Browsing by Author "Beatriz A. Castillo-De Lima"

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    The Complexity of Managing Pain in Burn Patients: A Review of Current Therapies
    (Başkent Üniversitesi, 2022-12) Beatriz A. Castillo-De Lima; Santiago J. Santelis; V. L. Kalyani Gottemukkala; Yatrimar Atacho; Ayse E. Abali
    ABSTRACT Burn injuries requiring medical treatment are very common, devastating, and painful. Pain management in burn patients has been a great challenge for many years. Unfortunately, inconsistent and outdated practices are still reported in the literature, mainly due to a lack of data supporting high-level evidence-based standards of care. Many studies have shown how inadequate and undertreated pain management is detrimental to burn patients. In general, pain management requires a comprehensive understanding of the complex physiology and dynamic pharmacokinetic changes occurring in the patient. Pharmacologic therapy can alleviate pain, and nonpharmacologic treatment may provide improved pain control as an adjunct; thus, using both can provide greater analgesia. By meeting the goal of alleviating pain and creating an environment that is less stressful for our patients, we will also achieve greater adherence to the follow-up and treatment of these wounds, which also leads to less risk of infections. This article reviews recent literature on pharmacologic and nonpharmacologic strategies to manage burn pain.
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    The Endocrine Heart and Burns: Release of Natriuretic Peptides in Response to Burn Injuries
    (Başkent Üniversitesi, 2022-06) Santiago J. Santelis; Beatriz A. Castillo-De Lima; Neel R. Patel; Abner Mavarez Valero
    ABSTRACT In addition to being a pump, the heart also has an endocrine function. The peptides synthesized and secreted from the heart may exert endocrine, autocrine, and paracrine effects. The natriuretic peptides are a family of vasoactive hormones that play a dominant role in the regulation of cardiovascular and renal homeostasis. The 2 major hormones synthesized by the heart are the atrial and the brain natriuretic peptides, and elevated circulating levels of these substances have important prognostic and therapeutic implications. Although plasma natriuretic peptide measurements are helpful in excluding chronic heart failure in the ambulatory setting, many factors independent of heart failure may influence their levels. During the acute phase response of severe burn injuries, the severity of the cardiac stress can determine the postburn outcomes, and the pleiotropic effects exerted by the natriuretic peptide system play a key role in this process by activating compensatory mechanisms that promote systemic arterial dilatation, diuresis, natriuresis, and renin inhibition. Natriuretic peptides may also play a role in the wound healing process, which could be of clinical utility to reduce apparent scar formation in burn patients.