Başkent Üniversitesi Makaleler
Permanent URI for this collectionhttps://hdl.handle.net/11727/13096
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Item Beyond Breastfeeding:Prolactin's Powers in Burn Wounds(Başkent Üniversitesi, 2023-03) Arnaldo Acosta; Matthew Araujo; Santiago J. SantelisABSTRACT Burn injuries represent a significant health care challenge worldwide that requires effective interventions to optimize patient outcomes. Prolactin, a versatile hormone traditionally associated with lactation, has emerged as a promising factor with potential implications beyond its classical role. In this review article, we aim to synthesize and analyze the existing literature on the role of prolactin in burn injuries, focusing on its impact on inflammation, immune response, tissue repair, and potential neuroprotective effects. By exploring the mechanisms underlying prolactin's actions, this article provides insights into the therapeutic potential of prolactin in burn injury management.Item The Impact of Fat Rich Enteral Feeding on the Histopathological Changes of Liver in Third Degree Burns: An Experimental Study(Başkent Üniversitesi, 2022-12) Santiago J. Santelis; Ayse Ebru Abali; Gonca Ozgun; Binnaz Handan Ozdemir; Burak Ozkan; Mehmet HaberalABSTRACT OBJECTIVES: This study aimed to describe the histo-pathological changes in the liver secondary to severe burns and to investigate the effects of a fat-rich diet during the initial 7 days post burn in a rat model. MATERIALS & METHODS: We randomly assigned 21 Wistar-albino rats into 3 groups: sham group, burn + standard-diet group, and burn + fatty-diet group. A full-thickness burn wound was induced on the dorsa of the animals in both burn groups. Seven days after sham procedures/burn induction, hepatic tissues were examined under light microscopy; hepatocyte size, portal-triad size, and binuclear hepatocyte numbers were calculated. RESULTS: The mean number of binuclear hepatocytes was higher in burn + standard-diet group than in the sham group. Mean hepatocyte area and mean portal-triad area were narrower in the burn + standard-diet group compared with the sham group (P < .05). Mean hepatocyte area and mean portal-triad area in the burn + fatty-diet group were closer to those shown in the sham animals, and binuclear hepatocytes number in the burn + fatty diet group was slightly higher than in the burn + standard diet group(P > .05). CONCLUSIONS: Liver damage was mildly influenced by fat-rich enteral feeding in the 7 days postburn. Further studies must focus on dynamic feeding protocols designed according to the phases involved in the burn trauma instead of seeking a stable suitable protocol.Item 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. AbaliABSTRACT 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.Item Clinical Presentation and Outcomes of Burn Patients With Diabetes: A 5-Year Single-Center Experience(Başkent Üniversitesi, 2022-09) Santiago J. Santelis; Cem Aydogan; Ayse Ebru Abali; Hasan Turkoglu; Mehmet HaberalABSTRACT OBJECTIVES: Diabetes mellitus is one of the most important independent risk factor for poor outcomes in patients with burn injuries. In this study, we aimed to determine the demographics characteristics, clinical presentation, and outcomes of burn patients with preexisting diabetes mellitus seen over the previous 5 years at a single burn center. MATERIALS AND METHODS: We conducted a retrospective study that included all burn patients ≥18 years of age with a diagnosis of diabetes who were admitted to our unit over the previous 5 years (2018 to 2022). We collected demographics and relevant clinical data from medical records. Patients were evaluated by age subgroups and time interval between occurrence of injury and admission to a medical center. RESULTS: Our study included 52 patients, with male-to-female ratio of 0.86:1 and mean age of 62.7 ± 12.4 years (range, 33-85 y). Scalding was the most common cause of the burn injury. A total of 32.7% of the patients had burns affecting their hands, either as part of a more extensive burn or as an isolated injury. The median extent of burns was 1.0% total body surface area (range, 0.05%-10%). We found an association between age and burn etiology and age and burn site. A high number of patients with injuries in the lower extremity sought medical care after day 1 but before day 4 postinjury. Delayed admission was found to be an important factor causing an increase in complication frequency. CONCLUSIONS: There are many factors associated with age that affect the incidence and outcomes of burn injuries. Risk factors leading to burns are preventable, and the physical and psychological consequences of people who survive burn injuries can be life-threatening and often devastating. The best way to treat a burn is to prevent it from happening in the first place.Item Electronic Protocol for Systematic Data Collection of Burn Patients: A Proposal to Standardize Burn Patient Data(Başkent Üniversitesi, 2022-09) Santiago J. Santelis; Gerardo Elem; Mehmet Haberal; Fortunato BenaimABSTRACT OBJECTIVES: Burn patients usually present with a long medical history and require a prolonged management that makes the process of collecting and storing information complex and confusing. Electronic health records have been deployed to replace or supplement existing paper-based records and can improve the quality of health care. A system that completely addresses the needs of patient care providers and researchers probably does not exist, and this integration would reduce redundant data collection. Here, we share our experiences with a customizable and standardized electronic protocol with the ability to systematize, store, and analyze relevant information from burn patients that can be used worldwide since it contains a universal codification and can be easily adapted to any specific requirement by the user or legal/regulatory authorities. MATERIALS AND METHODS: The database was developed based on medical literature searches on burn injuries. A web platform was designed using Microsoft.NET framework technology with C# and MVC programming languages. The data collection items were selected and grouped into 2 main categories that contained 7 subcategories each, with a unique code assigned to each customizable item for universal comparability in the collection, processing, categorization, and presentation of the data. An SQL server stored data to ensure encryption, protection, and invulnerability. RESULTS: The system recognized the user by identifying a predefined security authorization and allowed the creation, storage, organization, combination/aggregation, analyses, exportation, and editing of collected information. The protocol has been successfully verified in a medical institution by the Benaim Burn Foundation. CONCLUSIONS: A new validated electronic database protocol focusing on burn patients was successfully created, resulting in a substantial improvement of medical record standardization. This system has laid a solid foundation for future data mining, medical records sharing, and academic purposes.Item Knowledge and Attitude of Health Care Staff in First Aid for Minor Burns(Başkent Üniversitesi, 2022-09) Ayse Gul Atay Doygaci; Ayse Ebru Abali; Elif Unlu; Santiago J. Santelis; Eylem Gul; Mehmet HaberalABSTRACT OBJECTIVES: This study aimed to assess the level of knowledge and awareness of first aid for minor burns of health care workers in a university hospital. MATERIALS AND METHODS: A total of 402 subjects including nurses (n = 163), medical technicians (n = 94), technicians/patient care support personnel (n = 145) participated. Data were collected by face-to-face interview technique using our 2 evaluation forms (characteristics of participants was form 1 and first aid knowledge on minor burns was form 2) (P < .005). RESULTS: Mean age was 29.7 years. Female to male ratio was 1:0.7. Form 2 was correctly answered by 76.9% of participants. Participants who stated that they have received first aid training on burns was 41.5%, but only 38.3% of the subjects felt confident for providing first aid. Running water was preferred by 85.6%. High education level, receiving first aid training, and seniority in the profession and in the institution were the effective factors for providing proper first aid (P < .005). Female (58.5%), single (59.8%), child-free (61.7%) participants and those who had attended first aid education programs more recently were prone to providing proper first aid than the others (P < .005). CONCLUSIONS: In the present study, many participants had basic knowledge about first aid for minor burns, but they felt unconfident. Health care staff need periodical educational programs specific to them in addition to the basic awareness programs for burn injuries.Item CASE REPORT Role of Burn Teams in Management of Inflammatory Skin Reactions: Report of 2 Cases(Başkent Üniversitesi, 2022-06) A. Ebru Abali; Cem Aydogan; Santiago J. Santelis; Nesibe Deren Ozcan; Ozlem Ozbek; Mehmet HaberalABSTRACT Several manifestations of inflammatory skin reactions have been described. Toxic epidermal necrolysis is an acute skin inflammatory reaction. It is generally triggered by upper respiratory tract infections or by medications such as nonsteroid anti-inflammatory drugs, antibiotics, and anticonvulsants. It is associated with a significant mortality of 30% to 50% and long-term sequelae. Here, we present 2 cases of toxic epidermal necrolysis who were treated by a multidisciplinary team involving burn professionals.Item Effects of a Fat-Rich Diet in the Pancreas of Rats During the Acute Phase of Burns(Başkent Üniversitesi, 2022-06) Neslihan Başçıl Tütüncü; Ayse Ebru Abali; Santiago J. Santelis; Özlem Turhan İyidir; B. Handan Ozdemir; Gonca Ozgun; Nilüfer Bayraktar; Meriç Çolak; Mehmet HaberalABSTRACT OBJECTIVES: Oversupply of nutrients overstimulates beta cells in standard conditions, and severe burn injuries increase the metabolic needs. In this study, we investigated the effects of fat-rich nutrients on the endocrine pancreas during the acute phase of severe burns.Item Incidence of Infections in Transfused Burn Patients: A 5-Year Single-Institution Experience(Başkent Üniversitesi, 2022-06) María Auxiliadora Mazloum Pérez; Carlos Alfredo Diaz Cordones; Juan Ramón García Pino; Santiago J. Santelis; Thaís Carolina González RomeroABSTRACT OBJECTIVES: Transfusion has been associated with infections in many disease states. Patients with severe burn injuries have major transfusion requirements. In this study, we aimed to determine the incidence of infections in burn patients who underwent transfusion. MATERIALS AND METHODS: We conducted a descriptive, retrospective, and cross-sectional study. We reviewed the medical records of 179 male and female patients, over 18 years of age, who required blood transfusions as a result of burn injuries. Demographic and relevant clinical data were collected from medical records. RESULTS: Of 179 burn patients, 112 were male patients (62.57%). The mean age was 46.08 ± 5.05 years (range, 18-72 years), and the median age was 54 years. Patients between the ages of 48 and 57 years represented 25.14% of the sample. Almost half of the patients required transfusion (49.72%), and packed red blood cells was the most used blood product (30.72%). Overall, 52 transfused patients (29.04%) had major infectious complications, defined as invasive burn wound infection or pneumonia. CONCLUSIONS: The incidence of infections in hospitalized burn patients who underwent transfusions at our center between 2015 and 2019 was low. Blood transfusion remains a highly effective and potentially lifesaving treatment for many patients. KEY WORDS: Fresh frozen plasma, Packed red blood cells, Thermal injuries, Transfusion of blood productsItem 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 ValeroABSTRACT 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.