervical spine injuries, 35 (24.1%) had thoracic spine injuries, 54 (37.2%) had lumbar spine injuries, and 35 (24.1%) had brain trauma. Conclusions: In the present study, the epidemiology of neurosurgical and orthopedic trauma in children was investigated. Given the prevalence of these types of trauma in Ilam, it is necessary to provide essential training to prevent or reduce their occurrence in the future.

ON THE QUESTION OF THE EFFECT OF REGENERATION STIMULATION DRUGS ON THE RESTORATION OF THE SKIN IN CASE OF INJURY

Background. The study of the reaction of tissue (epidermis and dermis) to the medication of regeneration stimulants (МSR) in injuries is relevant both for the development of wound coatings and treatment regimens for the traumatic process. In this study, special attention is paid to the process of stimulation of stem cells in the hair papilla, which play an important role in the restoration of skin structures. The aim of the study was also to study the morphological changes of the epidermis and dermis in the dynamics of trauma. Materials and methods. To conduct the experiment, experimental groups were formed: a burn model without treatment; a burn model with a МSR preparation (oral administration and wound coating); an experimental group with a linear wound with МSR treatment, an experimental group similar reproduction of a wound without suturing with МSR, a control group similar reproduction of a wound without treatment with suturing, a control group - similar reproduction of the wound without treatment and without suturing. Animals were removed from the experiment by inhalation of ether vapors in accordance with the "Rules for carrying out work using experimental animals" and in accordance with the principles of the Helsinki Declaration of the World Medical Association (Declaration of Helsinki, and approved by the Institutional Review Board). Tissue fragments were taken from the site of thermal trauma and healthy tissue for the preparation of histological preparations. The production of paraffin histological sections with a thickness of 5-7 microns was carried out according to generally accepted standard methods. The sections were stained with hematoxylin and eosin. The photos were taken using the Vision Bio system (Epi 2014) and stained with hematoxylin-eosin, which were examined under x100 magnification. The obtained data were processed using MS Excel and Statgraphics software packages using generally accepted methods of statistics. Results. When reproducing thermal trauma In the control group on day 14, there is no epidermis in part of the visual fields within the studied material, the layers are replaced by connective tissue strands, scar tissue is visualized. The dermis is moderately edematous, with neutrophilic and lymphocytic infiltration is weakly expressed, in the papillary and reticular layer it is evenly represented, there are single apoptotic corpuscles. No areas of hemorrhage were detected, but the blood vessels were dilated. While in the experimental group there are signs of restoration of microcirculation with a large number of vessels and a more pronounced layer of the epidermis. When examining scars after a linear wound, it was found that animals who did not receive therapy have a thin scar, and in animals who received МSR, the consequences of surgical intervention are not visualized. Conclusion. The dynamics of the wound process was studied when using a prototype ointment containing a regeneration complex in the treatment of burn and linear wounds in an experiment. The effectiveness of the regenerative complex of a prototype ointment for the treatment of experimental burn and linear wounds in laboratory animals in comparison with the control group was revealed. It has been established that in the treatment of burn and linear wounds with experimental ointment, the healing period of burn wounds is reduced due to more active formation of the microcirculatory bed and the early onset of epithelization.

Standardized Testing for Thermal Evaluation of Bone Drilling: Towards Predictive Assessment of Thermal Trauma.

To ensure the prevention of thermal trauma and tissue necrosis during bone drilling in surgical procedures, it is crucial to maintain temperatures below the time- and temperature-dependent threshold of 50 °C for 30 s. However, the absence of a current standard for assessing temperatures attained during bone drilling poses a challenge when comparing findings across different studies. This article aims to address this issue by introducing a standardized testing method for acquiring thermal data during experimental bone drilling. The method requires the use of three controlled variables: infrared thermography, standard bone blocks, and a regulated drilling procedure involving a drill press with irrigation that simulates a surgeon. By utilizing this setup, we can obtain temperature data that can be effectively applied in the evaluation of other variables, such as surgical techniques or drill bit design, and translate the data into bone damage/clinical outcomes. Two surgical drill bits (2.0 mm-diameter twist drill bit and 3.3 mm-diameter multi-step drill bit) are compared using this experimental protocol. The results show the 2.0 mm bit reached significantly higher temperatures compared to the 3.3 mm bit when preparing an osteotomy (p < 0.05). The 2.0 mm drill bit reached temperatures over 100 °C while the 3.3 mm drill bit did not exceed 50 °C.

Thyroid Nodule Rupture Following Radiofrequency Ablation for Benign Thyroid Nodules

Nodule rupture is a rare but serious complication of thyroid radiofrequency ablation (RFA). With growing adoption of thyroid RFA across the US, an understanding of thyroid nodule rupture (TNR) is crucial for recognition, management, and, ultimately, prevention. To determine procedural and patient factors that may contribute to TNR and describe experiences in managing TNR while synthesizing existing literature. This retrospective case series examined all RFA procedures for benign thyroid nodules performed by 2 attending physicians at a single academic referral center between December 2019 and January 2024. A total of 298 consecutive patients underwent RFA for benign thyroid nodules. Criteria for offering RFA included nodules with 2 benign fine-needle aspirations, no suspicious ultrasonography features, a greatest dimension of 2 cm or greater, compressive or cosmetic concerns, and accessibility to a straight needle. All RFAs were performed using ultrasonography guidance using the moving-shot technique and a 7-mm or 10-mm active tip. The primary outcome was TNR, and measures were procedure, nodule, and patient characteristics that may have contributed to its pathogenesis. Secondary outcomes were nodule volume reduction, thyroid function, and management and sequelae of TNR. The hypothesis on the pathogenesis of TNR was formed before data collection. Six of 298 patients (2%; 4 women [67%]) with a mean age of 48.5 years (range, 34-65 years) experienced TNR for a mean of 36 days postprocedure (range, 19-54 days). The mean (SD) initial nodule volume among patients with TNR was 31.45 (16.52) mL, and 3 of 6 patients (50%) underwent prior lobectomy. All ruptures were anterior. All patients were treated conservatively, and none required surgery. Five patients recovered completely; the sixth and most recent patient was healing as of last follow-up. There are limited data on the etiology and optimal management of TNR. These 6 cases of anterior rupture suggest that a potential contributor to TNR is thermal and mechanical trauma exerted at the fulcrum point during the moving-shot technique. The use of a smaller active tip (eg, 7 mm) and cessation of energy delivery before this point may help avoid TNR. More robust reporting of this complication may clarify risk factors for and enhance prevention of TNR.

Determinants of Temperature Development during Dental Implant Surgery

Mechanical and thermal trauma during implant surgery may be reasons for initial peri-implant bone loss. Temperature development during drilling and implant insertion were quantified in this series of in vitro and animal experiments. Polyurethane foam material mimicking different classes of alveolar bone was used as a model material for simulating implant surgery. Using thermocouples, temperature development was determined in the model material at depths of 3 mm and 10 mm during site preparation and implant insertion. Additionally, an infrared camera allowed for measuring drill temperatures both in vitro and as part of an animal trial using an intraoral minipig model. Drill diameter and repeated usage of drills did not have a major effect on temperature generation. The addition of a diamond-like carbon coating, bone density, predrilling, and irrigation heavily affected intraosseous temperatures. In vivo, applying regular drill protocols, an intraosseous temperature rise of approximately 3 °K was determined. Implant geometry as well as the amount of undersizing of an osteotomy governed heat generation during implant insertion. Drill protocols and the amount of undersizing of an implant osteotomy constitute parameters by which clinicians can limit trauma during implant surgery.

Thanatognomonic substantiation of the forensic veterinary diagnosis in the death of dogs and cats due to haemodynamic disorders and hypoxaemia

At present, there are no legally consolidated, regulated procedures for conducting forensic veterinary examination of animal cadavers in Ukraine, which makes it difficult for law enforcement agencies to objectively qualify forms of administrative and criminal offences within the framework of pre-trial investigations. Therefore, scientifically sound research results in the field of animal treatment are of particular relevance. The purpose of this study was to substantiate the cause-and-effect relationships in the genesis of violent death of animals caused by mechanical injuries, thermal trauma, and mechanical asphyxiation with the identification of thanatognomonic patterns according to a two-level system of evidence. Methods of comprehensive forensic veterinary examination of animal cadavers were employed, followed by logical and epistemological processing of the results. It was argued that the main links of thanatogenesis in the case of death of animals from these species are irreversible haemodynamic disorders and acute hypoxemia. Based on this approach, an estimate of the area of pathological damage to internal organs incompatible with life is proposed, followed by an “expert hypothesis” regarding the determining cause of the animal’s death. The morphological positions of the forensic veterinary diagnosis in the form of thanatognomonic positions inherent in a certain subspecies of violent animal death were distinguished by two levels of evidence and their criterion informativeness was proved. Patterns of rapid death of animals of the first level of evidence common to the fatal consequences of mechanical and thermal trauma and mechanical asphyxiation were established: “asphyxiated heart”, congestive venous hyperaemia of internal organs, Tardieu’s spots, alveolar emphysema of the lungs. Patterns of the second level of evidence were selectively randomised and their species specificity was presented. The circumstances under which animals suffer fatal mechanical and thermal injuries and asphyxiation were detailed, and the mechanisms of death were substantiated. The study focused on the specific features of argumentation in concluding the necessary direct causal link between the genesis of violent death and the cause of death. The findings obtained following the standard of evidentiality “study of the object of forensic veterinary examination at different morphological levels” are recommended for implementation in the practice of forensic veterinary examination of animal cadavers

Structural and functional assessment of the condition of wound bed using microwave dielectrometry and laser doppler flowmetry

The aim of the work was to develop and test a combined method for assessing the structural and functional features of the burn wound and periwound area with the use of microwave dielectrometry and Dopplerometry. The study was performed on twenty Wistar rats, thermal injuries from contact were created on each rat, and ten healthy animals. The assessment of the wound condition was performed 24 and 72 hours after burn injury. The study of the dielectric properties of tissues was carried out using a hardware and software complex for near-field resonant microwave sensing. From the results of our studies, it can be concluded that in the early post-injury period (within the first days), a sharp coordinated decrease in the intensity of microcirculation and dielectric permittivity is observed in the wound tissues, gradually and partially restored by the end of the third day after burning. The increased microcirculatory blood flow to the periwound area, leading to an increase in the degree of tissue hydration was observed, and as a consequence, the values of these two indices became higher. In addition, it has been shown that during thermal trauma, a regulatory imbalance of factors providing capillary blood flow around a burn wound area and surrounding tissues is formed, which is compensatory in nature and, in the absence of adequate correction, contributes to the inhibition of regeneration processes. Thus, the combination of the methods used in this study may potentially provide more specific information for a description of the structural and functional features of the analyzed tissue and their dynamics. This is clearly shown by the example of an experimental burn wound.

The Influence of Singlet Oxygen Inhalations on Rats with Experimental Burn Trauma

This article aims to study the dynamics of the crystallogenic properties of rat blood serum during a course of singlet oxygen inhalation in the post-burn period. The experiment was performed on 30 mature Wistar rats randomly divided into three groups of equal numbers. The first group (n=10) was intact, no manipulations were performed on the animals included in it, but only a single blood irradiation from the sublingual vein was performed. The animals of the second (control) and third (main) groups under combined anesthesia were subjected to thermal trauma according to our methodology, standard local treatment was carried out. Starting from the day following the injury, the rats of the main group were inhaled daily for 10 days of the airflow coming from the singlet oxygen generator. Blood samples from rats of all groups were collected and tested for crystallogenic properties and crystallogenesis-inducing activity. It was found that the inhalation of singlet oxygen in animals with severe thermal trauma contributes to the partial normalization of the crystallogenic activity of blood serum, which positively characterizes its rehabilitation potential. This trend must take place when assessing both the intrinsic crystallogenic and initiating properties of biological fluid, which is manifested both in the dynamics of morphological and morphometric indicators and the optical characteristics of serum facies.

Immunoregulatory effects of local and systemic use of melatonin in experimental thermal trauma

High incidence of thermal trauma (TT), increased risk of infectious and non-infectious short- and long-term complications, and limited effectiveness of the therapeutic approaches are the main pre-requisites for searching and pathogenetic justification of new therapies. E.g., melatonin, an endogenous homeostatic regulator with pleiotropic properties, deserves special attention. The aim of the work was to study the effect of local application (as an original dermal film) and systemic usage of melatonin upon concentrations of circulating TNF and IL-4 in the course of experimental thermal trauma.&#x0D; The rates of wound epithelization were expressed as per cent values. The plasma concentrations of IL-4, TNF were determined with automatic enzyme immunoassay analyzer Personal LAB (Italy).&#x0D; In the series with TT, the rate of wound epithelization increased from the 5th to the 20th day of experiment. When using dermal films with MT in experimental TT on days +5, +10 and +20, an increase in the rate of wound epithelization was registered. Under the conditions of intraperitoneal MT injection in experimental TT, the rate of wound epithelization increased on days +10 and +20. A correlation analysis revealed stronger interrelations observed when applying dermal films with MT in thermal trauma, rather than in series with intraperitoneal usage of MT thus suggesting faster repair processes in the first case, along with diminished area of alterations and decreased amounts of cytokines in serum.&#x0D; In experimental TT, the concentrations of TNF and IL-4 increase in blood serum on days +5, +10 and +20. On days +10 and +20, moderate positive associations were recorded between the rate of wound epithelialization and the concentration of serum cytokines. Upon intraperitoneal use of MT in experimental TT, on days +5, +10 and +20, the rate of epithelization increases, along with decrease of TNF concentration on days +10 and +20. On days +5, +10 and +20, moderate negative associations were recorded between the rate of wound epithelization and the concentration of TNF. Under the conditions of using DP with MT with TT, the rate of wound epithelization increases on days 5, 10 and 20, the concentration of TNF decreases in serum, the concentration of IL-4 decreases on day +10. On days +5, +10 and +20, the negative correlations were recorded between the rate of wound epithelization and serum concentrations of TNF and IL-4. A comparative efficiency analysis of MT-containing dermal films versus intraperitoneal use of MT in experimental thermal trauma revealed a more accelerated epithelization of the wound along with earlier decrease in TNF, a greater number and strength of relationships between the rate of the wound epithelization and concentrations of cytokines in blood serum.

Thermal injuries in the Siberian region

Introduction. Thermal lesions represent a significant medical and social problem, they are characterized by the duration and high cost of treatment, a significant proportion of the limitation or disability. In Siberian region besides burn injuries, cold injury is common.&#x0D; The purpose of the work was to identify factors influencing the indicators of specialized medical care for patients with thermal injuries in the Siberian region.&#x0D; Materials and methods. The analysis of the reports of the main specialists of the subjects of the Siberian Federal District on the provision of specialized medical care to victims of thermal injuries in 2017 was carried out. Statistical processing was performed using the Microsoft Excel for Windows 10.0 program.&#x0D; Results. The average provision for victims of thermal trauma is 2.8 beds per 100,000 of the district’s population, the turnover rate per 100,000 of the population is 134, the mortality rate is 4.6%. The hospitalization rate for patients with burns per 100,000 populations is 39, with cold injury — 6.0. In the structure of adult patients, non-core patients hospitalized for a “burn” bed occupy 12%. The mortality rate in adults is 10 times higher than in children. For each specialized bed for a patient with thermal injuries, 6.4 beds intensive critical care are required. Over 12% of victims in intensive care units require mechanical ventilation. The rate of anesthetic management per patient varies in subjects by 6 times.&#x0D; Limitations. The study was conducted on the basis of available official statistical data, primary data were not used.&#x0D; Conclusion. Cold trauma has a significant impact on the performance of the medical care system in the Siberian Federal District for patients with the “combustiology” profile. The variability of a number of key parameters in the provision of specialized care for thermal trauma is due to different numbers and densities of the population, the degree of industrialization and the financial capabilities of the region. A significant proportion of those treated in burn hospitals are patients with another (without thermal injury) pathology.

The Role of Lyophilized Xenodermotransplants in Repairing the Atria's Structure and the Peculiarities of Regenerative Processes after Thermal Trauma in an Experiment.

The effects of severe burn injuries on the cardiovascular system, specifically the atria and auricles of the heart, were investigated. The potential benefits of using lyophilized xenodermotransplants as a treatment option were also evaluated. The experiments were conducted on adult guinea pigs divided into three groups: intact animals, animals with burns, and animals with burns who underwent early necrectomy followed by wound closure with lyophilized xenodermotransplants. Third-degree burns caused significant ultrastructural changes in atrial cardiomyocytes, leading to long-term destructive changes in the structural components of the atria. However, the use of lyophilized xenodermotransplants had a positive effect on the atrial ultrastructure over time. This study highlights the complex and varied effects of burn injuries on the body and the potential benefits of lyophilized xenodermotransplants in treating severe burn injuries. By preventing destructive changes in the heart and activating regenerative processes, lyophilized xenodermotransplants can improve the condition of the heart after thermal injury. Further research and development in this area are necessary for understanding the potential of lyophilized xenodermotransplants in tissue repair and regeneration.

Association between catastrophizing, postoperative pain, and injury severity in soldiers injured during the first year of the war in Ukraine

Aims: The aim of this study was to investigate the associ-ation between catastrophizing, postoperative pain, and in-jury severity following war-related injuries among soldiers injured during the first year of the war in Ukraine.Methods: This cross-sectional study included 135 patients with war-related injuries treated at the Center of Thermal Trauma and Reconstructive Surgery of the Vinnytsia re-gional University hospital in Ukraine between August 2022 and November 2022. Following surgical treatment, patients’ catastrophizing was assessed using the Ukrainian version of the Pain Catastrophizing Scale (UA-PCS) and correlated with the pain levels assessed with the numerical rating scale (NRS), and the scores obtained with Injury Severity Score (ISS) and the Combat Exposure Scale (CES). The poten-tial pre-existing traumatic events in a participant’s lifetime were assessed with The Life Events Checklist for DSM-5 (LEC-5).Results: Multiple regression analyses showed no significant association between the PCS total score and demographic variables of age, gender, marital status, education, duration of military service, or time from injury. Only 3.6% of the variance in the catastrophizing scores was accountable for the contribution of independent demographic variables. We found a moderate positive correlation between catastroph-izing scores (including all the subscales) with pain NRS, ISS, and CES scores. The pain NRS, ISS, and CES scores account for 43.4% of the variability of PCS scores. Previous traumat-ic events did not contribute to the catastrophizing scores.Conclusion: Our study describes a positive association be-tween catastrophizing, sustained injuries, combat expo-sure, and postoperative pain. Since our sample consists of injured soldiers that were young and healthy before suffering major war-related polytrauma, our study offers a unique perspective, different from all other previous studies in which catastrophizing was investigated in a ci-vilian population.

Immunological aspects of the use of melatonin in experimental thermal trauma

The prevalence of thermal trauma, the high risk of infectious and non-infectious short- and long- term complications, and the limited effectiveness of the therapeutic approaches used are prerequisites for the search and pathogenetic justification of new therapies, among which the endogenous homeostasis regulator with pleiotropic properties melatonin attracts attention.The aim of the work is to investigate the immunological aspects of intraperitoneal use of melatonin (MT) in experimental thermal trauma (TT).The work was performed on 158 rats of the Wistar line, grade III TT and a relative area of 3.5% were simulated by skin immersion in water at 98-99 °C for 12 s. MT was administered intraperitoneally daily at a dose of 10 mg/kg for 5 days. The quantitative composition of blood cells was evaluated on a hematological analyzer. Plasma concentrations of IL-4, TNFa, IFNg, and CRP were determined on an automatic enzyme immunoassay using rat-specific test systems, and MT by capillary electrophoresis.With experimental TT, against the background of a progressive increase in the number of leukocytes in the blood from 5 to 20 days due to neutrophils, monocytes, basophils, the number of lymphocytes decreases. With TT, the concentration of CRP increases in serum on days 5 and 10. The content of TNFa, IL-4 increases on days 5, 10 and 20 in the absence of significant changes in the concentration of IFNg. The concentration of serum MT does not change significantly. Intraperitoneal use of MT in TT leads to a partial restoration of the number of lymphocytes in the blood on day 5. Evaluation of the cytokine profile in serum revealed a decrease in the concentration of TNFa on days 10 and 20, no significant changes in the concentration of IL-4 and IFNg were recorded, the concentration of CRP decreased on day 5. The concentration of serum MT increases by 5 days.With TT on the 5th, 10th, 20th day of the experiment, the number of neutrophils, monocytes, basophils in the blood increases, decreases – lymphocytes, the serum content of CRP, TNFa, IL-4 increases, the content of IFNg and melatonin does not change. Intraperitoneal use of MT in TT partially restores the number of lymphocytes in the blood, the concentration of CRP, TNFa. A decrease in serum concentrations of TNFa and CRP in TT under the conditions of MT use suggests a limitation of the acute phase response as a consequence of the antioxidant, anti-inflammatory effect of MT, which can accelerate healing and reduce the area of the lesion of TT.

Teat open lesions can lead to challenges at milking time on dairies in the Northeast United States.

During evaluations of teat skin by the authors using National Mastitis Council procedures, teat open lesions (TOL) have been more commonly identified in dairies in the Northeast United States over the last 10 years. The TOL described here are found in all stages of lactation and in any age lactating cow, which is unique from TOL that present mainly in first lactation animals just after calving. Cows with these TOL exhibit more abnormal cow behaviors during the milking event. Based on the authors' subjective field evaluations, dry teat skin condition appears to be a significant risk factor. Although there is a paucity of published literature, the other risk factors that the authors have observed are exposure to wind and significant temperature fluctuations, wet bedding, certain bedding additives, and occasionally mechanical, chemical, or thermal trauma. Teat open lesions have been observed in herds with all the common types of bedding. Treatment and preventative measures have focused on supporting skin conditions through higher emollients in the postmilking teat disinfection (PMTD) and controlling the environmental conditions to which the teat is exposed. This includes an evaluation of cow positioning in the stall as well as bedding levels, which influence bedding contamination. The accuracy of PMTD application can also have an influence. The objective of this narrative review was to search the current literature describing TOL, identify knowledge gaps, describe the authors' field experience with TOL on dairy operations in the Northeast United States, and identify opportunities for future research.

Pathophysiology of the coagulation system in general heat injury (scientific and literary review)

General unintentional overheating of the body (heat stroke) is a severe life-threatening condition that causes thousands of deaths worldwide every year due to climate changes. Coagulation disorders associated with general heat injury are a determining factor in the course and prognosis of the pathological condition. Coagulopathy is a pathophysiological process that is activated as a result of a systemic inflammatory reaction the basis of which is a destabilized external primary protection of the body against hyperthermia and negative changes in the vascular endothelium. Based on the data of foreign authors and their own clinical experience, the authors were able to highlight certain features and patterns of the development of coagulopathies in thermal trauma.

Effect of probiotic administration in inflammatory responses of thermal burns

Objectives &amp; Introduction It is possible to damage the natural intestinal barrier following severe burn injuries. Oral probiotics' positive effects on the innate immune system or intestinal epithelial layer are proven. This research aimed to evaluate the role of probiotics on plasma inflammatory changes and bacterial colonization in the burned wound after high-grade thermal trauma. Methods This double-blinded randomized controlled trial was conducted on 80 patients with a total body surface area of 20–70%. Patients were allocated to two groups based on four blocks randomization model. Intervention and control groups received daily LactoCare and placebo capsules for 14 consecutive days. Obtaining demographic data, burn and gastrointestinal symptoms were registered by filling out a questionnaire. Additionally, measuring plasma levels of highly sensitive C-reactive protein(hs-CRP), IgA, absolute neutrophilic, and lymphocytic count were performed cumulatively four times prior to and after the intervention. Results Considering eligible data, following the study period analysis showed significant mitigation of inflammatory status in probiotic receivers. The hs-CRP reduced following probiotic (21.38 ± 44.45) consumption compared with placebo (−36.36 ± 79.03) intake ( p &lt; 0.001). Also, the plasma level of IgA significantly decreased in the intervention group (0.88 ± 0.65) than in the control group (0.79 ± 0.18) ( p &lt; 0.001). Wound cultures showed no significant difference between groups, although the incidence rate of bacterial colonization was slightly lower after using probiotics ( p = 0.159). Regarding wound healing, data illustrated that probiotics could accelerate wound healing after 14 days of regular consumption ( p &lt; 0.001). Conclusion Probiotics have advantages for the mitigation of inflammation and wound healing following severe thermal burn injuries. Trends toward Improvement Immune system by increasing IgA level and lymphocytic count and possible Reduction of wound area with exogenous probiotic administration in patients with burns suggest that further investigation in larger sample size is necessary to corroborate our initial, promising findings.

Morphofunctional Properties of Spindle-Shaped Platelets

Morphofunctional properties of spindle-shaped platelets under normal and pathological conditions were studied by the method based on vital staining. In donor blood and plasma isolated by centrifugation at 300g, no spindle-shaped platelets were detected; after centrifugation at 3000g, spindle-shaped platelets were detected in a small amount in 20% samples. During plasma storage at 20-22°C, spindle-shaped platelets appeared after 1-2 days, after 3 days their number increased to 30% and higher. Spindle-shaped platelets contained a small number of granules and did not exhibit active adhesion, while the structure of their membranes was normal after 1-2 days of storage and abnormalities appeared during subsequent storage. Spindle-shaped platelets were found in the blood of patients with acute exogenous poisoning and severe thermal trauma. Spindle-shaped platelets can be used as an additional criterion for assessing the quality of the platelet population.

Minimizing Thermal Damage During Thulium Laser-Assisted Partial Arytenoidectomy: Pulsed Versus Continuous Cutting in an Ex-Vivo Calf Model.

The 2 µm-wavelength thulium laser is an effective cutter during partial arytenoidectomy, but thermal trauma can damage adjacent laryngeal tissue. Pulsing laser energy may reduce trauma when compared to continuous-wave cutting. This study measured temperature changes, thermal trauma, and time to complete partial arytenoidectomy, with and without pulsing, in an ex-vivo calf model. Tissue temperature and time to complete a trans-cartilaginous cut were measured during partial arytenoidectomy on ex-vivo calf vocal folds (N = 24) using a thulium laser in continuous-wave (CW, N = 12) and pulsed-wave (PW, N = 12) modes. Energy was 5 W for CW and PW cuts; pulse-widths were 250, 500, and 750 ms. Thermal damage was analyzed histologically by measuring the depth of lactate dehydrogenase (LDH) inactivation perpendicular to the laser-cut edge at the vocal process. Paired t-tests compared CW and PW modes. Change in temperature was lower using CW (6.5°C) compared to PW modes (250 ms = 18°; 500 ms = 16°; 750 = 19°; P < .05). Trans-cartilaginous cuts were completed faster using CW (37 seconds) compared to PW (250 ms = 136 seconds; 500 ms = 61 seconds; 750 = 44 seconds; P < .05), and both modes delivered the same total Joules. The average depth of LDH depletion (thermal damage) was similar for all cuts. 1. Thulium laser cuts in continuous-mode unexpectedly produced less tissue heating yet created similar thermal damage than pulsed-mode cuts during simulated partial arytenoidectomy. 2. Trans-cartilaginous cuts were completed significantly faster in continuous-mode as compared to pulsed-mode cutting. 3. Pulsing the thulium laser does not minimize thermal damage compared to continuous wave cutting during thulium laser-assisted partial arytenoidectomy.