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The article offers a guide to wound dressings, wound assessment and selection of wound dressings based on wound aetiology, depth and patient factors.

Introduction: Smoke inhalation injury (II) is an independent risk factor for mortality in burns and its management is inherently complex. We aim to make recommendations for best practice in managing II and its sequelae by reviewing all available current evidence in order to provide an evidence-based approach.Methods: We conducted a systematic search of the Cochrane database and Embase using PRISMA guidelines with no patient population exclusion criteria. Published work was reviewed and evidence levels graded.Results: We identified 521 abstracts for inclusion. Of the 84 articles identified for secondary review, 28 papers were excluded leaving 56 papers suitable for final inclusion.Conclusions: We are able to identify a number of strategies in both diagnosis and treatment of II that have support in the published literature, including the role of bronchoscopy, permissive hypercapnia, nebulized heparin and hydroxycobalamin. Other strategies have not been shown to be harmful, but their efficacy is also not firmly established, such as high frequency oscillatory ventilation and exogenous surfactant. Prophylactic antibiotics and corticosteroids are not recommended. In general, published evidence for II is mostly Level 3 or below, due to a noticeable lack of large-scale human studies. This represents a challenge for evidence-based burns practice as a whole. [ABSTRACT FROM AUTHOR]

Serum iron concentration is usually decreased in true iron deficiency and with inflammatory disease in man and domestic animals. Serum total iron binding capacity (TIBC) may be increased in true iron deficiency and decreased with inflammatory disease. This prospective study was designed to measure serum iron analytes in healthy free-ranging and housed Florida manatees (Trichechus manatus latirostris) of both sexes and various ages and to evaluate the effects of diseases common to manatees on these analytes. Blood samples were collected without anticoagulant from 137 healthy free-ranging manatees, 90 healthy housed manatees and 74 free-ranging diseased manatees, and serum was prepared by centrifugation. Serum iron concentration and unsaturated iron binding capacity were measured colourimetrically, and TIBC and percent transferrin saturation with iron were calculated. Serum amyloid A (SAA) was measured to assist in the health assessment of manatees and provide evidence of inflammation in diseased manatees. Based on the serum iron analytes, iron availability was lower in immature manatees compared with adults, and it was lower in housed manatees compared with free-ranging manatees. In contrast to other mammals studied, serum iron concentration was elevated rather than depressed in late pregnancy. Serum iron concentrations and transferrin saturation with iron percentages were significantly lower, and SAA concentrations were significantly higher, in diseased (ill and injured) manatees compared with healthy manatees. Serum iron concentration and transferrin saturation with iron values were negatively correlated with SAA concentrations, and manatees with the highest SAA concentrations had lower serum TIBC values. These findings indicate that inflammation is the major factor responsible for alterations in iron analytes in diseased manatees. Consequently, hypoferraemia may be used as supportive evidence of inflammatory disease in manatees (unless haemorrhage is also present). A decision threshold of ≤13.8 μmol/l was determined for hypoferraemia using receiver operating curve analysis. Based on studies in man and domestic animals, iron therapy is unnecessary for manatees with hypoferraemia associated with inflammation and has the potential for causing tissue damage and increased susceptibility to bacterial infections., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The objective was to validate a high-sensitivity chemiluminescent assay of serum progesterone concentrations for pregnancy diagnosis in manatees. Assay analytical sensitivity was 0.1 ng/mL, with mean intra- and inter-assay coefficients of variation of 9.7 and 9.2%, respectively, and accuracy had a mean adjusted R(2) of 0.98. Methods comparison (relative to Siemen's Coat-A-Count RIA) demonstrated r=0.98, Deming regression slope of 0.95, and an intercept of 0.01. Based on ROC analysis, a progesterone concentration >or=0.4 ng/mL was indicative of pregnancy. Assay results were not significantly altered by two freeze-thaw cycles of samples. Characteristic progesterone concentrations during pregnancy were Months 1-4 (1.7-4.7 ng/mL), 5-8 ( approximately 1.0 ng/mL), and 10 and 11 (0.3-0.5 ng/mL), whereas two late-pregnant females with impending abortion had progesterone concentrations of 0.1 ng/mL. Among pregnant females, maximum progesterone concentrations occurred in autumn (3.9+/-1.8 ng/mL), and were greater during all seasons than concentrations in non-pregnant females (0.1-0.2 ng/mL). Progesterone concentrations were also significantly higher in pregnant females than in non-pregnant females and males. This highly sensitive, specific, and diagnostic assay will be valuable for monitoring pregnancy and abortion in manatees.

Paracoccus denitrificans requires potassium for normal growth and transports this cation by at least two systems, one with low (Km approximately 1 to 2 mM) and another with high (Km approximately 0.1 microM) affinity. Neither of the two systems seems to be dependent on periplasmic components since each retains full activity in cells subjected to an osmotic shock. P. denitrificans accumulates potassium at high velocity (270 nmol of K+/min/mg dry weight of cells) and against a large concentration gradient. The intracellular concentration of K+ in media of high osmolarity (about 320 mosmol) is 0.4 M; this gives a concentration gradient [K+]i/[K+]e of greater than or equal to 2 X 10(4). The uptake of potassium against its concentration gradient requires a source of energy and is eliminated by the addition of uncouplers. The increased rate of energy usage for potassium transport results in an increased rate of ATP synthesis by the respiratory chain and is expressed in enhanced rates of respiration and substrate utilization. The stimulation of respiration is accompanied by increased steady state reduction level of the components of the respiratory chain. The calculations show that two K+ are most likely to be transported per one ATP hydrolyzed.

19F NMR pH measurements with the fluorinated pH indicators we have described are rapid and sensitive, work with readily available commercial instruments, and extend the applicability of nondestructive NMR measurements to systems for which 31P NMR measurements are presently impractical. The family of 19F pH indicators is useful for independent confirmation of pHi values obtained by 31P NMR, distribution of radioactive weak acids, or other methods. The necessity for using exogenous indicators, which at first appears as a liability, can be turned to advantage also. Our future goal is to direct our measurements unambiguously to compartments (in cells or in tissues) of particular interest, by matching the indicator precursor molecule to the hydrolytic enzyme activities inherent in the target cell or compartment, so that the pH indicator is generated in situ.

The pH dependence of the 19F chemical shift has been characterized for a number of fluorine-substituted aniline derivatives. These compounds constitute a new class of 19F nuclear magnetic resonance (NMR) pH indicators, characterized by single 19F resonance lines with sensitivities ranging from 2 to 7 ppm/pH unit near the aniline pKa; total shifts between conjugate acid and base of 5-15 ppm; and pKas ranging from 1 to 7. One compound, N,N-(methyl-2-carboxyisopropyl)-4-fluoroaniline, has a pKa of 6.8 and a sensitivity of 5 ppm/pH unit. This compound displays significant broadening of its 19F resonance near the aniline pKa (6.8), due to a decreased rate of exchange between conjugate acid and base species. Our results are consistent with slow dissociation of an intramolecular hydrogen bond in the zwitterionic species that limits the exchange rate between protonated and unprotonated forms for N,N-(methyl-2-carboxyisopropyl)-4-fluoroaniline.

Paracoccus denitrificans suspended in media containing 20-300 mM NaCl swelled progressively as the salt concentration was decreased. The increase in intracellular water volume was accompanied by an enhancement of respiration and a stimulation of the rates of net potassium and alpha-aminoisobutyric acid accumulation. It is postulated that influx of water and consequent lowering of intracellular solute concentration trigger transport mechanisms which are destined to restore the original ion and metabolite balance. Since a number of transport reactions operate against the electrochemical gradient of their substrates, energy utilization increases. The increased ATP usage and lowering of [ATP] stimulates the activity of the respiratory chain and increases oxygen uptake and energy production.