The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects

Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for ‘omics’ profiling of blister fluid from burn wounds of differing severity.

Evaluation of the efficacy and economics of irrigation management, plant resistance and Brassica(spot)(TM) models for management of white blister on Brassica crops

Options for the integrated management of white blister (caused by Albugo candida) of Brassica crops include the use of well timed overhead irrigation, resistant cultivars, programs of weekly fungicide sprays or strategic fungicide applications based on the disease risk prediction model, Brassica(spot)(TM). Initial systematic surveys of radish producers near Melbourne, Victoria, indicated that crops irrigated overhead in the morning (0800-1200 h) had a lower incidence of white blister than those irrigated overhead in the evening (2000-2400 h). A field trial was conducted from July to November 2008 on a broccoli crop located west of Melbourne to determine the efficacy and economics of different practices used for white blister control, modifying irrigation timing, growing a resistant cultivar and timing spray applications based on Brassica(spot)(TM). Growing the resistant cultivar, 'Tyson', instead of the susceptible cultivar, 'Ironman', reduced disease incidence on broccoli heads by 99 %. Overhead irrigation at 0400 h instead of 2000 h reduced disease incidence by 58 %. A weekly spray program or a spray regime based on either of two versions of the Brassica(spot)(TM) model provided similar disease control and reduced disease incidence by 72 to 83 %. However, use of the Brassica(spot)(TM) models greatly reduced the number of sprays required for control from 14 to one or two. An economic analysis showed that growing the more resistant cultivar increased farm profit per ha by 12 %, choosing morning irrigation by 3 % and using the disease risk predictive models compared with weekly sprays by 15 %. The disease risk predictive models were 4 % more profitable than the unsprayed control.

Evaluation of haemoglobin in blister fluid as an indicator of paediatric burn wound depth

The early and accurate assessment of burns is essential to inform patient treatment regimens; however, this first critical step in clinical practice remains a challenge for specialist burns clinicians worldwide. In this regard, protein biomarkers are a potential adjunct diagnostic tool to assist experienced clinical judgement. Free circulating haemoglobin has previously shown some promise as an indicator of burn depth in a murine animal model. Using blister fluid collected from paediatric burn patients, haemoglobin abundance was measured using semi-quantitative Western blot and immunoassays. Although a trend was observed in which haemoglobin abundance increased with burn wound severity, several patient samples deviated significantly from this trend. Further, it was found that haemoglobin concentration decreased significantly when whole cells, cell debris and fibrinous matrix was removed from the blister fluid by centrifugation; although the relationship to depth was still present. Statistical analyses showed that haemoglobin abundance in the fluid was more strongly related to the time between injury and sample collection and the time taken for spontaneous re-epithelialisation. We hypothesise that prolonged exposure to the blister fluid microenvironment may result in an increased haemoglobin abundance due to erythrocyte lysis, and delayed wound healing

Indentation of sintered alumina clay composite - an experimental discussion of a combined Boussinesq and blister stress field approach

Surface elastic strain field generated in conical indentation of sintered alumina clay composite was measured to verify the suitability of a superposed combination of Boussinesq and blister stress fields, used previously for analysing the indentation problem. The residual strain measured in the elastic hinterland is used to estimate the blister field strength without any reference to stress relation within that field. The approach may be useful in fracture studies of brittle materials.

A Novel Investigation of a Blister-Like Syndrome in Aquarium Echinopora lamellosa

This study investigates potential causes of a novel blister-like syndrome in the plating coral Echinopora lamellosa. Visual inspections of this novel coral syndrome showed no obvious signs of macroparasites and the blisters themselves manifested as fluid-filled sacs on the surface of the coral, which rose from the coenosarc between the coral polyps. Histological analysis of the blisters showed that there was no associated necrosis with the epidermal or gastrodermal tissues. The only difference between blistered areas and apparently healthy tissues was the presence of proliferated growth (possible mucosal cell hyperplasia) directly at the blister interface (area between where the edge of the blister joined apparently healthy tissue). No bacterial aggregates were identified in any histological samples, nor any sign of tissue necrosis identified. We conclude, that the blister formations are not apparently caused by a specific microbial infection, but instead may be the result of irritation following growth anomalies of the epidermis. However, future work should be conducted to search for other potential casual agents, including viruses. © 2014 Smith et al.

Das OtCM-System zur elektronischen Compliance-Messung : Qualitätsuntersuchung der OtCM-Blister und e-Dispenser ; Validierung und Nutzenevaluation im Vergleich mit MEMS

Im Rahmen der vorliegenden Arbeit wurden Eignung und Nutzen des „Objective therapy Compliance Measurement“ (OtCMTM)-Systems, einer innovativen Weiterentwicklung im Bereich der elektronischen Compliance-Messung, untersucht. Unter experimentellen Bedingungen wurden Funktionalität und Verlässlichkeit der elektronischen OtCMTM-Blisterpackungen überprüft, um deren Eignung für den klinischen Einsatz zu zeigen. Funktionalität (≥90% lesbare Blister), Richtigkeit (≤2% Fehler) und Robustheit waren bei den OtCMTM-Blistern der Version 3 gegeben, nachdem die Fehler der Versionen 1 und 2 in Zusammenarbeit mit dem Hersteller TCG identifiziert und eliminiert worden waren. Der als Alternative zu den elektronischen Blistern für die Verpackung von klinischen Prüfmustern entwickelte OtCMTM e-Dispenser wurde bezüglich Funktionalität und Anwenderfreundlichkeit in einer Pilotstudie untersucht. Dabei wurde ein Optimierungsbedarf festgestellt. In einer klinischen Studie wurde das OtCMTM-System mit dem als „Goldstandard“ geltenden MEMS® verglichen. Vergleichskriterien waren Datenqualität, Akzeptanz und Anwenderfreundlichkeit, Zeitaufwand bei der Bereitstellung der Medikation und Datenauswertung, sowie Validität. Insgesamt 40 Patienten, die mit Rekawan® retard 600mg behandelt wurden, nahmen an der offenen, randomisierten, prospektiven Studie teil. Das OtCMTM-System zeigte sich bezüglich Validität, Akzeptanz und Anwenderfreundlichkeit mit MEMS® vergleichbar. Eine erwartete Zeitersparnis wurde mit dem OtCMTM-System gegenüber MEMS® nicht erreicht. Vorteile des OtCMTM-Systems sind eine höhere Datenqualität und die Möglichkeit zum Einsatz in der Telemedizin.

Einflüsse von Folienqualität und Blister-Design auf die Funktionalität von Blisterverpackungen

Ziel dieser Arbeit ist die Untersuchung der Einflüsse von Blister-Design und Folienqualität auf die Funktionalität von Blisterverpackungen. Hierzu werden analytische Methoden mittels Interferometrie, IR-Spektroskopie, Betarückstreuverfahren, Wirbelstromverfahren und Impedanzspektroskopie entwickelt, die zur quantitativen Bestimmung von Heißsiegellacken und Laminatbeschichtungen von Aluminium-Blisterfolien geeignet sind. Ein Vergleich der Methoden zeigt, dass sich das Betarückstreuverfahren, die Interferometrie und IR-Messungen für die Heißsiegellackbestimmung, die Interferometrie und das Wirbelstromverfahren für die Bestimmung von Kunststofflaminaten eignen.rnIm zweiten Abschnitt der Arbeit werden Einflüsse des Heißsiegellack-Flächengewichtes von Deckfolien auf die Qualität von Blisterverpackungen untersucht. Mit Zunahme des Flächengewichtes zeigt sich eine Erhöhung der Siegelnahtfestigkeit aber auch der Wasserdampfdurchlässigkeit von Blistern. Die untersuchten Heißsiegellacke zeigen Permeationskoeffizienten vergleichbar mit Polyvinylchlorid. In Untersuchungen zur Siegelprozessvalidität zeigt das Heißsiegellack-Flächengewicht nur geringfügige Auswirkungen auf diese. rnIm dritten Abschnitt der Arbeit werden Einflüsse des Blister-Designs auf die Benutzerfreundlichkeit von Blisterverpackungen durch eine Handlingstudie untersucht. Variationen der Öffnungskräfte von Durchdrück-Blistern wirken sich deutlich auf die Bewertungen der Blister durch die Probanden aus. Während die meisten Probanden alle getesteten Durchdrück-Blister innerhalb der Testdauer von 4 Minuten öffnen können (>84%), treten beim Peel-Blister und Peel-off-push-through-Blister deutlich mehr Handlingprobleme auf. Die Handlingprobleme korrelieren mit dem Alter, der Lebenssituation, der gesundheitlichen Verfassung und der Sehfähigkeit der Probanden. rn

Studio di fattibilità tecnica di una macchina automatica per la gestione di blister farmaceutici

Lo scopo principale dell’elaborato è descrivere e studiare la fattibilità tecnica e le fasi di progettazione e di realizzazione di una macchina automatica adibita alla gestione di blister farmaceutici. Tale attività è stata svolta in collaborazione con l’azienda Siropack Italia S.r.l. a seguito di un percorso di tirocinio curriculare. E’ dunque obiettivo della tesi esplicitare, motivandole, le scelte effettuate in campo progettuale, grazie alle quali si è arrivati alla realizzazione vera e propria della macchina. Dopo una descrizione dell’azienda e dei settori verso cui si interfaccia, si passa ad esporre, in maniera generale, il panorama farmaceutico nazionale ed internazionale, descrivendo anche il cliente per il quale è stata realizzata la macchina e ogni step affrontato per la sua progettazione. In questa fase viene descritto anche il nastro adibito alla gestione del magazzino, dove sosteranno numerose unità del prodotto lavorato. Si conclude poi con la descrizione dei passi che portano la macchina al suo effettivo funzionamento. Essendo un prototipo, dovrà poi affrontare numerose ore di prove e collaudi prima di essere definitivamente consegnata al cliente; in questo elaborato non verrà, però, descritto quest’ultimo step poiché la linea, della quale la macchina fa parte, è tutt’ora in fase di realizzazione.

CD8+ T cells and NK cells from blister fluid of an EEM/SJS overlap highly express Fas ligand and Granulysin

INTRODUCTION Erythema exsudativum multiforme majus (EEMM) and Stevens-Johnson Syndrome (SJS) are severe cutaneous reaction patterns caused by infections or drug hypersensitivity. The mechanism by which widespread keratinocyte death is mediated by the immune system in EEMM/SJS are still to be elucidated. Here, we characterized the blister cells isolated from a patient with EEMM/SJS overlap and investigated its cause. METHODS Clinical classification of the cutaneous eruption was done according to the consensus definition of severe blistering skin reactions and histological analysis. Common infectious causes of EEMM were investigated using standard clinical techniques. T cell reactivity for potentially causative drugs was assessed by lymphocyte transformation tests (LTT). Lymphocytes isolated from blister fluid were analyzed for their expression of activation markers and cytotoxic molecules using flow cytometry. RESULTS The healthy 58 year-old woman suffered from mild respiratory tract infection and therefore started treatment with the secretolytic drug Ambroxol. One week later, she presented with large palmar and plantar blisters, painful mucosal erosions, and flat atypical target lesions and maculae on the trunc, thus showing the clinical picture of an EEMM/SJS overlap (Fig. 1). This diagnosis was supported by histology, where also eosinophils were found to infiltrate the upper dermis, thus pointing towards a cutaneous adverse drug reaction (cADR). Analysis of blister cells showed that they mainly consisted of CD8+ and CD4+ T cells and a smaller population of NK cells. Both the CD8+ T cells and the NK cells were highly activated and expressed Fas ligand and the cytotoxic molecule granulysin (Fig. 2). In addition, in comparison to NK cells from PBMC, NK cells in blister fluids strongly upregulated the expression of the skin-homing chemokine receptor CCR4 (Fig 4). Surprisingly, the LTT performed on PBMCs in the acute phase was positive for Ambroxol (SI=2.9) whereas a LTT from a healthy but exposed individual did not show unspecific proliferation. Laboratory tests for common infectious causes of EEMM were negative (HSV-1/-2, M. pneumoniae, Parvovirus B19). However, 6 weeks later, specific proliferation to Ambroxol could no longer be observed in the LTT (Fig 4.).

Orchard practice for the control of blister canker of apple trees /

Cover title.

Blister rust news.

Mode of access: Internet.

Grasshopper egg pods destroyed by larvae of bee flies, blister beetles, and ground beetles /

Literature cited: p. 28-29.

Spread of white pine blister rust from ribes to sugar pine in California and Oregon /

Literature cited: p. 59-60.

Relation of Canyon Physiography to the incidence of Blister Rust in the Central Sierra Nevada /

Mode of access: Internet.