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Fluid resuscitation in treatment of burn shock
Bratland, Benedicte ; Zajíček, Robert (advisor)
Treatment of burns can be divided into 3 phases. During first 36 hours fluid resuscitation and securing airways are the most important aspects of therapy. The fluid resuscitation is complex, and protocols are used to increase the consistency and success of treatment. The adequacy of the protocols should be continuously monitored and adjusted to the patients response. Current studies are exploring the use of antioxidants to minimize the oxidant stress during the burn shock phase. The aim of this thesis is to review current strategies in fluid resuscitation during the first 36 hours after burns.
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Non-termic skin losses at the Prague Burn Centre through the years 1998 -2008
Pintar, David ; Zajíček, Robert (advisor)
Exfoliative loses of the skin are rare, but potentially lethal disorders that includes toxical epidermal necrolysis and staphylococcal scalded skin syndrome. They should be considered in a differential diagnosis and a quick transfer to the burn center is essential. The level of care and the effectiveness of the treatment at the burn unit significantly decreases the morbidity and mortality of these diseases. A transport of the patient proceeds with a time delay and the usage of the systemic corticosteroids at the previous hospital unit is frequent, according to the results of our clinical study. TEN patients are often unsuccesfully treated at the different units, mostly at the dermatological clinics and the infection diseases clinics, where the treatment of the involved skin surface is insufficient and corticosteroids are often administered. This evidence indicates that there is a requisiteness of an wider education intended for the medical public, especially for the medical members who may have a greater probability of encountering TEN patients.
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Influence of acellular pig dermis on the healing of thermal skin injuries
Zajíček, Robert ; Königová, Radana (advisor) ; Brychta, Pavel (referee) ; Klein, Leo (referee)
The submitted dissertation addresses the issue of acellular pig dermis in healing burn wound. The acellular xenodermis Xe-Derma® (XD) has been developed in the Prague Burn Centre in cooperation with the Czech Academy of Sciences and has been produced by a Czech company. Several culture techniques for cultivation of human primary keratinocytes were tested. The bioactivity of XD was studied by a cell culture assay in an organotypic culture system at the air-liquid interface. We compared keratinocyte proliferation and formation of epidermis in vitro with formation of neo-epidermis in the deep dermal wounds treated with XD (in vivo). Morphological and immunohistochemical analysis of keratinocytes confirmed the similarity of organization and differentiation of the cultured epidermal cells to the normal epidermis. Ability to stimulate growth and differentiation of keratinocytes connote bioactivity of XD. The natural structure and firmness of XD (composed of collagen and elastic fibres with the surface responding to the basement membrane) enables adhesion,proliferation, migration and differentiation of epidermal cells. In the clinical use XD appertains to temporary covers in burn treatment, particularly on scalds in children. In the frame of grant project IGA there has been investigated healing of widely meshed...
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Complex Care of a Patient with Thermal Trauma
Aloisdóttir, Lara Dina ; Šetelíková, Lenka (advisor) ; Zajíček, Robert (referee)
Complex Care of a Patient with Thermal Trauma The goal of this thesis is the reader's introduction into the burn trauma issue in general and illustrating the complex care of a burned patient by a case study. The patient is a professional pilot who suffered burns on 25 % of the body surface area. In the first part I describe theoretical foundations of thermal trauma, the treatment progress including operations and permanent mutilation. In the other part I deal with a case study of a patient who was hospitalized for 43 days - first in the resuscitation unit and then in burn injuries clinic. I specifically reflect nutrition of burned patients and long-term, often life- long care of scars and psychological condition. Key words: nursing care, burns, thermal trauma, burn shock, necrectomy, autotransplantation, scars, rehabilitation, psychology
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Nutrition in thermic injury
Zemanová, Markéta ; Zajíček, Robert (advisor) ; Novák, František (referee)
Výživa u termických úrazů [Nutrition in Thermic Injury]. Bc. ZEMANOVÁ, Markéta, DiS. Praha, 2017. Počet stránek 84, 2. Diplomová práce (Mgr.) Univerzita Karlova, 1.lékařská fakulta Obor: Nutriční specialista Vedoucí práce MUDr. Robert Zajíček, Ph.d Abstract Aim of the thesis is summarizing current knowledge about clinical nutrition of patients with severe thermal injuries. Special emphasis is given to specifics of pediatric patients, who in many aspects react differently. The introduction focuses on history of burn medicine including nutrition, classification of burn injuries, prehospital care and role of individual members of the therapeutical multidisciplinary team logically centring on role of the dietitian. Extreme hypermetabolism, persisting a year or longer after the insult, influences nutritional recommendations including energy, macronutrients (protein, fats and carbohydrates) and micronutrients (minerals, vitamins and trace elements). Mode of administration is influenced as well. Specific facts are shown how these characteristics are reflected in daily dietetic therapy at the Clinic of Burn Medicine of the Prague Vinohrady Faculty Hospital (FNKV). In the investigative part we compare two groups of adult patients with extensive burn injuries. Inclusion criteria were age of 18-65 years, extent of...
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Influence of acellular pig dermis on the healing of thermal skin injuries
Zajíček, Robert ; Königová, Radana (advisor) ; Brychta, Pavel (referee) ; Klein, Leo (referee)
The submitted dissertation addresses the issue of acellular pig dermis in healing burn wound. The acellular xenodermis Xe-Derma® (XD) has been developed in the Prague Burn Centre in cooperation with the Czech Academy of Sciences and has been produced by a Czech company. Several culture techniques for cultivation of human primary keratinocytes were tested. The bioactivity of XD was studied by a cell culture assay in an organotypic culture system at the air-liquid interface. We compared keratinocyte proliferation and formation of epidermis in vitro with formation of neo-epidermis in the deep dermal wounds treated with XD (in vivo). Morphological and immunohistochemical analysis of keratinocytes confirmed the similarity of organization and differentiation of the cultured epidermal cells to the normal epidermis. Ability to stimulate growth and differentiation of keratinocytes connote bioactivity of XD. The natural structure and firmness of XD (composed of collagen and elastic fibres with the surface responding to the basement membrane) enables adhesion,proliferation, migration and differentiation of epidermal cells. In the clinical use XD appertains to temporary covers in burn treatment, particularly on scalds in children. In the frame of grant project IGA there has been investigated healing of widely meshed...
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Fluid resuscitation in treatment of burn shock
Bratland, Benedicte ; Zajíček, Robert (advisor)
Treatment of burns can be divided into 3 phases. During first 36 hours fluid resuscitation and securing airways are the most important aspects of therapy. The fluid resuscitation is complex, and protocols are used to increase the consistency and success of treatment. The adequacy of the protocols should be continuously monitored and adjusted to the patients response. Current studies are exploring the use of antioxidants to minimize the oxidant stress during the burn shock phase. The aim of this thesis is to review current strategies in fluid resuscitation during the first 36 hours after burns.
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|
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Non-termic skin losses at the Prague Burn Centre through the years 1998 -2008
Pintar, David ; Zajíček, Robert (advisor)
Exfoliative loses of the skin are rare, but potentially lethal disorders that includes toxical epidermal necrolysis and staphylococcal scalded skin syndrome. They should be considered in a differential diagnosis and a quick transfer to the burn center is essential. The level of care and the effectiveness of the treatment at the burn unit significantly decreases the morbidity and mortality of these diseases. A transport of the patient proceeds with a time delay and the usage of the systemic corticosteroids at the previous hospital unit is frequent, according to the results of our clinical study. TEN patients are often unsuccesfully treated at the different units, mostly at the dermatological clinics and the infection diseases clinics, where the treatment of the involved skin surface is insufficient and corticosteroids are often administered. This evidence indicates that there is a requisiteness of an wider education intended for the medical public, especially for the medical members who may have a greater probability of encountering TEN patients.
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