609 Combined Physical, Occupational, and Psychotherapies in the Holistic Care of the Burn

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S157-S158
Author(s):  
Melanie K Dae ◽  
Tyler M Smith ◽  
Stephen Goetz ◽  
Erin Schnake ◽  
Anne L Lambert Wagner
Keyword(s):  
Patient Engagement ◽  
Distress Tolerance ◽  
Treatment Effectiveness ◽  
Recovery Process ◽  
Traumatic Experiences ◽  
High Association ◽  
Psychological Reactions ◽  
Patient Goals ◽  
Common Barriers

Abstract Introduction Burn patients often experience pain and fear of the recovery process, negatively impacting their engagement in necessary treatments for maximal functional outcomes. Patients routinely exhibit aversions toward physical and occupational therapies (PT and OT). As a result, therapists have been tasked with managing the patient’s psychological reactions while simultaneously providing rehabilitation. We developed a program for our psychologist to co-treat patients with burn physical and occupational therapists to directly address the painful or feared aspects of burn recovery. These multidisciplinary visits offer in-vivo interventions for managing patient distress and allows therapists the ability to focus solely on their specialized interventions. Methods This program has been active for 12 months and was created during therapy to aid a patient with high distress during PT and OT. Therapists now work with psychology to co-treat improving patient engagement in rehabilitative interventions. During co-treatment, the patients are able to engage in PT and OT more effectively and achieve short-term goals. The burn center psychologist and therapists have developed an interventional method to explore potential generalization of co-treatment effectiveness. Patients are identified based on high need for psychological support during therapy sessions. Each patient case is reviewed and discussed to develop individualized treatment plans and establish goals. Through qualitative review of each co-treatment visit, common barriers have been identified as well as strategies to improve engagement and compliance. Results The common barriers encountered had a high association with a history of traumatic experiences and avoidant coping/low distress tolerance. The most effective co-treatment interventions included: collaboratively setting patient goals with PT, OT and psychology; scheduling patient therapy with burn psychology in advance; teaching distress tolerance skills to manage anticipatory and in-vivo distress related to rehabilitation. Conclusions Treating the emotional aspects of burn recovery during moments of acute distress is integral for holistic patient care. This multidisciplinary approach offers patients increased involvement through collaboratively tailored treatment planning and improved ability to tolerate distressing aspects of recovery. Additionally, therapists were taught various approaches to improve patient engagement and adherence.

scholarly journals Protective Response in Experimental Paracoccidioidomycosis Elicited by Extracellular Vesicles Containing Antigens of Paracoccidioides brasiliensis

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1813
Author(s):  
Ludmila Matos Baltazar ◽  
Gabriela Fior Ribeiro ◽  
Gustavo J. Freitas ◽  
Celso Martins Queiroz-Junior ◽  
Caio Tavares Fagundes ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Treatment Effectiveness ◽  
Ex Vivo ◽  
Paracoccidioides Brasiliensis ◽  
Systemic Disease ◽  
Host Immune System ◽  
Antigen Delivery ◽  
Activated T Lymphocytes ◽  
Cell Mobilization

Paracoccidioidomycosis (PCM) is a systemic disease caused by Paracoccidioides spp. PCM is endemic in Latin America and most cases are registered in Brazil. This mycosis affects mainly the lungs, but can also spread to other tissues and organs, including the liver. Several approaches have been investigated to improve treatment effectiveness and protection against the disease. Extracellular vesicles (EVs) are good antigen delivery vehicles. The present work aims to investigate the use of EVs derived from Paracoccidioides brasiliensis as an immunization tool in a murine model of PCM. For this, male C57BL/6 were immunized with two doses of EVs plus adjuvant and then infected with P. brasiliensis. EV immunization induced IgM and IgG in vivo and cytokine production by splenocytes ex vivo. Further, immunization with EVs had a positive effect on mice infected with P. brasiliensis, as it induced activated T lymphocytes and NKT cell mobilization to the infected lungs, improved production of proinflammatory cytokines and the histopathological profile, and reduced fungal burden. Therefore, the present study shows a new role for P. brasiliensis EVs in the presence of adjuvant as modulators of the host immune system, suggesting their utility as immunizing agents.

scholarly journals Inhibition of Staphylococcus aureus cysteine proteases by human serpin potentially limits staphylococcal virulence

2011 ◽  
Vol 392 (5) ◽  
Author(s):  
Tomasz Kantyka ◽  
Karolina Plaza ◽  
Joanna Koziel ◽  
Danuta Florczyk ◽  
Hennig R. Stennicke ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Serine Proteases ◽  
Peptide Bond ◽  
Cysteine Proteases ◽  
Reactive Site ◽  
Association Rate ◽  
High Association ◽  
Endogenous Protease ◽  
Covalent Complex

AbstractBacterial proteases are considered virulence factors and it is presumed that by abrogating their activity, host endogenous protease inhibitors play a role in host defense against invading pathogens. Here we present data showing thatStaphylococcus aureuscysteine proteases (staphopains) are efficiently inhibited by Squamous Cell Carcinoma Antigen 1 (SCCA1), an epithelial-derived serpin. The high association rate constant (kass) for inhibitory complex formation (1.9×104m/s and 5.8×104 m/s for staphopain A and staphopain B interaction with SCCA1, respectively), strongly suggests that SCCA1 can regulate staphopain activityin vivoat epithelial surfaces infected/colonized byS. aureus. The mechanism of staphopain inhibition by SCCA1 is apparently the same for serpin interaction with target serine proteases whereby the formation of a covalent complex result in cleavage of the inhibitory reactive site peptide bond and associated release of the C-terminal serpin fragment. Interestingly, the SCCA1 reactive site closely resembles a motif in the reactive site loop of nativeS. aureus-derived inhibitors of the staphopains (staphostatins). Given thatS. aureusis a major pathogen of epithelial surfaces, we suggest that SCCA1 functions to temper the virulence of this bacterium by inhibiting the staphopains.

scholarly journals The language of wounds and scars in Edwige Danticat's "The Dew Breaker" : a case in trauma symptoms and the recovery process

2010 ◽  
Vol 8 ◽  
pp. 23 ◽  
Author(s):  
Aitor Ibarrola-Armendáriz
Keyword(s):  
Short Stories ◽  
Recovery Process ◽  
Traumatic Experiences ◽  
Trauma Symptoms ◽  
American Writer ◽  
The Past ◽  
Difficult Time ◽  
Haitian American ◽  
To Come

This article examines the representation of a violent and traumatizing past in Edwidge Danticat’s The Dew Breaker (2004), a collection of short stories that depicts the effects of a torturer’s atrocious crimes on the lives of his victims and their descendants. The contribution argues that this work of fiction by the Haitian-American writer is structured upon the principle that traumatic experiences can only become intelligible – and, therefore, “representable” – by considering the severe psychical wounds and scars they leave on the victims. These scars habitually take the form of paranoia, nightmares, ghostly presences, schizophrenia, and “dead spots” that have a very difficult time finding their place in the protagonists’ consciousness and language. In spite of the fragmented and discontinuous character of these representations, the writer manages to unveil the kind of psychological and social dysfunctions that often surface when people have not fully accepted or assimilated aspects of the past that keep itching in their unconscious. However, despite the prevailingly bleak tone of the stories, Danticat still leaves some room for hope and recovery, as many of the victims find ways to come to terms with and overcome those individual and collective dysfunctions.

scholarly journals Enhanced Oral Bioavailability, Anti-Tumor Activity and Hepatoprotective Effect of 6-Shogaol Loaded in a Type of Novel Micelles of Polyethylene Glycol and Linoleic Acid Conjugate

Pharmaceutics ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 107 ◽  
Author(s):  
Huiyun Zhang ◽  
Qilong Wang ◽  
Congyong Sun ◽  
Yuan Zhu ◽  
Qiuxuan Yang ◽  
...  
Keyword(s):  
Linoleic Acid ◽  
Oral Bioavailability ◽  
Water Solubility ◽  
Oral Absorption ◽  
Treatment Effectiveness ◽  
Hepatoprotective Effect ◽  
Nanoprecipitation Method ◽  
Acid Conjugate

：6-shogaol is a promising anti-cancer and anti-inflammatory agent. However, the treatment effectiveness of 6-shogaol is limited by poor water solubility, poor oral absorption and rapid metabolism. Herein, 6-shogaol loaded in micelles (SMs) were designed to improve 6-shogaol’s solubility and bioavailability. The micelles of a PEG derivative of linoleic acid (mPEG2k-LA) were prepared by the nanoprecipitation method with a particle size of 76.8 nm, and entrapment of 81.6 %. Intriguingly, SMs showed a slower release in phosphate buffer saline (PBS) (pH = 7.4) compared to free 6-shogaol while its oral bioavailability increased by 3.2–fold in vivo. More importantly, the in vitro cytotoxic effect in HepG2 cells of SMs was significantly higher than free 6-shogaol. Furthermore, SMs could significantly improve the tissue distribution of 6-shogaol, especially liver and brain. Finally, SMs showed a better hepatoprotective effect against carbon tetrachloride (CCl4)-induced hepatic injury in vivo than free 6-shogaol. These results suggest that the novel micelles could potentiate the activities of 6-shogaol in cancer treatment and hepatoprotection.

scholarly journals Cell membrane shape control--effects of chloromethyl ketone peptides

Blood ◽  
1984 ◽  
Vol 63 (5) ◽  
pp. 1203-1208 ◽  
Author(s):  
E Alhanaty ◽  
MP Sheetz
Keyword(s):  
Shape Control ◽  
Shape Recovery ◽  
Cultured Cells ◽  
Shape Change ◽  
Lactic Acid Production ◽  
Recovery Process ◽  
Chloromethyl Ketone ◽  
Membrane Shape

Abstract The shape of the human erythrocyte is normally maintained in vivo as a biconcave disc for 120 days. In vitro, the cell shape can be altered readily by amphipathic compounds; however, given time and an energy source, the cells can recover the discoid morphology. An active shape control mechanism is postulated to regulate erythrocyte shape. The shape recovery process is a necessary element in reversing perturbations of shape and is basic to our understanding of how membrane shape is altered. We report here that the process of shape recovery from crenation is dramatically accelerated upon pretreatment of the cells with micromolar (20–100 microM) concentrations of chloromethyl ketone peptides [such as N-alpha-tosyl-L-phenylalanine- chloromethyl ketone (tos-pheCH2Cl)]. Such pretreatments do not appear to affect cellular viability, as judged by their normal biconcave disc shape, their sensitivity to crenators, their lactic acid production, or the ATP-dependent shape change of the purified membranes. Treatment with high concentrations of tos-pheCH2Cl does cause normal cells to become stomatocytic by an energy-requiring process, i.e., it requires glucose, incubation at 37 degrees C, and will not occur in ATP-depleted cells. We suggest that the chloromethyl ketone peptides affect a metabolic process that is associated with the hexose monophosphate (HMP) shunt. Through the alteration of the HMP shunt metabolism, they modify an active stomatocytic process in the erythrocyte that can correct for the perturbation caused by crenators. Implications of these findings for analogous phenomena in cultured cells are discussed.

scholarly journals Does Croton Argyrophyllus Extract Has an Effect on Muscle Damage and Lipid Peroxidation in Rats Submitted to High Intensity Strength Exercise?

2019 ◽  
Vol 16 (21) ◽  
pp. 4237 ◽  
Author(s):  
de Araújo ◽  
Aidar ◽  
Matos ◽  
Santos ◽  
Souza ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Muscle Damage ◽  
High Intensity ◽  
Recovery Process ◽  
Exercise Group ◽  
Vehicle Group ◽  
Sedentary Group ◽  
Hydroethanolic Extract ◽  
Muscular Damage

Many species of the genus Croton have been used for anti-inflammatory, antiproliferative, antidiabetic, and antitumor purposes. The objective was to evaluate the effect of a hydroethanolic extract (HEE) from the inner bark of Croton argyrophyllus (Euphorbiaceae) on muscle damage and oxidative stress in rats after high intensity exercise. The animals were divided into four groups: (i) the sedentary group (SV; n = 7), (ii) the exercise vehicle group (EV, n = 7), (iii) the sedentary group HEE (SHG; n = 7) composed of sedentary animals and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.), and (iv) the HEE exercise group (HEE; n = 7) composed of animals submitted to resistance exercise (RE) and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.). In the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) test, the HEE showed lower values of inhibition potential (IP%) at 39.79% compared to gallic acid, 87.61%, and lipoperoxidation inhibition at 27.4% (100 µg/mL) or 28.6% (200 µg/mL) (p < 0.001). There was inhibition in free radicals in vivo. The HEE of C. argyrophyllus partially reduced the biomarkers of oxidative stress in muscle tissue and muscular damage (creatine kinase (CK) and Lactate Dehydrogenase (LDH)) (p < 0.05) in rats, and in this sense it can be an aid to the recovery process after exhaustive efforts.

scholarly journals Generic Vancomycin Enriches Resistant Subpopulations of Staphylococcus aureus after Exposure in a Neutropenic Mouse Thigh Infection Model

2011 ◽  
Vol 56 (1) ◽  
pp. 243-247 ◽  
Author(s):  
Carlos A. Rodriguez ◽  
Maria Agudelo ◽  
Andres F. Zuluaga ◽  
Omar Vesga
Keyword(s):  
Staphylococcus Aureus ◽  
Population Analysis ◽  
Recovery Process ◽  
Control Group ◽  
Infection Model ◽  
Content Type ◽  
Sterile Saline ◽  
Generic Products ◽  
The Impact

ABSTRACTPrevious studies have shown that “bioequivalent” generic products of vancomycin are less effectivein vivoagainstStaphylococcus aureusthan the innovator compound. Considering that suboptimal bactericidal effect has been associated with emergence of resistance, we aimed to assessin vivothe impact of exposure to innovator and generic products of vancomycin onS. aureussusceptibility. A clinical methicillin-resistantS. aureus(MRSA) strain from a liver transplant patient with persistent bacteremia was used for which MIC, minimum bactericidal concentration (MBC), and autolytic properties were determined. Susceptibility was also assessed by determining a population analysis profile (PAP) with vancomycin concentrations from 0 to 5 mg/liter. ICR neutropenic mice were inoculated in each thigh with ∼7.0 log10CFU. Treatment with the different vancomycin products (innovator and three generics; 1,200 mg/kg of body weight/day every 3 h) started 2 h later while the control group received sterile saline. After 24 h, mice were euthanized, and the thigh homogenates were plated. Recovered colonies were reinoculated to new groups of animals, and the exposure-recovery process was repeated until 12 cycles were completed. The evolution of resistance was assessed by PAP after cycles 5, 10, 11, and 12. The initial isolate displayed reduced autolysis and higher resistance frequencies thanS. aureusATCC 29213 but without vancomycin-intermediateS. aureus(VISA) subpopulations. After 12 cycles, innovator vancomycin had significantly reduced resistant subpopulations at 1, 2, and 3 mg/liter, while the generic products had enriched them progressively by orders of magnitude. The great capacity of generic vancomycin to select for less susceptible organisms raises concerns about the role of therapeutic inequivalence of any antimicrobial on the epidemiology of resistance worldwide.

Maternal Transferability of Trauma and Psychosomatic Nation in Sorayya Khan’s Noor

2020 ◽  
Vol 27 (1) ◽  
pp. 129-143
Author(s):  
Hamza Rauf Awan ◽  
Fatima Syeda
Keyword(s):  
Sexual Assault ◽  
Focal Point ◽  
Traumatic Experiences ◽  
Main Concern ◽  
Next Generation ◽  
Maternal Trauma ◽  
Psychological Reactions ◽  
Life Patterns ◽  
Mothers And Children ◽  
Essential Questions

Ignored or less voiced representation of victimized mothers may appear in the form of certain explicit psychological reactions within generations. Maternal trauma may seep through generations resulting in a psychologically paralyzed nation. The main concern of this paper is to study Sorayya Khan’s novel Noor to unearth treachery and to unfold unspoken traumas (PTSD) inflicted specifically upon mothers during violent incidents. Mothers have always been the carriers of distortion, loss, violence, abuse and acute callousness, transmitting confused and anxious situations to the next generation. Sorayya Khan’s first novel, Noor, addresses such violence and prejudice, thereby reflecting how such intense traumatic experiences actuate the suffering of mothers. This epic piece of art brings forth the hushed voices of both mothers and children who are marginalized, forgotten, oppressed, traumatized, subjected to dislocation and exposed to violence and sexual assault against the backdrop of war. This research tends to unveil the ways in which mothers have been subjected to trauma to cripple the sound psychological foundations of the community/nation. The main purpose of this essay is to address certain essential questions such as: what in fact trauma is, how war affects the life patterns of society, how the trauma inflicted upon women (Mothers) becomes an irresolvable disorder, how trauma can act as a catalyst for the disruption of all sectors of the society, and finally how inherited trauma gives birth to a traumatized nation. The focal point of this research is to examine and explore the issues faced by the fallen ones (Mothers) during times of war and how these issues become precursors for the future lives of the characters, thereby resulting in a hollow nation.

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