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See detaileffects of cholecaciferol supplementation and optimized calcium intakes on vitamin D status, muscle strength and bone haelth: a one-year pilot randomized controlled trial in adults with severe burns
ROUSSEAU, Anne-Françoise ULg; FOIDART-DESSALLE, Marguerite ULg; LEDOUX, Didier ULg et al

in Burns : Journal of the International Society for Burn Injuries (in press)

Objective: 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 ... [more ▼]

Objective: 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. Design: Monocentric randomized controlled trial. Methods: Fifteen adults with thermal burns dating from 2 to 5 years were randomized into two groups. For 12 months, they either received a quarterly IM injection of 200,000 IU VD3 and daily oral Ca (Group D) or placebo (Group P). VD status and bone remodeling markers were assessed every 3 months. Knee muscle strength and bone mineral density were, respectively, assessed using isokinetic dynamometry and dual X-ray absorptiometry at initiation (M0) and completion (M12) of the protocol. Results: Of all the patients, 66% presented with VD deficiency and 53% (with 3 men <40 y) were considered osteopenic at inclusion. After one year, calcidiol levels significantly increased in Group D to reach 40 (37–61) ng/ml. No significant change in bone health was observed in both groups while Group D significantly improved quadriceps strength when tested at high velocity. Conclusions: 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. [less ▲]

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See detailVitamin D status after a high dose of cholecalciferol in healthy and burn subjects
ROUSSEAU, Anne-Françoise ULg; DAMAS, Pierre ULg; LEDOUX, Didier ULg et al

in Burns : Journal of the International Society for Burn Injuries (in press)

Background: Burn patients are at risk of vitamin D (VD) deficiency and may benefit from its pleiotropic effects as soon as acute phase. Aim of this observational study was to assess effects of a ... [more ▼]

Background: Burn patients are at risk of vitamin D (VD) deficiency and may benefit from its pleiotropic effects as soon as acute phase. Aim of this observational study was to assess effects of a cholecalciferol (VD3) bolus on VD status in adult burn patients (Group B, GB) after admission, compared to healthy subjects (Group H, GH). Methods: Both groups received an oral dose of 100,000 IU VD3. Blood samples were collected before (D0) and 7 days (D7) after bolus to measure 250H-D, 1,25(OH)2-D, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). Albumin (ALB) and VD binding protein (DBP) were measured and used to calculate free 25OH-D level. Data were expressed as median (min–max) or proportions. Results: A total of 49 subjects were included: 29 in GH and 20 in GB. At D0, prevalence of VD deficiency was higher in GB: 25OH-D was 21.5 (10.1–46.3) ng/ml in GH vs 11 (1.8–31.4) ng/ml in GB. DBP and ALB were lower in GB. At D7, DBP was stable in both groups while ALB decreased in GB. 25OH-D increased by 66.6 (13.5–260.3)% in GH. In GB, changes in 25OH-D extended from 36.7% to 333.3% with a median increase of 33.1%. Similar changes were observed in each group for free 25OH-D. High FGF23 levels were observed in GB. Conclusions: This study highlighted the differences in VD status and in response to a high dose VD3 in burn patients when compared to healthy patients. Pitfalls in VD status assessment are numerous during acute burn care: 25OH-D measurement needs cautious interpretation and interest of free 25OH-D is still questionable. They should not prevent burn patients to receive VD supplements during acute care. Higher doses than general recommendations should probably be considered. [less ▲]

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See detailEffect of N-acetylcysteine combined with infliximab on toxic epidermal necrolysis. A proof-of-concept study.
PAQUET, Philippe ULg; JENNES, Serge; ROUSSEAU, Anne-Françoise ULg et al

in Burns : Journal of the International Society for Burn Injuries (2014)

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See detailQuantitative evaluation of fluid resuscitation in burn children : a retrospective study.
ROUSSEAU, Anne-Françoise ULg; LEDOUX, Didier ULg; RICHARD, Patrick et al

in Burns : Journal of the International Society for Burn Injuries (2011), 37(suppl 1), 12

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See detailTreatment of drug-induced toxic epidermal necrolysis (Lyell’s syndrome) with intravenous human immunoglobulins
Paquet, Philippe ULg; Jacob, Emilie ULg; Damas, Pierre ULg et al

in Burns : Journal of the International Society for Burn Injuries (2001), 27(6), 652-655

Toxic epidermal necrolysis (TEN) is a rare drug-induced life-threatening disease. Currently, the disease is only treated by supportive and antiseptic measures. Quite recently intravenous immunoglobulins ... [more ▼]

Toxic epidermal necrolysis (TEN) is a rare drug-induced life-threatening disease. Currently, the disease is only treated by supportive and antiseptic measures. Quite recently intravenous immunoglobulins (IG) were shown to be a promising TEN treatment. The rationale for their use is based on the fact that keratinocyte apoptosis in TEN involves the CD95 (APO-1/Fas) cell surface receptor–ligand system. We successfully treated a TEN patient with high dose of intravenous IG. The clinical recovery appeared exceptionally rapid. Immunohistochemistry showed that the IG action probably developed on the CD95 receptor–ligand system at the keratinocytes surface. [less ▲]

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