Database : MEDLINE
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PMID:29446573
Author:Rukavishnikov VS; Kolycheva IV; Lakhman OL
Title:[Modern aspects of the conservation and promotion of health of firefighters].
Source:Gig Sanit; 95(12):1175-9, 2016.
ISSN:0016-9900
Country of publication:Russia (Federation)
Language:rus
Abstract:On the basis of complex hygienic studies there were determined conditions of the work of firefighters in liquidation of foci of fires at the incipient stage, identified the complex of toxic substances, their quantitative content in the area of the smoke of fires. The analysis of the etiological role of occupational factors in the shaping of the morbidity and the physiological and clinical manifestations, established indices of the risk for occupational and industrial-caused pathology have allowed to substantiate the relationship of a number of nosological forms associated with working conditions of firefighters. There was developed a system of preventive activities for the promotion and preservation of the health of firefighters, as well as a conceptual model for monitoring of working conditions and state of health.
Publication type:JOURNAL ARTICLE


  2 / 1131 MEDLINE  
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PMID:29206379
Author:Griesser GC
Title:Pet Patients: Assessment and treatment of dogs and cats involved in structure fires.
Source:JEMS; 41(12):49-53, 2016 12.
ISSN:0197-2510
Country of publication:United States
Language:eng
Publication type:JOURNAL ARTICLE


  3 / 1131 MEDLINE  
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PMID:29275618
Author:Liu MZ; Wang JJ; Fu ZH; Li YC; Jiang ZY; Sun W; Guo GH; Zhu F
Address:Department of Burns, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Title:[Effects of non-muscle myosin ⅡA silenced bone marrow mesenchymal stem cells on lung damage of rats at early stage of smoke inhalation injury].
Source:Zhonghua Shao Shang Za Zhi; 33(12):766-771, 2017 Dec 20.
ISSN:1009-2587
Country of publication:China
Language:chi
Abstract:To investigate the effects of non-muscle myosin ⅡA (NMⅡA) silenced bone marrow mesenchymal stem cells (BMSCs) on the lung damage of rats at early stage of smoke inhalation injury. Forty Sprague-Dawley rats were divided into control, simple injury, NMⅡA-BMSCs, and BMSCs groups according to the completely random method, with 10 rats in each group. Rats in control group inhaled air normally, while rats in the latter 3 groups inhaled smoke to reproduce model of smoke inhalation injury. At 30 min post injury, rats in simple injury group were injected with 1 mL normal saline via caudal vein, and rats in group BMSCs were injected with 1 mL the fifth passage of BMSCs (110(7)/mL), and rats in group NMⅡA-BMSCs were injected with 1 mL NMⅡA silenced BMSCs (110(7)/mL). At post injury hour (PIH) 24, abdominal aorta blood and right lung of rats in each group were harvested, and then arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), and pH value were detected by blood gas analyzer. Ratio of wet to dry weight of lung was determined by dry-wet weight method. Pathological changes of lung were observed with HE staining. Bronchoalveolar lavage fluid (BALF) were collected, and then tumor necrotic factor-α (TNF-α) and interleukin-10 (IL-10) content of BALF was determined by enzyme-linked immunosorbent assay. Data were processed with one-way analysis of variance, Kruskal-Wallis test, and least-significant difference test. (1) At PIH 24, compared with those in control group, PaO(2) values of rats in simple injury, BMSCs, and NMⅡA-BMSCs groups were obviously decreased (with values below 0.05), and PaCO(2) values were obviously increased (with values below 0.05). Compared with those in simple injury group, PaO(2) values of rats in groups NMⅡA-BMSCs and BMSCs were obviously increased (with values below 0.05), while PaCO(2) values were obviously decreased (with values below 0.05). PaO(2) value of rats in group NMⅡA-BMSCs was obviously increased as compared with that in group BMSCs ( <0.05). The pH value of arterial blood of rats in simple injury group was obviously lower than that in control group ( <0.05). (2) At PIH 24, ratios of wet to dry weight of lung of rats in control, simple injury, BMSCs, and NMⅡA-BMSCs groups were 4.360.15, 7.790.42, 5.770.18, and 5.110.20, respectively. Compared with that in control group, ratio of wet to dry weight of lung of rats was obviously increased in the other 3 groups (with values below 0.05). Compared with that in simple injury group, ratio of wet to dry weight of lung of rats was obviously decreased in groups BMSCs and NMⅡA-BMSCs (with values below 0.05). Compared with that in group BMSCs, ratio of wet to dry weight of lung of rats in group NMⅡA-BMSCs was obviously decreased ( <0.05). (3) At PIH 24, alveolar structure of rats in control group was complete without abnormality. Compared with those in simple injury group, lung injury and infiltration of inflammatory cells of rats in groups BMSCs and NMⅡA-BMSCs were obviously alleviated, and alveolar structure was relatively complete with no thickening of alveolar wall. (4) At PIH 24, compared with that in control group, TNF-α content of BALF of rats in simple injury and BMSCs groups was obviously increased (with values below 0.05). Compared with that in simple injury group, TNF-α content of BALF in groups BMSCs and NMⅡA-BMSCs was obviously decreased (with values below 0.05). Compared with that in control group, IL-10 content of BALF in simple injury, NMⅡA-BMSCs and BMSCs groups were obviously increased (with values below 0.05). Compared with that in simple injury group, IL-10 content of BALF in groups BMSCs and NMⅡA-BMSCs was obviously increased (with values below 0.05). Compared with that in group BMSCs, IL-10 content of BALF in group NMⅡA-BMSCs was obviously increased ( <0.05). NMⅡA silenced BMSCs can alleviate lung damage of rats at early stage of smoke inhalation injury, showing better effectiveness than using BMSCs only.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Tumor Necrosis Factor-alpha); 130068-27-8 (Interleukin-10); EC 3.6.1.- (Nonmuscle Myosin Type IIA)


  4 / 1131 MEDLINE  
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PMID:29275617
Author:Yang FW; Xin HM; Zhu JH; Feng XY; Jiang XC; Gong ZY; Tong YL
Address:Department of Burns and Plastic Surgery, the 181st Hospital of PLA, Guilin 541002, China.
Title:[Treatment of patients with different degree of acute respiratory distress syndrome caused by inhalation of white smoke].
Source:Zhonghua Shao Shang Za Zhi; 33(12):760-765, 2017 Dec 20.
ISSN:1009-2587
Country of publication:China
Language:chi
Abstract:To summarize the treatment experience of patients with different degree of acute respiratory distress syndrome (ARDS) caused by inhalation of white smoke from burning smoke bomb. A batch of 13 patients with different degree of ARDS caused by inhalation of white smoke from burning smoke bomb, including 2 patients complicated by pulmonary fibrosis at the late stage, were admitted to our unit in February 2016. Patients were divided into mild (9 cases), moderate (2 cases), and serious (2 cases) degree according to the ARDS Berlin diagnostic criteria. Patients with mild and moderate ARDS were conventionally treated with glucocorticoid. Patients with severe ARDS were sequentially treated with glucocorticoid and pirfenidone, and ventilator-assisted breathing, etc. were applied. The vital signs, arterial oxygenation index, changes of lung imaging, pulmonary ventilation function, general condition, and the other important organs/systems function were timely monitored according to the condition of patients. The above indexes were also monitored during the follow-up time of 10-15 months post injury. Data were processed with SPSS 18.0 statistical software. (1) The symptoms of respiratory system of patients with mild and moderate ARDS almost disappeared after 3 days' treatment. Their arterial oxygenation index was decreased from post injury day 1 to 4, which almost recovered on post injury day 7 and completely recovered one month post injury. The symptoms of respiratory system of patients with severe ARDS almost disappeared at tranquillization condition 1-3 month (s) post injury. Their arterial oxygenation index was decreased from post injury day 3 to 21, which gradually recovered 1-3 month (s) post injury and was normal 15 months post injury. (2) Within 24 hours post injury, there was no obvious abnormality or only a little texture enlargement of lung in image of chest CT or X-rays of patients with mild and moderate ARDS. One patient with moderate ARDS had diffuse patchy and ground-glass like increased density shadow (pulmonary exudation for short) at post injury hour 96. Chest iconography of all patients with mild and moderate ARDS showed no abnormalities 10 months post injury. Both lungs of each of the two patients with severe ARDS showed obvious pulmonary exudation at post injury hours 45 and 75, respectively. One patient with severe ARDS showed no abnormality in chest image 10 months post injury, but there was still a small mesh-like increased density shadow in double lobes with slight adhesion of pleura in the other patient with severe ARDS 15 months post injury. (3) All patients showed severe restrictive hypoventilation when admitted to hospital. Pulmonary ventilation function of patients with mild and moderate ARDS recovered to normal one month post injury, and they could do exercises like running, etc. Pulmonary ventilation function of one patient with severe ARDS recovered to normal 6 months post injury, and the patient could do exercises like running, etc. The other patient with severe ARDS showed mild restrictive hypoventilation 15 months post injury and could do exercises like rapid walking, etc. (4) The condition of all mild and one moderate ARDS patients was better on post injury day 3, and they were transferred to the local hospital for subsequent treatment and left hospital on post injury day 21. One patient with moderate ARDS healed and left hospital on post injury day 29. Patients with severe ARDS healed and left hospital on post injury day 81. During the follow-up time of 10-15 months post injury, the other important organs/systems of all patients showed no abnormality, and there was no adverse reaction of glucocorticoid like osteoporosis, femoral head necrosis, or metabolic disorder. Two patients with severe ARDS did not have any adverse reaction of pirfenidone like liver function damage, photosensitivity, anorexia, or lethargy. Early enough and uninterrupted application of glucocorticoid can significantly reduce the ARDS of patients caused by inhalation of white smoke from burning smoke bomb. Sequential application of glucocorticoid and pirfenidone can effectively treat pulmonary fibrosis at the late stage.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Smoke)


  5 / 1131 MEDLINE  
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PMID:28953914
Author:Kim Y; Kym D; Hur J; Yoon J; Yim H; Cho YS; Chun W
Address:Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Title:Does inhalation injury predict mortality in burns patients or require redefinition?
Source:PLoS One; 12(9):e0185195, 2017.
ISSN:1932-6203
Country of publication:United States
Language:eng
Abstract:Inhalation injury is known to be an important factor in predicting mortality in burns patients. However, the diagnosis is complicated by the heterogeneous presentation and inability to determine the severity of inhalation injury. The purpose of this study was to identify clinical features of inhalation injury that affect mortality and the values that could predict the outcome more precisely in burns patients with inhalation injury. This retrospective observational study included 676 burns patients who were over 18 years of age and hospitalized in the Burns Intensive Care Unit between January 2012 and December 2015. We analyzed variables that are already known to be prognostic factors (age, percentage of total body surface area (%TBSA) burned, and inhalation injury) and factors associated with inhalation injury (carboxyhemoglobin and PaO2/FiO2 [PF] ratio) by univariate and multivariate logistic regression. Age group (odds ratio [OR] 1.069, p<0.001), %TBSA burned (OR 1.100, p<0.001), and mechanical ventilation (OR 3.774, p<0.001) were identified to be significant predictive factors. The findings for presence of inhalation injury, PF ratio, and carboxyhemoglobin were not statistically significant in multivariate logistic regression. Being in the upper inhalation group, the lower inhalation group, and having a PF ratio <100 were identified to be significant predictors only in univariate logistic regression analysis (OR 4.438, p<0.001; OR 2.379, p<0.001; and OR 2.765, p<0.001, respectively). History and physical findings are not appropriate for diagnosis of inhalation injury and do not predict mortality. Mechanical ventilation should be recognized as a risk factor for mortality in burns patients with inhalation injury.
Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
Name of substance:S88TT14065 (Oxygen)


  6 / 1131 MEDLINE  
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PMID:28953660
Author:Xie F; Zhang X; Xie L
Address:Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
Title:Prognostic value of serum zinc levels in patients with acute HC/zinc chloride smoke inhalation.
Source:Medicine (Baltimore); 96(39):e8156, 2017 Sep.
ISSN:1536-5964
Country of publication:United States
Language:eng
Abstract:Hexachloroethane (HC)/zinc chloride (ZnCl, smoke bomb) exposure in the military setting results in lung injury which is uncommon and has been rarely described in previous studies. The aim of this study is to investigate the correlation between the serum zinc in patients with HC/ZnCl smoke inhalation lung injury and disease severity. A total of 15 patients with HC/ZnCl-related conditions were recruited in this study. The serum zinc level and the pulmonary function tests and liver function tests including total lung capacity (TLC), forced vital capacity (FVC), forced expiratory pressure in 1 second (FEV1), alanine aminotransferase (ALT), and aspartate transaminase (AST) were analyzed. Eleven cases had mild clinical manifestations. Four cases rapidly developed features typical of severe adult respiratory distress syndrome. The level of serum zinc was increased, but FVC, FEV1, and TLC was decreased significantly in the moderate and severe cases. In addition, the serum zinc level correlated well with the TLC, FVC, and FEV1 (r = -0.587, -0.626, -0.617, respectively; P = .027, .017, .019, respectively). The 4 cases in moderate and severe group had delayed impairment of liver functions after the accident. This study suggested that the serum zinc level may be associated with the severity of lung and liver injuries after HC/ZnCl smoke inhalation.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Chlorides); 0 (Hydrocarbons, Chlorinated); 0 (Smoke); 0 (Zinc Compounds); 86Q357L16B (zinc chloride); EC 2.6.1.1 (Aspartate Aminotransferases); EC 2.6.1.2 (Alanine Transaminase); G30K3QQT4J (hexachloroethane); J41CSQ7QDS (Zinc); L99N5N533T (Ethane)


  7 / 1131 MEDLINE  
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PMID:28592162
Author:De Carvalho FO; Silva R; Felipe FA; Teixeira LGB; Zago LBS; Nunes PS; Shanmugam S; Serafini MR; Arajo AAS
Address:a Post-graduate Program in Health Sciences , Federal University of Sergipe , So Cristvo , Brazil.
Title:Natural and synthetic products used for the treatment of smoke inhalation: a patent review.
Source:Expert Opin Ther Pat; 27(8):877-886, 2017 Aug.
ISSN:1744-7674
Country of publication:England
Language:eng
Abstract:INTRODUCTION: Inhalation injury is the leading cause of death in burn patients and is usually caused by the uninhibited absorption of smoke, which has an extremely toxic effect on the respiratory system. The physiopathology of inhalation injury covers multiple factors and the injured respiratory system may present deterioration in a few hours. Areas covered: In this present review, we analyzed patents based on both natural and synthetic products developed for the treatment of smoke inhalation. We found 14 patents in Espacenet, 25 in WIPO and none in the USPTO data search. Expert opinion: Several previous reports on treatments used for smoke inhalation are discussed. Although there are a number of research based products for this injury, there has been no review of the patents dealing with treatments for smoke inhalation. The development of novel natural or synthetic products are discussed in detail in the review.
Publication type:JOURNAL ARTICLE; REVIEW
Name of substance:0 (Biological Products)


  8 / 1131 MEDLINE  
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PMID:28527873
Author:Moritz A; Prottengeier J; Schmidt J
Address:Department of Anesthesiology, University Hospital Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany. Electronic address: andreas.moritz@kfa.imed.uni-erlangen.de.
Title:Comparison of Xenon with LED illuminant in difficult and inhalation injury airway scenario: A randomized crossover manikin study.
Source:Am J Emerg Med; 35(11):1639-1644, 2017 Nov.
ISSN:1532-8171
Country of publication:United States
Language:eng
Abstract:PURPOSE: The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. METHODS: We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios. The primary endpoint was the "time to intubate". Other endpoints were the "time to vocal cords", the "time to ventilate", the rate of successful intubation, the number of intubation attempts, the Cormack-Lehane score, the number of optimization maneuvers, the number of audible dental click sounds indicating dental damage and subjective impressions. RESULTS: In the difficult airway scenario, no significant differences in the recorded intubation times were observed. In the inhalation injury airway scenario, the intubation times were significantly shorter using the LED light handle. Regarding the subjective values, the LED illuminant enabled a significant better view and illumination of the oropharyngeal space and the vocal cords, in both manikin scenarios. CONCLUSION: The LED laryngoscope light handle did not affect the recorded intubation times in the simulated difficult airway scenario, but provided significant advantages in the inhalation injury airway scenario that combines a difficult airway with a limited view caused by a sooted pharynx. We therefore hypothesize, that the LED illuminant might be beneficial in the airway management of burn patients with severe inhalation injury.
Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
Name of substance:0 (Soot); 3H3U766W84 (Xenon)


  9 / 1131 MEDLINE  
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PMID:28525551
Author:Liu JC; Wilson A; Mickley LJ; Ebisu K; Sulprizio MP; Wang Y; Peng RD; Yue X; Dominici F; Bell ML
Title:Who Among the Elderly Is Most Vulnerable to Exposure to and Health Risks of Fine Particulate Matter From Wildfire Smoke?
Source:Am J Epidemiol; 186(6):730-735, 2017 Sep 15.
ISSN:1476-6256
Country of publication:United States
Language:eng
Abstract:Wildfires burn more than 7 million acres in the United States annually, according to the US Forest Service. Little is known about which subpopulations are more vulnerable to health risks from wildfire smoke, including those associated with fine particulate matter. We estimated exposure to fine particles specifically from wildfires, as well as the associations between the presence of wildfire-specific fine particles and the amount of hospital admissions for respiratory causes among subpopulations older than 65 years of age in the western United States (2004-2009). Compared with other populations, higher fractions of persons who were black, lived in urban counties, and lived in California were exposed to more than 1 smoke wave (high-pollution episodes from wildfire smoke). The risks of respiratory admissions on smoke-wave days compared with non-smoke-wave days increased 10.4% (95% confidence interval: 1.9, 19.6) for women and 21.7% (95% confidence interval: 0.4, 47.3) for blacks. Our findings suggest that increased risks of respiratory admissions from wildfire smoke was significantly higher for women than for men (10.4% vs. 3.7%), blacks than whites (21.7% vs. 6.9%), and, although associations were not statistically different, people in lower-education counties than higher-educated counties (12.7% vs. 6.1%). Our study raised important environmental justice issues that can inform public health programs and wildfire management. As climate change increases the frequency and intensity of wildfires, evidence on vulnerable subpopulations can inform disaster preparedness and the understanding of climate change consequences.
Publication type:JOURNAL ARTICLE
Name of substance:0 (Particulate Matter); 0 (Smoke)


  10 / 1131 MEDLINE  
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PMID:28358811
Author:Walsh DM; McCullough SD; Yourstone S; Jones SW; Cairns BA; Jones CD; Jaspers I; Diaz-Sanchez D
Address:Curriculum in Toxicology, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Title:Alterations in airway microbiota in patients with PaO2/FiO2 ratio ≤ 300 after burn and inhalation injury.
Source:PLoS One; 12(3):e0173848, 2017.
ISSN:1932-6203
Country of publication:United States
Language:eng
Abstract:BACKGROUND: Injury to the airways after smoke inhalation is a major mortality risk factor in victims of burn injuries, resulting in a 15-45% increase in patient deaths. Damage to the airways by smoke may induce acute respiratory distress syndrome (ARDS), which is partly characterized by hypoxemia in the airways. While ARDS has been associated with bacterial infection, the impact of hypoxemia on airway microbiota is unknown. Our objective was to identify differences in microbiota within the airways of burn patients who develop hypoxemia early after inhalation injury and those that do not using next-generation sequencing of bacterial 16S rRNA genes. RESULTS: DNA was extracted from therapeutic bronchial washings of 48 patients performed within 72 hours of hospitalization for burn and inhalation injury at the North Carolina Jaycee Burn Center. DNA was prepared for sequencing using a novel molecule tagging method and sequenced on the Illumina MiSeq platform. Bacterial species were identified using the MTToolbox pipeline. Patients with hypoxemia, as indicated by a PaO2/FiO2 ratio ≤ 300, had a 30% increase in abundance of Streptococcaceae and Enterobacteriaceae and 84% increase in Staphylococcaceae as compared to patients with a PaO2/FiO2 ratio > 300. Wilcoxon rank-sum test identified significant enrichment in abundance of OTUs identified as Prevotella melaninogenica (p = 0.042), Corynebacterium (p = 0.037) and Mogibacterium (p = 0.048). Linear discriminant effect size analysis (LefSe) confirmed significant enrichment of Prevotella melaninognica among patients with a PaO2/FiO2 ratio ≤ 300 (p<0.05). These results could not be explained by differences in antibiotic treatment. CONCLUSIONS: The airway microbiota following burn and inhalation injury is altered in patients with a PaO2/FiO2 ratio ≤ 300 early after injury. Enrichment of specific taxa in patients with a PaO2/FiO2 ratio ≤ 300 may indicate airway environment and patient changes that favor these microbes. Longitudinal studies are necessary to identify stably colonizing taxa that play roles in hypoxemia and ARDS pathogenesis.
Publication type:JOURNAL ARTICLE
Name of substance:0 (RNA, Ribosomal, 16S)



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