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Study evaluated the basic psychometric features of a modified version of the Coma Recovery Scale-Revised (CRS-R) for use in young children with disorders of consciousness. The CRS-R was modified to create the Coma Recovery Scale for Pediatrics (CRS-P) and administered to 33 typically developing children (ages 8 to 59 months). ...

Study identified the prevalence and predictors of tobacco smoking among veterans and military service members with traumatic brain injury (TBI) admitted for rehabilitation. Participants were drawn from the Veterans Affairs (VA) TBI Model Systems (TBIMS) multicenter longitudinal research study. Tobacco smoking was assessed both preinjury and at 1- or 2-year ...

Study investigated the prevalence of drinking within the recommended limits (i.e., low-risk drinking) after moderate or severe traumatic brain injury (TBI). National Institute on Alcohol Abuse and Alcoholism guidelines define low-risk drinking as no more than 4 drinks per day for men or 3 drinks per day for women and ...

Objectives. We compared insulin-like growth factor (IGF-I) levels obtained in two groups with different methods of assessing compliance. Burned children were randomized to receive a daily injection of 0.05-0.1mg/kg per day of recombinant human growth hormone (rhGH) or placebo. Study design. One hundred twenty-five children (age range 6 months ...

The purpose of this study is to gain insight into the level of agreement, in terms of personal problems, between burn survivors and an informant with whom they have a close personal relationship. Participants in the study were 72 young adult burn survivors between the ages of 18 and ...

Autografting of burn wounds results in generation of donor site wounds. Here we measured donor site wound protein fractional synthesis rate (FSR) in a burn pediatric population and showed that FSR increases over time postsurgery and correlates with the length of hospital stay (LOS) normalized for total body surface ...

The posttraumatic response to burn injury leads to marked and prolonged skeletal muscle catabolism and weakness, which persist despite standard rehabilitation programs of occupational and physical therapy. We investigated whether a resistance exercise program would attenuate muscle loss and weakness that is typically found in children with thermal injury. ...

Previous studies indicate that rehabilitation programs supplemented with a strength and endurance-based exercise program improve lean body mass, pulmonary function, endurance, strength, and functional outcomes in severely burned children over the age of 7-years when compared with standard of care (SOC). To date, supplemental exercise programming for severely burned ...

Severe burn injuries are associated with growth delays a persistent hypermetabolic response and severe muscle catabolism and wasting. Growth hormone (GH), a potent anabolic agent and salutary modulator of post-traumatic metabolic responses has been shown to decrease muscle wasting, improve net protein synthesis and attenuate growth delays in burned ...

BACKGROUND: Severe burns cause exaggerated catabolism of muscle protein and inhibit bone deposition. Weakness and bony growth arrest interfere with rehabilitation. The purpose of this study was to determine whether oxandrolone administration for 1 year after the burn reverses muscle and bone catabolism in hypermetabolic pediatric burn patients. METHODS: ...

Objective: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. Summary Background Data: One-hundred eighty-nine children sustaining a 40% ...

The hypercatabolism after massive pediatric burns has been effectively treated with recombinant human growth hormone, an anabolic agent that stimulates protein synthesis and abrogates growth arrest. While experimental studies have shown increased potential for fibrosis induced by growth hormone therapy, adverse effects on human scars have not been investigated. ...

Although dermal collagens appear increased in hypertrophic scars, this has not been tested in tissue samples using objective methods. We compared the expression of types I and III collagen in hypertrophic and non hypertrophic scars at 6-12 and 18-24 months after burn using a quantitative method. Among 17 patients ...

INTRODUCTION: Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. ...

The profound hypermetabolic response to burn injury is associated with insulin resistance and hyperglycemia, significantly contributing to the incidence of morbidity and mortality in this patient population. These responses are present in all trauma, surgical, or critically ill patients, but the severity, length, and magnitude is unique for burn ...

BACKGROUND: In the treatment of burns, patients' own skin is the preferred material to cover burn wounds, resulting in the need to create a donor site wound. Enhancement of healing of the donor site wound would be beneficial in burn patients. Insulin, an anabolic agent, is used routinely to ...

BACKGROUND: Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of ...

Objective: When given to children for 1 year after a severe burn, oxandrolone significantly improves lean body mass, bone mineral content, and muscle strength. The beneficial effects of oxandrolone on height and weight were observed 1 year after treatment was discontinued. To study the efficacy of oxandrolone in severely ...

BACKGROUND: There is currently a lack of objective methods to assess scars. OBJECTIVES: The objectives of this study were to (1) determine the pattern of scar formation up to 24 months after a burn, compare clinical and photographic scar assessment, and determine what percentage of scars became hypertrophic after ...