Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Effects of cholecalciferol supplementation and optimized calcium intakes on vitamin D status, muscle strength and bone health: A one-year pilot randomized controlled trial in adults with severe burns.
Burn patients are at risk of hypovitaminosis D and osteopenia or sarcopenia. Vitamin D pleiotropic effects may influence bone and muscle health. The aim of this pilot study was to assess effects of a cholecalciferol (VD3) supplementation and an optimized calcium (Ca) regimen on vitamin D (VD) status, bone and muscle health during sequelar stage of burn injury. ⋯ This VD3 supplementation was safe and efficient to correct hypovitaminosis D in burn adults. When combined with optimized Ca intakes, it demonstrated positive effects on muscle health but not on bone health. A high prevalence of hypovitaminosis D and osteopenia in these patients, as well as their wide range of muscle performances, seem to be worrying when considering rehabilitation and quality of life.
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Decompensation of epilepsy in burned patients may be caused by several factors. Burn is a classic etiology of systemic inflammatory response syndrome, and evolves into two physiological phases. The first 48h after injury corresponds to the first phase involving severe hypovolemic shock. ⋯ Albumin and other plasma proteins are reduced, leading to increased free fraction of phenytoin, resulting in greater clearance and a lower total drug concentration. Associated with metabolic changes of burned patient, this fact predisposes to seizures in epileptic burned patients. The authors present the case of an epileptic 36-year-old-woman who developed recurrent seizures after a thermal injury, despite using the same medications and doses of anticonvulsant drugs of last 12 years, with controlled epilepsy.
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Review Case Reports
Pulmonary embolism in burns, is there an evidence based prophylactic recommendation? Case report and review of literature.
Burn patients exhibit an acquired hypercoagulable state with increased risk of venous thromboembolism. Currently, no randomized control study assessing the efficacy of chemical venous thromboembolism (VTE) prophylaxis in burn patients has been performed. We present a case of a morbidly (body mass index>54kg/m(2)) obese patient with 18% total body surface area (TBSA) burn who developed a VTE and a non-fatal submassive pulmonary embolus (PE). We will be reviewing the current consensus of venous thrombosis prophylaxis in burn patients and briefly discuss the treatment of PE in this population.