This proposal will test the hypotheses that exercise and daily administration of oxandrolone, propranolol, or ketoconazole will benefit severely burned children in their recovery to normal physiological function. An intervention study will be performed in which clinically relevant outcomes will be quantified at three-month intervals. Patients will be randomized into five groups to receive exercise plus oxandrolone, propranolol, ketoconazole, or placebo given by pill. The fifth group will receive home care. Primary endpoints during the first year after burn are: resting energy expenditure, linear growth, body composition, muscle strength, and hemodynamic function. Other measures to support the hypotheses include weight, liver size, total energy expenditure, bone mineral content and density, and hormone and drug blood and urine levels. Body composition, height, and weight will be followed yearly until the patient is 18 years of age. Support of this project allows a unique group of clinicians and basic scientists the rare opportunity of examining the mechanisms in which exercise and anabolic and anti-catabolic agents effect protein synthesis, degradation in muscle, fat synthesis and oxidation, and how these mechanisms translate into clinical outcomes and eady rehabilitation in severely burned children.
| ?apek, Karel D; Culnan, Derek M; Desai, Manubhai H et al. (2018) Fifty Years of Burn Care at Shriners Hospitals for Children, Galveston. Ann Plast Surg 80:S90-S94 |
| Korkmaz-Icöz, Sevil; Szczesny, Bartosz; Marcatti, Michela et al. (2018) Olaparib protects cardiomyocytes against oxidative stress and improves graft contractility during the early phase after heart transplantation in rats. Br J Pharmacol 175:246-261 |
| Cambiaso-Daniel, Janos; Rivas, Eric; Carson, Joshua S et al. (2018) Cardiorespiratory Capacity and Strength Remain Attenuated in Children with Severe Burn Injuries at Over 3 Years Postburn. J Pediatr 192:152-158 |
| Rontoyanni, Victoria G; Malagaris, Ioannis; Herndon, David N et al. (2018) Skeletal Muscle Mitochondrial Function is Determined by Burn Severity, Sex, and Sepsis, and is Associated With Glucose Metabolism and Functional Capacity in Burned Children. Shock 50:141-148 |
| Cambiaso-Daniel, Janos; Rontoyanni, Victoria G; Foncerrada, Guillermo et al. (2018) Correlation between invasive and noninvasive blood pressure measurements in severely burned children. Burns 44:1787-1791 |
| Ojeda, Sylvia; Blumenthal, Emily; Stevens, Pamela et al. (2018) The Safety and Efficacy of Propranolol in Reducing the Hypermetabolic Response in the Pediatric Burn Population. J Burn Care Res 39:963-969 |
| Capek, Karel D; Sousse, Linda E; Hundeshagen, Gabriel et al. (2018) Contemporary Burn Survival. J Am Coll Surg 226:453-463 |
| Foncerrada, Guillermo; Culnan, Derek M; Capek, Karel D et al. (2018) Inhalation Injury in the Burned Patient. Ann Plast Surg 80:S98-S105 |
| Bohanon, Fredrick J; Nunez Lopez, Omar; Herndon, David N et al. (2018) Burn Trauma Acutely Increases the Respiratory Capacity and Function of Liver Mitochondria. Shock 49:466-473 |
| Cambiaso-Daniel, Janos; Boukovalas, Stafanos; Bitz, Genevieve H et al. (2018) Topical Antimicrobials in Burn Care: Part 1-Topical Antiseptics. Ann Plast Surg : |
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