Publications by authors named "Lauren T Moffatt"

Burn injury results in hypercoagulability and an increased venous thromboembolism risk. However, the most effective chemoprophylaxis for burn-injured patients has yet to be elucidated. Therefore, this study aims to identify the safety and efficacy of a burn center's venous thromboembolism protocol modification which increased the dose of enoxaparin from 40mg daily to 40mg twice daily with peak anti-Xa level adjustments.

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  • ECMO usage is increasing, but determining which patients will benefit the most is challenging, making risk stratification crucial.
  • This study evaluated the impact of two biomarkers, SDC-1 and soluble thrombomodulin (sTM), on mortality rates in patients on venoarterial ECMO.
  • Results showed that higher levels of sTM significantly correlate with increased mortality risk, while SDC-1 levels are marginally predictive; these findings suggest that incorporating these biomarkers could enhance existing scoring systems for better patient assessment.
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Introduction: Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes.

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Introduction: Plasma inclusive resuscitation (PIR) uses fresh frozen plasma as an adjunct to crystalloid in the management of burn shock and has potential benefits over other colloids. Yet, safety concerns for transfusion-related acute lung injury (TRALI) exist. The aim of this study evaluated the association between TRALI and PIR in a cohort of severely burn-injured patients using the updated Canadian Blood Services Consensus definitions.

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Introduction: The contribution of endothelial injury to the pathogenesis of burn shock is not well characterized. This work investigates potential mechanisms underlying dysregulation of endothelial barrier function by burn patient plasmas.

Methods: Plasma was collected from burn-injured patients (n = 8) within 4 h of admission.

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  • Dynamically titrated crystalloids are the primary method for treating burn shock, and this study investigates whether adding allogeneic plasma (known as plasma-inclusive resuscitation, or PIR) affects coagulation negatively.
  • The study involved 35 patients treated with PIR, analyzing their blood to check for coagulopathy at multiple points during treatment, finding no significant coagulation issues or complications like transfusion reactions.
  • Results indicate that PIR does not cause harmful blood clotting changes compared to baseline in burn patients, suggesting it may be safe, but further research is necessary to confirm these results and assess its effectiveness in burn resuscitation.
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In recent years, it has become apparent that fibrinolytic dysfunction and endotheliopathy develop in up to 40% of patients during the first hours following thermal injury and are associated with poor outcomes and increased resuscitation requirements. Rapidly following burn injury, the fibrinolytic system is activated, with activation generally greater with increased severity of injury. Very high plasma concentrations of plasmin-antiplasmin complex (marker of activation) have been associated with mortality.

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  • The study investigates the effectiveness of combining autologous skin cell suspension (ASCS) with meshed split-thickness skin grafts (mSTSG) for treating large burns, aiming to improve healing times and reduce aesthetic issues.
  • Experiments conducted on pigs showed that wounds treated with ASCS had significantly faster re-epithelialization rates compared to those without ASCS, particularly noted on days 3, 5, and 7 post-grafting.
  • However, despite the improved healing rates, the presence of ASCS did not affect the patterning of the scars, indicating that while ASCS enhances healing, it may not address visual scarring issues.
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  • - The study aimed to explore how different pulse energy settings of fractional ablative CO lasers affect gene transcription related to wound healing in uninjured pig skin.
  • - Researchers treated skin samples with laser settings of 70, 100, and 120 mJ and analyzed gene expression over time, focusing on eight specific genes tied to healing and the extracellular matrix.
  • - Results showed that while laser treatment enhanced the expression of six out of eight genes, varying pulse energies did not lead to significant differences in gene transcription levels, suggesting that lower energy may suffice for effective treatment.
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  • Endothelial dysfunction is a key factor in burn shock, and components like Syndecan-1 (SDC-1) are used to measure endothelial damage after thermal injuries.
  • A study with Sprague-Dawley rats tested different resuscitation methods, including fresh frozen plasma (FFP) given at various times post-injury, to assess their effect on endothelial health.
  • Results indicated that early administration of FFP reduced vascular leakage and levels of SDC-1 in the bloodstream compared to groups that received only lactated Ringer's solution, highlighting the importance of timing in resuscitation strategies.
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  • Infection can delay burn wound healing, increasing complications and scarring, necessitating an effective antimicrobial that spares skin cells crucial for recovery.
  • The study evaluated a handheld device, the Aceso Plasma Generator, which produces Aceso Cold Plasma (ACP), demonstrating its effectiveness in killing bacteria without hindering wound healing in tested animals.
  • ACP appears to be a promising treatment for reducing infection risk in acute burn injuries and may also benefit wounds prone to delayed healing and scarring, offering a new method for efficient wound management.
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Objectives: Dyschromia is an understudied aspect of hypertrophic scar (HTS). The use of topical tacrolimus has successfully shown repigmentation in vitiligo patients through promotion of melanogenesis and melanocyte proliferation. It was hypothesized that HTSs treated with topical tacrolimus would have increased repigmentation compared to controls.

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Neutrophil extracellular trap (NET) formation is a mechanism that neutrophils possess to respond to host infection or inflammation. However, dysregulation of NETosis has been implicated in many disease processes. Although the exact mechanisms of their involvement remain largely unknown, this study aimed to elucidate NET formation over the time course of coronavirus disease 2019 (COVID-19) infection and their possible role in endothelial injury.

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  • The study investigated the effectiveness of different thromboelastography (TEG) methods—rapid-TEG (rTEG), kaolin-TEG (kTEG), and native-TEG (nTEG)—in assessing coagulopathy in burn patients over a 21-day period.
  • 121 burn patients were evaluated, revealing significant correlations between severe burns, mortality rates, and specific TEG parameters like α-angle and maximum amplitude (MA), with rTEG showing the strongest links to patient outcomes.
  • Overall, the TEG methods had variable agreement and reliability, suggesting that the choice of TEG technique can significantly influence clinical decisions and patient management strategies in severe burn cases.
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Dyschromic hypertrophic scar (HTS) is a common sequelae of burn injury, however, its mechanism has not been elucidated. This work is a histological study of these scars with a focus on rete ridges. Rete ridges are important for normal skin physiology, and their absence or presence may hold mechanistic significance in post-burn HTS dyschromia.

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The Burn Care Quality Platform (BCQP) consolidates data previously collected from the National Burn Repository and the Burn Quality Improvement Program into a single registry. Its data elements and their associated definitions are tailored to create consistency across other national trauma registries, namely the National Trauma Data Bank implemented by the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP). The BCQP now includes 103 participating burn centers and has captured data from 375,000 total patients as of 2021.

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Introduction: Literature examining the connection between obesity and burn injuries is limited. This study is a secondary analysis of a multicenter trial data set to investigate the association between burn outcomes and obesity following severe burn injury.

Materials And Methods: Body mass index (BMI) was used to stratify patients as normal weight (NW; BMI 18.

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  • Dyschromia, characterized by abnormal pigmentation in hypertrophic scars (HTS), is a common issue after burn injuries, and current treatment options are limited.
  • This study explores the effects of synthetic alpha melanocyte stimulating hormone (α-MSH) delivered via laser-assisted drug delivery (LADD) on repigmenting hypopigmented scars in red Duroc pigs.
  • Results showed that treated scars exhibited a gradual increase in hyperpigmented areas compared to control scars, indicating that topical α-MSH could effectively enhance pigmentation in HTSs over a four-week period.
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  • * In a study using a swine model, researchers found that levels of syndecan-1 (SDC-1), a marker indicating damage to blood vessel linings, significantly increased in animals with inhalation injury compared to those without, showing a clear link between inhalation and vascular injury.
  • * The findings suggest that understanding how inhalation injuries cause endothelial damage could lead to better treatments for burn victims, particularly in managing the shock that often follows such injuries.
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  • The study investigates how fractional ablative CO2 laser scar revision (FLSR) affects hypertrophic scars (HTS) by examining changes in skin structure and gene expression in experimental Duroc pigs.
  • Researchers performed four weekly FLSR treatments on injured pigs and monitored skin healing using noninvasive probes and biopsies to assess epidermal thickness and other factors.
  • Results showed that FLSR significantly improved barrier function and increased epidermal thickness and rete ridge ratios, particularly with immediate treatment, while control groups showed no such improvements.
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Countermeasures for radiation diagnosis, prognosis, and treatment are trailing behind the proliferation of nuclear energy and weaponry. Radiation injury mechanisms at the systems biology level are not fully understood. Here, mice skin biopsies at h2, d4, d7, d21, and d28 after exposure to 1, 3, 6, or 20 Gy whole-body ionizing radiation were evaluated for the potential application of transcriptional alterations in radiation diagnosis and prognosis.

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  • Hypertrophic scar (HTS) formation is a major issue for burn injury patients, with dermal microvascular endothelial cells (DMVECs) playing a key but under-researched role in this process.
  • The study discovered that DMVECs in HTS exhibited significant differences in gene expression and functionality compared to those from normal skin, including altered permeability and a specific profile of 31 differentially expressed genes.
  • Results indicated that HTS DMVECs have a unique response to injury, being less permeable and displaying mixed factors that can affect scar formation, suggesting their important role in understanding and treating HTS development.
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  • Urinary output (UOP) is commonly used to gauge fluid resuscitation during burns, but it's not very reliable for assessing fluid responsiveness.
  • This study tested whether advanced monitoring methods, like arterial pulse wave analysis (PWA), could provide better insights into cardiac output (CO) and stroke volume (SV) during burn treatment.
  • Results showed that PWA-derived indices closely matched reference CO and SV measurements and may offer valuable information alongside UOP for effective burn resuscitation.
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, a gram-positive bacterium, causes toxic shock through the production of superantigenic toxins (sAgs) known as Staphylococcal enterotoxins (SE), serotypes A-J (SEA, SEB, etc.), and toxic shock syndrome toxin-1 (TSST-1). The chronology of host transcriptomic events that characterizes the response to the pathogenesis of superantigenic toxicity remains uncertain.

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The lack of an easy and fast radiation-exposure testing method with a dosimetric ability complicates triage and treatment in response to a nuclear detonation, radioactive material release, or clandestine exposure. The potential of transcriptomics in radiation diagnosis and prognosis were assessed here using wet skin (blood/skin) biopsies obtained at hour 2 and days 4, 7, 21, and 28 from a mouse radiation model. Analysis of significantly differentially transcribed genes (SDTG; ≤ 0.

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