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Sample records for burn patients admitted

  1. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    OpenAIRE

    Parviz Saleh; Hamid Noshad

    2014-01-01

    Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1...

  2. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Parviz Saleh

    2014-11-01

    Full Text Available Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1 year period in Sina Hospital, Tabriz University of Medical Sciences, Iran, and 81 burn were included. We collected patients’ data about their age, body weight, cause of burn, lesion color, place and percentage of burn by getting history and studying of their files. Then we documented all interventions. Blood tests and cultures and colonies criteria were recorded. Results: In this study, 39 patients were male (48.1%, and 42 was female (51.9%. Mean age was 32.06 ± 17.46 years. In patients without bacteremia, 57 patients did not need catheterization (89.1%, however in patients with bacteremia 9 patients demanded catheter insertion (52.9%. In patients with bacteremia 12 patients survived (70.9%, however in the without bacteremia group 56 patients survived (92.2%. Then, the relationship between type of burn, wound infection and bacterial species investigated, (P = 0.650, P = 0.210 and P = 0.110 respectively. Conclusion: We concluded, invasive interventions increased bacteremia susceptibility in our studied burned patients. Mortality rate is directly related to bacteremia prevalence and increased by extent of burn area in these patients. The three most frequent microbial agents responsible for bacteremia were Pseudomona aeruginosa, Klebsiella and Staphylococcus aureus.

  3. Epidemiology and Outcome of Chemical Burn Patients Admitted in Burn Unit of JNMC Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India: A 5-year Experience

    OpenAIRE

    Akhtar, Md Sohaib; Ahmad, Imran; Khurram, M. Fahud; Kanungo, Srikanta

    2015-01-01

    Aims and Objective: The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. Materials and Methods: A retrospective analysis was performed on all the patients with chemical burns admitted at author's center between November 2008 and December 2013. All the patients were evaluated in terms of age, sex, total body surface area, etiology, treatment given, morbidity, mo...

  4. Evaluation of Drug-Resistance Pseudomonas and Staphylococcal Infections in Admitted Burned Patients in

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    E. Nemati, M.Sc

    2007-09-01

    Full Text Available Nosocomial infection is an important prognostic factor in out comes of burned patients. In this descriptive cross. Sectional study, 82 burned patients and related medical equipment were assessed in zareh hospital in 2033-2004. Pseudomonas aeruginosa and staphylococcus areus were found in 69(51.4% and 31 (23.2% of 134 clinical specimens respectively. Hence it is mandatory to plan programs for redusing harmful and resistance bacterial infection in this patients.

  5. Tissue expander, a modality in the treatment of burn induced deformities: A 6-year study of patients with burn deformities admitted to Plastic Surgery Department of Imam Hospital

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    Farah Vash. MR

    2000-06-01

    Full Text Available Use of tissue expander in the recent decade has revolutionized the plastic surgery. The tissue expansion technique is advantageous in body reconstruction because it makes it possible to resurface the defects resulting from excision of burn scars with neighboring skin similar in color and texture and superior to skin grafts or distant flaps. Treatment of burn alopecia was a major problem in the past, but with the application of tissue expander this deformity is treated. We have learned by experience that tissue expander should not be used in the limbs, because of the high risk of complications. The best locations for tissue expander are in order: Scalp, face, neck and trunk. The incidence of burn induced deformities in Iran is high. In this research, I analyze the use of TE in 130 patients with burn deformities. The variables studied were: Sex of patients (43.1% male, 56.9% female, age groups, level of education, occupation, the anatomical site of burn, extension of burn, volume of tissue expansion, the location of placing the TE and complications.

  6. Burn-Center Quality Improvement: Are Burn Outcomes Dependent On Admitting Facilities and Is There a Volume-Outcome “Sweet-Spot”?

    OpenAIRE

    Hranjec, Tjasa; TURRENTINE, FLORENCE E.; STUKENBORG, GEORGE; Young, Jeffrey S; Sawyer, Robert G.; Calland, James F

    2012-01-01

    Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 ...

  7. Burn-Center Quality Improvement: Are Burn Outcomes Dependent On Admitting Facilities and Is There a Volume-Outcome “Sweet-Spot”?

    Science.gov (United States)

    HRANJEC, TJASA; TURRENTINE, FLORENCE E.; STUKENBORG, GEORGE; YOUNG, JEFFREY S.; SAWYER, ROBERT G.; CALLAND, JAMES F.

    2012-01-01

    Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes. PMID:22546129

  8. Burns in diabetic patients

    OpenAIRE

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical...

  9. Epidemiological data, outcome, and costs of burn patients in Kermanshah

    OpenAIRE

    Karami Matin, B.; Karami Matin, R.; Ahmadi Joybari, T.; Ghahvehei, N.; M Haghi; M. Ahmadi; S. Rezaei

    2012-01-01

    Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned bod...

  10. Pattern and outcome of children admitted for burns in Benin City, mid-western Nigeria

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    Oludiran O

    2009-01-01

    Full Text Available Children are a vulnerable to burns, an injury, which is often preventable. A study of the profile of cases of children admitted for burns will provide background information to suggest locally doable preventive strategies as well as supply basic information for future reference. We studied the records of 62 children aged 0-16 years, admitted for burns, at the University of Benin Teaching Hospital, Benin City, between January 2002 and December 2006. There were 34 male and 28 female children. Children under three years constituted 56.5%. Whereas the leading cause of burns in all the children was flame burns from kerosene explosions (52%, scalds were responsible for 68.6% of cases in those under three. The extent of burn injury ranged from 6 to 50% and most of them presented late. 64.6% were discharged within three weeks. Wound sepsis and post burn contractures were the most frequently encountered complications (19.4% and 9.7% respectively. There were two deaths (3.2% related to sepsis. Particular attention to burn safety precautions in children (especially, in the> 3 years age group, safer storage and dispensing of combustible chemicals particularly petroleum products is advocated. Fire safety awareness, correct first aid measures and early presentation in the hospital will reduce morbidity and mortality. Early physiotherapy and splinting strategies will reduce contractures. There is the need locally for the establishment of specialized burn centres both to treat these children and to stimulate interest in burn management.

  11. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

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    A. Tavassoli-Ashrafi, M.D.

    2007-09-01

    Full Text Available Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center in Tehran was performed. A short structured questionnaire was used to collect data. The questionnaire covered demographic information, etiology, clinical manifestations, and outcomes.Results: 74 (5% of the 1480 women of reproductive age who were admitted for burn treatment during this period were pregnant. The mean age of 74 patients was 22.54 years (SD = 4.78 with a range of 16-35. The majority of the women (50% were between 20 and 30 weeks of gestational age. The most common cause of burn was kerosene fire 52 (70%. Most of the women 50 (68% suffered from severe burns with TIBC>40%. 49 (66% mothers and 50 (67.5% died as a result of the burn damages. Conclusion: Burn size, TIBC, follow up of clinical manifestations for pregnant women, fetus and performance of proportional treatment protocols were the strongest predictor of mortality for mother and fetus.

  12. Crusted Scabies in the Burned Patient

    DEFF Research Database (Denmark)

    Berg, Jais Oliver; Alsbjørn, Bjarne

    2011-01-01

    The objectives of this study were 1) to describe a case of crusted scabies (CS) in a burned patient, which was primarily undiagnosed and led to a nosocomial outbreak in the burn unit; 2) to analyze and discuss the difficulties in diagnosing and treating this subset of patients with burn injury; and...... 3) to design a treatment strategy for future patients. Case analysis and literature review were performed. The index patient had undiagnosed crusted scabies (sive Scabies norvegica) with the ensuing mite hyperinfestation when admitted to the department with minor acute dermal burns. Conservative...... healing and autograft healing were impaired because of the condition. Successful treatment of the burns was only accomplished secondarily to scabicide treatment. An outbreak of scabies among staff members indirectly led to diagnosis. CS is ubiquitous, and diagnosis may be difficult. This is the first...

  13. Candidemia in major burns patients.

    Science.gov (United States)

    Renau Escrig, Ana I; Salavert, Miguel; Vivó, Carmen; Cantón, Emilia; Pérez Del Caz, M Dolores; Pemán, Javier

    2016-06-01

    Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge. PMID:26931414

  14. Indications and strategies for Mechanical Ventilation in the Burned Patients

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    Murat Yılmaz

    2011-07-01

    Full Text Available Respiratory tract is one of the most seriously injured system in burned patients. Besides the direct inhalation injury, respiratory organs may be effected by the inflammatory mediators released due to systemic inflammatory response syndrome. As a result, many severely burned patients are needed to be intubated and mechanically ventilated after admitted to ICU. For this purpose, the medical staff working in the ICU’s which admit severely burned patients should be experienced in mechanical ventilation modes, complications related to mechanical ventilation and weaning strategies. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 31-6

  15. Microbiological Monitoring and Proteolytic Study of Clinical Samples From Burned and Burned Wounded Patients

    International Nuclear Information System (INIS)

    In this study, clinical samples were collected from 100 patients admitted to Burn and Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Egypt, over a period of 12 months. The proteolytic activity of 110 clinical samples taken from surfaces swabs which taken from burned and burned wounded patients with different ages and gender was examined. Screening for the proteolytic activity produced by pathogenic bacteria isolated from burned and burned wounded patients was evaluated as gram positive Bacilli and gram negative bacilli showed high proteolytic activity (46.4%) while 17.9% showed no activity. The isolated bacteria proved to have proteolytic activity were classified into high, moderate and weak. The pathogenic bacteria isolated from burned and burned wounded patients and showing proteolytic activity were identified as Pseudomonas aeruginosa, Proteus mirabilis, Proteus vulgaris, Bacillus megaterium, Bacillus cereus, Staphylococcus aureus, Escherichia coli, Klebsiella ozaeanae, Klebsiella oxytoca, Klebsiella pneumoniae and Pseudomonas fluoresces.

  16. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a...

  17. Transdermal fluid loss in severely burned patients

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    Lange, Thomas

    2010-01-01

    Full Text Available Introduction: The skin protects against fluid and electrolyte loss. Burn injury does affect skin integrity and protection against fluid loss is lost. Thus, a systemic dehydration can be provoked by underestimation of fluid loss through burn wounds. Purpose: We wanted to quantify transdermal fluid loss in burn wounds. Method: Retrospective study. 40 patients admitted to a specialized burn unit were analyzed and separated in two groups without (Group A or with (Group B hypernatremia. Means of daily infusion-diuresis-ratio (IDR and the relationship to totally burned surface area (TBSA were analyzed. Results: In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean abbreviated burned severity index (ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Statistical analysis of the period from day 3 to day 6 showed a significant higher daily IDR-amount in Group A (Group A vs. Group B: 786±1029 ml vs. –181±1021 ml; p<0.001 and for daily IDR-TBSA-ratio (Group A vs. Group B: 40±41 ml/% vs. –4±36 ml/%; p<0.001. Conclusions: There is a systemic relevant transdermal fluid loss in burn wounds after severe burn injury. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy to avoid water and electrolyte imbalances.

  18. Privacy of Patients Admitted to the ICU : Systematic Literature Review

    OpenAIRE

    Nabunya, Christine; Chesop, Beatrice

    2015-01-01

    Aim: The aim of this systematic literature review is to evaluate how nurses can uphold/ safeguard the privacy of patients admitted in the ICU. The objectives of this study are; to help nurses understand the need and effectiveness of patients’ privacy in the ICU as well as to understand the concept of privacy and its benefits to patients admitted in the ICUs. This study research is part of the EVICURES people’s project in anticipation of the building of a new ICU for the Seinäjoki Central Hosp...

  19. Rehabilitation of the burn patient

    OpenAIRE

    Procter Fiona

    2010-01-01

    Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns...

  20. Anomalous subjective experience among first-admitted schizophrenia spectrum patients

    DEFF Research Database (Denmark)

    Parnas, Josef; Handest, Peter; Jansson, Lennart;

    2005-01-01

    Our research group has for several years conducted philosophically informed, phenomenological-empirical studies of morbid alterations of conscious experience (subjectivity) in schizophrenia (Sz) and its spectrum of disorders. Some of these experiential alterations constitute, in our view, the......, may be potentially effective for early differential diagnosis. In this study, 151 consecutive first-admitted patients (with bipolar, melancholic and organic patients excluded) diagnosed according to the ICD-10, were evaluated on a number of expressive and experiential psychopathological dimensions...

  1. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

    Full Text Available Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns Rehabilitation′ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration

  2. Protocolized Resuscitation of Burn Patients.

    Science.gov (United States)

    Cancio, Leopoldo C; Salinas, Jose; Kramer, George C

    2016-10-01

    Fluid resuscitation of burn patients is commonly initiated using modified Brooke or Parkland formula. The fluid infusion rate is titrated up or down hourly to maintain adequate urine output and other endpoints. Over-resuscitation leads to morbid complications. Adherence to paper-based protocols, flow sheets, and clinical practice guidelines is associated with decreased fluid resuscitation volumes and complications. Computerized tools assist providers. Although completely autonomous closed-loop control of resuscitation has been demonstrated in animal models of burn shock, the major advantages of open-loop and decision-support systems are identifying trends, enhancing situational awareness, and encouraging burn team communication. PMID:27600131

  3. Wound Care in Burn Patients

    OpenAIRE

    Orhan Çizmeci; Samet Vasfi Kuvat

    2011-01-01

    Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are generea...

  4. Cytomegalovirus Colitis in a Burn Patient.

    Science.gov (United States)

    Gibbs, Jeff T; Zieger, Madeline; Sood, Rajiv

    2016-01-01

    The prevalence of cytomegalovirus in the burn population is high. However, its role in the clinical management of burn patients is still being defined. This report documents a 41-year-old man who developed cytomegalovirus (CMV) colitis after being admitted with a 72% burn. Before the administration of ganciclovir, the authors had difficulty controlling his quantitative wound cultures with serial debridements, topical agents, and systemic antibiotics for known pathogens, which led to graft loss. After the ganciclovir was given, his quantitative wound cultures improved without changing the authors' topical agents or systemic antibiotics and had improved graft take. Whether CMV infection alone contributed to an increased morbidity in this patient or the combination of bacteria/fungal infection with CMV led to a synergistic effect is still not clearly understood. CMV may have contributed to a dysfunction in his cell mediated immunity, which, in turn, lowered the bacterial and fungal load necessary to cause graft loss. Patients who continue to do poorly despite adequate treatment for known pathogens may need to be screened for CMV and treated. PMID:26056763

  5. Mortality and causes of death in first admitted schizophrenic patients

    DEFF Research Database (Denmark)

    Mortensen, P B; Juel, K

    1993-01-01

    9156 first admitted schizophrenic patients. Suicide accounted for 50% of deaths in men and 35% of deaths in women. Suicide risk was particularly increased during the first year of follow-up. Death from natural causes, with the exception of cancer and cerebrovascular diseases, was increased. Suicide...... risk during the first year of follow-up increased by 56%, with a 50% reduction on psychiatric in-patient facilities. The study confirms that mortality in schizophrenia is still markedly elevated, and the finding of an increasing suicide risk may be an indicator of some adverse effects of...

  6. Effect of pulmonary rehabilitation program on patients admitted to ICU:

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    Abbas Fadaii

    2015-11-01

    Full Text Available Generally ICU patients are in critical status and need long stay in ICU. Pulmonary rehabilitation program (PRP is considered as an important tool to improve outcome and shorten the length of stay in ICU. The aim of this study was to investigate whether PRP can affect outcome and duration of hospitalization in ICU patients. This study was performed in medical ICU of Labafi Nejad hospital, Tehran, Iran during 2012 and 2013. All of patients who had more than one day stay in ICU were included in the study. They underwent PRP. We compared length of stay, mortality rate and number of hospitalized patients within 2 years in patients with PRP and patients without PRP. In 2012, 155 patients and in 2013, 173 patients were admitted in ICU. Admission period was 15 ± 2.7 and 11 ± 2.1 days, respectively (p< 0.001. Pulmonary physiotherapy showed no effect on patients’ outcome in which during 2012, 94 patients were discharged and 61 patients were died and in 2013, 98 patients were discharged and 64 patients were died (p=0.9. Our study shows that PRP can shorten hospitalization time which can indirectly decrease hospitalization costs but there is no effect on overall survival.

  7. Characteristics of patients with measles admitted to allied hospital rawalpindi

    International Nuclear Information System (INIS)

    Measles, a virus borne droplet infection, is one of the leading causes of death among young children worldwide despite presence of a safe and cost-effective vaccine. Objective of our study was to identify the characteristics of measles patients admitted to Allied Hospitals, Rawalpindi. Methods: This cross-sectional study was conducted amongst patients admitted with measles in paediatric units of Rawalpindi Medical College Allied Hospitals, Rawalpindi. A standard proforma was used to collect data from the respondents. Results: A total of 55 patients (mean age-29.36 months) with measles were included in the study. 65.5% children were vaccinated while 34.5% were not vaccinated. Among those vaccinated 14 were male. Out of the vaccinated children 52.6% were residents of middle class areas, 31.6% lower middle class area, 10.5% upper middle class areas and 5.3% rural areas. In 55.0% of patients who were vaccinated with at least one dose of measles at nine month of age the estimated calendar months of vaccination was March to April while in 30% the overall climatic period of vaccination was of summer (May to September). Twenty one study subjects were exposed to a case of measles in the family and thirty five out of all developed at least one known complication of the disease. Pneumonia was the most common complication reported in patients (63.6%) followed by diarrhoea (27.3%). Conclusion: Majority of the patients suffering from measles were not vaccinated and the most common reason for failure to immunize children was lack of awareness. Educated and well off fathers were more likely to get their children immunized. The vaccinated children who developed measles majority were vaccinated during months of March, April and May. (author)

  8. Antibiotics and the burn patient.

    Science.gov (United States)

    Ravat, François; Le-Floch, Ronan; Vinsonneau, Christophe; Ainaud, Pierre; Bertin-Maghit, Marc; Carsin, Hervé; Perro, Gérard

    2011-02-01

    Infection is a major problem in burn care and especially when it is due to bacteria with hospital-acquired multi-resistance to antibiotics. Moreover, when these bacteria are Gram-negative organisms, the most effective molecules are 20 years old and there is little hope of any new product available even in the distant future. Therefore, it is obvious that currently available antibiotics should not be misused. With this aim in mind, the following review was conducted by a group of experts from the French Society for Burn Injuries (SFETB). It examined key points addressing the management of antibiotics for burn patients: when to use or not, time of onset, bactericidia, combination, adaptation, de-escalation, treatment duration and regimen based on pharmacokinetic and pharmacodynamic characteristics of these compounds. The authors also considered antibioprophylaxis and some other key points such as: infection diagnosis criteria, bacterial inoculae and local treatment. French guidelines for the use of antibiotics in burn patients have been designed up from this work. PMID:20510518

  9. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    Objective To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Design Retrospective, descriptive cohort study. Setting 10-bed burn PICU facility. Patients All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Measurements and results Data of 12...

  10. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Retrospective, descriptive cohort study. 10-bed burn PICU facility. All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Data of 123 patients were studied. The incidence of AKI w...

  11. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    OpenAIRE

    A. Tavassoli-Ashrafi, M.D.; H. Khani, M.D.

    2007-01-01

    Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center) in Tehran was performed. A short structured ...

  12. Comparison of Mortality in Patients With Acute Myocardial Infarction Accidentally Admitted to Non-cardiology Departments Versus That in Patients Admitted to Coronary Care Units

    DEFF Research Database (Denmark)

    D'Souza, Maria; Saaby, Lotte; Poulsen, Tina S; Diederichsen, Axel C P; Hosbond, Susanne; Diederichsen, Søren Z; Larsen, Torben B; Schmidt, Henrik; Gerke, Oke; Hallas, Jesper; Gislason, Gunnar; Thygesen, Kristian; Mickley, Hans

    2014-01-01

    The aim of this study was to prospectively investigate the clinical characteristics including symptoms and long-term mortality in patients with acute myocardial infarction (AMI) accidentally admitted to non-cardiology departments (NCDs). For comparison, similar observations in patients admitted to...

  13. Incidence of cardiac events in burned patients.

    Science.gov (United States)

    Meyers, David G; Hoestje, Sara M; Korentager, Richard A

    2003-06-01

    Given the increased level of adrenergic stimulation in burn patients, it would be expected that they would experience an increased incidence of cardiac arrhythmias and other cardiac events. We performed a retrospective chart review of 56 acute burn patients matched by age, length of hospital stay, and sex to 56 trauma patients, all of whom had been continuously monitored electrocardiographically. Burn and trauma patients were similar in injury severity, admission laboratory values, and prior history of cardiopulmonary diseases. Arrhythmias were noted in 34% of burn patients and 28% of trauma patients. One myocardial infarction and six deaths occurred in burn patients. No myocardial infarctions or deaths were observed in trauma patients. A past history of cardiopulmonary disease increased the risk of myocardial infarction or death by 6.6 times. Cardiac arrhythmias and other events are relatively infrequent and benign in burn patients and are similar to those experienced by other patients with acute injuries. PMID:12781616

  14. Wound Care in Burn Patients

    Directory of Open Access Journals (Sweden)

    Orhan Çizmeci

    2011-07-01

    Full Text Available Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are genereally adequate for first-degree burns. However, topical antibacterial agents are usually required for second to third-degree wounds. Standart treatment for the open wound without epithelization is autologous skin grafting. In cases where more than 50% of the skin surface in affected, autologus donor skin may not be enough. For these cases, epidermal cell culture in vitro may be used. Mesenchymal stem cell applications which have immunosupressive effects should be utilized in cases where cells need to be prepared as allografts. (Journal of the Turkish Society intensive Care 2011; 9 Suppl: 51-4

  15. BURN SIZE AND SURVIVAL PROBABILITY IN PEDIATRIC PATIENTS IN MODERN BURN CARE

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Al-Mousawi, Ahmed M; Williams, Felicia N; Finnerty, Celeste C; Jeschke, Marc G

    2012-01-01

    Background Patient survival following severe burn injury is largely determined by burn size. Modern developments in burn care have tremendously improved survival and outcomes. However, no large analysis on outcomes in pediatric burn patients with current treatment regimen exists. This study was designed to identify the burn size presently associated with significant increases in morbidity and mortality in pediatric burn patients. Methods Single center prospective observational cohort study utilizing the clinical data of severely burned pediatric patients admitted between 1998 and 2009. This study included 952 severely burned pediatric patients with burns over at least 30% of their total body surface area (TBSA). Patients were stratified by burn size in 10% increments, ranging from 30 to 100%, with a secondary assignment made according to the outcome of a receiver operating characteristic (ROC) analysis. Statistical analysis was performed using Student’s t-test, χ2 test, logistic regression and ROC analysis, as appropriate, with significance set at p<0.05. Findings All groups were comparable in age (age in years: 30–39: 6.1±5.1, 40–49: 7.1±5.2, 50–59: 7.6±5.1, 60–69: 7.2±5.1, 70–79: 8.3±5.9, 80–89: 8.4±5.6, 90–100: 9.6±5.4), and gender distribution (male: 30–39: 68%, 40–49: 64%, 50–59: 65%, 60–69: 59%, 70–79: 71%, 80–89: 62%, 90–100: 82%). Mortality (30–39: 3%, 40–49: 3%, 50–59: 7%, 60–69: 16%, 70–79: 22%, 80–89: 35%, 90–100: 55%), multi-organ failure (30–39: 6%, 40–49: 6%, 50–59: 12%, 60–69: 27%, 70–79: 29%, 80–89: 44%, 90–100: 45%), and sepsis (30–39: 2%, 40–49: 5%, 50–59: 6%, 60–69: 15%, 70–79: 13%, 80–89: 22%, 90–100: 26%), increased significantly (p<0.001) among the groups and at a threshold of 62% TBSA. Comparison of patients with burns larger than 62% with those smaller showed significant differences in inflammatory (Cytokines), acute phase (CRP) and hypermetabolic responses (REE

  16. Nosocomial Infections in Burned Patients in Motahari Hospital, Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Leila Azimi

    2011-01-01

    Full Text Available Burn patients are at high risk of developing nosocomial infection because of their destroyed skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic and diagnostic procedures. Studies on nosocomial infection in burn patients are not well described. The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2% on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aureus, and 215 others. The percentage of mortality was 12%. All of patients had at least 1 positive culture with Pseudomonas and/or with Acinetobacter. Hospitals suggest continuous observationof burn infections and increase strategies for antimicrobial resistance control and treatment of infectious complications.

  17. Psychological Evaluation of Patients in Critical Care/Intensive Care Unit and Patients Admitted in Wards

    OpenAIRE

    Sharma B, Gaurav; EVS, Maben; MS, Kotian; B., Ganaraja

    2014-01-01

    Background: Psychological assessment for depression, anxiety and stress among ICU patients and the patients admitted to ward in a hospital in India. This aspect did not get much attention in India so far. Such studies were common in developed countries. Therefore we decided in this study, to analyse the psychological status responses from the hospitalised patients in Mangalore using a validated questionnaire.

  18. Aeromonas hydrophila in a burn patient.

    Science.gov (United States)

    Yasti, Ahmet Cinar; Otan, Emrah; Doganay, Mutlu; Kama, Nuri A

    2009-01-01

    Infectious consequences are still a major problem and leading cause of mortality in burn patients. Among others, aeromonads need special concern because they mimic pseudomonal infections; however, they have a more rapid progression with considerable mortality if undiagnosed promptly. Here, we present a major burn case extinguished with tap water pooled in a tank. With the possibility of aeromonal infection in mind, the patient underwent aggressive debridement with proper antibiotic medication, which resulted in a successful patient management. Aeromonads should always be kept in mind in burn cases that contacted with tanked water or soil after the burn. PMID:19692919

  19. Infection control in severely burned patients

    OpenAIRE

    Coban, Yusuf Kenan

    2012-01-01

    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood strea...

  20. Nutrition Support in Burn Patients

    Directory of Open Access Journals (Sweden)

    Cem Aydoğan

    2012-08-01

    Full Text Available Severe burn trauma causes serious metabolic derangements. Increased metabolic rate which is apart of a pathophysiologic characteristic of burn trauma results in protein-energy malnutrition. This situation causes impaired wound healing, muscle and fat tissue’s breakdown, growth retardation in children and infections. Nutrition support is vital in the treatment strategies of burn victims to prevent high mortal and disabling complications in this devastating trauma. Our aim in this study is to review management of nutrition in burn victims. (Journal of the Turkish Society Intensive Care 2012; 10: 74-83

  1. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital

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    Abebe T

    2015-01-01

    Full Text Available Teshome Abebe, Mullu Girmay, Girma G/Michael, Million Tesfaye Department of Anesthesia, Jimma University, Jimma, Ethiopia Background: In least developing countries, there are few data on children's critical care. This makes the provision of aid and improvement of outcome difficult. Objectives: To describe admission and outcome patterns of children managed in a general intensive care unit at Jimma University Specialized Hospital (JUSH, Ethiopia, over a 5-year period. Methods: A retrospective cross-sectional study design was used. All children from birth to 14 years of age who were admitted to the general ICU of the hospital from 2009–2013 were included. Patient charts and ICU documentation log were reviewed. Results: A total of 170 children were admitted to the ICU of JUSH over the study period. The greater share was taken by males (54.7%, with a male-to-female ratio of 1.2:1. The overall mortality rate was 40%. The majority of the children were in the age range of 10–14 years (38.8%. Of the total number of patients admitted, 34.7% were trauma cases, 45.8% of whom died. The highest percentage, 69.5%, of trauma patients were admitted for head injuries. Among the trauma cases, burn and polytrauma were the second and third leading causes (15.3% of admission. Postoperative patients and medical patients accounted for the rest of the admitted cases (28.2% and 27.6% of the cases respectively. Conclusion: The leading cause of admission and death was trauma. Postoperative and medical causes of admission were also significant. The mortality rate in the ICU was very high, and this could be due to various factors. Further research benchmarking and interventions are highly recommended. Keywords: trauma, critical care, pediatric, ICU, ventilation, oxygenation

  2. Intensive Care Management in Pediatric Burn Patients

    Directory of Open Access Journals (Sweden)

    Ayşe Ebru Sakallıoğlu Abalı

    2011-07-01

    Full Text Available Burn injury is still a leading cause of morbidity and mortality in children. This article aimed to review the current principles of management from initial assessment to early management and intensive care for pediatric burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 62-9

  3. Acute pain management in burn patients

    DEFF Research Database (Denmark)

    Gamst-Jensen, Hejdi; Vedel, Pernille Nygaard; Lindberg-Larsen, Viktoria Oline;

    2014-01-01

    OBJECTIVE: Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain...

  4. Successful treatment of invasive burn wound infection with sepsis in patients with major burns

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To investigate the clinical characteristics of invasive bum wound infection with sepsis in patients with major burns and to summarize the successful expenences in the treatment of such patients. Methods Eight patients with major bums, complicated by invesive bum wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock. The plasma concentrations of IL-6,IL-8,TNFα and lypopolysaccharibe (LPS) were assayed before and after surgical intervention, as well as when the patient' s vital signs became stable. Results The patients' conditions usually deterieorated abruptly when extensive invasive bum wound infection emerged. While multi-microbial infection was usually found, Pseudomonas aeruginosa was the predominant bactena isolated from the subeschar tissue. The plasma concentrations of IL-6, IL-8, TNFα and LPS before surgical intervention wore significantly higher than those after surgical intervention (P<0.05).The lowest levels of the inflammatory mediators were abserved when the patients'conditions became stable,and the values were significantly lower than those before surgical intervention ( P<0.001). Conclusion Since the main cause of burn wound sepsis is the presence of a large area of infected bum wound, they should be excised and covered as early as possible. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn sepsis. Athough favorable results should be attributed to compmhessive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role.

  5. Factors affecting mortality in patients with burns

    Directory of Open Access Journals (Sweden)

    Halil Erbiş

    2015-09-01

    Full Text Available Objective: The increase in life quality and expectancy causes an increase in the elderly population. Improvements in burn treatment resulted in decreased mortality in children and young adults but in elderly patients burns are still an important trauma that should be handed differently than other age groups. The aim of this study was to evaluate the factors effecting mortality in patients with burns over 45 years old. Methods: Fifty-eight patients over 45 years of age, who were treated in our burns unit in the last 3 years were included in our study. Their age, burn percentage and depth, coexisting diseases and mortality rates were examined retrospectively. Results: The average age of surviving patients was 57.4 years while it was 70 years for nonsurviving patients (p=0.002. The width of burn area was 21.1 % in surviving and 50 % in nonsurviving patients (p<0.01. The effect of additional coexistent diseases on mortality was significant (p=0.001. The most common reasons of mortality were sepsis and congestive heart failure. Conclusion: We found out that the age, percentage of burns and coexistent diseases had a negative effect on success of treatment and mortality. Mortality rates will decrease in these cases with careful follow-up and a multidisciplinary approach. J Clin Exp Invest 2015; 6 (3: 240-243

  6. Evaluation of Patients with Paracetamol Intoxication Who Admitted to Emergency Service

    OpenAIRE

    Kıvanç Karaman; Mücahit Avcil; Sibelnur Avcil

    2016-01-01

    Objective: To evaluate the effects of demographic and clinical features on follow-up period and laboratory parameters in patients with paracetamol intoxication who were admitted to our emergency department. Materials and Methods: One hundred sixty-four patients, who were admitted to the emergency department at Adnan Menderes University Faculty of Medicine between April 2013 and April 2015, were retrospectively evaluated and a total of 44 patients who have ingested paracetamol were...

  7. [Invasive yeast infections in severely burned patients].

    Science.gov (United States)

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective. PMID:27395025

  8. A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India

    Directory of Open Access Journals (Sweden)

    Gupta Ashok

    2011-01-01

    Full Text Available Aim : To analyze the causes, demographic and socio-cultural aspects, and the magnitude of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to burns ICU of tertiary care hospital. Materials and Methods : A total of 892 burn patients admitted over a period of 6 years from January 2002 to December 2007 at tertiary care hospital in Punjab, India, were analyzed. Results : 54% patients were males. A majority of the patients, 704(79%, were in the age group of 15-45 years. Six hundred and thirty-four patients (72% sustained flame burns, while 17% and 7% sustained electrical and scald burns, respectively. A total of 470(53% patients sustained major two to three degree flame burns involving more than 45% of total body surface area (TBSA. The mortality rate was 40%, i.e. 357 patients died of burns and its related problems, in our study. Six hundred and thirty-nine patients (72% sustained burns in closed space of which 331 patients (52% sustained burns in kitchen. Seven hundred and seventy-nine patients sustained accidental burns. Burn victims were mainly Hindus and Sikhs. The mean hospital stay varied depending upon the percentage of burns. On an average, a patient with >45% TBSA burns received 15 whole blood transfusions. Split skin grafting was done in 416 patients. Most common complication encountered during their hospital stay was wound infection which was seen in 671 patients, followed by ARDS in 221 patients. The most common organisms causing wound infection were Pseudomonas and Acinetobacter. Conclusion : Developing country like India need an aggressive public education program so that people become more literate about various etiological factors causing burns and means of preventing them. Also needed are burn care hospitals which are easily accessible and affordable.

  9. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards

    OpenAIRE

    Morris, R.; Sonibare, A.; Green, D.; Masud, T.

    2000-01-01

    OBJECTIVE—To investigate the characteristics and outcomes of older patients with pelvic fracture admitted to medical and geriatric wards.
METHODS—All patients admitted to medical and geriatric wards with a pelvic fracture over a four year period were identified using the hospital clinical coding database. Data were collected from casenotes, hospital and Family Health Services Authority databases. Where available, pelvic radiographs were graded according to the Singh index.
RESULTS—The casenot...

  10. Risk factors for mortality in patients admitted to intensive care units with pneumonia

    OpenAIRE

    Li, Guowei; Cook, Deborah J.; Thabane, Lehana; Friedrich, Jan O.; Crozier, Tim M.; Muscedere, John; Granton, John; Mehta, Sangeeta; Steven C. Reynolds; Lopes, Renato D.; Francois, Lauzier; Freitag, Andreas P; Levine, Mitchell A. H.; ,

    2016-01-01

    Background Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited. Methods In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship...

  11. Risk Factors for Recurrent Hypoglycemia in Hospitalized Diabetic Patients Admitted for Severe Hypoglycemia

    OpenAIRE

    Lin, Yen-Yue; Hsu, Chin-Wang; Sheu, Wayne Huey-Herng; Chu, Shi-Jye; Wu, Chin-Pyng; Tsai, Shih-Hung

    2010-01-01

    Purpose Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia. Materials and Methods We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 ± 9.8 years) with type 2 diabetes treated ...

  12. Effect of pulmonary rehabilitation program on patients admitted to ICU:

    OpenAIRE

    Abbas Fadaii; Bahador Bagheri; Ali Pirsalehi; Bahar Taherkhanchi; Mohammad Amin Abbasi

    2015-01-01

    Generally ICU patients are in critical status and need long stay in ICU. Pulmonary rehabilitation program (PRP) is considered as an important tool to improve outcome and shorten the length of stay in ICU. The aim of this study was to investigate whether PRP can affect outcome and duration of hospitalization in ICU patients. This study was performed in medical ICU of Labafi Nejad hospital, Tehran, Iran during 2012 and 2013. All of patients who had more than one day stay in ICU were included in...

  13. Incidence of pterygium in patients admitted to a university hospital

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    Fethiye Gülden Turgut

    2013-12-01

    Full Text Available Objectives: This study aimed to investigate the incidence of pterygium in a particular district of Istanbul, its association with age, and gender, and the severity of the disease. Methods: All patients aged ≥ 30 years referred to our outpatient clinics between January 2009 and December 2009 were included in this retrospective study. Age, gender, anterior segment photos, and findings of biomicroscopic eye examination were evaluated. Results: The incidence of pterygium for all age groups was 2.91% (male 1.75%, female 3.67% with an increasing incidence with age. A significant difference was detected in its incidence favoring female patients in 40-49, and 70-79, and male patients in ≥ 80 age groups, respectively. In addition, pterygium was seen in one (75.4% or both eyes (24.6% preferring right or left eye in 50.7%, and 49.3% of the patients, respectively. Pterygium was in nasal or temporal region in 98%, and 2% of the patients, respectively. The disease state in 59.9% of the patients was consistent with Stage 2 pterygium. The distance of pterygium from limbus was observed greatest in 60-69, and at a minimum in 40-49 age groups. No relationship was found between eye colour and development of pterygium. Conclusion: The incidence of pterygium increases with age. Incidence of pterygium differs between genders but without any significant difference. Its occurrence in one or both eyes and in right and left eyes was not influenced by gender of the patients. A statistically significant impact of eye colour of the patient on the development of pterygium was not disclosed. J Clin Exp Invest 2013; 4 (4: 436-442

  14. Increased mortality in hypernatremic burned patients

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    Lange, Thomas

    2010-01-01

    Full Text Available Introduction: In-hospital hypernatremia develops usually iatrogenically from inadequate or inappropriate fluid prescription. In severely burned patient an extensive initial fluid resuscitation is necessary for burn shock survival. After recovering of cellular integrity the circulating volume has to be normalized. Hereby extensive water and electrolyte shifts can provoke hypernatremia. Purpose: Is a hypernatremic state associated with increased mortality? Method: Retrospective study for the incidence of hypernatremia and survival in 40 patients with a totally burned surface area (TBSA >10%. Age, sex, TBSA, ABSI-Score and fluid resuscitation within the first 24 hours were analyzed. Patients were separated in two groups without (Group A or with (Group B hypernatremia. Results: Hypernatremia occurred on day 5±1.4. No significant difference for age, sex, TBSA, ABSI-Score and fluid resuscitation within the first 24 hours were calculated. In Group A all patients survived, while 3 of the hypernatremic patient in Group B died during ICU-stay (Odds-ratio = 1.25; 95% CI 0.971–1.61; p=0.046. Conclusion: Burned patients with an in-hospital acquired hypernatremia have an increased mortality risk. In case of a hypernatremic state early intervention is obligatory. There is a need of a fluid removal strategy in severely burned patient to avoid water imbalance.

  15. Focused cardiac ultrasound in the emergency department for patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, C. B.

    2015-01-01

    In patients admitted with respiratory failure, a large proportion is diagnosed incorrectly in the emergency department and an even larger proportion seems to receive inappropriate treatment. Inappropriate initial treatment of these patients in the emergency department is associated with increased...... triage, patients with cardiac arrest, patients with undifferentiated shock, patients with cardiopulmonary instability, patients with respiratory symptoms, trauma patients with suspected cardiac injuries, and assessment of the fluid status before fluid loading. When using focused cardiac ultrasound (US...

  16. Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital.

    Science.gov (United States)

    Soerensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt; Lisby, Marianne; Mainz, Jan

    2016-07-01

    Background Very little is known about the general appropriateness of prescribing for psychiatric patients. Aims To identify prevalence and types of potentially inappropriate prescribing (PIP) of psychotropic and somatic medications, to assess the severity of potential clinical consequences and to identify possible predictive factors of PIP in a sample of adult psychiatric in-patients. Methods A descriptive, cross-sectional design using medication reviews by clinical pharmacologists to identify PIP during a 3-month period. The setting was in-patient units in a psychiatric department of a Danish university hospital during a 3-month period (September 2013-November 2013). Patients medication lists (n = 207) were reviewed at the time of admission and all identified PIPs were assessed for potential consequences by clinical pharmacologists. Results There were 349 PIP identified in 1291 prescriptions. The proportion of patients found to have at least one PIP was 123/207 (59%) and the proportions of patients with at least one PIP assessed to be potentially serious or fatal was 69/207 (33%) and 24/207 (12%), respectively. Interactions between drugs 125/207 (36%) and too high doses of drugs 56/207 (16%) were the most frequent PIP. Predictive factors for PIP were polypharmacy (>5 prescriptions) and having one or more somatic diagnoses. Conclusion PIP is common in psychiatric patients and potentially fatal. Particularly polypharmacy (>5 prescriptions) and concomitant somatic illness were associated with the probability of PIP. Improving the quality of prescribing might benefit from an interprofessional approach and thus better training of physicians and nurses is needed in order to minimize PIP. PMID:26824679

  17. Increased mortality in hypernatremic burned patients

    OpenAIRE

    de Lange, Thomas; Mailänder, Peter; Stollwerck, Peter. L.; Stang, Felix H.; Siemers, Frank; Namdar, Thomas

    2010-01-01

    Introduction: In-hospital hypernatremia develops usually iatrogenically from inadequate or inappropriate fluid prescription. In severely burned patient an extensive initial fluid resuscitation is necessary for burn shock survival. After recovering of cellular integrity the circulating volume has to be normalized. Hereby extensive water and electrolyte shifts can provoke hypernatremia. Purpose: Is a hypernatremic state associated with increased mortality? Method: Retrospective study for the in...

  18. Increased mortality in hypernatremic burned patients

    OpenAIRE

    Namdar, T; Siemers, F; Stollwerck, PL; Stang, FH; Mailänder, P; de Lange, T

    2010-01-01

    Introduction: In-hospital hypernatremia develops usually iatrogenically from inadequate or inappropriate fluid prescription. In severely burned patient an extensive initial fluid resuscitation is necessary for burn shock survival. After recovering of cellular integrity the circulating volume has to be normalized. Hereby extensive water and electrolyte shifts can provoke hypernatremia.Purpose: Is a hypernatremic state associated with increased mortality?Method: Retrospective study for the i...

  19. [The Nutrition Care of Severe Burn Patients].

    Science.gov (United States)

    Hsieh, Yu-Hsiu

    2016-02-01

    In addition to recent advances in burn patient care techniques such as maintaining warm circumambient temperature, the early excision of wounds, and the use of closed dressing, providing nutrition support through early feeding has proven instrumental in greatly increasing the survival rate of burn patients. Severe burns complicated by many factors initiate tremendous physiological stress that leads to postburn hypermetabolism that includes enhanced tissue catabolism, the loss of muscle mass, and decreases in the body's reservoirs of protein and energy. These problems have become the focus of burn therapy. Treating severe burns aims not only to enhance survival rates but also to restore normal bodily functions as completely as possible. Recent research evaluating the application of anabolic agents and immune-enhance formula for severe burns therapy has generated significant controversy. Inadequate caloric intake is one of the main differences among the related studies, with the effect of many special nutrients such as bran acid amides not taken into consideration. Therefore, considering the sufficiency of caloric and protein intake is critical in assessing effectiveness. Only after patients receive adequate calories and protein may the effect of special nutrients such as glutamine and supplements be evaluated effectively. PMID:26813059

  20. Diabetic Foot: Infections and Outcomes in Iranian Admitted Patients

    OpenAIRE

    Hadadi, Azar; Omdeh Ghiasi, Houra; Hajiabdolbaghi, Mahboubeh; Zandekarimi, Majid; Hamidian, Reza

    2014-01-01

    Background: Diabetes mellitus (along with its complications) has become a global problem. Diabetic foot infection, among the most common complications, is responsible for 40 to 50% of foot amputations. Antibiotic-resistant microorganisms, however, have compromised empiric therapy in the infected patients. Objectives: The current study aimed to determine the most common microorganisms involved in diabetic foot infection in order to minimize the failure of antibiotic therapy and the risk of dev...

  1. Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

    Directory of Open Access Journals (Sweden)

    Latha KS

    2011-04-01

    Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.

  2. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

    OpenAIRE

    Aktürk, Abdulkadir; Avci, Akkan; Gülen, Müge; Ay, Mehmet Oğuzhan; İçme, Ferhat; Satar, Salim

    2013-01-01

    Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the pat...

  3. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

    OpenAIRE

    Abdulkadir Akturk; Akkan Avci; Muge Gulen; Mehmet Oguzhan Ay; Ferhat Icme; Salim Satar

    2013-01-01

    Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the pati...

  4. The effect of extensive excision of burn wound with invasive infection on hypermetabolism in burn patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 刁力

    2000-01-01

    Objective: To evaluate the effect of extensive excision of invasive burn wound infection on hypermetabolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before and after surgical intervention and at the time when the patients' vital signs became stable. Correlation analysis between REEs and IL-6、IL-8、TNF-α、LPS was respectively made. Results: A total of 8 patients were treated and all of them survived. Values of REE before surgical intervention were significantly higher than those after surgical intervention(P<0.01), and when patients vital signs became stable the values were significantly lower compared with that after surgical intervention(P<0.01). The plasma concentrations of IL-6、 IL-8、TNF-α and LPS after excision of invasive burn wound infection were significantly lower than those before surgical intervention (P<0.05). The lowest levels of these inflammatory mediators were observed when the conditions of patients became stable, and the values were significantly lower compared with those before surgical intervention (P<0. 001). There was a significant positive correlation between REE level and respective values of plasma IL-6、 IL-8、 TNF-α、 LPS(P <0.01). Conclusions: It is deemed that the extensive excision of invasively infected burn wound in patients with major burn should be performed as early as possible to reduce an increased release of inflammatory mediators, and to control the hypermetabolic response during sepsis.

  5. Methylene Blue for Acute Septic Cardiomyopathy in a Burned Patient.

    Science.gov (United States)

    Schlesinger, Joseph J; Burger, Christina F

    2016-01-01

    The objective of this case summary was to describe the use of methylene blue (MB) in a burned patient with acute septic cardiomyopathy. A 60-year-old Caucasian man was admitted to the Burn Intensive Care Unit with 45% TBSA burns after a house explosion. During the course of his care, he experienced hypotension that was refractory to fluid therapy and vasoactive medications. Echocardiography and right heart catheterization showed new acute systolic dysfunction with concurrent elevated systemic vascular resistance (SVR). High-dose inotropic agents did not improve cardiac function, and septic shock rendered him a poor candidate for mechanical intra-aortic balloon pump support. MB was administered to sensitize the myocardium to catecholamines and improve contractility with the goal of weaning the other vasoactive medications and diuresing for afterload reduction when hemodynamic stability was achieved. MB has been described in critical care medicine predominately for vasoplegia after cardiopulmonary bypass and vasodilatory septic shock., Our patient had acute septic cardiomyopathy that was refractory to standard pharmacologic approaches to inotropy with concurrent elevated SVR. Hypothesizing the differential temporal effect of inducible nitric oxide synthase on the vasculature and myocardium, we administered MB to improve contractility and support the impending vasodilatory effects of distributive shock. Although MB is not a new drug, the application for septic cardiomyopathy with a supranormal SVR is a unique application. Because of the risk profile associated with MB, we recommend drug monitoring utilizing serial echocardiography and/or right heart catheterization. PMID:25798807

  6. Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

    DEFF Research Database (Denmark)

    Larsen, Mette V; Janner, Julie H; Nielsen, Susanne D; Friis-Møller, Alice; Ringbaek, Thomas; Lange, Peter

    2009-01-01

    We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of a...... AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment....

  7. Analysis of antibiotic consumption in burn patients.

    Science.gov (United States)

    Soleymanzadeh-Moghadam, Somayeh; Azimi, Leila; Amani, Laleh; Rastegar Lari, Aida; Alinejad, Faranak; Rastegar Lari, Abdolaziz

    2015-01-01

    Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used. The results indicated that P. aeruginosa is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR) microorganisms, but it can also decrease the cost of treatment. PMID:26124986

  8. Analysis of antibiotic consumption in burn patients

    Directory of Open Access Journals (Sweden)

    Soleymanzadeh-Moghadam, Somayeh

    2015-06-01

    Full Text Available Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of and were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used.The results indicated that is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR microorganisms, but it can also decrease the cost of treatment.

  9. Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy

    Science.gov (United States)

    Weber, Ralph; Reimann, Gernot; Weimar, Christian; Winkler, Angela; Berger, Klaus; Nordmeyer, Hannes; Hadisurya, Jeffrie; Brassel, Friedhelm; Kitzrow, Martin; Krogias, Christos; Weber, Werner; Busch, Elmar W.; Eyding, Jens

    2015-01-01

    Background: After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated. Aims: We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit. Methods: Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients. Results: In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0–2, 44.0% versus 35.7%, p = 0.08). Conclusions: Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging. PMID:27006695

  10. Assisted Vaginal Deliveries in Mothers Admitted as Public or Private Patients in Western Australia

    OpenAIRE

    Einarsdóttir, Kristjana; Haggar, Fatima A; Stock, Sarah; Gunnell, Anthony S.; Stanley, Fiona J.

    2013-01-01

    Background Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. Methods and findings We included 158,241 vaginal, singleton, term birth admissions in our study where the infant wa...

  11. Pyoderma gangrenosum in burned patient: Case report

    OpenAIRE

    Obradović-Tomašev Milana; Jovanović Mladen; Popović Aleksandra

    2015-01-01

    Introduction. Pyoderma gangrenosum is a rare, chronic, destructive, ulcerating skin disease of uncertain etiology. It develops most frequently in patients between 25-45 years of age and affects both sexes equally. Case report. We present a case of pyoderma gangrenosum in a young female patient who sustained a burn injury of 40% total body surface area. She underwent four operations. She developed a wound infection and urinary infection during her hospital s...

  12. Prehospital behaviour of patients admitted with acute coronary syndrome or witnessed cardiac arrest

    DEFF Research Database (Denmark)

    Ottesen, Michael Mundt; Dixen, Ulrik; Torp-Pedersen, Christian; Køber, Lars

    2003-01-01

    OBJECTIVE: To study prehospital behaviour of patients admitted with acute coronary syndrome or witnessed cardiac arrest. DESIGN: Structured interview of 250 consecutive patients with acute coronary syndrome and relatives of 48 patients with witnessed cardiac arrest. The following courses of action...... hundred and thirteen patients (45%) knew of thrombolytic therapy. Twenty-seven of 75 patients with knowledge of the benefit of prompt treatment with thrombolysis, acted in accordance with this awareness. CONCLUSION: Patients misinterpret symptoms of acute coronary syndrome and are misguided when calling...

  13. Aetiology and Outcome of Elderly Burn Patients in Tabriz, Iran

    OpenAIRE

    H. Maghsoudi; Ghaffari, A

    2009-01-01

    Background. Geriatric patients, usually defined as being 65 years of age or over, now make up about 10% of the major burn population. Main aim. To conduct a prospective study of elderly burn patients, analysing the predictive value of age, gender, total body surface area (TBSA) burned, inhalation trauma, pre-morbid conditions, and mortality. Methods. A 10-year prospective study of burn victims hospitalized in a major burn centre in Iran was conducted to analyse the association between age, pe...

  14. Point-of-care ultrasonography in patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian B; Sloth, Erik; Lassen, Annmarie Touborg;

    2014-01-01

    of the heart, lungs, and deep veins in addition to the usual initial diagnostic testing in this patient population. METHODS: In a prospective, parallel-group trial in the emergency department at Odense University Hospital, Odense, Denmark, patients (≥18 years) with a respiratory rate of more than 20 per min......BACKGROUND: When used with standard diagnostic testing, point-of-care ultrasonography might improve the proportion of patients admitted with respiratory symptoms who are correctly diagnosed 4 h after admission to the emergency department. We therefore assessed point-of-care ultrasonography...... diagnosis within 4 h. It should therefore be considered for routine use as part of the standard diagnostic tests in the emergency department for patients admitted with respiratory symptoms. FUNDING: University of Southern Denmark, Odense University Hospital, and Højbjerg Fund....

  15. Characteristics of 985 pediatric burn patients in the south of Liaoning province of China

    Directory of Open Access Journals (Sweden)

    Hongjun Zhai

    2014-07-01

    Full Text Available Accidental injury due to burns is a serious and common, but preventable, occurrence in children. To analyze the characteristics of pediatric burns in the south of Liaoning province of China, a retrospective review was conducted of information, including general characteristics, demographics, etiology of burns, anatomical areas burned, and severity of injuries, obtained from medical records of pediatric burn patients admitted to the Burn Center of Anshan Hospital of the First Hospital of China Medical University from 2002 to 2011. Differences between age-groups and cause and severity of injuries were examined using Cochran-Mantel-Haenzsel ­(C-M-H statistic or chi-square (χ2 analyses where appropriate. A total of 985 pediatric burn cases were included, with only one death. The maximal burn area recorded was 80% and the maximal third-degree burn area was 45%. The majority of burns (637/985, 64.67% were moderate second-degree wounds, encompassing 5-14% of the total body surface area. The infant age-group (<3 years old had the largest representation (622/985, 63.15%, with more males than females affected. Most of the injuries occurred at home in children living in the local region. Scalding accounted for 89.85% (885/985 of all injuries, with a decreasing incidence with age, whereas injuries due to flames and from electrical sources markedly increased with age. Only a minority of guardians (244/985, 24.77% had burn prevention knowledge, and none of them knew how to provide first-aid treatment for burn injuries. These results indicate that the majority of pediatric burns occur in children less than 3 years of age from scalds received while at home. As a large proportion of these cases occurred in rural areas, programs emphasizing burn prevention and treatment knowledge should therefore be made more available to these families.

  16. Evaluation of Different Methods for Removing Oral Biofilm in Patients Admitted to the Intensive Care Unit

    OpenAIRE

    Oliveira, Maria Sonia; Borges, Alvaro Henrique; Mattos, Fernanda Zanol; Semenoff, Tereza Aparecida Della Vedove; Segundo, Alex Semenoff; Tonetto, Mateus Rodrigues; Bandeca, Matheus Coêlho; Porto, Alessandra Nogueira

    2014-01-01

    Background: The present study aimed to evaluate the different methods for removing oral biofilm in combination with 0.12% chlorhexidine, in patients admitted to the intensive care unit (ICU) of the General University Hospital. Materials and Methods: Initially, the patients were included in the study and underwent periodontal evaluation by means of the visible plaque index (VPI) and gingival bleeding index (GBI). The removal of visible biofilm, by a professional, was...

  17. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    OpenAIRE

    de Araújo Carlos José Soares; Gonçalves Fernanda Souza; Bittencourt Hugo Souza; dos Santos Noélia Gonçalves; Junior Sérgio Vitor Mecca; Neves Júlio Leal Bandeira; Fernandes André Maurício Souza; Junior Roque Aras; dos Reis FranciscoJoséFariasBorges; Guimarães Armênio Costa; Junior ErenaldodeSouzaRodrigues; Carvalho Vitor Oliveira

    2012-01-01

    Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failu...

  18. Mealtime habits and meal provision are associated with malnutrition among elderly patients admitted to hospital

    OpenAIRE

    Söderström, Lisa; Thors-Adolfsson, Eva; Rosenblad, Andreas; Frid, Hanna; Saletti, Anja; Bergkvist, Leif

    2013-01-01

    Background & aims: Large-scale studies performed in hospitals with the validated Mini Nutritional Assessment tool (MNA) are scarce. However, factors associated with malnutrition are important for identifying individuals at risk. The aims of the present study were to estimate the prevalence of malnutrition and to examine the association between mealtime habits, meal provision, and malnutrition among elderly patients admitted to hospital. Methods: This cross-sectional study included patient...

  19. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

    Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

  20. Influence of early post-burn enteral nutrition on clinical outcomes of patients with extensive burns

    OpenAIRE

    Lu, Guozhong; Huang, Jiren; Yu, Junjie; Zhu, Yugang; Cai, Liangliang; Gu, Zaiqiu; Su, Qinghe

    2011-01-01

    Sepsis commonly occurs in severe post-burn patients, often resulting in death. We aimed to evaluate the influence of early enteral feeding on outcomes in patients with extensive burns, including infection incidence, healing and mortality. We retrospectively reviewed 60 patients with extensive burns, 35 who had received early enteral nutrition and 25 who had received parenteral nutrition. Average healing time, infection incidence and mortality were clinically observed. Hemoglobin and serum alb...

  1. In-hospital mortality among a cohort of cirrhotic patients admitted to a Tertiary Hospital

    Directory of Open Access Journals (Sweden)

    Mohammad A Alsultan

    2011-01-01

    Full Text Available Background/Aim : To determine the mortality rate in a cohort of hospitalized patients with cirrhosis and examine their resuscitation status at admission. Materials and Methods : A retrospective chart review was conducted of patients with cirrhosis who were admitted to a tertiary care hospital in Riyadh, Saudi Arabia, from January 1, 2009, to December 31, 2009. Results: We reviewed 226 cirrhotic patients during the study period. The hospital mortality rate was 35%. A univariate analysis revealed that worse outcomes were seen in patients with advanced age or who had worse child-turcotte-pugh (CPT scores, worse model for end-stage liver disease (MELD scores, low albumin and high serum creatinine. Using a multivariate analysis, we found that advanced age (P=0.004 and high MELD (P=0.001 scores were independent risk factors for the mortality of cirrhotic patients. The end-of-life decision were made in 34% of cirrhotic patients, and the majority of deceased patients were "no resuscitation" status (90% vs. 4%, P<0.001. Conclusions : The relatively high mortality in cirrhotic patients admitted for care in a tertiary hospital, Saudi Arabia was comparable to that reported in the literature. Furthermore, end-of-life discussions should be addressed early in the hospitalization of cirrhotic patients.

  2. Infectious Endocarditis Presenting as Intracranial Hemorrhage in a Patient Admitted for Lumbar Radiculopathy

    OpenAIRE

    David Ethan Kahn; Ross Bullock; Kristine O'Phelan

    2011-01-01

    Infectious endocarditis is frequently found in the neurologic intensive care unit and may rarely be the cause of intracranial hemorrhage. In such instances, further diagnostic imaging to search for an underlying structural lesion is prudent. Well-known causes of these hemorrhages include cardioembolism with hemorrhagic transformation, septic emboli, and mycotic aneurysms. We present a case of a patient who was admitted for routine evaluation and pain management of lumbar radiculopathy, who de...

  3. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    OpenAIRE

    Uysalol, Metin; Uysalol, Ezgi Paslı; SARAÇOĞLU, GAMZE VAROL; Kayaoğlu, Semra

    2011-01-01

    Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female) who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis. Results...

  4. Three-year Study of Effective Factors in Gastrointestinal Bleeding in Hospitalized Burn Patients in Ahvaz Taleghani Hospital

    Directory of Open Access Journals (Sweden)

    Pipelzadeh MH

    2011-01-01

    Full Text Available Background and Objective: Gastrointestinal bleeding can arise following various stressing conditions such as burns. Gastrointestinal bleeding has serious effect on the treatment process of burn patients. The aim of the present study was to investigate the incidence of gastrointestinal bleeding and to identify factors contributing to its occurrence in burn patientsSubjects and Methods: In this descriptive and retrospective research study, the population of the study included all patients admitted in the Ahvaz Taleghani burn center from the year 2008 to 2010 and 3901 medical records were reviewed. Data were collected by a checklist and analyzed using descriptive and analytical statistical methods. Results: From a total of 3901 patients admitted during the three years period of study, 45 patients had gastrointestinal bleeding (1.15%. The average of burned surface area in these patients was 61%. Seventy seven percent of gastrointestinal bleeding had occurred in patients with burn over 50 percent, and there was direct correlation between the incidence of gastrointestinal bleeding and the extent of burn. The age group of 15-30 years comprised 40.1% of our cases. The mortality among patients suffered from gastrointestinal bleeding was 71%. A significant relationship was found between burn in face and incidence of gastrointestinal bleeding (P<0.001. However, the risk of gastrointestinal bleeding among different sexes was not statistically significant.Conclusion: The results of this study show that the importance of timely diagnosis and treatment of gastrointestinal bleeding in burn patients. Therefore, doing preventive procedures such as medication and psychiatric interventions to reduce stress can decrease the incidence of gastrointestinal bleeding in burn patients.Sci Med J 2011; 9(6:535-542

  5. MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

    Science.gov (United States)

    Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

  6. Prospective Analysis of Geriatric Patients Admitted to Emergency Department With Trauma

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    Abdulkadir Akturk

    2013-08-01

    Full Text Available Objective: The aim of this study is to reveal the demographic characteristics, causes of trauma, physical examination findings, the presence of fractures and the status of the outcome of the geriatric trauma patients admitted to the emergency department of an educational research hospital. Material and Methods: This study covers all the cases over 65 years who were admitted to emergency department with trauma between September 1 2011-31 August 2012. The demographic characteristics of the patients such as, age, gender, date of application and as well as the causes of trauma, physical examination findings and outcome situation in the emergency department were evaluated. The study was performed prospectively. SPSS V.20 was used for statistical analysis of the data obtained. Results: Total 175 patients were included to the study, 74 were male (42.28% and 101 were female (57.72%. The mean age of male patients were 75.01 ± 6.557 while the mean age of female patients were 76.10 ± 7.353. The most common cause of trauma in both gender was falls. This rate was 91.1% in female and 8.9% in male patients. 40.6% of the female patients and 27% of the male patients were admitted to the hospital before because of any trauma. The most common form of trauma according to exposed body localization in both gender was extremity traumas. It was seen in 51.5% of the females and 56.8% of the males. 30 female patients (29.7% and 13 male patients (17.6% had fracture in limbs. 78.3% of all patients were discharged from the emergency department and 21.7% of the patients were hospitalised. None of the patients were died in emergency department and none of the patients were referred to another institution from the emergency department. Total 38 patients were hospitalised, 32 of them were discharged, 2 of them were referred to another institution, and 4 of them were died. 26 of 38 hospitalised patients had undergone surgery while 20 of them were orthopedic surgeries

  7. Epidemiologic Evaluation of Ocular Trauma in Patients Admitted to Ophthalmology Ward of Farshchian Hospital in Hamadan in 2012

    Directory of Open Access Journals (Sweden)

    N. Bazzazi

    2014-04-01

    Full Text Available Introduction & Objective: Ocular trauma is one of the important reasons of visual loss which can cause multiple damages to eyelid, eyeball and adenexal tissues. Furthermore, ocular trauma is one of the major causes of unilateral blindness and the third leading cause of hospi-talization in ophthalmology wards. The aim of this study is to determine the prevalence and characteristics of eye trauma at Farshchian hospital in Hamadan in 2012. Material & Methods: In this cross-sectional descriptive study, 70 patients with ocular trauma, admitted to Farshchian hospital, were studied. We assessed the age, sex, job , educational level, location, cause of trauma, its type and site of injury. The data was analyzed by SPSS 16 software and t, ?2 statistical tests. Results: The mean age of patients in this study was 24.01 years (SD= 16.04. Among 70 pa-tients, 58 people (82.1% were males and 12 patients (17.1% were females. The most com-mon cause of trauma was observed in 19 patients (27.1%. The most common location of the trauma in this study was homing, seen in 28 patients (40%. Among the 70 patients, 29 peo-ple (41.4% had open globe injuries, 25 people had (35.7% closed globe injuries, 5 patients (7.1% had burning and 11 patients (15.7% had adenexal injury. Conclusions: The results showed that most ocular traumas occur in the early ages and in males. The most common type of them is open globe injury and the most common cause is a sharp object. (Sci J Hamadan Univ Med Sci 2014; 21 (1:25-31

  8. Safe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitis

    Science.gov (United States)

    Plaudis, Haralds; Fokins, Vladimirs; Mukans, Maksims; Pupelis, Guntars

    2016-01-01

    Backgrounds/Aims Laparoscopic treatment of patients with choledocholithiasis and cholangitis is challenging due to mandatory recovery of the biliary drainage and clearance of the common bile duct (CBD). The aim of our study was to assess postoperative course of cholangitis and biliary sepsis after laparoscopic clearance of the CBD in emergently admitted patients with choledocholithiasis and cholangitis. Methods Emergently admitted patients who underwent laparoscopic clearance of the CBD were included prospectively and stratified in 2 groups i.e., cholangitis positive (CH+) or negative (CH-) group. Patient demographics, comorbidities, preoperative imaging data, inflammatory response, surgical intervention, complication rate and outcomes were compared between groups. Results Ninety-nine of a total 320 patients underwent laparoscopic clearance of the CBD, of which, 60 belonged to the acute cholangitis group (CH+) and 39 to the cholangitis negative group (CH-). Interventions were done on average 4 days after admission, operation duration was 95-105 min, and the conversion rate was 3-7% without differences in the groups. Preoperative inflammatory response was markedly higher in the CH+ group. Inflammation signs on intraoperative choledochoscopy were more evident in patients with cholangitis. Postoperative inflammatory response did not differ between the groups. The overall complication rate was 8.3% and 5.1%, respectively. Laparoscopic clearance of the CBD resulted in 1 lethal case (CH+ group), resulting in 1% mortality rate and a similar 12-month readmission rate. Conclusions Single-stage laparoscopic intraoperative US and choledochoscopy-assisted clearance of the CBD is feasible in emergently admitted patients with choledocholithiasis and cholangitis. PMID:27212991

  9. The pattern of neurological disorders in patients admitted to El shaab teaching hospital

    International Nuclear Information System (INIS)

    This thesis was designed to study the pattern of neurological disorders of admitted patients to the neurology centre at El shaab teaching hospital in the period from january 1997 to december 1998. 402 cases were admitted. (35%) were in the age group 21-40, 30% in 41-60, 20% in 61-80, 14% in 0-20 and 1% in >81 males constituted 72% and females 28%. Cerebrovascular diseases top the list with 18.9%, followed by paraplegia's with 17.4%, peripheral neuropathies 11.7, (guillain barre was the most common). Brain space occupying lesions 10.4% (tumors and tuberculomas was the most common),movement disorders with 10% (Parkinson's disease was the most encountered), muscle disorders 6.2% (myasthenia gravis was the commonest). Ataxias 5.5%, headache and migraine was the least group of disorders

  10. The relationship of air pollution and asthma patients admitted to hospitals in Kermanshah (2008-2009

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    Razieh Khamutian

    2015-01-01

    Full Text Available Background: Industrialization and urbanization have had a devastating impact on public health. Asthma is considered as one of the major challenges of public health. The purpose of this study was to determine the association between air pollution and the number of asthma patients admitted to hospitals in Kermanshah, Iran. Methods: In this cross-sectional and ecological study, the data on the number of asthma patients, the concentration levels of air pollutants and weather conditions were collected from the city of Kermanshah. To determine the association between asthma patients admitted to hospitals and air pollutants, Poisson regression was used (P<0.05. Results: according to the statistical analysis, air pollutants had significant correlation with each other. Based on the results of multiple Poisson regression, among air pollutants CO and O3 were significantly correlated with the number of asthma patients referred to hospitals, with relative risk of 1.18 and 1.016, respectively, and based on the results of single Poisson regression, among air pollutants NOx, NO, NO2 and CO were significantly correlated with the number of asthma patients referred to hospitals with relative risk of 1.011, 1.012, 1.054 and 1.247, respectively. Conclusion: according to the results of the present study, there was a significant association between air pollutants (mainly carbon monoxide and ozone and the total number of asthma patients referred to the hospitals in Kermanshah.

  11. [Risk factors for development of hypomagnesemia in the burned patient].

    Science.gov (United States)

    Durán-Vega, Héctor César; Romero-Aviña, Francisco Javier; Gutiérrez-Salgado, Jorge Eduardo; Silva-Díaz, Teresita; Ramos-Durón, Luis Ernesto; Carrera-Gómez, Francisco Javier

    2004-01-01

    Electrolyte abnormalities are common in the severely burned patient. There is little information with regard to the frequency and magnitude of hypomagnesemia, as well as on risk factors for this condition. We performed an observational, retrospective analysis of 35 burned patients treated at the Plastic and Reconstructive Surgery Service at the Hospital Central Sur PEMEX, Mexico City. We determined serum magnesium behavior and divided patients into two groups: the first included 11 patients with burns and hypomagnesemia, and the second, 24 patients with burns but without hypomagnesemia. Risk factor identification was performed. We found patient at risk was the one with more than 40% of 2nd or 3rd degree total burned body area, in day 4 or 10 after the burn, and with hypokalemia, hypocalcemia, or both, and without intravenous (i.v.) supplementation of magnesium. The best way to prevent or avoid major complications is to identify the high-risk patient, or to diagnose earlier. PMID:15633562

  12. Burn patient: emergency treatment and reanimation

    Directory of Open Access Journals (Sweden)

    Berrocal-Revueltas Manuela

    2011-12-01

    Full Text Available Burns are a worldwide public Health Problem. This matter mainly affects the populationsof developing countries, due to their vulnerability and the lack of statistical recordsavailable to acknowledge the truly dimensions of the problem, which are needed todevelop efficient prevention proposals. This trauma or injury of the tissue, produced bythe transference of energy from one body to another, severely affects the quality of lifeof the burn patient, with high risk of morbidity and mortality, if the emergency treatmentof resuscitation or reanimation procedure, performed by the medical or paramedical teamfails to operate in a efficient way. This Guidelines is an easy, updated, effective and safetysupport, designed for physicians and paramedics, since they are the first who go to theplace of the accident to offer the primary support to the burned patient.RESEUMEN:Las quemaduras son un problema de salud pública a nivel mundial, que afecta con mayorgravedad a las poblaciones vulnerables de los países en vías de desarrollo, por la falta deregistros estadísticos que permitan conocer la dimensión del problema, para desarrollarpropuestas eficientes en materia de prevención. Este trauma o lesión tisular, producidapor la transferencia de energía de un cuerpo a otro, puede afectar en forma severa lacalidad de vida del paciente y su familia, con alto riesgo de morbi-mortalidad, si no seaplica en forma oportuna y eficiente un tratamiento de emergencia para la reanimación óresucitación del paciente, por parte del equipo médico y paramédico, asignados en cadacaso. La presente guía de manejo de urgencia del paciente quemado, es de fácil aplicación,efectiva y actualizada, orientada a los médicos generales y paramédicos, quienes son losprimeros en acudir al lugar del accidente para ofrecer los primeros cuidados al pacientequemado.

  13. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  14. Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

    Science.gov (United States)

    Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

    2012-01-01

    The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

  15. Evaluation of Patients with Paracetamol Intoxication Who Admitted to Emergency Service

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    Kıvanç Karaman

    2016-04-01

    Full Text Available Objective: To evaluate the effects of demographic and clinical features on follow-up period and laboratory parameters in patients with paracetamol intoxication who were admitted to our emergency department. Materials and Methods: One hundred sixty-four patients, who were admitted to the emergency department at Adnan Menderes University Faculty of Medicine between April 2013 and April 2015, were retrospectively evaluated and a total of 44 patients who have ingested paracetamol were enrolled in the study. The demographic and laboratory data of the patients were recorded. The study protocol was approved by the Ethics Committee and Institutional Review Board of Adnan Menderes University Faculty of Medicine. Results: Of the 44 patients, 29 were followed up in the observation unit at the emergency department (OUED, while 15 were followed up in the critical care unit at the emergency department (CCUED. There was no difference in age, sex and additional drug usage between the groups. Paracetamol dose was significantly higher in CCUED group than in OUED group (15013±6942 vs. 5351±3382 mg, p<0.001. Antidote administration was performed in 14 patients in CCUED (93.3% and 12 patients in OUED groups (41.1% (p=0.003. When we compared the patients who received antidote treatment with those who did not, it was observed that the dose of paracetamol (12344±6388 vs. 3302±1291 mg, p<0.001 and the length of hospitalization (2.46±0.7 vs. 1.39±0.6 day, p<0.001 were significantly higher in antidote-administered patients. The international normalized ratio (INR was also significantly higher in patients who received antidote treatment than in those who did not receive (1.14±0.14 vs. 1.05±0.13, p=0.042. Conclusion: The role of emergency physicians in triage is very important. Laboratory findings are not important in the management of paracetamol intoxication in patients admitted to the emergency department. Intravenous administration of N-acetylcysteine as

  16. Procalcitonin: a diagnostic and prognostic biomarker of sepsis in burned patients

    Science.gov (United States)

    Mokline, A.; Garsallah, L.; Rahmani, I.; Jerbi, K.; Oueslati, H.; Tlaili, S.; Hammouda, R.; Gasri, B.; Messadi, A.A.

    2015-01-01

    Summary The goal of this study was to analyse plasma procalcitonin (PCT) concentrations during infectious events of burns in ICU. We conducted a prospective, observational study in a 20-bed Burn Intensive Care Unit in Tunisia. A total of 121 patients admitted to the Burn ICU were included in our study. Serum PCT was measured over the entire course of stay in patients with predictive signs of sepsis according to the Americain Burn Association Criteria for the presence of infection. Patients were assigned to two groups depending on the clinical course and outcome: Group A = non septic patients; Group B = septic patients. A PCT cutoff value of 0,69 ng/ml for sepsis prediction was associated with the optimal combination of sensitivity (89%), specificity (85%), positive predictive value (82%) and negative predictive value (88%). Serum procalcitonin levels can be used as an early indicator of septic complication in patients with severe burn injuries as well as in monitoring the response to antimicrobial therapy. PMID:27252609

  17. Honey dressing versus silver sulfadiazene dressing for wound healing in burn patients: A retrospective study

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    Shilpi Singh Gupta

    2011-01-01

    Full Text Available Objective : The aim was to evaluate the effect of honey dressing and silver sulfadiazene (SSD dressing on wound healing in burn patients. Materials and Methods : We retrospectively reviewed the records of 108 patients (14-68 years of age, with first and second degree burns of less than 50% of the total body surface area admitted to our institution, over a period of 5 years (2004-2008. Fifty-one patients were treated with honey dressings and 57 with SSD. Time elapsed since burn, site, percentage, degree and depth of burns, results of culture sensitivity at various time intervals, duration of healing, formation of post-treatment hypertrophic scar, and/or contracture were recorded and analyzed. Results : The average duration of healing was 18.16 and 32.68 days for the honey and SSD group, respectively. Wounds of all patients reporting within 1 h of burns became sterile with the honey dressing in less than 7 days while there was none with SSD. All wounds treated with honey became sterile within 21 days while for SSD-treated wounds, this figure was 36.5%. A complete outcome was seen in 81% of all patients in the "honey group" while in only 37% patients in the "SSD group." Conclusion : Honey dressings make the wounds sterile in less time, enhance healing, and have a better outcome in terms of hypertropic scars and postburn contractures, as compared to SSD dressings.

  18. Quality of Life in Patients with Substance Use Disorders Admitted to Detoxification Compared with Those Admitted to Hospitals for Medical Disorders: Follow-Up Results

    Science.gov (United States)

    Vederhus, John-Kåre; Pripp, Are Hugo; Clausen, Thomas

    2016-01-01

    Quality of life (QoL) in patients admitted to a general hospital was compared with those admitted to a detoxification unit for the treatment of substance use disorder (SUD). This study combines data from two separate data collections: a cross-sectional study in a general hospital unit (somatic sample, N = 519) and a follow-up study in a detoxification unit (SUD sample, N = 140). A total of 659 patients recruited during 2008–2013 were included in this study. All patients completed a generic QoL questionnaire at inclusion, and the SUD sample also completed it at the six-month follow-up. SUD patients experienced comparably low physical QoL and had significantly lower psychological, social, and existential QoL domain scores when compared with the somatic sample. Mental distress and having a SUD were the major factors explaining variations in QoL, with both influencing QoL negatively. In the SUD sample, QoL improved moderately at the six-month follow-up with less improvement for the domain relationship to a partner. To facilitate the recovery of SUD patients, clinicians must view their patients’ situation holistically and invest efforts into the different life domains affected by poor QoL. PMID:27226719

  19. Outcome of patients with hematological malignancies admitted to the intensive care with life-threatning complications

    International Nuclear Information System (INIS)

    To access the outcome of patients with hematological malignancies (HM) admitted to medical intensive care unit (MICU) and to identify prognostic factors that may effect patient's outcome. Data were collected in 44 patients with HM admitted to the MICU at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia within a 9-year period from 1993 to 2004. Demographic, physiological, clinical, laboratory and therapeutic data were collected on admission to MICU. Thirty-four percent of patients had acute lymphocytic leukemia; 25% had acute myelocytic leukemia (AML) followed by non-Hodgkin's lymphoma in 20%, only 13.6% of these patients were in remission. The reason for admission of these patients into MICU were shock (34.15%), respiratory failure (31.8%), cardiac arrest (20.4%), neurological causes (9.1%) and for other causes like small bowel perforation, hepatic failure, acute renal failure and metabolic disorders (4.5%). The overall in-hospital mortality was 72.7%, intensive care unit (ICU) mortality 61%, and the mean length of stay in the MICU was 5.4+-4.8 days. A statistically significance association was demonstrated between both remission status and aspartate aminotransferase values on one side and patient's outcome on the other side. Patients with AML had poorer prognosis with mortality rate of 90.9%. Although mortality in patients with HM requiring ICU care is high, our results indicate that critical care support may be lifesaving. Apart from remission status and AML disease, no other prognostic factor could be identified. (author)

  20. Incidence of Osteoporosis in Patients Admitted to our Physical Medicine and Rehabilitation Outpatient Clinics

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    Berat Meryem Alkan

    2011-04-01

    Full Text Available Aim: Osteoporosis is a skeletal disease characterized with decreased bone mass and microarchtitectural deterioration of bone tissue which increases bone fragility and fracture risk. Osteoporosis and osteoporotic fractures constitute an important health problem in general population. This study aimed to determine the incidence of osteoporosis, chronic diseases accompanying osteoporosis and incidence of falls in male and female patients admitted to our out patient clinics retrospectively. Material and Methods: Patient records of the 11624 patients admitted to Ankara Atatürk Education and Research Hospital Physical Medicine and Rehabilitation Outpatient clinics between January 2010 and July 2010 were retrospectively reviewed and 644 patients diagnosed as osteoporosis according to femoral neck and/or lumbar dual energy x ray absoptiometry measurements were included in the study. Ages of the patients, sexes, chronic ilnesses, musculoskeletal sytem complaints and fall histories were also recorded. Results: The incidence of osteoporosis was found to be 7.61% in female patients and it was determined that incidence was 5-fold increased in women than in men. Besides, chronic ilnesses and fall history were accompanying in higher ratios in osteoporotic patients. Conclusion: Heart diseases, hypertension, diabetes, neurological diseases leading to impairment in balance and musculoskelatal system complaints were quite frequent in patients with osteoporosis and these diseases should be taken seriously since they increase the risk of falling. It is important to avoid using drugs which lead to balance impairment, to use walk aids like canes or walkers, to perform exercises including balance and coordination training and endurance exercises in order to prevent falls. (Turkish Journal of Osteoporosis 2011;17:10-3

  1. Evaluation of pregnant patients admitted to the emergency department with suicide attempt

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    Yılmaz Zengin

    2015-06-01

    Full Text Available Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods. Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared. Results: In this study, 15 (26.7% patients in the violent suicide attempt group, and 41 (73.3% patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively. Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2: 115-120

  2. Determination of the prevalence of congenital heart disease in the patients admitted to the heart clinic

    Institute of Scientific and Technical Information of China (English)

    Shokoufeh Ahmadipour; Behzad Mohammadpour Ahranjani; Sara Daeichin; Zahra Mirbeig Sabzevari

    2015-01-01

    Objective:To investigate the prevalence of congenital heart disease (CHD) among the patients who refferred to the heart clinic so as to make an early and correct diagnosis. Methods: In this descriptive-cross sectional study, all the patients admitted to the heart clinic who had symptoms or signs ofCHDwere included. The data were collected in one year based on the medical records. The main variables consisted of age, gender, history of folic acid consumption by the mother in pregnancy, clinical signs, symptoms and so on. Results: Among the 763 admitted patients, 498 were males and the rest were females. Infants were the most common group and teenagers were the least one. The most common findings for which the patients had been referred were chest pain and a murmur heard during a normal physical examination. Based on the echocardiography findings, ventricular and atrial septal defects were the most common ones. The history of folic acid consumption was negative in 168 mothers within their pregnancy. Conclusions: Since the causes and risk factors in the incidence ofCHD in children are numerous, we recommended that the information about these diseases should be given to the community and strengthen the referral system, design registration system ofCHD set up in the country round.

  3. Acute kidney injury is common, parallels organ dysfunction or failure, and carries appreciable mortality in patients with major burns: a prospective exploratory cohort study

    OpenAIRE

    Steinvall, Ingrid; Bak, Zoltan; Sjöberg, Folke

    2008-01-01

    Introduction: The purpose of this study was to determine the incidence, time course, and outcome of acute kidney injury after major burns and to evaluate the impact of possible predisposing factors ( age, gender, and depth and extent of injury) and the relation to other dysfunctioning organs and sepsis. Method: We performed an explorative cohort study on patients with a TBSA% (percentage burned of total body surface area) of 20% or more who were admitted to a national burn centre. Acute kidne...

  4. Short-term mortality in hip fracture patients admitted during weekends and holidays

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Kehlet, H

    2006-01-01

    BACKGROUND: Acute surgical admission during weekends, with reduced staffing levels, has been associated with increased risk of mortality, but the effect of longer vacation/holiday periods has not been studied. We therefore examined early postoperative mortality in hip fracture patients admitted...... during weekends and holiday periods, compared with normal weekdays. METHODS: Prospective, descriptive study in 600 consecutive hip fracture patients treated with a well-defined multimodal care plan, in a specialized hip fracture unit between September 2002 and July 2004. Patients were stratified...... independent risk factor for both 5-day (4.34, 95% CI 1.74-10.8) and 30-day mortality (1.84, 95% CI 1.08-3.12). CONCLUSION: Staff reduction during holiday periods in units that care for acute surgical patients may adversely influence postoperative outcome. This may have important consequences both for outcome...

  5. Prevalence of unrecognized diabetes mellitus in patients admitted with acute coronary syndrome.

    Science.gov (United States)

    Abdullatef, W K; Al-Aqeedi, R F; Dabdoob, W; Hajar, H A; Bener, A; Gehani, A A

    2013-01-01

    We assessed the prevalence of unrecognized diabetes mellitus (DM) in patients with acute coronary syndrome (ACS) as determined by elevated glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and random plasma glucose (RPG) levels. This prospective study recruited 583 patients admitted with ACS without previous diagnosis of DM during 1-year period. Glycosylated hemoglobin was checked for most patients especially those with high values of FPG and or RPG. Patients were classified according to their glycemic state into 123 (21.1%) with DM, 82 (14.1%) with prediabetes, and 57(9.8%) with stress hyperglycemia, while 321 (55%) were classified as nondiabetics. Glycosylated hemoglobin estimation in the setting of ACS was helpful in the diagnosis of DM to eliminate the effect of stress-induced hyperglycemia that might accompany this condition. PMID:22550348

  6. Focus assessed transthoracic echocardiography (FATE) in patients acutely admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Jakobsen, Carl-Johan; Lassen, Annmarie Touborg;

    2012-01-01

    appraisal in patients acutely admitted with respiratory symptoms. Method: We conducted a prospective crosssectional, blinded observational study in a medical emergency department. Patients were included if one of the following symptoms or clinical findings was present: respiratory rate >20, saturation ... the diagnostic performance of the clinical examination in patients with acute respiratory symptoms [3]. Thus FATE could be integrated as a part of the patient assessment, potentially improving diagnostics. We evaluated the use of a sonographic examination, including FATE, performed within one hour of the primary....... Discussion: FATE is a fast, highly feasible and non-invasive bedside method. In acute admissions with respiratory symptoms, routine use of FATE may help the clinician to diagnose acute life threatening conditions, which could otherwise be missed. As use of the FATE protocol seems to improve the diagnostic...

  7. Time course of thrombocytes in burn patients and its predictive value for outcome.

    Science.gov (United States)

    Marck, Roos Elisabeth; Montagne, Harriet Leonie; Tuinebreijer, Willem Eduard; Breederveld, Roelf Simon

    2013-06-01

    Thrombocytopenia is common in trauma and critically ill patients and is associated with a poor outcomes. The objective of this retrospective study was to investigate the course of thrombocyte concentration changes in burn patients, the influences of various factors on this course, and a possible predictive value of thrombocyte counts on outcome in 244 patients admitted to our burn centre. Their thrombocyte counts were obtained until 50 days after burn. Data on patient demographics, total percentage burned surface area (%TBSA), sepsis and mortality were collected. Multilevel multivariable analysis was performed to investigate the influence of the variables on the platelet course. Cox regression analysis was performed to analyse the predictive value of the variables for mortality. A distinct pattern of thrombocyte counts was observed, with a nadir at day 3 followed by a peak at day 15 and a temporary thrombocytosis. %TBSA and age (p<0.05) influence this course. The mean thrombocyte course of septic and non-surviving patients depicts a significant lower nadir. Furthermore, higher age, %TBSA and low thrombocyte counts at the peak are predictive for 50 day mortality (p<0.05). Platelets follow a distinct course after burn, influenced by %TBSA and age. These factors and a low thrombocyte peak count predict mortality. PMID:23490002

  8. Micafungin Concentrations in the Plasma and Burn Eschar of Severely Burned Patients

    OpenAIRE

    Sasaki, Junichi; Yamanouchi, Satoshi; Kudo, Daisuke; Endo, Tomoyuki; Nomura, Ryosuke; Takuma, Kiyotsugu; Kushimoto, Shigeki; Shinozawa, Yotaro; Kishino, Satoshi; Hori, Shingo; Aikawa, Naoki

    2012-01-01

    Micafungin concentrations in plasma and burn eschar after daily intravenous infusion (1 h) of micafungin (200 to 300 mg) were investigated for six patients with severe burns. Micafungin treatment was initiated more than 72 h after the burn injuries. The peak and trough levels in the plasma after the initial administration and repeated administrations for more than 4 days were comparable with or slightly lower than the reported values for healthy volunteers. Micafungin concentrations in the pl...

  9. Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru

    International Nuclear Information System (INIS)

    Objective: to identify and analyze the prevalence of cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru. Materials and methods: cross-sectional study analyzing 200 consecutive non contrast-enhanced cranial computed tomography reports of patients admitted to the emergency unit of Hospital Universitario Cajuru. Results: alterations were observed in 76.5% of the patients. Among them, the following findings were most frequently observed: extracranial soft tissue swelling (22%), bone fracture (16.5%), subarachnoid hemorrhage (15%), nonspecific hypodensity (14.5%), paranasal sinuses opacification (11.5%), diffuse cerebral edema (10.5%), subdural hematoma (9.5%), cerebral contusion (8.5%), hydrocephalus (8%), retractable hypodensity /gliosis/ encephalomalacia (8%). Conclusion: the authors recognize that the most common findings in emergency departments reported in the literature are similar to the ones described in the present study. This information is important for professionals to recognize the main changes to be identified at cranial computed tomography, and for future planning and hospital screening aiming at achieving efficiency and improvement in services. (author)

  10. The effect of hospital volume on mortality in patients admitted with severe sepsis.

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    Sajid Shahul

    Full Text Available IMPORTANCE: The association between hospital volume and inpatient mortality for severe sepsis is unclear. OBJECTIVE: To assess the effect of severe sepsis case volume and inpatient mortality. DESIGN SETTING AND PARTICIPANTS: Retrospective cohort study from 646,988 patient discharges with severe sepsis from 3,487 hospitals in the Nationwide Inpatient Sample from 2002 to 2011. EXPOSURES: The exposure of interest was the mean yearly sepsis case volume per hospital divided into tertiles. MAIN OUTCOMES AND MEASURES: Inpatient mortality. RESULTS: Compared with the highest tertile of severe sepsis volume (>60 cases per year, the odds ratio for inpatient mortality among persons admitted to hospitals in the lowest tertile (≤10 severe sepsis cases per year was 1.188 (95% CI: 1.074-1.315, while the odds ratio was 1.090 (95% CI: 1.031-1.152 for patients admitted to hospitals in the middle tertile. Similarly, improved survival was seen across the tertiles with an adjusted inpatient mortality incidence of 35.81 (95% CI: 33.64-38.03 for hospitals with the lowest volume of severe sepsis cases and a drop to 32.07 (95% CI: 31.51-32.64 for hospitals with the highest volume. CONCLUSIONS AND RELEVANCE: We demonstrate an association between a higher severe sepsis case volume and decreased mortality. The need for a systems-based approach for improved outcomes may require a high volume of severely septic patients.

  11. Clinical profile of burn injured patients

    OpenAIRE

    Efstathiou, Flora; Svardagalou, Paraskevi

    2016-01-01

    Abstract Introduction: Burn injury is a severe systemic disease with social implications. Aim: The recording of patient’s clinical profile with burn injury worldwide and in Greece, the outcome and impact of the injury on the patient’s mental health and social, professional and family life. Methods: There were collected surveys and reports concerned burn victims, men and women, teenagers and adults of all types and severities of burns in the world and in Greece. The inf...

  12. Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

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    Wallin Juliska

    2008-02-01

    Full Text Available Abstract Background The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM. Methods This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS and the Global Assessment of Functioning (GAF. The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21, The Hospital Anxiety and Depression Scale (HADS and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM. Results Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales. Conclusion Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

  13. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

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    Ishimoto Kayo

    2010-12-01

    Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission

  14. Two cases of jugular vein thrombosis in severely burned patients

    OpenAIRE

    Cen H; He X

    2013-01-01

    Hanghui Cen, Xiaojie HeDepartment of Burn, The Second Affiliated Hospital, Zhejiang University Medical College, Hangzhou, People’s Republic of ChinaAbstract: Here we present two cases of jugular vein thrombosis in burn patients, with diagnosis, risk factor analysis, and treatment approaches. Severely burned patients have high risk of deep vein thrombosis occurrence due to multiple surgeries. The deep vein catheter should be carefully performed. Once deep vein thrombosis is detected, a w...

  15. Plasmid Mediated Antibiotic Resistance in Isolated Bacteria From Burned Patients

    OpenAIRE

    Beige, Fahimeh; Baseri Salehi, Majid; Bahador, Nima; Mobasherzadeh, Sina

    2014-01-01

    Background: Nowadays, the treatment of burned patients is difficult because of the high frequency of infection with antibiotic resistance bacteria. Objectives: This study was conducted to evaluate the level of antibiotic resistance in Gram-negative bacteria and its relation with the existence of plasmid. Materials and Methods: The samples were collected from two hundred twenty hospitalized burned patients in Isfahan burn hospital during a three-month period (March 2012 to June 2012). The samp...

  16. Prevalence of Burnout Syndrome in Patients Admitted with Acute Coronary Syndrome

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    Ana Cláudia Giaxa Prosdócimo

    2015-03-01

    Full Text Available Background: Burnout Syndrome is the extreme emotional response to chronic occupational stress, manifesting as physical and mental exhaustion. Although associated with higher prevalence of cardiovascular risk factors, no study so far has evaluated whether the Burnout Syndrome could be a prevalent factor in non-elderly individuals active in the labor market, admitted for acute coronary syndrome (ACS. Objective: To evaluate the prevalence of the Burnout Syndrome in non-elderly, economically active patients, hospitalized with ACS. Methods: Cross-sectional study conducted in a tertiary and private cardiology center, with economically active patients aged <65 years, hospitalized with diagnosis of ACS. The Burnout Syndrome was evaluated with the Burnout Syndrome Inventory (BSI, which assesses workplace conditions and four dimensions that characterize the syndrome: emotional exhaustion (EE, emotional distancing (EmD, dehumanization (De and professional fulfillment (PF. The Lipp’s Stress Symptoms Inventory for Adults (LSSI was applied to evaluate global stress. Results: Of 830 patients evaluated with suspected ACS, 170 met the study criteria, 90% of which were men, overall average age was 52 years, and 40.5% had an average income above 11 minimum wages. The prevalence of the Burnout Syndrome was 4.1%. When we evaluated each dimension individually, we found high EE in 34.7%, high De in 52.4%, high EDi in 30.6%, and low PF in 5.9%. The overall prevalence of stress was 87.5%. Conclusion: We found a low prevalence of Burnout Syndrome in an economically active, non-elderly population among patients admitted for ACS in a tertiary and private hospital.

  17. Assisted vaginal deliveries in mothers admitted as public or private patients in Western Australia.

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    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. METHODS AND FINDINGS: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (< 7, neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI  =  1.68-1.80. Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08-1.45, neonatal resuscitation (OR  =  1.69, 1.42-2.00 and admission to special care nursery (OR  =  1.64, 1.53-1.76. The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR  =  2.13 than public patients (OR  = 1 .55, p(interaction  =  0.03. CONCLUSIONS: Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a

  18. Does mixing acute medical admissions with burn patients increase infective complications from paediatric thermal injuries?

    OpenAIRE

    Shaban, Fadlo; Stewart, Ken; Kalima, Pota

    2010-01-01

    In the winter of 2005–2006, the management at our children's hospital elected to admit ‘overspill’ acute medical admissions to the ward used for plastic surgery and burns for logistical reasons. This study was conducted to assess the effects of that change on the incidence of infective complications in thermally-injured patients. Seventy-three patients were studied, 23 in the sample winter and 50 in the two preceding control winters. The data gathered included days on IV fluids and antibiotic...

  19. Association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic

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    Hocagil H

    2016-02-01

    Full Text Available Hilal Hocagil,1 Filiz Izci,2 Abdullah Cüneyt Hocagil,1 Ebru Findikli,3 Sevda Korkmaz,4 Merve Iris Koc5 1Department of Emergency, School of Medicine, Bulent Ecevit University, Zonguldak, 2Department of Psychiatry, School of Medicine, Istanbul Bilim University, Istanbul, 3Department of Psychiatry, School of Medicine, Sutcu Imam University, Kahramanmaras, 4Department of Psychiatry, School of Medicine, Firat University, Elazig, 5Department of Psychiatry, Erenkoy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey Background: Here we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic.Methods: This study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients.Results: Of the patients exposed to violence 63% (n=46 were female and 27% (n=27 were male. Of these patients, 68.5% (n=50 were married, 43.8% (n=25 were workers, 34.2% were housewives, 11% were unemployed, and 11% were civil servants. Of the violence-exposed patients, 56.2% (n=41 were primary school, 21.9% (n=16 were high school, and 21.9% (n=16 were university graduates. Smoking and alcohol use rates were 54.8% (n=40 and 17.8% (n=13, respectively. The most common trauma type was assault using physical force with a ratio of 78.1% (n=57. In addition, anxiety scores were high in 42.5% (n=31 and moderate in 9.6% (n=7 of the patients. Mentioned psychiatric disorder was present in 17.8% (n=13 of the patients and 19.2% (n=14 of the patients’ relatives. The correlation between sociodemographic

  20. Risk factors of mortality among dengue patients admitted to a tertiary care setting in Kerala, India.

    Science.gov (United States)

    Karunakaran, Aswath; Ilyas, Waseem Mohammed; Sheen, S F; Jose, Nelson K; Nujum, Zinia T

    2014-01-01

    Dengue is one of the most serious and rapidly emerging tropical mosquito-borne diseases. The state of Kerala in India is hyperendemic for the disease and is one of the leading states in the reporting of deaths due to dengue. As primary prevention of dengue has had limited success, the prevention of mortality through the identification of risk factors and efficient patient management is of utmost importance. Hence, a record-based case control study was conducted in the Medical College Hospital in Thiruvananthapuram to identify the risk factors of mortality in patients admitted with dengue. Dengue patients over 40years of age were 9.3 times (95% CI; 1.9-44.4) more likely to die compared with younger patients. The clinical features associated with mortality from dengue were altered sensorium (odds ratio (OR) - 156, 95% CI; 12.575-1935.197), abnormal reflexes (OR - 8.5, 95% CI; 1.833-39.421) and edema (OR - 13.22, 95% CI; 2.651-65.951). Mortality was also higher in those patients with co-morbidities such as diabetes mellitus (OR - 26, 95% CI; 2.47-273.674) and hypertension (OR - 44, 95% CI; 6.23-315.499). The independent predictors of mortality were altered sensorium and hypertension. Dengue fever patients with these clinical features and those who are elderly should be more rigorously monitored and promptly referred from lower settings when required to reduce mortality. PMID:24290074

  1. Clinical practice recommendations for positioning of the burn patient.

    Science.gov (United States)

    Serghiou, M A; Niszczak, J; Parry, I; Richard, R

    2016-03-01

    The objective of this review was to systematically examine whether there is clinical evidence to support recommendations for positioning patients with acute burn. Review of the literature revealed minimal evidence-based practice regarding the positioning of burn patients in the acute and intermediate phases of recovery. This manuscript describes recommendations based on the limited evidence found in the literature as well as the expert opinion of burn rehabilitation specialists. These positioning recommendations are designed to guide those rehabilitation professionals who treat burn survivors during their acute hospitalization and are intended to assist in the understanding and development of effective positioning regimens. PMID:26787131

  2. Effect of the full moon on mortality among patients admitted to the intensive care unit

    International Nuclear Information System (INIS)

    Objective: To determine the lunar effect on mortality among patients admitted to the intensive care unit. Methods: The retrospective study conducted at Rosalind Franklin University of Medicine and Science, North Chicago, and comprised data of 4387 patients in intensive care unit from December 2002 to November 2004. The subjects were divided into two groups: patients who died on full moon days (the 14th, 15th, and 16th days of the lunar month); and patients who died on the other days of the month. The mortality rates were calculated for patients in both groups. Parameters including patients' age, gender, acute physiology and chronic health evaluation scores, predicted mortality rates, type of intensive care unit, and actual mortality were compared, and non-parametric tests were performed to determine whether there were any differences between the groups. Results: Of the 4387 patients who were followed for 23 months, 297 patients died, including 31 on full moon days and 266 patients on the other days of the month. Both groups were similar in terms of mean age (73.6 +-14.59 vs. 71.07+-16.13 years; p=0.599), acute physiology and chronic health evaluation scores (82.06+-24.19 vs. 76.52+-27.42; p=0.258), and predicted mortality (0.405+-0.249 vs. 0.370+-0.268; p=0.305). There was no difference in the frequency of death between the full moon days and the other days (10.33+-0.58 vs. 9.8 +-3.46; p=0.845). Conclusions: The full moon does not affect the mortality of the patients in intensive care unit. (author)

  3. Factors influencing resilience in patients with burns during rehabilitation period

    Directory of Open Access Journals (Sweden)

    Zhen Yang

    2014-03-01

    Conclusion: During psychological crisis intervention, medical staff should guide burn patients according to their individual coping styles. Such guidance would achieve a better effect, improve patient resilience, and promote positive psychological adaptation.

  4. Acceptance of NCPAP in a sample of patients admitted for geriatric rehabilitation

    Directory of Open Access Journals (Sweden)

    Frohnhofen H

    2009-12-01

    Full Text Available Abstract Objective Sleep apnea syndrome (SAS is common in older people. Nasal continuous airway pressure (NCPAP therapy is the treatment of choice for sleep apnea, but is not always accepted by patients. The rate of successful initiation of NCPAP is unknown in geriatric patients. Methods All patients admitted for geriatric rehabilitation were considered for sleep studies. Sleep apnea was assessed using an Edentrace (Nellcor, Hayward, CA multi-channel recording system. SAS was defined as an apnea-hypopnea-index (AHI of more than five events per hour plus excessive daytime sleepiness, or an AHI of more than fifteen events per hour regardless of reported sleepiness. Disability was assessed using the Barthel Index of Activities of Daily Living. Results Two hundred sixty nine of 322 consecutive patients (84% had adequate sleep studies and gave informed consent. SAS was found in 169 subjects (68%. There was no gender difference in the prevalence of SAS. Six subjects (4% accepted NCPAP therapy. Individuals who accepted NCPAP were younger and less disabled (p Conclusion NCPAP should not be withheld in the elderly. However, initiation of treatment for SAS remains to be a great challenge in those patients. Geriatric assessment procedures may help better manage older subjects with sleep apnea syndrome.

  5. Post-traumatic stress disorder in patients with acute burn injury

    International Nuclear Information System (INIS)

    Objective: To determine the risk of PTSD in patients with acute burn incidents. Method: This was an observational prospective cross-sectional study conducted in admitted patients in Burns Ward of Civil Hospital, Karachi during a period of 6 months from January 1 to June 30, 2011. Data was collected through questionnaire having socio demographic variables and the Impact of Event-Scale (IES-R) was used to determine the risk of PTSD. Results: Out of 145 patients, 12 (77.3%) were at risk of PTSD with 75 (66.9%) males and 37 (33%) females. Out of these 112 cases, 50% belonged to age group 16-29 years. All burn patients with more than 60% total body surface area (TBSA) involved in injury were at risk. Conclusion: The study reports an astronomic number of burns patients with PTSD risk. PTSD drastically affects the quality of life. The earlier this disorder is diagnosed and assessed; better chances are there for enhanced treatment and better recovery. (author)

  6. Skin Dendritic Cells in Burn Patients

    OpenAIRE

    D’Arpa, N.; D’Amelio, L.; Accardo-Palumbo, A.; Pileri, D.; Mogavero, R.; Amato, G.; Napoli, B.; Alessandro, G.; Lombardo, C.; F. Conte

    2009-01-01

    The body's immunological response to burn injury has been a subject of great inquiry in recent years. Burn injury disturbs the immune system, resulting in a progressive suppression of the immune response that is thought to contribute to the development of sepsis. Dendritic cells (DCs) are potent antigen-presenting cells that possess the ability to stimulate naïve T cells.

  7. The outcomes of patients with severe dengue admitted to intensive care units.

    Science.gov (United States)

    Chen, Chin-Ming; Chan, Khee-Siang; Yu, Wen-Liang; Cheng, Kuo-Chen; Chao, Hui-Chun; Yeh, Chiu-Yin; Lai, Chih-Cheng

    2016-08-01

    Outcomes of adult patients with dengue infections requiring intensive care unit (ICU) admissions remain unclear. We assessed the clinical manifestations and prognostic factors of patients critically ill with severe dengue.This retrospective study was done in a tertiary referral hospital with 96 adult ICU beds. All of the patients with laboratory-confirmed severe dengue infections and admitted to the ICU were enrolled between July 31 and November 31, 2015, during the large outbreak period. The medical records of all the recruited patients were reviewed for the following information: age, gender, clinical manifestations, disease severity scores, underlying conditions, laboratory examinations, and outcomes. The primary endpoint was to find the predictors of ICU mortality.During the study period, 4787 patients with dengue infections required ICU admission. One hundred forty-three (2.99%) were critically ill (mean age: 69.7 years). Hypertension (n = 90, 62.9%) and diabetes mellitus (n = 70, 49.0%) were the 2 most common underlying diseases. Eighty critically ill patients (55.9%) had cobacterial infections, and 33 had cobacteremia. The hematologic system failed most often, followed by thoracic and cardiovascular systems. Fever was the most common presentation (n = 112; 78.3%), followed by anorexia (n = 47; 32.9%) and abdominal pain (n = 46; 32.2%). Overall, 33 patients died (mortality rate: 23.1%). Multivariate analysis showed that ICU mortality was significantly associated with lower Glasgow Coma Scale (GCS) scores, lower platelet counts before ICU discharge, and more organ failures.The number of severe dengue patients who require ICU admission remains high. The mortality rate was associated with lower GCS scores, lower platelet counts, and more organ failures. In addition, more than half of the critically ill dengue patients had comorbid bacterial infections. PMID:27495047

  8. The outcomes of patients with severe dengue admitted to intensive care units

    Science.gov (United States)

    Chen, Chin-Ming; Chan, Khee-Siang; Yu, Wen-Liang; Cheng, Kuo-Chen; Chao, Hui-Chun; Yeh, Chiu-Yin; Lai, Chih-Cheng

    2016-01-01

    Abstract Outcomes of adult patients with dengue infections requiring intensive care unit (ICU) admissions remain unclear. We assessed the clinical manifestations and prognostic factors of patients critically ill with severe dengue. This retrospective study was done in a tertiary referral hospital with 96 adult ICU beds. All of the patients with laboratory-confirmed severe dengue infections and admitted to the ICU were enrolled between July 31 and November 31, 2015, during the large outbreak period. The medical records of all the recruited patients were reviewed for the following information: age, gender, clinical manifestations, disease severity scores, underlying conditions, laboratory examinations, and outcomes. The primary endpoint was to find the predictors of ICU mortality. During the study period, 4787 patients with dengue infections required ICU admission. One hundred forty-three (2.99%) were critically ill (mean age: 69.7 years). Hypertension (n = 90, 62.9%) and diabetes mellitus (n = 70, 49.0%) were the 2 most common underlying diseases. Eighty critically ill patients (55.9%) had cobacterial infections, and 33 had cobacteremia. The hematologic system failed most often, followed by thoracic and cardiovascular systems. Fever was the most common presentation (n = 112; 78.3%), followed by anorexia (n = 47; 32.9%) and abdominal pain (n = 46; 32.2%). Overall, 33 patients died (mortality rate: 23.1%). Multivariate analysis showed that ICU mortality was significantly associated with lower Glasgow Coma Scale (GCS) scores, lower platelet counts before ICU discharge, and more organ failures. The number of severe dengue patients who require ICU admission remains high. The mortality rate was associated with lower GCS scores, lower platelet counts, and more organ failures. In addition, more than half of the critically ill dengue patients had comorbid bacterial infections. PMID:27495047

  9. Admission Patterns and Outcomes of Paediatric Patients Admitted at the Diarrhea Unit of Muhimbili National Hospital (MNH )

    OpenAIRE

    Sanyiwa, John; Penza, Nuru

    2008-01-01

    To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at uhimbili National Hospital (MNH). A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis checklists. Ethical clearance was sought from MNH and confidentiality in handling the information was observed. Data was analyzed using Epi-info 2002 statistical software. A total of 50 children were admitted d...

  10. Burns

    Science.gov (United States)

    ... Chemical burns Burns can be the result of: House and industrial fires Car accidents Playing with matches ... hairs Burned lips and mouth Coughing Difficulty breathing Dark, black-stained mucus Voice changes Wheezing

  11. Determination of burn patient outcome by large-scale quantitative discovery proteomics

    Science.gov (United States)

    Finnerty, Celeste C.; Jeschke, Marc G.; Qian, Wei-Jun; Kaushal, Amit; Xiao, Wenzhong; Liu, Tao; Gritsenko, Marina A.; Moore, Ronald J.; Camp, David G.; Moldawer, Lyle L.; Elson, Constance; Schoenfeld, David; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Arnoldo, Brett; Remick, Daniel; Smith, Richard D.; Davis, Ronald; Tompkins, Ronald G.; Herndon, David N.

    2013-01-01

    Objective Emerging proteomics techniques can be used to establish proteomic outcome signatures and to identify candidate biomarkers for survival following traumatic injury. We applied high-resolution liquid chromatography-mass spectrometry (LC-MS) and multiplex cytokine analysis to profile the plasma proteome of survivors and non-survivors of massive burn injury to determine the proteomic survival signature following a major burn injury. Design Proteomic discovery study. Setting Five burn hospitals across the U.S. Patients Thirty-two burn patients (16 non-survivors and 16 survivors), 19–89 years of age, were admitted within 96 h of injury to the participating hospitals with burns covering >20% of the total body surface area and required at least one surgical intervention. Interventions None. Measurements and Main Results We found differences in circulating levels of 43 proteins involved in the acute phase response, hepatic signaling, the complement cascade, inflammation, and insulin resistance. Thirty-two of the proteins identified were not previously known to play a role in the response to burn. IL-4, IL-8, GM-CSF, MCP-1, and β2-microglobulin correlated well with survival and may serve as clinical biomarkers. Conclusions These results demonstrate the utility of these techniques for establishing proteomic survival signatures and for use as a discovery tool to identify candidate biomarkers for survival. This is the first clinical application of a high-throughput, large-scale LC-MS-based quantitative plasma proteomic approach for biomarker discovery for the prediction of patient outcome following burn, trauma or critical illness. PMID:23507713

  12. Treatment needs, diagnoses and use of services for acutely admitted psychiatric patients in northwest Russia and northern Norway

    Directory of Open Access Journals (Sweden)

    Sørgaard Knut W

    2013-01-01

    Full Text Available Abstract Background We compared demography, diagnoses and clinical needs in acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. Method All acutely admitted psychiatric patients in 1 psychiatric hospital in north-west Russia and 2 in northern Norway were in a three months period assessed with HoNOS and a Norwegian form developed to study acute psychiatric services (MAP. Data from a total of 841 patients were analysed (377 Norwegian, 464 Russian with univariate and multivariate statistics. Results Russian patients were more often males who had paid work. 2/3 were diagnosed with alcohol and organic disorders, and 70% reported problems related to sleep. Depression was widespread, as were problems associated with occupation. Many more Norwegian patients were on various forms of social security and lived in community supported homes. They had a clinical profile of affective disorders, use of drugs, suicidality and problems with activities involved of daily life. Slightly more Norwegian patients were involuntary admitted. Conclusion Acutely admitted psychiatric patients in North West Russia and Northern Norwegian showed different clinical profiles: alcohol, depression and organic disorders characterised Russian patients, affective disorders, suicidality and use of drugs characterised the Norwegians. Whereas Norwegian patients are mainly referred from GPs the Russians come via 1.line psychiatric services (“dispensaries”. Average length of stay for Russian patients was 2.5 times longer than that of the Norwegian.

  13. Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

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    Sinem İliaz

    2016-08-01

    Full Text Available Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters. Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients’ quinolone use were questioned by showing fluoroquinolone antibiotic boxes’ photographs available on the market. The departments of the doctors who prescribed quinolones were recorded. Results: The mean age of 179 patients included in the study was 37±16 (15–89 years. Among these, 113 patients (63.1% were male. Seventy five patients (41.9% were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104 had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15% had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04. Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.

  14. Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU.

    LENUS (Irish Health Repository)

    Owens, C

    2012-02-01

    BACKGROUND: Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. METHODS: We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. RESULTS: Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11\\/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. CONCLUSIONS: While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.

  15. STUDY OF SEVERITY OF HYPONATRAEMIA AND ITS CLINICAL OUTCOME IN PATIENTS ADMITTED TO TERTIARY CARE ICU

    Directory of Open Access Journals (Sweden)

    Hareesh

    2016-06-01

    Full Text Available BACKGROUND OF THE STUDY Hyponatraemia is a commonly encountered plasma electrolyte abnormality noticed in the patients admitted to ICU, which has a diverse variety of manifestations. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life-threatening and is associated with increased mortality and morbidity. OBJECTIVES To study the clinical profile at different levels of hyponatraemia in ICU patients and its clinical outcome at different levels. METHODOLOGY A retrospective descriptional study was done at Intensive Care Unit of Dr. B.R. Ambedkar Medical College and Hospital during the period from April 2015 to March 2016 among the patients having serum sodium levels less than 135 mEq/L. RESULTS Commonly involved age group is between 50 to 70 years. Severe form of Hyponatraemia is seen in elderly males. The most common underlying predisposing factor for hyponatraemia in our case series was sepsis (26% followed by gastrointestinal fluid loss (15.5%, diabetic ketoacidosis (10% and cirrhosis of liver (10%. Mortality was highest with severe hyponatraemia (10.5% who had pulmonary sepsis, metabolic encephalopathy, diabetic ketoacidosis and cirrhosis of liver. CONCLUSIONS Hyponatraemia is one of the good predictor of ICU mortality in association with wide variety of systemic diseases and wide spectrum of clinical profile.

  16. Dengue fever in patients admitted in tertiary care hospitals in Pakistan

    International Nuclear Information System (INIS)

    Objectives: To assess the gaps in the diagnosis and management of dengue fever cases. Methods: The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Results: Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3+-14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Conclusions: Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed. (author)

  17. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg

    2014-01-01

    OBJECTIVE: Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal...... presentation, 1440/4292 (33.6%) had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21-90 years) and 446/1440 (31.0%) deteriorated within 24 hours. Independent risk factors for deterioration included age 65-84 years odds ratio (OR): 1.79 (95.......2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10). CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open...

  18. Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Jose Orsini

    2013-01-01

    Full Text Available Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome. Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted. Results. A total of 42 patients were admitted during the study period. Their median CD4 cell count was 123 cells/μL (mean 205.7, range 2.0–694.0, with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649. At the time of admission, 23 patients (54.8% were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD4 cell counts and lower HIV viral loads. Twenty-five patients (59.5% had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%. Thirteen patients (31.0% died. Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related, in those receiving mechanical ventilation, and in patients with decreased CD4 cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU.

  19. Development of an algorithm for early clarification of isolation indication for acutely admitted patients with gastroenteritis (GE)

    DEFF Research Database (Denmark)

    Skyum, Florence; Backer Mogensen, Christian; Chen, Ming;

    factors for identification of contagious GE in the patient history, examination and laboratory investigations. Design: The study is a questionnaire survey over 18-month. Metod: All acutely admitted patients due to the suspicion of GE will be interviewed concerning symptoms of defecation, travel activity...

  20. Progressive fluid removal can avoid electrolyte disorders in severely burned patients

    Directory of Open Access Journals (Sweden)

    Mailänder, Peter

    2011-01-01

    Full Text Available Introduction: Extensive burn injury has systemic consequences due to capillary leak. After restoration of cellular integrity, infused fluid volume has to be removed partially. This can provoke electrolyte disorders. Purpose: We investigated the effect of progressive fluid removal on serum sodium level. Method: Retrospective study. Patients admitted to a burn unit were analyzed and separated in two groups without (Group A or with (Group B prolonged hypernatremia. Daily infusion-diuresis-ratio (IDR was analyzed. Results: Fourty (12 female; 28 male patients with a mean age of 47±19 years, a total burn surface area (TBSA of 26±12%, and a mean abbreviated burned severity index (ABSI score of 7.3±2 were included. In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Hypernatremia occurred on day 5±1.4. There was no significant difference between both groups for fluid resuscitation amount within the first 24 hours. Statistical analysis of the first 7 days after burn injury showed a significantly higher percentage of removed fluid in Group B for day 3, day 4, day 5, day 6 and day 7. Conclusions: Amount and velocity of fluid removal regimen after burn injury can provoke electrolyte disorders. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy.

  1. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    Directory of Open Access Journals (Sweden)

    Metin Uysalol

    2011-09-01

    Full Text Available Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide intoxication was heaters, waterheaters and fi re in 82.1%, 7.1% and 6% of cases, respectively. There was a statistically signifi cant difference between the carboxyhemoglobin levels of the patients according to the clinical classifi cation (p<0.05. The intoxication caused by heaters was observed signifi cantly in November, December and January (p<0.001, between 16:00-24:00 hours (p<0.001 and among more than one member of a family (p<0.001. A medium level correlation was detected between the treatment approach and clinical classifi cation (r=0.50, p<0.001. Conclusion: Carbon monoxide intoxication, in the presented series, was found to develop accidentally; mostly in the Winter season; during night hours when the family members gathered together. The carboxyhemoglobin levels were appropriate with the developing clinical findings. Carboxyhemoglobin level solely was not enough for achieving the diagnosis and planning the treatment.

  2. Special considerations in paediatric burn patients

    Directory of Open Access Journals (Sweden)

    Sharma Ramesh

    2010-10-01

    Full Text Available Burn injuries are a major cause of morbidity and mortality in children. In India, the figure constitutes about one-fourth of the total burn accidents. The management of paediatric burns can be a major challenge for the treating unit. One has to keep in mind that "children are not merely small adults"; there are certain features in this age group that warrant special attention. The peculiarities in the physiology of fluid and electrolyte handling, the uniqueness of the energy requirement and the differences in the various body proportions in children dictate that the paediatric burn management should be taken with a different perspective than for adults. This review article would deal with the special situations that need to be addressed while treating this special class of thermal injuries. We must ensure that not only the children survive the initial injury, but also the morbidity and complications are minimized. If special care is taken during the initial management of paediatric burn injuries, these children can be effectively integrated into the society as very useful and productive members.

  3. Re: Infection control in burn patients: are fungal infections underestimated?

    OpenAIRE

    Dries David J

    2009-01-01

    Abstract A response to Struck MF. Infection control in burn patients: are fungal infections underestimated? Scand J Trauma Resusc Emerg Med. 2009 Oct 9;17(1):51. [Epub ahead of print] PubMed PMID: 19818134.

  4. Assessment of medical resident's attention to the health literacy level of newly admitted patients

    Directory of Open Access Journals (Sweden)

    Cecile Karsenty

    2013-12-01

    Full Text Available Objectives: The objective of this study was to assess communication at the bedside in the emergency room between residents and their patients in order to identify common communication gaps. We also intended to evaluate whether residents for whom English is a second language (ESL residents communicate less effectively. Methods: A scorable checklist was developed in order to assess and identify communication gaps between the residents and their patients. Medical students observed the internal medicine and family medicine residents while they admitted patients to the medical service in the Emergency Room. Before this, medical students were trained for two weeks with a senior internist. The role of the medical student was not revealed; rather they were self-described as observers of the admission process. Results: Over an 8 week period, 71 observations were made of 27 medicine residents. 71 patient intakes were observed, evaluating 27 residents. In 52.1% of these interactions, the residents used medical acronyms when communicating with the patients. During 66.2% of interactions, technical medical terms or expressions were used during the history taking and in only 27.6% of those cases were the terms explained at least partially. Teach back technique was not observed in any of the interactions evaluated. Data was also analyzed based on whether the doctors were ESL residents or native English speakers. ESL residents tended to use significantly more technical language than the native English speakers, but the native English speakers tended to use more acronyms. Conclusions: How much patients understand of what their doctor says is called “health literacy.” Resident physicians often overestimate their patients’ health literacy, and this leads to communication gaps which have the potential to result in poorer health outcomes for the patients. The checklist developed for this pilot study assessed how well residents tailor their communication to

  5. Factors influencing resilience in patients with burns during rehabilitation period

    OpenAIRE

    Zhen Yang; Jun-qiao Wang; Bao-zhen Zhang; Yu Zeng; Hai-ping Ma

    2014-01-01

    Purpose: To investigate the factors that influence levels of resilience in patients with burns during rehabilitation, and to provide theoretical guidance for psychological crisis prevention and intervention. Methods: A total of 129 patients with burns and undergoing rehabilitation were investigated using a demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Social Support Rating Scale (SSRS), and the Simplified Coping Styles Questionnaire. Results: The overall...

  6. Assessment for benign paroxysmal positional vertigo in medical patients admitted with falls in a district general hospital.

    Science.gov (United States)

    Abbott, Joel; Tomassen, Sylvia; Lane, Laura; Bishop, Katie; Thomas, Nibu

    2016-08-01

    Having benign paroxysmal positional vertigo (BPPV) puts patients at a significantly higher risk of falling. It is poorly recognised and diagnosis is frequently delayed. BPPV has been studied in outpatient settings, but there have been no studies looking at the prevalence in patients admitted with falls. This study aims to establish how common BPPV is in these patients.For a 4-month period, patients admitted on an unselected medical take were screened for an admission precipitated by a fall. Patients who consented were assessed for BPPV using the Dix-Hallpike manoeuvre. Patients who tested positive were treated using the Epley manoeuvre. The assessments were carried out by specialist physiotherapists who were experienced at assessing and diagnosing patients with peripheral vestibular disorders. Out of the 111 patients initially identified, 37 (33%) were considered to be appropriate and consented to be part of the study. Of these, 20 patients (54%) had a positive Dix-Hallpike manoeuvre.Of the patients included in the study, over half tested positive for BPPV. This merits further study. Potentially, there is a proportion of patients admitted with falls who have an easily treatable contributing factor that is not being identified with standard practice. PMID:27481376

  7. Glycated hemoglobin screening identifies patients admitted for retreatment of tuberculosis at risk for diabetes in Tanzania

    Science.gov (United States)

    Sariko, Margaretha L; Mpagama, Stellah G; Gratz, Jean; Kisonga, Riziki; Saidi, Queen; Kibiki, Gibson S; Heysell, Scott K

    2016-01-01

    Introduction World Health Organization recommendations of bidirectional screening for tuberculosis (TB) and diabetes have been met with varying levels of uptake by national TB programs in resource-limited settings. Methodology Kibong’oto Infectious Diseases Hospital (KIDH) is a referral hospital for TB from northern Tanzania, and the national referral hospital for multidrug-resistant (MDR)-TB. Glycated hemoglobin (HgbA1c) testing was done on patients admitted to KIDH for newly diagnosed TB, retreatment TB, and MDR-TB, to determine the point prevalence of diabetes (HgbA1c ≥ 6.5%) and prediabetes (HgbA1c 5.7%– 6.4%). Results Of 148 patients hospitalized at KIDH over a single week, 59 (38%) had no prior TB treatment, 22 (15%) were retreatment cases, and 69 (47%) had MDR-TB. Only 3 (2%) had a known history of diabetes. A total of 144 (97%) had successful screening, of which 110 (77%) had an HgbA1c ≤ 5.6%, 28 (19%) had ≥ 5.7 < 6.5, and 6 (4%) had ≥ 6.5. Comparing subjects with prediabetes or diabetes to those with normal A1c levels, retreatment patients were significantly more likely to have a A1c ≥ 5.7% (odds ratio: 3.2, 95% CI: 1.2–9.0; p = 0.02) compared to those without prior TB treatment. No retreatment case was a known diabetic, thus the number needed to screen to diagnose one new case of diabetes among retreatment cases was 11. Conclusions Diabetes prevalence by HgbA1c was less common than expected, but higher HgA1c values were significantly more frequent among retreatment cases, allowing for a rational, resource-conscious screening approach. PMID:27131008

  8. Epidemiology of patients admitted to a major trauma centre in northern India

    Directory of Open Access Journals (Sweden)

    Rastogi Devarshi

    2014-04-01

    Full Text Available Objective: Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northern India. Methods: An observational study of 748 patients chosen by random assortment was carried out over a period of 1 year (August 2008 to July 2009. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results:Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6:1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries (94.92% were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common (40.3%. Most spinal cord injuries were caused by falls from height (51.09%. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than upper limb fractures. Conclusion: Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and planning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends. Key words: Wounds and injuries; Epidemiology; Accidents, traffic; India

  9. Effect of White Noise on Sleep in Patients Admitted to a Coronary Care

    Science.gov (United States)

    Farokhnezhad Afshar, Pouya; Bahramnezhad, Fatemeh; Asgari, Parvaneh; Shiri, Mahmoud

    2016-01-01

    Introduction: Sleep disorders are a common problem in patients in the critical care unit. The objective of the present study was to determine the effect of white noise on the quality of sleep in patients admitted to the CCU. Methods: The present study was single-blind, quasi-experimental study. A total of 60 patients were selected using the purposive sampling method. Quality of sleep was measured with PSQI on the first day in admission, then after three nights of admission without any intervention for control group and for the experimental group quality of sleep measured by white noise with intensity of 50-60 dB then Quality of sleep was measured with PSQI. Data were analyzed by SPSS 13 software. Results: The average total sleep time in the control group before the study reached from 7.08 (0.8) to 4.75 (0.66) hours after three nights of hospitalization, while in the experimental group, no significant changes were seen in the average sleep hours (6.69 ± 0.84 vs. 6.92 ± 0.89, P = 0.15).The average minutes of sleep in the control group before the study reached from 12.66 (7.51) to 25.83 (11.75) minutes after a three- night stay, while in the experimental group, no significant changes were observed in the average sleep duration (12.16 ± 7.50 vs. 11 ±6. 07, P = 0.16). Conclusion: The use of white noise is recommended as a method for masking environmental noises, improving sleep, and maintaining sleep in the coronary care unit. PMID:27354974

  10. Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

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    Anne Opsal

    2011-12-01

    Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.

  11. AETIOLOGICAL PROFILE AND OUTCOME IN PATIENTS WITH ACUTE KIDNEY INJURY (AKI ADMITTED TO VIMS, BELLARY

    Directory of Open Access Journals (Sweden)

    Ramamurthy

    2014-10-01

    Full Text Available BACKGROUND AND OBJECTIVES: This was a study about the various causes of ARF, in our hospital (VIMS, Bellary during a specified period, and to find out the incidence of Pre-renal, Renal and Post-renal causes by using renal failure indices and to analyze outcome of ARF pertaining to the aetiology. MATERIALS AND METHODS: 70 cases admitted at VIMS, Bellary during the period January 2012 to june 2013, with clinical evidence of acute renal failure were included in the study. They were evaluated for various etiological, prognostic factors and its outcome. RESULTS: Among the various aetiologies in our study, snake bite (28.6%, ADD (27.1%, RPGN (7.1% were the most common. Most common type of renal failure was prerenal (50%, among them ADD was the predominant cause followed by intrinsic failure (47%, among them snake bite was leading cause. Patients presenting with Anuria, late presentation to hospital, blood pressure 3mg had poor outcome. CONCLUSION: Amongst the etiological factors snake bite and ADD ranked first. Prognosis was determined by age, aetiology of renal failure, initial creatinine value, blood pressure, time of presentation to. Even though both snake bite and ADD are equally common causes, morbidity is more in snake bite and cost of treatment also more in snake bite as many of them require dialysis.

  12. Factors predicting early outcome in patients admitted at emergency department with severe head trauma

    Institute of Scientific and Technical Information of China (English)

    Rejeb Belfekih Imen; Chakroun Olfa; Chtara Kamilia; Boujelbene Meriam; Ksibi Hichem; Chaari Adel; Bahloul Mabrouk; Rekik Noureddine

    2015-01-01

    Objective:To determine predictive factors of early mortality among severe traumatic brain injury in emergency department. Methods: This study is based on a retrospective analysis of 198 admitted in emergency depatment with severe head injury (Glasgow coma scale score≤8) of an university hospital (Sfax, Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during emergency department stay. Results: Forty two patients were died. Univariate analysis showed that the presence of shock, cardiac arrest, bilateral mydriasis, high value of injury severity score and low value of Glasgow coma scale were associated with mortality. Moreover, meningeal hemorrhage, cerebral and subdural haematoma were associated with poorer outcome. Multivariate analysis showed that factors associated with a poor prognosis were cardiac arrest cerebral and the presence of cerebral haematoma. Conclusions: Improving pre-hospital care and ovoid futile resuscitation to given priority in resource allocation and urgent CT scan of the head to look for operable mass lesions as early detection should improve the prognosis of severe head injury at emergency department.

  13. The characteristics of advanced cancer patients followed at home, but admitted to the hospital for the last days of life.

    Science.gov (United States)

    Mercadante, Sebastiano; Masedu, Francesco; Valenti, Marco; Mercadante, Alessandro; Aielli, Federica

    2016-08-01

    Information regarding advanced cancer patients followed at home who are admitted to the hospital in the last days of life are lacking. The aim of this study was to assess the characteristics of patients who were hospitalized in the last days of life after being assisted by a home palliative care team. The secondary outcome was to identify possible risk factors for hospitalization. The charts were analyzed of a consecutive sample of advanced cancer patients admitted to hospital wards in the last days of life after being followed at home by a palliative care team. Of 550 consecutive patients followed at home, 138 (25.1 %) were admitted to the hospital. Younger patients were more likely to die in the hospital. In a logistic risk analysis adjusted for age, patients with lung and head-neck cancer were more likely to die in the hospital. Patients having a female relative or a female consort as a caregiver were more likely to die at home. CAGE-positive patients (7.25 %), and patients with a shorter period of home assistance were more likely transported to hospital before dying (p = 0.00 and p risk factors of hospitalization at the end of life for advanced cancer patients followed at home. PMID:26895033

  14. Enteral nutrition intolerance in critically ill septic burn patients.

    Science.gov (United States)

    Lavrentieva, Athina; Kontakiotis, Theodore; Bitzani, Militsa

    2014-01-01

    The purpose of this study was to investigate the frequency of enteral feeding intolerance in critically ill septic burn patients, the effect of enteral feeding intolerance on the efficacy of feeding, the correlation between the infection marker (procalcitonin [PCT]) and the nutrition status marker (prealbumin) and the impact of feeding intolerance on the outcome of septic burn patients. From January 2009 to December 2012 the data of all burn patients with the diagnosis of sepsis who were placed on enteral nutrition were analyzed. Septic patients were divided into two groups: group A, septic patients who developed feeding intolerance; group B, septic patients who did not develop feeding intolerance. Demographic and clinical characteristics of patients were analyzed and compared. The diagnosis of sepsis was applied to 29% of all patients. Of these patients 35% developed intolerance to enteral feeding throughout the septic period. A statistically significant increase in mean PCT level and a decrease in prealbumin level was observed during the sepsis period. Group A patients had statistically significant lower mean caloric intake, higher PCT:prealbumin ratio, higher pneumonia incidence, higher Sequential Organ Failure Assessment Maximum Score, a longer duration of mechanical ventilation, and a higher mortality rate in comparison with the septic patients without gastric feeding intolerance. The authors concluded that a high percentage of septic burn patients developed enteral feeding intolerance. Enteral feeding intolerance seems to have a negative impact on the patients' nutritional status, morbidity, and mortality. PMID:24879397

  15. Clinical characteristics and outcomes of patients with acute myelogenous leukemia admitted to intensive care: a case-control study

    OpenAIRE

    Roze des Ordons, Amanda L; Chan, Kris; Mirza, Imran; Townsend, Derek R; Bagshaw, Sean M

    2010-01-01

    Background There is limited epidemiologic data on patients with acute myelogenous (myeloid) leukemia (AML) requiring life-sustaining therapies in the intensive care unit (ICU). Our objectives were to describe the clinical characteristics and outcomes in critically ill AML patients. Methods This was a retrospective case-control study. Cases were defined as adult patients with a primary diagnosis of AML admitted to ICU at the University of Alberta Hospital between January 1st 2002 and June 30th...

  16. Prospective cohort study of a pharmacological follow-up program of anticoagulated patients admitted to nursing homes

    Directory of Open Access Journals (Sweden)

    Lluís Cuixart Costa

    2013-02-01

    Full Text Available Introduction. Anticoagulant treatment, despite providing a clear benefit to prevent and treat thrombo-embolic disease, is difficult to manage in routine practice. This is due to individual variability of dosing, narrow therapeutic margin, drug interactions, and side effects. An increasing number of patients admitted to nursing homes are under oral anticoagulant therapy because of deep venous thrombosis and, especially, atrial fibrillation. These are patients with a profile that makes prescription of anticoagulant treatment more difficult - elderly, taking multiple concomitant medications and with multiple ailments. Objetive. We hypothesized that the implementation of a primary care pharmacological follow-up program of oral anticoagulant therapy in patients admitted to nursing homes, with the purpose of coordinating the different professionals and care levels, would lead to greater benefit and reduction of side effects. Methods. A one-year descriptive prospective cohort study was conducted of 27 patients admitted to nursing homes who are under anticoagulation therapy followed by the primary care team. We analyzed different variables obtained from computerized medical records, from which indicators on the program were established (coverage and registration as well as outcome indicators (as defined by the British Committee for Standards in Haematology. Results. The profile of patients under anticoagulation and admitted to nursing homes is elderly (84 years, with a predominance of women (70%, atrial fibrillation as most frequent indication (70.4%, hypertension as major cardiovascular risk factor (92% and most of them on multiple drugs (92%. The analysis of the program results showed excellent coverage and registration indicators (100%. Outcome indicators also showed good results, with percentages of optimal international normalized ratio of 78% (exceeding the defined minimum standard and very low rates of complications (3%. Conclusions. The

  17. One fourth of acutely admitted patients use over-the-counter-drugs 24 hours prior to hospitalisation

    DEFF Research Database (Denmark)

    Pedersen, Magnus; Brabrand, Mikkel

    2014-01-01

    hospitalisation and the effects of this intake. MATERIAL AND METHODS: Junior physicians on call interviewed patients admitted to the medical admission unit at South-West Jutland Hospital in Esbjerg using a modified chart template. Adult patients aged 15 and older admitted during a two-week period in August 2012...... were included. Patients were asked about consumed OTC drugs, dosage, indication and effect. RESULTS: From a total of 349 admissions, 188 usable chart templates were registered (54%), and information on OTC usage was registered on 165 of these (88%). The patients where elderly (median: 70 years) and 43...... reported use of OTC drugs (26%). A total of 22 different OTC drugs had been consumed with analgesics being the most widely used OTC drugs (74%). The majority had taken the drugs on a relevant indication (88%), most commonly pain. Half of the patients had taken the drugs in a relevant dosage (51%). In all...

  18. Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts

    DEFF Research Database (Denmark)

    Eriksen, Nanna; Vestbo, Jørgen

    2010-01-01

    discharged patients admitted in 2006-2007 with an exacerbation of chronic obstructive pulmonary disease from three respiratory departments. Data were collected from patient charts and compared with a replicate study done in 2001. RESULTS: The mean age was 72.1years; 61.7% were women. Mean forced expiratory...... volume in 1s was 37.6% of predicted. On admission, 11.3% were treated with non-invasive ventilation, and 84.3% were given systemic corticosteroids. In-hospital mortality was 4.7%. At discharge, treatment with inhaled corticosteroids or at least one long-acting bronchodilator was given to 86.7% and 89% of......months following discharge was 42.3%. Long-term oxygen treatment, treatment with anti-dysrhythmic drugs and lack of outpatient follow-up were independent predictors of 1-year mortality. Risk of readmission was increased with dependence in self-care activities, previous admissions and treatment with...

  19. The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

    DEFF Research Database (Denmark)

    Andreasen, Jane; Lund, Hans; Aadahl, Mette;

    2015-01-01

    INTRODUCTION: Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences of the...... disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged...

  20. Benchmarking Outcomes in the Critically Injured Burn Patient

    Science.gov (United States)

    Klein, Matthew B.; Goverman, Jeremy; Hayden, Douglas L.; Fagan, Shawn P.; McDonald-Smith, Grace P.; Alexander, Andrew K.; Gamelli, Richard L.; Gibran, Nicole S.; Finnerty, Celeste C.; Jeschke, Marc G.; Arnoldo, Brett; Wispelwey, Bram; Mindrinos, Michael N.; Xiao, Wenzhong; Honari, Shari E.; Mason, Philip H.; Schoenfeld, David A.; Herndon, David N.; Tompkins, Ronald G.

    2014-01-01

    Objective To determine and compare outcomes with accepted benchmarks in burn care at six academic burn centers. Background Since the 1960s, U.S. morbidity and mortality rates have declined tremendously for burn patients, likely related to improvements in surgical and critical care treatment. We describe the baseline patient characteristics and well-defined outcomes for major burn injuries. Methods We followed 300 adults and 241 children from 2003–2009 through hospitalization using standard operating procedures developed at study onset. We created an extensive database on patient and injury characteristics, anatomic and physiological derangement, clinical treatment, and outcomes. These data were compared with existing benchmarks in burn care. Results Study patients were critically injured as demonstrated by mean %TBSA (41.2±18.3 for adults and 57.8±18.2 for children) and presence of inhalation injury in 38% of the adults and 54.8% of the children. Mortality in adults was 14.1% for those less than 55 years old and 38.5% for those age ≥55 years. Mortality in patients less than 17 years old was 7.9%. Overall, the multiple organ failure rate was 27%. When controlling for age and %TBSA, presence of inhalation injury was not significant. Conclusions This study provides the current benchmark for major burn patients. Mortality rates, notwithstanding significant % TBSA and presence of inhalation injury, have significantly declined compared to previous benchmarks. Modern day surgical and medically intensive management has markedly improved to the point where we can expect patients less than 55 years old with severe burn injuries and inhalation injury to survive these devastating conditions. PMID:24722222

  1. HOSPITALIZATION AND COMPLICATIONS IN ELDERLY PATIENTS ADMITTED AT INFECTIOUS DISEASE REFERENCE HOSPITALS

    Directory of Open Access Journals (Sweden)

    Gabriella Xavier Xavier Barbalho Mesquita

    2015-07-01

    Full Text Available Backgound and Objectives: Mortality from infectious diseases has declined; however, it remains a challenge for the National Public Health due to continuing high levels of diseases related to poverty and social exclusion. Thus, the objective of the study is to identify the causes of hospitalization among the elderly and the observed complications in an infectious disease reference hospital in Rio Grande do Norte, Brazil and evaluate the hospitalization costs. Methods: Cross-sectional study of elderly patients admitted at the Hospital Giselda Trigueiro from 2005 to 2010, through analysis of medical records. The dependent variables were: “consequence of admission” and “financial cost”. The chi-square test was applied to determine the association between variables and the analysis of the independent effect of other variables on the outcome was performed by multiple logistic regression. Results: Mean age was 72.4 years, with a predominance of the male gender. Prevalent diagnoses: nontuberculous lung infection; skin and soft tissue infections and pulmonary and extrapulmonary tuberculosis. In the multivariate analysis with the “consequence of admission” variable, the following were significant: mechanical ventilation, nasogastric and enteral tube, upper gastrointestinal bleeding and acute renal failure. For the “financial cost” variable, nontuberculous lung infection, pulmonary and extrapulmonary tuberculosis, urinary catheter and mechanical ventilation variables remained significant. Conclusions: The prevalence of respiratory infections indicates the need for preventive measures that must occur at the level of primary health care, consequently reducing the demand for specialized care. KEYWORDS: Aged; Hospitalization; Health of the Elderly; Hospital costs; Communicable diseases.

  2. Psychiatric History and Adaptation in Burn Injured Patients

    OpenAIRE

    Dyster-Aas, Johan

    2006-01-01

    The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury. Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult pat...

  3. Historical review: First facial pain patient admitted to Massachusetts General Hospital, February 1823 and first case series.

    Science.gov (United States)

    Keith, David A; Dodson, Thomas B; Kaban, Leonard B

    2013-08-01

    Founded in 1811, the Massachusetts General Hospital recently celebrated its bicentennial. The War of 1812 delayed construction of the building so the first patient actually was admitted to the hospital 10 years later, on September 3, 1821. By 1823, the 60 hospital beds were full. Patient 66 was admitted on February 28, 1823, and his hospital course, as described in the admissions book, was transcribed for the Massachusetts General Hospital bicentennial celebration. That case history is reproduced and a case series of 6 similar patients published in 1828 by Dr John Warren, surgeon-in-chief and a founder of the hospital, is presented. In this report, the authors comment on the diagnosis, treatment, and outcome of these patients in the context of the contemporaneous health care environment and in light of the current knowledge of facial pain disorders. This article was adapted from the authors' commentary for the bicentennial celebration. PMID:23866949

  4. Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis

    OpenAIRE

    Sean M Bagshaw; Webb, Steve AR; Delaney, Anthony; George, Carol; Pilcher, David; Hart, Graeme K; Bellomo, Rinaldo

    2009-01-01

    Introduction Older age is associated with higher prevalence of chronic illness and functional impairment, contributing to an increased rate of hospitalization and admission to intensive care. The primary objective was to evaluate the rate, characteristics and outcomes of very old (age ≥ 80 years) patients admitted to intensive care units (ICUs). Methods Retrospective analysis of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. Data we...

  5. Multidrug-resistant organisms detected in refugee patients admitted to a University Hospital, Germany June‒December 2015.

    Science.gov (United States)

    Reinheimer, Claudia; Kempf, Volkhard A J; Göttig, Stephan; Hogardt, Michael; Wichelhaus, Thomas A; O'Rourke, Fiona; Brandt, Christian

    2016-01-01

    Multidrug-resistant Gram-negative bacteria (MDR GNB) were found to colonise 60.8% (95% confidence interval: 52.3-68.9) of 143 refugee patients mainly from Syria (47), Afghanistan (29), and Somalia (14) admitted to the University Hospital Frankfurt, Germany, between June and December 2015. This percentage exceeds the prevalence of MDR GNB in resident patients four-fold. Healthcare personnel should be aware of this and the need to implement or adapt adequate infection control measures. PMID:26794850

  6. Hospital acquired blood stream infection as an adverse outcome for patients admitted to hospital with other principle diagnosis

    OpenAIRE

    Hamdan H Al-Hazmi; Tariq Al-Zahrani; Ahmed M Elmalky

    2014-01-01

    Background: Hospital acquired infections (HAI) have emerged as an important public health problem and are a leading cause of morbidity and mortality worldwide. They affect both developed and resource-poor countries and constitute a significant burden both for the patient and for the health care system. Specific objectives in this study are assessment of HAI rate among patients admitted with other principle diagnosis, to identifying the causative agents of hospital acquired infections and to i...

  7. [Follow-up of extensive burns in an HIV positive patient. Case report].

    Science.gov (United States)

    de Roche, R; Lüscher, N J; Zimmerli, W

    1990-02-01

    The case of a 33-year-old HIV-positive patient who suffered from second- and third-degree burn injuries involving 30% of the body surface is reported. She was treated by early tangential excision of the burnt skin and split-thickness mesh grafting. The burn wounds healed without complications within the usual time, with excellent cosmetic and functional results. In spite of the successful treatment, she suffered from fever and various infections for several months. With the appearance of these constitutional symptoms, we recognized the AIDS-related complex. Her general condition deteriorated continuously and 10 months after the accident she had to be admitted to a hospital again. The skin had nevertheless healed perfectly and in spite of not having compression treatment for the grafts or physiotherapy, she did not show any signs of hypertrophic scars. Some important conclusions drawn from this case are discussed. The fact that healing occurred without complications is in contrast to the results reported in the literature concerning impaired wound healing in AIDS patients with anorectal surgery. We therefore believe that the reluctant and perhaps even anxious attitude of the medical and nursing staff towards performing technical and expensive procedures in HIV-positive burn patients is not justified. PMID:2315721

  8. Analysis of predictor factors of limb amputation in patients with high-voltage electrical burns

    Directory of Open Access Journals (Sweden)

    Guillermo García Álvarez

    2015-09-01

    Full Text Available Background: Limb amputation is considered one of the most devastating consequences of electrical injury. Any factors that correlate with the degree of muscle damage can be used to predict the necessity of limb amputation. The aim of this study was to determine the factors that can be used to predict limb amputation in high-voltage electrically injured patients. Methods: Eighty-two high-voltage electrically injured patients were admitted to the Department of Plastic and Reconstructive Surgery and Burns of National Arzobispo Loayza Hospital on a 5 year period. A retrospective analysis of the possible related risk factors between amputation and non-amputation patients was performed. Results: A total of 68 patients were enrolled for analysis. Thirteen patients underwent limb amputations. Multivariate analysis of the risk factors between amputation and non-amputation groups showed statistical significance for first 24 hour creatine kinase-isoenzyme MB (CKMB level. A serum CK-MB level above 14,955 U/L predicted high risk of limb amputation with high specificity (84% and sensitivity (77%. Only one patient with a remarkable decrease of creatine kinase (CPKt and CK-MB levels after fasciotomy avoided a major limb amputation. Conclusion: Our results suggest that CPK-MB level is an independent factor for prediction of limb amputation in patients with high-voltage electrical burns. We suggest that the addition of CPK-MB evaluation to clinical symptom screening may be a valuable method for early detection of muscle damage.

  9. OPTIMIZED FLUID MANAGEMENT IMPROVES OUTCOMES OF PEDIATRIC BURN PATIENTS

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Branski, Ludwik K; Finnerty, Celeste C; Leonard, Katrina R; Jeschke, Marc G

    2012-01-01

    Background One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on bodyweight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is inadequate and that over- and under-resuscitation is associated with increased morbidity and mortality. We hypothesize that optimizing fluid administration during the critical initial phase using a transcardiopulmonary thermo-dilution monitoring device (PiCCO) would have beneficial effects on the outcome of burned patients. Methods A cohort of seventy-six severely burned pediatric patients with burns over 30% total body surface area (TBSA) who received adjusted fluid resuscitation using the PiCCO (P) system were compared to 76 conventionally monitored patients (C). Clinical hemodynamic measurements, organ function (DENVER2 score), and biomarkers were recorded prospectively for the first 20 days after burn injury. Results Both cohorts were similar in demographic and injury characteristics. Patients in the PiCCO group received significantly less fluids (p<0.05) with similar urinary output, resulting in a significantly lower positive fluid balance (p<0.05). The central venous pressure (CVP) in the P group was maintained in a more controlled range (p<0.05), associated with a significantly lower heart rate and significantly lower incidence of cardiac and renal failure, p<0.05. Conclusions Fluid resuscitation guided by transcardiopulmonary thermo-dilution during hospitalization represents an effective adjunct and is associated with beneficial effects on post-burn morbidity. PMID:22703982

  10. Suicidal Behavior in a Patient with Burning Mouth Syndrome

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    Konstantinos Kontoangelos

    2014-01-01

    Full Text Available Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of “burning mouth syndrome” (BMS was made. Discussion. Burning mouth syndrome (BMS is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major and suicidal thoughts.

  11. The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury

    OpenAIRE

    Spyropoulou, G.A.; Iconomou, T.; Tsagarakis, M.; Tsoutsos, D.

    2005-01-01

    The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest ra...

  12. Scales for evaluating self-perceived anxiety levels in patients admitted to intensive care units: a review

    OpenAIRE

    Perpiñá Galvañ, Juana; Richart Martínez, Miguel

    2009-01-01

    Objective: To review studies of anxiety in critically ill patients admitted to an intensive care unit to describe the level of anxiety and synthesize the psychometric properties of the instruments used to measure anxiety. Methods: The CUIDEN, IME, ISOC, CINAHL, MEDLINE, and PSYCINFO databases for 1995 to 2005 were searched. The search focused on 3 concepts: anxiety, intensive care, and mechanical ventilation for the English-language databases and ansiedad, cuidados intensivos, and ventilación...

  13. Can selection of mechanical ventilation mode prevent increased intra-abdominal pressure in patients admitted to the intensive care unit?

    OpenAIRE

    Mohammad Reza Rafiei; Omid Aghadavoudi; Babak Shekarchi; Seyed Sajed Sajjadi; Mehrdad Masoudifar

    2013-01-01

    Background: Increased intra-abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. Methods: In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure (BIPAP) group, synchronize intermittent mandatory ventilation (SI...

  14. Chest physiotherapy on intracranial pressure of critically ill patients admitted to the intensive care unit: a systematic review

    OpenAIRE

    Ferreira, Lucas Lima; Valenti, Vitor Engrácia; Vanderlei, Luiz Carlos Marques

    2013-01-01

    Objective To analyze the outcomes of increased or decreased intracranial pressure and/or the decrease in cerebral perfusion pressure resulting from respiratory physiotherapy on critically ill patients admitted to the intensive care unit. Methods Through a systematic review of the literature, clinical trials published between 2002 and 2012 were selected. The search involved the LILACS, SciELO, MedLine and PEDro databases using the keywords "physical therapy", "physiotherapy", "respiratory ther...

  15. Prevalence of Burnout Syndrome in Patients Admitted with Acute Coronary Syndrome

    OpenAIRE

    Ana Cláudia Giaxa Prosdócimo; Luciane Boreki Lucina; Olandoski Marcia; Priscila Megda João Jobs; Nicolle Amboni Schio; Fernanda Fachin Baldanzi; Costantino Ortiz Costantini; Ana Maria Teresa Benevides-Pereira; Luiz Cesar Guarita-Souza; José Rocha Faria-Neto

    2015-01-01

    Background: Burnout Syndrome is the extreme emotional response to chronic occupational stress, manifesting as physical and mental exhaustion. Although associated with higher prevalence of cardiovascular risk factors, no study so far has evaluated whether the Burnout Syndrome could be a prevalent factor in non-elderly individuals active in the labor market, admitted for acute coronary syndrome (ACS). Objective: To evaluate the prevalence of the Burnout Syndrome in non-elderly, economically act...

  16. Characterization of Candida isolates from pediatric burn patients.

    OpenAIRE

    Neely, A N; Odds, F.C.; Basatia, B K; Holder, I A

    1988-01-01

    To provide more detailed information about Candida epidemiology and pathogenesis in pediatric burn patients, Candida isolates from 113 patients collected over 3 years were identified at the species level and the serotypes and biotypes of the C. albicans isolates were determined. A total of 85% of the patients were colonized or infected by C. albicans, 18% by C. tropicalis, and 11% by C. parapsilosis. Although colonization or infection often was found at multiple sites and times, 87% of the pa...

  17. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    . Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation ...Background: Acute admitted patients with respiratory symptoms remains a diagnostic challenge. At the primary evaluation the clinician has to rely on the clinical examination when initiating treatment and further diagnostic work up. Several studies have questioned the diagnostic performance...... of the clinical examination. In addition, most of the diseases, which are commonly seen in patients with acute respiratory symptoms, can be diagnosed using sonography. Sonography could be integrated as a part of the primary evaluation, potentially improving the diagnostic performance. We therefore evaluated...

  18. Characteristics of Older Adults Admitted to Hospital versus Those Discharged Home, in Emergency Department Patients Referred to Internal Medicine

    Science.gov (United States)

    Hominick, Kathryn; McLeod, Victoria; Rockwood, Kenneth

    2016-01-01

    Background Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge. Methods We preformed a chart-based, exploratory study. Data were abstracted from consultation records and ED charts. All cases had a standard Comprehensive Geriatric Assessment (CGA which records a Clinical Frailty Scale (CFA) and allows calculation of a Frailty Index (FI). Results Of 100 consecutive patients, 2 died in the ED, 75 were admitted, and 23 were discharged, including one urgent placement. Compared with discharged patients (0.39 ± SD 0.16), those admitted had a higher mean FI-CGA (0.48 ± 0.13; p < .01). Greater mobility dependence (2% in discharged vs. 32% in admitted; p < .05) was notable. Conclusions Discharge decisions require assessment of medical, functional, and social problems. Ill, frail patients often can be discharged home when social and nursing support can be provided. The degree of frailty, impaired mobility, and likely delirium must be taken into account when planning for their care. PMID:27076860

  19. Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts

    DEFF Research Database (Denmark)

    Eriksen, Nanna; Vestbo, Jørgen

    2010-01-01

    discharged patients admitted in 2006-2007 with an exacerbation of chronic obstructive pulmonary disease from three respiratory departments. Data were collected from patient charts and compared with a replicate study done in 2001. RESULTS:  The mean age was 72.1years; 61.7% were women. Mean forced expiratory...... volume in 1s was 37.6% of predicted. On admission, 11.3% were treated with non-invasive ventilation, and 84.3% were given systemic corticosteroids. In-hospital mortality was 4.7%. At discharge, treatment with inhaled corticosteroids or at least one long-acting bronchodilator was given to 86.7% and 89% of......months following discharge was 42.3%. Long-term oxygen treatment, treatment with anti-dysrhythmic drugs and lack of outpatient follow-up were independent predictors of 1-year mortality. Risk of readmission was increased with dependence in self-care activities, previous admissions and treatment with...

  20. Intensive Insulin Therapy in Severely Burned Pediatric Patients

    Science.gov (United States)

    Jeschke, Marc G.; Kulp, Gabriela A.; Kraft, Robert; Finnerty, Celeste C.; Mlcak, Ron; Lee, Jong O.; Herndon, David N.

    2010-01-01

    Rationale: Hyperglycemia and insulin resistance have been shown to increase morbidity and mortality in severely burned patients, and glycemic control appears essential to improve clinical outcomes. However, to date no prospective randomized study exists that determines whether intensive insulin therapy is associated with improved post-burn morbidity and mortality. Objectives: To determine whether intensive insulin therapy is associated with improved post-burn morbidity. Methods: A total of 239 severely burned pediatric patients with burns over greater than 30% of their total body surface area were randomized (block randomization 1:3) to intensive insulin treatment (n = 60) or control (n = 179). Measurements and Main Results: Demographics, clinical outcomes, sepsis, glucose metabolism, organ function, and inflammatory, acute-phase, and hypermetabolic responses were determined. Demographics were similar in both groups. Intensive insulin treatment significantly decreased the incidence of infections and sepsis compared with controls (P < 0.05). Furthermore, intensive insulin therapy improved organ function as indicated by improved serum markers, DENVER2 scores, and ultrasound (P < 0.05). Intensive insulin therapy alleviated post-burn insulin resistance and the vast catabolic response of the body (P < 0.05). Intensive insulin treatment dampened inflammatory and acute-phase responses by deceasing IL-6 and acute-phase proteins compared with controls (P < 0.05). Mortality was 4% in the intensive insulin therapy group and 11% in the control group (P = 0.14). Conclusions: In this prospective randomized clinical trial, we showed that intensive insulin therapy improves post-burn morbidity. Clinical trial registered with www.clinicaltrials.gov (NCT00673309). PMID:20395554

  1. The Effect of Shiatsu Massage on Pain Reduction in Burn Patients

    OpenAIRE

    Ardabili, Fatemeh Mohaddes; Purhajari, Soybeh; Najafi Ghezeljeh, Tahereh; Haghani, Hamid

    2014-01-01

    BACKGROUND Burn is a tragedy that follows multiple problems in a patient including pain, anxiety and lack of confidence into medical team. This study evaluated the effect of shiatsu massage on pain intensity of burn patients. METHODS A total of 120 burn patients from Motahhari Burn Hospital and of both genders were randomly divided into 4 groups of undergoing hand massage, leg massage, both hand and leg massages, and the control group. The effect of shiatsu massage in pain relief of burned pa...

  2. Burns

    Science.gov (United States)

    ... touching the stove This list is not all-inclusive. You can also burn your airways if you ... extinguishers in key locations at home, work, and school. Remove electrical cords from floors and keep them ...

  3. Nutritional, immunological and microbiological profiles of burn patients

    Directory of Open Access Journals (Sweden)

    ASAA Barbosa

    2009-01-01

    Full Text Available A burn is a lesion on an organic tissue resultant from direct or indirect action of heat on the organism. The present study aimed to evaluate the nutritional, immunological and microbiological status of burn patients at the Bauru State Hospital, São Paulo state, Brazil, in 2007. Eight patients, aged more than 18 years and injured up to 24 hours, were evaluated at the moment of hospitalization and seven days later. All victims were males with a mean age of 38 years. On average, 17.5% of their body surfaces were burned and 50% of the patients were eutrophic. There were significant alterations in levels of erythrocytes, hemoglobin, hematocrit, total protein and albumin due to increased endothelial permeability, direct destruction of proteins in the heat-affected area and blood loss from lesions or debridement. At a second moment, cytokines IL-6 and TNF-α had augmented significantly, with IL-6 presenting elevated levels in relation to controls at the first moment. Microbiological analysis showed that 100% of the samples collected at hospital admission were negative and after one week Staphylococcus aureus was found in all cultures. Therefore, a burn patient may be considered immunosuppressed and these results indicate significant nutritional, immunological and microbiological alterations that can interfere in his recovery.

  4. The Comparison of Procalcitonin Guidance Administer Antibiotics with Empiric Antibiotic Therapy in Critically Ill Patients Admitted in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Atabak Najafi

    2015-10-01

    Full Text Available The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU with systemic inflammatory response syndrome (SIRS.  A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30 and patients who undergoing antibiotic empiric therapy as control group (n=30. Our primary endpoint was the use of antibiotic treatment. Additional endpoints were changed in clinical status and early mortality. Antibiotics use was lower in PCT group compared to control group (P=0.03. Current data showed that difference in SOFA score from the first day to the second day after admitting patients in ICU did not significantly differ (P=0.88. Patients in PCT group had a significantly shorter median ICU stay, four days versus six days (P=0.01. However, hospital stay was not statistically significant different between two groups, 20 days versus 22 days (P=0.23.  Early mortality was similar between two groups. PCT guidance administers antibiotics reduce antibiotics exposure and length of ICU stay, and we found no differences in clinical outcomes and early mortality rates between the two studied groups.

  5. A STUDY ON ROLE OF VARIOUS TYPES OF TOPICAL OINTMENT AND ITS OUTCOME AMONG BURN PATIENTS : AN INTERESTING FOLLOW UP STUDY

    Directory of Open Access Journals (Sweden)

    Sunita

    2015-08-01

    Full Text Available Burn injury causes major bulk of the surgical emergencies. Burn infection makes the burn wound complicated causes considerable mortality and morbidity. Timely and effective use of antimicrobial and topical dressings revolutionizes burn care by decreasing invasive wound infection. The administration of broad - spectrum antibiotics on routine basis is likely to en courage. The emergence of resistant organism therefore, timely and judicial use of antibiotics is essential for better result. MATERIAL AND METHOD S: The present study was carried out in 160 burns and scald admitted in surgical wards in Department of General Surgery, SGMH and S.S. Medical College, Rewa ( M. P. during period of one year. The cases are fully recorded and thoroughly studied with the aim of establishing the incidence, mode of burn and causes of burn, source of burn, clothing at timed incidence, time and place of incidence and detail clinical assessment. On admission resuscitation started with intravenous fluid, calculated according to the Parkland formula and prophylactic antibiotic giv en in all the patients after sampling for culture and sensitivity. Symptomatic and supportive treatment added as per need. RESULTS : Out of 160 patients, majority of the patient belong to 21 – 40 year 48.1%. Majority of patient ( 34.4% had total body surfac e burn area burnt between 21 - 40% and 12.5% patient had burnt area 61 - 80%. Maximum ( 50.0% complain of irritation was reported by the patients to whom Silver sulphadizine was applied while least ( 10% by the patients to whom nadoxin e was applied. CONCLUSION : The incident of invasive infection and overall mortality was significantly reduced after the introduction into clinical practice of topical burn wound anti - microbial agent, our study shows that the most effective topical antimicrobial agent in burn patie nt is Nadoxine.

  6. [The Mental Rehabilitation of Burn Patients After a Major Disaster].

    Science.gov (United States)

    Chou, Frank Huang-Chih

    2016-02-01

    Many catastrophic disasters have happened in Taiwan over the last decade. As disaster is not a special occurrence but rather a part of the norm, mental rehabilitation should be treated as a mainstream issue in psychiatry. The internalization of emergency psychological interventions is necessary for every mental-health professional. The two primary categories of major manmade disasters in Taiwan over the past decade have been gas explosions and powder burns. Both categories have led to the serious injury of many individuals. The physical deformities and job problems faced by burn patients affect their psychiatric and emotional states both directly and indirectly. The psychiatric comorbidities of burn patients include: major depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD), with GAD and PTSD comprising the most significant comorbidities in terms of numbers of diagnoses. To reduce psychological problems in the future, mental-health professionals should use appropriate psychological first aid (PFA) interventions in the early stages of treatment and rehabilitation. Mental rehabilitation is a major and comprehensive rehabilitation process. Mental-health professionals should thus use PFA to treat burn patients as well as provide long-term mental rehabilitation after discharge. PMID:26813061

  7. Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

    DEFF Research Database (Denmark)

    Noiesen, Eline; Trosborg, Ingelise; Bager, Louise;

    2014-01-01

    To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

  8. Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 杨红明

    2000-01-01

    Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients' vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged;②The major cause related to burn wound sepsis was extensive burn injuries, with large areas of deep burn remaining open; ③Although wound swabs taken on admission revealed the presence of colonization by many pathogenic bacteria, Pseudomonas aeruginosa was one of the most frequent bacteria isolated from the subeschar tissue; ④The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than that after surgical intervention (P<0.05) ;⑤The lowest level of the inflammatory mediators was observed when the patients' conditions became stable, as compared with before surgical intervention (P<0. 001).These findings suggest that the clinical characteristics of burn wound sepsis are abrupt deterioration of the general condition and prominent septic symptoms, often complicated by MODS. The main cause of burn wound sepsis is the presence of a large area of open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Although success in treating these patients is the result of appropriate application of multiple treatments, early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wound play a crucial role in the successful treatment of patients complicated by burn wound sepsis. Other treatments are adjuvant but also important.

  9. Prevalence of hepatitis B and C infection in patients admitted at tertiary eye care centre: a hospital based study

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and the risk factors in patients admitted for ocular treatment at a tertiary eye care centre in Sindh Pakistan. Methodology: Nine hundred thirty one patients admitted at Liaquat University Eye Hospital Hyderabad for ocular treatment, were screened for HBV and HCV. Patients of either sex, with more than thirty years of age were included. Screening for HBV surface antigen (HBsAg) and antibodies against HCV (anti-HCV) was performed through chromatography method. Samples repeatedly reactive for HBsAg or anti-HCV were considered positive. Results: Out of 931 registered patients, 497 (53.3%) were male and 434 (46.7%) female. Hepatitis B and C was detected in 167 (17.9%) subjects. The overall seroprevalence of HBV infection within the study period was 4.6%, HCV 13.3%, and for HBV and HCV both was 3.9%. Regarding the predisposing factors, past history of blood transfusion was present in 08.3% subjects, needle injection 89.2%, barber shaving 52.6%, and 46 (27.5%) patients presented with past history of surgery. Conclusion: For the prevention of transmission of HBV and HCV infection, the community awareness regarding vaccination against Hepatitis B and risk factors for spread of HBV and HCV, implementation of population based screening and vaccination for HBV on large scale should be ensured. (author)

  10. HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

    OpenAIRE

    Ssentongo Robert; Chalya Phillipo L; Kakande Ignatius

    2011-01-01

    Abstract Background HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting and to compare the outcome of these patients who are HIV positive with those who are HIV negative. Methods This was a prospective cohort study involving burn injury patients admitted to Mulago Hospital between November 2005 and February 2006. Patients were stratified...

  11. Comparison of the General Health, Self-Esteem and Social Support in Self-Inflicted Burn Patients and Non Self Inflicted Burn Patients of the Choromy Accidental and Burning Hospital of Ganaveh

    OpenAIRE

    MS Enayati; A Heidarei; Malekzadeh, M.; Y Abolfathi

    2006-01-01

    ABSTRACT: Introduction & Objective: Self-inflicted burn is a violent method of suicide. Since our society faces lots of psychological, social, personal and economical problems due to self-inflicted burn, more survey for this event can assist us to know its causes and prevent from its occurrence. This research was carried out to compare general health, self- esteem and social support in patient's self-inflicted burn and non-self-inflicted burn of the Choromy accidental and burning hospital...

  12. Serum 25-Hydroxyvitamin D Levels in Pediatric Burn Patients

    Science.gov (United States)

    Sobouti, Behnam; Riahi, Aina; Fallah, Shahrzad; Ebrahimi, Masoumeh; Shafiee Sabet, Azin; Ghavami, Yaser

    2016-01-01

    Background Previous studies have implicated the important and active role of vitamin D in the immune system. Objectives The aim of this study was to evaluate serum levels of 25-hydroxyvitamin D in children with burn injuries. Materials and Methods In this cross-sectional study, 118 patients with various degrees of burn injuries were enrolled. A checklist consisting of demographic data, total body surface area (TBSA) affected by burn, degree of burn, serum level of 25(OH)D, total protein, albumin, electrolytes, and parathyroid hormone was recorded for each patient. Results Sixty-eight (57.6%) males and 50 (42.4%) females with a mean age of 4.04 years (SD = 3.04) were evaluated. The mean level of 25(OH)D was 14.58 ng/mL (SD = 6.94). Levels of 25(OH)D in four (3.39%) cases were higher than 30 ng/mL, while 95 (81.35%) cases had levels lower than 20 ng/mL, and 19 (16.10%) cases had levels of 21 - 30 ng/mL. The level of 25(OH)D was below recommended levels in 96.61% of cases, while 81.34% had vitamin D deficiency and 16.1% had insufficiency. We found a significant correlation between vitamin 25(OH)D and total protein, albumin, and total and ionized calcium (P children suffering from severe burns were low. Supplementation might be useful in patients with very low levels of serum vitamin D.

  13. Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

    DEFF Research Database (Denmark)

    Matzen, Lars E; Jepsen, Ditte B; Ryg, Jesper; Masud, Tahir

    2012-01-01

    ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS...... Personal Registry. Co-morbidity was measured with Charlson ComorbidityIndex (CCI). Patients were followed until death or end of study. RESULTS: 5,087 patients were included, 1,852 (36.4%) men and 3,235 (63.6%) women with mean age(SD) 82.0 (6.8) and 84.0 (7.0) years respectively. The median [IQR] length of...

  14. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

    OpenAIRE

    Kobra Gaseminegad; Bita Kamranfar; Parviz Nemazi; Faride Ahrari; Jaber Musavi; Kamran As'adi; Seyed Hamid Salehi; Somaie Faramarzi; Saeed Shoar

    2012-01-01

    There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We ch...

  15. Health related quality of life in Critically ill Patients A study of health related quality of life in critically ill patients admitted on the Intensive Care

    OpenAIRE

    Hofhuis, José

    2008-01-01

    textabstractHealth related quality of life (HRQOL) is a relevant outcome measure for patients admitted to the intensive care unit (ICU). Long term outcome for physical and psychological factors, functional status and social interactions are becoming more and more important both for doctors and nurses as well as for patients and their relatives (1;2). Therefore doctors and nurses want to know what a “reasonable” quality of life means to their patients. The main reason for HRQOL research descri...

  16. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients)

    OpenAIRE

    Mussi Chiara; Galizia Gianluigi; Abete Pasquale; Morrione Alessandro; Maraviglia Alice; Noro Gabriele; Cavagnaro Paolo; Ghirelli Loredana; Tava Giovanni; Rengo Franco; Masotti Giulio; Salvioli Gianfranco; Marchionni Niccolò; Ungar Andrea

    2013-01-01

    To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65–101). Falls were defined “accidental” (fall explained by a definite accidental cause), “medical” (fall caused directly by a specific medical disease), “dementia-related” (fall in patients affected by moderate-severe dementia), and “unexplained” (nonaccidental falls, not related ...

  17. Cognitive Investigation Study of Patients Admitted for Cosmetic Surgery: Information, Expectations, and Consent for Treatment

    OpenAIRE

    Barone, Mauro; Cogliandro, Annalisa; La Monaca, Giuseppe; Tambone, Vittoradolfo; Persichetti, Paolo

    2015-01-01

    Background In all branches of medicine, it is the surgeon's responsibility to provide the patient with accurate information before surgery. This is especially important in cosmetic surgery because the surgeon must focus on the aesthetic results desired by the patient. Methods An experimental protocol was developed based on an original questionnaire given to 72 patients. The nature of the responses, the patients' motivation and expectations, the degree of patient awareness regarding the planne...

  18. A case-control study on risk factors for early-onset respiratory tract infection in patients admitted in ICU

    Directory of Open Access Journals (Sweden)

    Carneiro António H

    2007-09-01

    Full Text Available Abstract Background Respiratory tract infections are common in intensive care units (ICU, with incidences reported from 10 to 65%, and case fatality rates over 20% in pneumonia. This study was designed to identify risk factors for the development of an early onset respiratory tract infection (ERI and to review the microbiological profile and the effectiveness of first intention antibiotic therapy. Methods Case-control, retrospective clinical study of the patients admitted to the Intensive Care Unit (ICU of our hospital, a teaching and tertiary care facility, from January to September 2000 who had a respiratory tract infection diagnosed in the first 5 days of hospital stay. Results Of the 385 patients admitted to our unit: 129 (33,5% had a diagnosis of ERI and 86 patients were admitted to the control group. Documented aspiration (adjusted OR = 5,265; 95% CI = 1,155 – 24,007 and fractured ribs (adjusted OR = 12,150; 95% CI = 1,571 – 93,941 were found to be independent risk factors for the development of ERI (multiple logistic regression model performed with the diagnostic group as dependent variable and adjusted for age, sex, SAPS II, documented aspiration, non-elective oro-tracheal intubation (OTI, fractured ribs, pneumothorax and pleural effusion. A total of 78 organisms were isolated in 61 patients (47%. The normal flora of the upper airway (Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenza and Moraxella catharralis accounted for 72% of all isolations achieved, polimicrobian infections were responsible for 25% of all microbiological documented infections. First intention treatment was, in 62% of the patients, the association amoxacillin+clavulanate, being effective in 75% of the patients to whom it was administered. The patients with ERI needed more days of OTI (6 vs 2, p Conclusion In this study documented tracheobronchial aspiration and fractured ribs were identified as independent risk factors for ERI

  19. Health related quality of life in Critically ill Patients A study of health related quality of life in critically ill patients admitted on the Intensive Care

    NARCIS (Netherlands)

    J.G.M. Hofhuis (José)

    2008-01-01

    textabstractHealth related quality of life (HRQOL) is a relevant outcome measure for patients admitted to the intensive care unit (ICU). Long term outcome for physical and psychological factors, functional status and social interactions are becoming more and more important both for doctors and nurse

  20. Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

    Directory of Open Access Journals (Sweden)

    Matzen Lars E

    2012-06-01

    Full Text Available Abstract Background Functional decline is associated with increased risk of mortality in geriatric patients. Assessment of activities of daily living (ADL with the Barthel Index (BI at admission was studied as a predictor of survival in older patients admitted to an acute geriatric unit. Methods All first admissions of patients with age >65 years between January 1st 2005 and December 31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved from the hospital patient administrative system, and data on survival until September 6th 2010 were retrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson Co-morbidity Index (CCI. Patients were followed until death or end of study. Results 5,087 patients were included, 1,852 (36.4% men and 3,235 (63.6% women with mean age 81.8 (6.8 and 83.9 (7.0 years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2%. Mortality was greater in men than in women with median survival (95%-CI 1.3 (1.2 -1.5 years and 2.2 (2.1-2.4 years respectively (p  Conclusion BI is a strong independent predictor of survival in older patients admitted to an acute geriatric unit. These data suggest that assessment of ADL may have a potential role in decision making for the clinical management of frail geriatric inpatients.

  1. A STUDY OF METALLO-BETA-LACTAMASE PRODUCING PSEUDOMONAS AERUGINOSA IN BLOOD SAMPLES OF BURNED PATIENTS

    Directory of Open Access Journals (Sweden)

    Piyali

    2014-11-01

    Full Text Available : BACKGROUND: Septicaemia is a life threatening complication of severely burned patients. Among many organisms invading blood stream Pseudomonas aeruginosa is a well-known for its powerful antibiotic resistance mechanisms which increasingly limit the choices for treatment. Among many such resistance mechanisms it is the metallo-beta-lactamase (MBL which confers resistance to Carbapenem group of antibiotics, one of the final resorts to fight them. The present study was undertaken to detect MBL producing P. aeruginosa using phenotypic method from blood samples of burned patients as well as to know their drug sensitivity pattern. MATERIALS AND METHODS: For this purpose 67 Pseudomonas aeruginosa isolates from blood samples of admitted burned patients were subjected to susceptibility testing to antipseudomonal drugs by disc diffusion test and those found to be Carbapenem resistant were subjected to Imipenem - EDTA combined disk synergy test for MBL detection. RESULT: Out of 67 isolates of P.aeruginosa, 19 (28.4% were found to be Carbapenem resistant and 11 (16.4% were MBL producers. A particularly important feature was that the MBL producers were highly resistant to the antibiotics tested than the non-producers. However all of them were susceptible to Colistin and Polymixin B. CONCLUSION: This study has made us to think that a constant vigil and careful selection of antibiotics are necessary to keep prevalence of MBL producing P.aeruginosa in check. The accurate identification and reporting of MBL producing P. aeruginosa will aid infection control practitioners in preventing the spread of these multidrug-resistant isolates

  2. [Management of the patient with serious burns at admission].

    Science.gov (United States)

    Meunier, David; Dupré, Aurélie

    2012-01-01

    The first hours of care and treatment are determined by the quality of the preparation on a logistical, organisational and environmental level. The future of a patient with serious burns is at stake in these first few hours. The risk of threat to life is linked to potential vascular compressions, as well as cardio-respiratory failure.The occurrence of these complications can be prevented by the setting up of codified instrumental and clinical monitoring. PMID:22916393

  3. Elbow Reconstruction Using Island Flap for Burn Patients

    OpenAIRE

    Gi Yeun Hur; Woo Jin Song; Jong Wook Lee; Hoon Bum Lee; Sung Won Jung; Jang Hyu Koh; Dong Kook Seo; Jai Ku Choi; Young Chul Jang

    2012-01-01

    Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow. Methods A retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The pa...

  4. Hospital Acquired Infections Among Patients Admitted in the Medical and Surgical Wards of a Non-Teaching Secondary Care Hospital in Northern India

    OpenAIRE

    Ginawi, I.; Saleem, Mohd; Sigh, Mastan; Vaish, A.K.; I. Ahmad; Srivastava, V.K.; Abdullah, A. Fahad M.

    2014-01-01

    Objective: To investigate the incidence of Nosocomial Infection (NI) and type of bacteriological isolates among the patients admitted in the medical and surgical wards of a non-teaching secondary care hospital in north India.

  5. Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial

    DEFF Research Database (Denmark)

    Jakobsen, Anna Svarre; Laursen, Lars C; Østergaard, Birte;

    2013-01-01

    Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable...... phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional...

  6. Correlation between timing of tracheostomy and duration of mechanical ventilation in patients with potentially normal lungs admitted to intensive care unit

    OpenAIRE

    Mehrdad Masoudifar; Omid Aghadavoudi; Lida Nasrollahi

    2012-01-01

    Background: There is insufficient evidence to conclude that the timing of tracheostomy alters the duration of mechanical ventilation, hence this study was designed to investigate the correlation between timing of tracheostomy and duration of mechanical ventilation for patients admitted to intensive care unit (ICU) with potentially normal lungs. Materials and Methods: In a retrospective study for a period of 2 years, all adult patients admitted to the medical ICU of Al-Zahra Hospital in Is...

  7. Outcome of critically ill hyperglycemic stroke patients admitted to the intensive care unit

    Directory of Open Access Journals (Sweden)

    Kamel Abdelaziz Mohamed

    2013-01-01

    Conclusion Our current study showed that nondiabetic patients with hyperglycemia had a 1.6 times higher relative risk of in-hospital 28-day mortality than diabetic patients. Stress hyperglycemia predicts an increased risk of in-hospital mortality after ischemic stroke; thus, we should not underestimate the potential harm, as patients with the highest admission glucose levels would have most likely been treated earlier and more aggressively.

  8. Intensified microbiological investigations in adult patients admitted to hospital with lower respiratory tract infections

    DEFF Research Database (Denmark)

    Korsgaard, Jens; Rasmussen, TR; Sommer, T;

    2002-01-01

    microbiological sampling. Patients in the study group with known aetiology had higher values of inflammatory markers than patients with unknown aetiology. For Streptococcus pneumoniae infection culture and urine antigen detection were complimentary depending on recent antibiotic therapy since seven of eight...... diagnostic yield from 7% to 51% of patients in the study group with an aetiologic diagnosis. Routine FOB with BAL had no apparent effect on clinical outcome and seems only justified in selected patients with severe LRTI with infiltrates on chest X-ray and signs of severe inflammation where a high diagnostic...

  9. NT-ProBNP Independently Predicts Long-Term Mortality in Patients Admitted for Coronary Angiography

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth; Goetze, Jens Peter; Bech, Jan;

    2014-01-01

    Recently, research interests are focussed on biomarkers to predict the outcome in patients with coronary artery disease (CAD). We examined whether the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) could predict outcome in patients who underwent elective or acute coronary......%) patients died and 88 (26%) patients reached the combined end point. Preprocedural NT-proBNP above 32 pmol/L independently predicted ACM (hazard ratio [HR] 3.11; confidence interval [CI]: 1.60-6.07; P = .001) and the combined end point (HR 2.44 [CI: 1.50-3.97]; P NT...

  10. Spectrum of Opportunistic Infections and Risk Factors for In-Hospital Mortality of Admitted AIDS Patients in Shanghai.

    Science.gov (United States)

    Luo, Bin; Sun, Jianjun; Cai, Rentian; Shen, Yinzhong; Liu, Li; Wang, Jiangrong; Zhang, Renfang; Shen, Jiayin; Lu, Hongzhou

    2016-05-01

    To investigate the frequency and the spectrum of major opportunistic infections (OIs), evaluate the major clinical factors associated with each specific OI, and identify the risk factors for in-hospital death among HIV patients in East China.A retrospective cohort study was made including all the HIV-infected patients who were admitted for the first time to the Shanghai Public Health Clinical Center during June 1, 2013 to June 1, 2015. The demographic and clinical data were collected. Comparison of continuous variables was analyzed by one-way ANOVA and rank sum test. Person χ test and Fisher exact test were applied to analyze the categorical variables. A Cox proportional hazards regression model was used to determine the risk for the occurrence of in-hospital death.In total, 920 patients were enrolled with age of 41.59 ± 13.36 years and 91% male. Median CD4 was 34 (IQR, 13-94) cells/μL. Among these patients, 94.7% acquired OIs while the rest developed malignancies. Pneumocystis pneumonia and bacterial coinfection (42.1%) was found to be the most common OIs, followed by tuberculosis (31.4%), CMV (20.9%), Cryptococcosis (9.0%), and MAC infection (5.2%). Of the above 5 major OIs, CMV-infected patients had the lowest median CD4 cell count 22.50 (IQR, 7.50-82.00) while the patients with tuberculosis infection had the highest count 61.00 (IQR, 27.00-176.00). In-hospital death rate was 4.2 per 100 person-years among these patients. Of note, admitted patients with 2 types of OIs (2.20, 95% CI 1.39-3.48) and those patients who were 40-year old or older (1.75, 95% CI 1.10-2.78) had a higher risk of such death.Pneumocystis pneumonia and tuberculosis were still the leading causes for the admission of HIV-infected patients in East China, and these patients tended to have very low CD4 cell counts. It is believed that expanding the HIV screening test and pushing the infected ones get ART earlier is required for generating a more successful HIV management strategy. PMID

  11. Renal dysfunction, restrictive left ventricular filling pattern and mortality risk in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Kjaergaard, Jesper; Torp-Pedersen, Christian;

    2013-01-01

    Renal dysfunction is associated with a variety of cardiac alterations including left ventricular (LV) hypertrophy, LV dilation, and reduction in systolic and diastolic function. It is common and associated with an increased mortality risk in heart failure (HF) patients. This study was designed to...... evaluate whether severe diastolic dysfunction contribute to the increased mortality risk observed in HF patients with renal dysfunction....

  12. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department

    DEFF Research Database (Denmark)

    Mrgan, Monija; Rytter, Dorte; Brabrand, Mikkel

    2014-01-01

    relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality. METHODS: We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data...... descriptively. Difference between continuous data was analysed using Wilcoxon Rank Sum Test and categorical data using χ(2) test. The primary endpoint was 1-day all-cause mortality. RESULTS: 3046 patients were enrolled and CRT was measured on 1935. In univariate analyses, we found increasing all-cause 1-day...... mortality with all definitions of CRT. Performing multivariable analysis, controlling for age, sex, mean blood pressure, pulse, temperature and peripheral oxygen saturation, we found increasing CRT as a continuous variable and according to the Schriger and Baraff definition to be associated with increased...

  13. Detection and characterization of carbapenemase-producing Enterobacteriaceae in wounded Syrian patients admitted to hospitals in northern Israel.

    Science.gov (United States)

    Lerner, A; Solter, E; Rachi, E; Adler, A; Rechnitzer, H; Miron, D; Krupnick, L; Sela, S; Aga, E; Ziv, Y; Peretz, A; Labay, K; Rahav, G; Geffen, Y; Hussein, K; Eluk, O; Carmeli, Y; Schwaber, M J

    2016-01-01

    Since 2013, four hospitals in northern Israel have been providing care for Syrian nationals, primarily those wounded in the ongoing civil war. We analyzed carbapenemase-producing Enterobacteriaceae (CPE) isolates obtained from these patients. Isolate identification was performed using the VITEK 2 system. Polymerase chain reaction (PCR) was performed for the presence of bla KPC, bla NDM, and bla OXA-48. Susceptibility testing and genotyping were performed on selected isolates. During the study period, 595 Syrian patients were hospitalized, most of them young men. Thirty-two confirmed CPE isolates were grown from cultures taken from 30 patients. All but five isolates were identified as Klebsiella pneumoniae and Escherichia coli. Nineteen isolates produced NDM and 13 produced OXA-48. Among a further 29 isolates tested, multilocus sequence typing (MLST) showed that ST278 and ST38 were the major sequence types among the NDM-producing K. pneumoniae and OXA-48-producing E. coli isolates, respectively. Most were resistant to all three carbapenems in use in Israel and to gentamicin, but susceptible to colistin and fosfomycin. The source for bacterial acquisition could not be determined; however, some patients admitted to different medical centers were found to carry the same sequence type. CPE containing bla NDM and bla OXA-48 were prevalent among Syrian wounded hospitalized patients in northern Israel. The finding of the same sequence type among patients at different medical centers implies a common, prehospital source for these patients. These findings have implications for public health throughout the region. PMID:26581423

  14. Status of human dignity of adult patients admitted to hospitals of Tehran.

    Science.gov (United States)

    Borhani, Fariba; Abbaszadeh, Abbas; Moosavi, Soolmaz

    2014-01-01

    Maintaining dignity and respect is among patients' most fundamental rights. The importance of patient dignity, the status quo, patients' needs, and a shortage of survey studies in this area were the underlying incentives for conducting this study. This was a cross-sectional descriptive study in which data were collected through Patient Dignity Inventory (PDI). The questionnaire was completed by 280 inpatients in 2012 to determine their perspectives on their personal state of human dignity. In this study, the mean score of patients' dignity was 1.89 out of 5 (SD = 0.81). Results indicated a significant relationship between type of hospital and the distress caused by disease symptoms, peace of mind, and social support (P < 0.05). There were also relationship between type of ward and dependency (P < 0.05), type of disease and dependency (P < 0.05), gender and social support (P < 0.05), household size and peace of mind (P < 0.05). The person's satisfaction with household income showed significant relationship with symptom distress, dependency and existential distress (P < 0.05). Results showed a significant inverse correlation between age and patient dignity (P = 0.005, r = - 0.166). However, the relationship between employment status, health insurance, education level and the above factors were insignificant. Studies indicate that there is a relationship between patients' dignity and mental distress, and therefore policy makers and health services officials should establish and implement plans to maintain and enhance patients' dignity in hospitals. Educating the health team, particularly the nurses can be very effective in maintaining patients' dignity and respect. PMID:26587200

  15. Mental adjustment to cancer and survival of patients admitted for allogenic hemopoietic stem cell transplantation

    OpenAIRE

    Grulke, N; Bailer, H; Larbig, W; Kächele, H

    2006-01-01

    Objective: The Mental Adjustment to Cancer Scale (MAC scale) has evolved to a standard measure in the field of psycho-oncology. In this context an attitude called "fighting spirit" gained much attention as a coping style. Some reports suggest that coping efforts as measured by the MAC scale are predictive for survival of breast cancer patients. We explored the predictive power of the MAC scale by using a sample of patients with haematological malignancies undergoing allogenic hemopoietic ste...

  16. Emergency pre-hospital management of patients admitted with acute asthma

    OpenAIRE

    Simpson, A; Matusiewicz, S; Brown, P.; McCall, I; Innes, J; Greening, A.; Crompton, G

    2000-01-01

    BACKGROUND—Little is known about the management of acute asthma prior to hospital admission. Pre-hospital treatment of patients referred to hospital with acute asthma was therefore studied in 150 patients divided into three groups: those in the Edinburgh Emergency Asthma Admission Service (EEAAS) who can contact an ambulance and present directly to respiratory services when symptoms arise (n = 38), those under continuing supervision at a hospital respiratory outpatient cl...

  17. System of psycho-therapeutics influences in patients admitted to hospital with cardiovascular diseases.

    Directory of Open Access Journals (Sweden)

    Teresa Rodríguez Rodríguez

    2004-04-01

    Full Text Available Fundaments: Within the restricted field of the patients' psychological environment, anxiety and depression seem ti play an important role although it is still pending how to clear it up definitely in the case of ischemic cardiopathy and coronary diseases. However, it isostensible that the patients who suffer from cardiovascular diseases frequently present psychological disorders, mainly emotional ones. Objective: To assess the effectiveness of a system of psychotherapy influences in patients with cardiovasular diseases. Method: Intervention study witha cuasi experimental design in patients with cardiovascular urgencies hospitalized at the Integral Care Unit of the Heart of the ¨Dr. Gustavo A. Lima¨ Hospital from June 1st 2002 to june 1st 2003 and who received relaxing, stimulating and sleeping treatment. Psychological and physiological modifications were assessed after having received treatment with these psychological techniques. Result: Acute Myocardial infarction and Angina pectoris were the most common causes of admission. The variation of respiratory and cardiac frequency as well as blood pressure tend tomaintain, diminish or keep normal values. The psychological state of the patient was favoured after treatment. Conclusion: The effect of the system of psychotherapy influences were beneficial both organically and psychologically.

  18. Assessment of Mental Disorders in Cerebral Stroke Patients Admitted at Rasool Hospital

    Directory of Open Access Journals (Sweden)

    B Farzinrad

    2009-07-01

    Full Text Available Introduction: Cerebrovascular disorders are the third leading cause of death in individuals over the age of 50; mental disorders of this origin are reported in up to 50 and even 78 percent of patients. The global goal of this study was to assess mental disorders of stroke patients. Methods: In a cross-sectional study, 100 consecutive stroke patients in the neurology clinic of Rasool hospital were evaluated by accidental sampling and use of Neuropsychotic Inventory (NPI. Data was analyzed using Chi square and t-test. Results: 37 men and 63 women with mean age of 62.5 years were assessed over 1 to 12 months after their stroke. The results of Chi square suggested men patients had higher frequency in subscales of delusion, aphaty, disinhibition and sleep disorders and women patients in subscale of anxiety. The results of t-test reported that there was a correlation between right hemisphere lesions and euphory. Conclusion: Depression, anxiety and aggression were the most common mental disorders after stroke, respectively.

  19. How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns

    Science.gov (United States)

    Disseldorp, Laurien M.; Niemeijer, Anuschka S.; Van Baar, Margriet E.; Reinders-Messelink, Heleen A.; Mouton, Leonora J.; Nieuwenhuis, Marianne K.

    2013-01-01

    Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM[R]…

  20. A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care

    DEFF Research Database (Denmark)

    Houmann, Lise Jul; Chochinov, Harvey M; Kristjanson, Linda J;

    2014-01-01

    questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European...... purpose, dignity and will to live. Quality of life decreased (mean = -9 (95% confidence interval: -14.54; -2.49)) and depression increased (mean = 0.31 (0.06; 0.57)) on one of several depression measures. At T2 (n = 31), sense of dignity (mean = -0.52 (-1.01; -0.02)) and sense of being a burden to others...... (mean = -0.26 (-0.49; -0.02)) improved. Patients with children and lower performance status, emotional functioning and quality of life were more likely to report benefit.Conclusions:This study adds to the growing body of evidence supporting Dignity Therapy as a valuable intervention in palliative care...

  1. The experience of daily life of acutely admitted frail elderly patients one week after discharge from the hospital

    Directory of Open Access Journals (Sweden)

    Jane Andreasen

    2015-06-01

    Full Text Available Introduction: Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission. Methods: The qualitative methodological approach was interpretive description. Data were gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward. Results: Four main categories were identified: “The system,” “Keeping a social life,” “Being in everyday life,” and “Handling everyday life.” These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less. Conclusion and discussion: Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors.

  2. Liver stiffness and 30-day mortality in a cohort of patients admitted to hospital

    DEFF Research Database (Denmark)

    Lindvig, Kristoffer; Mössner, Belinda K; Pedersen, Court; Lillevang, Søren T; Christensen, Peer Brehm

    2012-01-01

    associated with increased 30-day mortality. Materials and methods  A prospective cohort study at the medical admissions ward at Odense University Hospital, Denmark, covering a population of 300 000 inhabitants. Consecutive patients ≥ 18 years of age were examined by TE (Fibroscan) at admission. Outcome...

  3. Etiologic evaluation of patients with dysphagia admitted to ENT and Thorax surgery wards of Ghaem Hospital, Mashhad, Northeast of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Naeimi

    2009-04-01

    Full Text Available ntroduction: Dysphagia is a common chief complain of various diseases with different benign or malignant etiologies. Iran is one of countries with a high incidence rate of esophageal cancer. The aim of this study was to evaluate the common causes of dysphagia for earlier diagnosis and treatment of this disease and reduction of its morbidity and mortality rate. Materials and Methods: In this descriptive study, we analyzed the etiology of dysphagia in 200 patients who were admitted to ENT and thorax surgery wards of Mashhad Ghaem Hospital during 2005-2007. Results: Of 200 patients, 79 patients were female and 121 patients were male. The most prevalent cause of dysphagia in these patients was esophageal SCC and the most common endoscopic presentation was the ulcerative view. Other common etiologic factors were esophageal stenosis, adenocarcinoma, mediastinal tumors, achalasia, lyomyoma, sarcoma and diffuse esophageal spasm, respectively. Conclusion: According to these results, the complaint of dysphagia with or without odinophagia has particular clinical importance, especially in our country with high frequency of esophageal malignancies.

  4. Etiology and Viral Genotype in Patients with End-Stage Liver Diseases admitted to a Hepatology Unit in Colombia

    Directory of Open Access Journals (Sweden)

    Fabian Cortes-Mancera

    2011-01-01

    Full Text Available Hepatitis B virus (HBV and hepatitis C virus (HCV infections are the principal risk factor associated to end-stage liver diseases in the world. A study was carried out on end-stage liver disease cases admitted to an important hepatology unit in Medellin, the second largest city in Colombia. From 131 patients recruited in this prospective study, 71% of cases were diagnosed as cirrhosis, 12.2% as HCC, and 16.8% as cirrhosis and HCC. Regarding the risk factors of these patients, alcohol consumption was the most frequent (37.4%, followed by viral etiology (17.6%. Blood and/or hepatic tissue samples from patients with serological markers for HCV or HBV infection were characterized; on the basis of the phylogenetic analysis of HCV 5′ UTR and HBV S gene, isolates belonged to HCV/1 and HBV/F3, respectively. These results confirm the presence of strains associated with poor clinical outcome, in patients with liver disease in Colombia; additionally, HBV basal core promoter double mutant was identified in HCC cases. Here we show the first study of cirrhosis and/or HCC in Colombian and HBV and HCV molecular characterization of these patients. Viral aetiology was not the main risk factor in this cohort but alcohol consumption.

  5. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

    Directory of Open Access Journals (Sweden)

    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  6. Epidemiology of major burns at the Lebanese Burn Center in Geitawi, Lebanon

    OpenAIRE

    Ghanimé, G.; Rizkallah, N.; Said, J.M.

    2013-01-01

    Burn care is one of the few areas in medicine considered both medically and surgically challenging, with burn injuries affecting people of all ages and both sexes. Between May 1992 and March 2012, 1,524 patients were admitted to the Lebanese Burn Center in Geitawi, with an average length of stay (LOS) of 36.5 days. The most frequently encountered injuries were thermal burns, generally resulting from domestic accidents. Of our patients, 47% were from rural areas and burned body surface (BBS) w...

  7. BIPAP protocol usage in patients admitted to the Internal Medicine unit

    OpenAIRE

    Óscar Bautista Villaécija; Fernando Campaña Castillo

    2013-01-01

    The use of noninvasive mechanical ventilation equipment becomes more common in internal medicine units. Due to its indications, such as severe respiratory failure, or hypoxemic respiratory failure, it means a great help in these units. Within the multidisciplinary team, the medical staff is responsible for the prescription and programming of the device parameters, and the nursing staff handles such equipment and provides care to the patients requiring noninvasive mechanical ventilation.The ob...

  8. Metabolic alkalosis in children: Study of patients admitted to pediatrics center

    Directory of Open Access Journals (Sweden)

    Sobhani A

    2001-07-01

    Full Text Available Metabolic alkalosis is characterized by high HCO3- as it is seen in chronic respiratory acidosis, but PH differentiates the two disorders. There is no characteristic symptom or sign. Orthostatic hypotension may be encountered. Weakness and hyporeflexia occur if serum K+ is markerdly low. Tetany and neuromuscular irritability occur rarely. We report the results of retrospective data analysis of metabolic alkalosis in 15463 patients hospitalized Pediatric Medical Center in Tehran during years 1995-1997. We found 50 cases of metabolic alkalosis (rate of 0.32 percent. 64 precent male and 36 percent female. Most of them had growth failure (40% were bellow 3 percentile of height by age, 44% bellow 5 percentile of weight by height. More than 60 percent had hypokalemia, hypocloremia and hyponatremia. The most common cause of Metabolic alkalosis was cystic fibrosis and pyloric stenosis. Fifty percent of cystic fibrosis patients and Bartter cases had metabolic alkalosis. Metabolic alkalosis should be considered in every pediatric patient presented with projectile vomitting.

  9. Gender differential on characteristics and outcome of leprosy patients admitted to a long-term care rural hospital in South-Eastern Ethiopia

    OpenAIRE

    Ramos José M; Martínez-Martín Miguel; Reyes Francisco; Lemma Deriba; Belinchón Isabel; Gutiérrez Félix

    2012-01-01

    Abstract Introduction In previous studies, women are less aware of causation and symptoms of leprosy and have less access to health care coverage than men, thus contributing to their delay in seeking for treatment. We assess the gender differences in leprosy cases admitted to a rural referral hospital in Ethiopia for 7 and a half years. Methods Retrospective data of the leprosy patients admitted to referral hospital were collected using leprosy admission registry books from September 2002 to ...

  10. Use of non-invasive ventilation is increasing in patients admitted with a chronic obstructive pulmonary disease exacerbation

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Johnsen, Søren Paaske; Thomsen, Reimar Wernich;

    2013-01-01

    INTRODUCTION: A nationwide chronic obstructive pulmonary disease (COPD) quality improvement programme - DrCOPD - was initiated in Denmark in 2008. We examined subsequent national and regional trends in the use of non-invasive ventilation (NIV) and trends in mortality following NIV and invasive...... mechanical ventilation among patients acutely admitted with a COPD exacerbation. MATERIALS AND METHODS: We did a nationwide, population-based prospective study using DrCOPD to identify all incident hospitalizations with COPD from 2008 through 2011 (n = 24,982) and to record the use of NIV during.......8% to 7.0% (adjusted for age, sex and co-morbidity, relative risk (RR): 1.21, 95% confidence interval (CI): 1.05-1.38). Concurrently, a statistically significant increase from 1.3% to 1.8% (RR: 1.36; 95% CI: 1.03-1.80) in NIV given together with invasive mechanical ventilation was observed. During the...

  11. Incidence and prevalence of hospital-acquired infections in a cohort of patients admitted to medical departments

    DEFF Research Database (Denmark)

    Petersen, Martin Haubro; Holm, Morten Olskjær; Pedersen, Svend Stenvang;

    2010-01-01

    INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal.......7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION: The...... incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies....

  12. BIPAP protocol usage in patients admitted to the Internal Medicine unit

    Directory of Open Access Journals (Sweden)

    Óscar Bautista Villaécija

    2013-06-01

    Full Text Available The use of noninvasive mechanical ventilation equipment becomes more common in internal medicine units. Due to its indications, such as severe respiratory failure, or hypoxemic respiratory failure, it means a great help in these units. Within the multidisciplinary team, the medical staff is responsible for the prescription and programming of the device parameters, and the nursing staff handles such equipment and provides care to the patients requiring noninvasive mechanical ventilation.The objective of this protocol is to show in a clear and simple way, the noninvasive mechanical ventilation system, as well as its advantages and complications, and the nursing diagnoses that should be considered.

  13. A STUDY ON HYPERTENSION AMONG CHRONIC KIDNEY DISEASE PATIENTS ADMITTED IN THE NEPHROLOGY DEPARTMENT OF GGH, KURNOOL

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    Padma Sri

    2015-04-01

    Full Text Available BACKGROUND: Hypertension is both a risk factor and complication of chronic renal disease. Managing hypertension plays a significant role in preventing complications and slowing down the progression as well. OBJECTIVES: 1. To study the association between hypertension and CKD. 2. To study the other known risk factors associated with hypertension. METHODOLOGY: Study design - Cross sectional descriptive study period - June to November 2012, Study area - The Department of Nephrology, Government General Hospital, Kurnool. STUDY SUBJECTS: All the chronic kidney disease patients admitted in the Nephrology ward from June to November 2012 are included in the study and are interviewed with a Pre - designed semi structured questionnaire. STATISTICAL ANALYSIS: proportions, percentages, chi - square . RESULTS: A total of 153 subjects were included in the study. T heir mean age was 4 7 . 96±11 . 14 years. Hyper tension was present in 126 (82. 35% of the patients with CKD. CONCLUSIONS: Smoking and Alcohol consumption had a significant association with hypertension among CKD patients. Presence of hypertension had an increased risk for heart d isease among CKD patients. Inadequately controlled hypertension had significant association with occurrence of heart disease.

  14. Burn Patients Infected With Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa: Multidrug-Resistant Strains

    OpenAIRE

    Anvarinejad, Mojtaba; Japoni, Aziz; Rafaatpour, Noroddin; Mardaneh, Jalal; Abbasi, Pejman; Amin Shahidi, Maneli; Dehyadegari, Mohammad Ali; Alipour, Ebrahim

    2014-01-01

    Background: Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa in the burn patients is a leading cause of morbidity and mortality and remains a serious health concern among the clinicians. Objectives: The aim of this study was to detect MBL-producing P. aeruginosa in burn patients and determine multidrug-resistant (MDR) strains, and respective resistance patterns. Patients and Methods: In this cross-sectional study, 270 strains of P. aeruginosa were isolated from the burn patients ...

  15. Epidemiological investigation on Wenchuan earthquake-struck trauma patients admitted to two hospitals of Chongqing

    Institute of Scientific and Technical Information of China (English)

    JIAN Hua-sheng; L(U) Zu-ming; LI Yin-yan

    2010-01-01

    Objective: To study epidemiological characteristics and influential factors of in-hospital patients struck by the Wenchuan earthquake disaster.Methods: The clinical data of 196 cases were collected from 2 hospitals of Chongqing city, including age, sex, occupation, injury site, dwelling and injury severity score.Results: In this series, 31.63% victims' age was over 60 years, and 54.08% were farmers.Multiple trauma ac-counted for 35.71%, and lower limb injury for 33.67%.There was no significant difference on injury severity score be-tween city dwellers and rural ones (P>0.05).Conclusion: The earthquake injury is influenced by many factors.More attention should be paid to the treat-ment at first 5 days after injury and high risk population.

  16. ANAESTHETIC MANAGEME NT OF A POST BURN CONTRACTURE PATIENT : A CASE REPORT

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    Anupam

    2015-08-01

    Full Text Available Airway management in a post - burn contracture patient is unique challenge due to scar contracture head and neck region. A female with 70 % burn along with history of post burn scar tissue over the neck region , MP - 3, reduced thyromental distance & mouth opening undergone release of nostril bl ockade with the help of difficult airway kit under general anaesthesia

  17. Evaluation on antibiotic resistance of helicobacter pylori isolated from patients admitted to tooba medical center, Sari

    Directory of Open Access Journals (Sweden)

    Amin Talebi BezminAbadi

    2009-01-01

    Full Text Available (Received 17 March, 2009; Accepted 8 July, 2009AbstractBackground and purpose: Helicobacter pylori, which infect approximately one half of the world’s population, are an important risk factor in chronic gastritis, peptic ulcer disease, and gastric cancer. H. pylori eradication is now widely recommended as the most effective treatment of peptic ulcer disease. One of the most important reasons for treatment failure is H. pylori resistance to the antimicrobials usage in therapy. The aim of this study was to determine susceptibility patterns of H. pylori isolates in 6 routine anti-microbial agents in Northern Iran.Materials and methods: 125 patients from Tooba Medical Center in Sari with endoscopic evidence of dyspepsia complaints were used for obtaining gastric biopsies specimens. Biopsies were sent to the laboratory in thioglycolate broth (transport medium. Bacteria were primarily cultured on Columbia agar supplemented with 7% horse blood, 7% fetal calf serum. Urease, Catalase and Oxidase activities were used for H. pylori identification. Bacterial suspensions equivalent to 3 Mc. Farlands were spread on plates, along with antibiotic disks and placed in the diameter zone. Inhibition was measured after 3 days of incubation in micro-aerophilic condition.Results: H. pylori were isolated from 116(92.8% subjects, a total of 125 biopsy specimens. Resistance to metronidazole, amoxicillin, clarithromycin, tetracycline, furazolidone and ciprofloxacin were 71%, 35%, 25%, 9%, 24% and 25%, respectively. Multiple resistance (amoxicillin-clarithromycin-metronidazole were found in (65% of the isolates.Conclusion: Comparison of our data with previous results showed that prevalence of H. pylori resistance to clarithromycin, furazolidone and metronidazole has increased in Iran considerably. Resistance to amoxicillin in our study was too high in comparison with foreign studies. The present study demonstrates the need for continuous monitoring of the antimicrobial

  18. Clinical Study of Obesity and associated morbidities in patients admitted to College of Medical Sciences Teaching-Hospital, Bharatpur

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    Manohar Pradhan

    2015-12-01

    Full Text Available Background and Objectives: The present study was conducted with objective to study the incidence of obesity and associated co-morbidities in patients admitted to CMS-TH, Bharatpur.Materials and Methods: One hundred and fifty consecutive overweight patients from the January 2009 to December 2012 with Basal metabolic index (BMI>25 and obese patients (BMI>30 were included in this hospital based prospective study. Detailed evaluation of risk factors and family history of other diseases were taken, other obesity related indicators like WPRO, 2000 for BMI, waist circumference (NCEP ATP III and NCEP for South Asian ethnicity NCEP– National Cholesterol Education Program and waist hip ratio (WHO criteria were measured and comparison done in order to detect best method for application. These cases were evaluated for associated co-morbid condition and metabolic syndrome which were diagnosed using NCEP ATP III criteria.Results: The mean age of patients was 52.7 years. Commonest co-existing risk factors were alcohol consumption, smoking, hypertension and type 2 diabetes mellitus. Evaluation based on WHO criteria revealed that 56.7% patients were overweight, 38.7 % were obese class II and 4.6 % were class II. While 45.1% male and 69.1% female patients had central obesity. The figure was 81.7 % for males and 94.1% for females with WHO criteria using waist hip ratio. Risk factors like alcohol consumption (52.7%, smoking (52.7% and fatty liver disease (22.66% were the commonest co-morbid conditions.Conclusion: In the present study, risk factors of alcohol, smoking and hypertension and co-morbid conditions diabetes mellitus, dyslipidemia, ischemic heart disease, stroke and fatty liver were noted. Waist hip ratio was the best indicator to detect central obesity and co-morbid conditions and recommended to be used for Nepali population.JCMS Nepal. 2015;11(3:16-19

  19. Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit

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    A. Mukhopadhyay

    2014-01-01

    Full Text Available Background. Data on long-term outcomes of elderly (≥65 years patients in ICU are sparse. Materials and Methods. Adult patients (n=1563, 45.4% elderly admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality. Results. 414 (26.5% and 337 (21.6% patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR 2.74, vasopressors (SHR 2.56, neurological disease (SHR 1.77, and Mortality Prediction Model II score (SHR 1.01 regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4 and prior renal replacement therapy (RRT, SHR 2.21 only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94, airway disease (SHR 2.23, and malignancy (SHR hematological 1.11, nonhematological 2.31 regardless of age and with comorbidities especially among the nonelderly. Conclusions. Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related, anemia, airway disease, and malignancy were significantly associated with mortality.

  20. The effect of obesity on adverse outcomes and metabolism in pediatric burn patients

    OpenAIRE

    Kraft, Robert; Herndon, David N; Williams, Felicia N.; Al-Mousawi, Ahmed M.; Finnerty, Celeste C.; Jeschke, Marc G.

    2011-01-01

    Hypothesis Obesity influences metabolism and increases the incidence of clinical complications and worsens outcomes in pediatric burn patients. Design Retrospective, single-center study. Subjects Five hundred ninety-two severely burned pediatric patients who had burns covering more than 30% of the total body surface area and who were treated between 2001 and 2008 were enrolled in this study. Patients were divided into ≥ 85th percentile (n = 277) and normal (n = 315) weight groups based on bod...

  1. S-C复合制剂在临床的应用和研究%Application and Study of the S-C Compound Agent in Burned Patients

    Institute of Scientific and Technical Information of China (English)

    严根荣; 陈国华

    2003-01-01

    173 patients with burn injury were admitted to Shanghai Power Hosptial from 2001 to 2002.These patients include 116 malesand 57 females with a mean age of 33 years. Ther bum injury involved 15% ± 2.3% per cent of TBSA(Total Body Surface Area). With fullthickness burn of 5.5 % ± 1.2% per cent of TBSA.These patients with burn injury were charged medicine by the S. C compound agent,57 casesof burned patients were changed medicine by silver sulfadiazin as a control. S. C compound agent is consisted of cerium nitrate,silver salt andsome additive agent etc. It is possessed of good anti - infection curative effects. Therefore many bacteriums that include Staphylococcus aureus,pseudomonas, aeruginosa, E. coli, E. cloacae, proteus, and some C. albicans etc have been killed by S. C compound agent in vitro, anantimicrobial susceptibility testing in vitro that includes a disk agar diffusion test and a dilution test namely minimal inhibitory concentration, MIChas approved it. Therefore, the wound healing time of partial thickness bum in an experimmt group was significant in statistics ( P < 0.05) ascompared with a control; group. No side - effects, no allergic reactions occurred in all course of applyning S. C compound agent for burned patients.

  2. Comparison of the number of patients admitted with renal colic during various stages of peri-ramadan month

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    Norouzy Abdolreza

    2011-01-01

    Full Text Available Ramadan fasting for Muslims means abstinence from eating, drinking, and smoking from sunrise to sunset. There are concerns whether the occurrence of renal colic increases during the month of Ramadan. In view of the importance of fasting among Muslims, the occurrence of renal colic during Ramadan fasting has been compared during the following periods: two weeks before commencement of Ramadan (stage-1, during the first two weeks (stage-2, the last two weeks (stage-3, and, two weeks after Ramadan (stage-4. This was a prospective observational study, which was carried out in patients with symptoms of renal colic who were referred to the emergency wards in two major hospitals in Iran. During the study period, 610 subjects were admitted with renal colic during the four periods of study; there were 441 males (72.3% and 169 females (27.7%. The number of patients with renal colic was highest during the first two weeks of Ramadan in comparison with the other periods (stage-1: 157, stage-2: 195, stage-3: 139, stage-4: 119, P < 0.05]. Results from this study show that the number of admissions due to renal colic was high during the first two weeks of Ramadan. However, the number of admissions decreased during the last two weeks of Ramadan and this trend continued after Ramadan.

  3. Evaluating the Level of Observance of Patient Charter of Rights from the Perspective of Patients Admitted to Shahid Beheshti Hospital in Qom

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    Fariba Dehghani

    2015-09-01

    Full Text Available Background and Objectives: The objective of this study was to evaluate the observance rate of patient charter of rights from the perspective of patients admitted to Shahid Dr Beheshti research and treatment training center affiliated to Qom University of Medical Sciences in an effort to enhance and promote medical care, defend patients' rights and ensure adequate medical and health care. Methods: The current cross-sectional study was conducted on 467 patients in the year 2014. The data were collected using a Likert scale questionnaire with 28 questions whose validity and reliability had been tested and approved in previous studies. Data analysis was performed using T-test analysis of variance via SPSS software Ver. 19. Results: The results obtained from this research indicated that the patient charter of rights was observed based on the overall score of patient charter of rights in 64.62% of cases. Patient rights was observed to be 71.00 % in the category of “optimal receipt of information,”, “patient privacy,” 71 .52 %, “optimal receipt of health services,” 71.44 %, and access to complaints handling system, 44.53 %. Conclusion: According to the findings, the patient charter of rights has been observed satisfactorily according to the admitted patients in the statistical population under investigation, yet it has not been desirable regarding access to the complaint handling system, thus it is suggested that necessary measures be conducted to expand patients and service recipients’ access to complaint handling system.

  4. Comparative Study Between Sodium Carboxymethyl-Cellulose Silver, Moist Exposed Burn Ointment, and Saline-Soaked Dressing for Treatment of Facial Burns

    OpenAIRE

    Hindy, A.

    2009-01-01

    Facial burns vary from relatively minor insults to severe debilitating injuries. Sustaining a burn injury is often a psychological trauma for the victim and is especially menacing when the face and neck are involved. This study was carried out on 60 patients with superficial dermal burns to the face admitted to the Burn Unit of Tanta University Hospital, Egypt, from September 2007 to July 2008. The patients were allocated randomly to one of three groups, each of which was treated with one of ...

  5. Effects of early physiotherapy with respect to severity of pneumonia of elderly patients admitted to an intensive care unit: a single center study in Japan

    OpenAIRE

    Chigira, Yusuke; Takai, Tomoko; Igusa, Hironobu; Dobashi, Kunio

    2015-01-01

    [Purpose] We performed early physiotherapy for elderly patients with pneumonia admitted to an intensive care unit (ICU), and examined the effects of this early physiotherapy on the severity of pneumonia. [Subjects and Methods] Patients for whom physiotherapy was started the day after admission to the ICU (acute phase) were assigned to the early intervention group and compared with patients in the standard intervention group. All patients were divided into three groups (Groups I, II, and III) ...

  6. Posttraumatic Stress and Cognitive Processes in Patients with Burns

    OpenAIRE

    Sveen, Josefin

    2011-01-01

    A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn. The psychometric properties of a Swedish version of the Impact of Event Scale-...

  7. EFFECTIVENESS OF BETA-GLUCAN COLLAGEN FOR TREATMENT OF PARTIAL THICKNESS BURNS IN PEDIATRIC AGE GROUP PATIENTS: A RANDOMIZED CONTROLLED TRIAL AT TERTIARY CARE CENTRE

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    Sanjay

    2014-12-01

    Full Text Available SUMMARY: BACKGROUND: Burn injuries present a major public health problem for children. In India this constitutes about one-fourth of total burn injuries. This article deals with situations that need to be addressed in the care of partial thickness wounds in children to provide optimal conditions for wound protection and repair while minimizing the morbidity and complications. AIM: To compare outcomes for pediatric age group patients who were applied beta-glucan collagen or anti-microbial dressing as primary wound covering in respect to pain, infection rate and healing time. DESIGN OF STUDY: Randomized controlled trial. SETTINGS AND DESIGN: Tertiary care hospital of central India from 2008-2010. METHODS: Patients admitted at tertiary care centre with partial thickness burns at first presentation were recruited to randomized controlled trial. Patients in trial were randomly allocated for beta-glucan collagen or anti-microbial dressings. RESULTS: Seventy-two patients were recruited over 28 months. Two were excluded from final analysis due to premature demise. Out of seventy subjects thirty-five were in BGC group while remaining thirty-five were in SSD group. Subjects were in 1-11 age range with majority being in 1-5 age groups. Out of total seventy patients thirty-three were male and thirty-three were females. Flame burns and scald burns were equally distributed in both groups and difference was not significant. Most of the patients presented within 6 hrs of initial injury (54.7%. TBSA% in BGC group was 16.4 while it was 18.2 in control group. Most of the patients in both the groups had burn injury over upper limb followed by anterior trunk. Partial thickness burns in children can be cost effectively treated with BGC with decreased pain, mean healing time and hospital stay with good cosmetic results.

  8. Baux’s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury

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    Peeyush Dahal

    2016-01-01

    Full Text Available jdjdBackground & Objectives: Prediction of outcome for patients with major thermal injury is important to inform clinical decision making, alleviate individual suffering and improve hospital resource allocation. Early prediction of outcome (i.e., survival or mortality may help triage effectively, and to implement medical and surgical interventions efficiently as soon as possible. Burn mortality has decreased markedly with the improvement in burn management in the past 100 years, and multiple burn mortality prediction models have been developed over these times in response to that decline. But these services are still not enough to reduce the burn related injuries in low income country like Nepal. So we did a study to observe the effectiveness of two different but very popular models (Baux and ABSI in our context.Materials & Methods: This was a prospective observational study where 92 cases of severe burn injury was selected and the results were compared with Baux and ABSI scoring system.Results: Total admission was 140 and mortality was 33. Out of these admission 92 cases of severe burn injury was selected for the study. Most (85.8 % of were among the young group 16-40 years. It comprises 41.3 % in total. In total 63.7 % were female. Mortality with severe burn injury was 29.3%. No death had occurred below the Baux’s score 30 and there was more than 51% mortality above the score of 60. There was no mortality with ABSI scoring < 3 and mortality was high in ABSI scoring > 6.Conclusion: Baux and ABSI score systems are simple to calculate and ABSI is more accurate for prediction of acute burn injury.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 24-27

  9. Pandemic Influenza A H1N1 in Oman: Epidemiology, Clinical Features, and Outcome of Patients Admitted to Sultan Qaboos University Hospital in 2009

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    Mujahid Al-Busaidi

    2016-07-01

    Full Text Available Objectives: Oman experienced the H1N1 pandemic in 2009 that initially started in Mexico and the United States. We present the epidemiology, clinical features, and outcome of cases admitted to Sultan Qaboos University Hospital. Methods: We retrospectively reviewed all patients admitted with confirmed influenza A H1N1 infection from August to December 2009. The study included adults and pediatric patients. We looked at the clinical and laboratory factors associated with increased length of hospital stay. Results: There were 68 patients admitted with influenza A H1N1 infection, and their median age was 23 years. The most common symptoms were fever (100% and cough (79.4%. The most common reason for admission was the severity of illness (69.1%. Lymphopenia was the most common hematological abnormality (41.8%. All patients received treatment with oseltamivir. One patient died secondary to multi-organ failure. On multivariate analysis, severity of illness, use of steroids, anemia, lymphopenia, and abnormal alanine amino transferase levels were associated with increased length of stay. Conclusions: The H1N1 pandemic in Oman followed the international trends in terms of clinical presentation and laboratory values for patients admitted to the hospital.

  10. Pandemic Influenza A H1N1 in Oman: Epidemiology, Clinical Features, and Outcome of Patients Admitted to Sultan Qaboos University Hospital in 2009

    Science.gov (United States)

    Al-Busaidi, Mujahid; Al Maamari, Khuloud; Al’Adawi, Badriya; Alawi, Fatma Ba; Al-Wahaibi, Adil; Belkhair, Abdullah

    2016-01-01

    Objectives Oman experienced the H1N1 pandemic in 2009 that initially started in Mexico and the United States. We present the epidemiology, clinical features, and outcome of cases admitted to Sultan Qaboos University Hospital. Methods We retrospectively reviewed all patients admitted with confirmed influenza A H1N1 infection from August to December 2009. The study included adults and pediatric patients. We looked at the clinical and laboratory factors associated with increased length of hospital stay. Results There were 68 patients admitted with influenza A H1N1 infection, and their median age was 23 years. The most common symptoms were fever (100%) and cough (79.4%). The most common reason for admission was the severity of illness (69.1%). Lymphopenia was the most common hematological abnormality (41.8%). All patients received treatment with oseltamivir. One patient died secondary to multi-organ failure. On multivariate analysis, severity of illness, use of steroids, anemia, lymphopenia, and abnormal alanine amino transferase levels were associated with increased length of stay. Conclusions The H1N1 pandemic in Oman followed the international trends in terms of clinical presentation and laboratory values for patients admitted to the hospital. PMID:27403242

  11. Applications of virtual reality for pain management in burn-injured patients

    OpenAIRE

    Sharar, Sam R.; Miller, William; Teeley, Aubriana; Soltani, Maryam; Hoffman, Hunter G.; Jensen, Mark P.; Patterson, David R.

    2008-01-01

    The pain associated with burn injuries is intense, unremitting and often exacerbated by anxiety, depression and other complicating patient factors. On top of this, modern burn care involves the repetitive performance – often on a daily basis for weeks to months – of painful and anxiety-provoking procedures that create additional treatment-related pain, such as wound care, dressing changes and rehabilitation activities. Pain management in burn patients is primarily achieved by potent pharmacol...

  12. Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

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    Terence J Coderre

    2000-01-01

    Full Text Available Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

  13. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients).

    Science.gov (United States)

    Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

    2013-01-01

    To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65-101). Falls were defined "accidental" (fall explained by a definite accidental cause), "medical" (fall caused directly by a specific medical disease), "dementia-related" (fall in patients affected by moderate-severe dementia), and "unexplained" (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury. PMID:23533394

  14. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients

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    Mussi Chiara

    2013-01-01

    Full Text Available To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82±7 years, range 65–101. Falls were defined “accidental” (fall explained by a definite accidental cause, “medical” (fall caused directly by a specific medical disease, “dementia-related” (fall in patients affected by moderate-severe dementia, and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause. According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

  15. Gram Negative Wound Infection in Hospitalised Adult Burn Patients-Systematic Review and Metanalysis-

    Science.gov (United States)

    Azzopardi, Ernest A.; Azzopardi, Elayne; Camilleri, Liberato; Villapalos, Jorge; Boyce, Dean E.; Dziewulski, Peter; Dickson, William A.; Whitaker, Iain S.

    2014-01-01

    Background Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. Methods Studies investigating adult hospitalised patients (2000–2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. Primary Findings Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens’ incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). Interpretation Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative “target organisms” facilitate clinical practice and target research towards a defined clinical demand. PMID:24751699

  16. Trends in incidence rate, health care consumption, and costs for patients admitted with a humeral fracture in The Netherlands between 1986 and 2012

    NARCIS (Netherlands)

    K.C. Mahabier (Kiran); D. den Hartog (Dennis); M.J.M. Panneman (Martien); J.R. van Veldhuizen (Joyce); S. Polinder (Suzanne); M.H.J. Verhofstad (Michiel); E.M.M. van Lieshout (Esther)

    2015-01-01

    textabstractIntroduction: This study aimed to examine long-term population-based trends in the incidence rate of patients with a humeral fracture admitted to a hospital in the Netherlands from 1986 to 2012 and to give a detailed overview of the health care consumption and productivity loss with asso

  17. Serum albumin level as a risk factor for mortality in burn patients

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    Olivia Alejandra Aguayo-Becerra

    2013-07-01

    Full Text Available OBJECTIVE: Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients. METHODS: We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality. RESULTS: In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p = 0.000, full-thickness burns (p = 0.004, inhalation injuries (p = 0.000, burns affecting >30% of the body surface area (p = 0.001, and burns associated with infection (p = 0.008. Protein and lipid levels were lower in the patients who died (p80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality.

  18. DIAGNOSTIC EFFICACY OF CARDIAC TROPONIN-T IN ACUTE MYOCARDIAL INFARCTION PATIENTS ADMITTED IN INTENSIVE CARDIAC CARE UNIT

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    Tapan

    2016-03-01

    Full Text Available INTRODUCTION Myocardial infarction is a common and severe manifestation of ischaemic heart disease (IHD. Acute myocardial infarction (AMI is the result of death of heart muscle cells following either from a prolonged or severe ischaemia. The World Health Organisation emphasises IHD as our "Modern Epidemic" and AMI as common cause of sudden death. AIM The present study has been undertaken with the aim to assess the role of cardiac Troponin-T in early diagnosis of AMI and to evaluate its positive roles over CK-MB and LDH enzyme assays. The study also aims to find out the role of cardiac Troponin-T test, where ECG changes are nondiagnostic and inconclusive for AMI. MATERIAL & METHOD One hundred cases of provisionally diagnosed AMI, who were admitted during June 2012 to July 2015 in ICC Unit of TMC & Dr. BRAM Teaching Hospital, formed the subjects for the study. Those patients reported 2 to 10 hours after onset of chest pain were included in this study. Patients reported beyond 10 hours after onset of chest pain of AMI cases and patients having chest pain of non-AMI causes are excluded from the study. The provisional diagnosis of AMI was done on the basis of the history, chest pain, clinical findings and ECG changes. Trop-T test (Troponin-T sensitive rapid test by Muller Bardoff, et al, 1991 as well as CK-MB (creatine kinase-MB isoenzymeassays were performed immediately for each and every patient. Trop-T test was repeated in some selective cases where the early changes were insignificant and the results were compared with those of CK-MB, at different period of the disease onset. RESULTS The rapid cardiac Troponin-T test (CTn-T has 100% specificity for AMI whereas CK-MB and LDH have specificities of 80% and 60% respectively. The CTn-T has diagnostic efficiency of 92% for AMI but ECG has only 69% sensitivity and 80% specificity. The overall diagnostic efficacy of cardiac Troponin-T is higher than that of CK-MB, LDH and ECG (94% versus 92%, 91 % and 72

  19. Psychophysiological Processing of Itch in Patients with Chronic Post-burn Itch: An Exploratory Study.

    Science.gov (United States)

    van Laarhoven, Antionette I M; Ulrich, Dietmar J O; Wilder-Smith, Oliver H; van Loey, Nancy E E; Nieuwenhuis, Marianne; van der Wee, Nic J A; Evers, Andrea W M

    2016-06-15

    A substantial proportion of patients with burn injury develop chronic itch, which can severely affect their quality of life. As found in research on chronic pain, different psychophysiological processes may also play a role in chronic itch, of which central sensitization, conditioned modulation, and attentional processes have been studied most frequently. This study aimed to explore psychophysiological processes of chronic post-burn itch by comparing 15 patients with long-term itch due to burn injury with 15 matched healthy controls. Exploratory results indicated tendencies for higher itch sensitivity in patients than in controls, for mechanical stimuli and histamine, but not for electrical stimulation. Results further suggest that the efficacy of itch modulation by an itch- or pain-conditioning stimulus or directing attention towards itch stimuli do not differ between these patients and controls. Further elucidation of the processes underlying post-burn itch may improve the early identification and treatment of burn patients developing chronic itch. PMID:26694745

  20. The Clinical Analysis of 47 Patients with Burning Mouth Syndrome

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    目的:研究灼口综合征的临床特征及精神因素分析.方法:对47例灼口综合征患者的临床资料进行分析并用HAD记分方法对其精神因素进行评估.结果:BMS患者中女性患病率高,男女比率1:6.5,舌部发病最为多见,平均发病年龄为53岁,BMS患者均有不同程度的精神因素的影响.%Objective:To analyse the clinical nature and psychiatric assessment.Methods:47 patients with burning mouth syndrome (BMS) were investigated.The clinical nature including distribution of orafacial sites affected by BMS and psychiatric assessment by the way of the Hospital Anxiety and Depression (HAD) scale were determined.Result:BMS affected females much more frequently than males, with a ratio of about 6.5∶1.The mean age of patients was around 53 years old. The most often affected site was the tongue and anxiety was a more important psychological factor in BMS than depression.

  1. Comparison of cardiovascular disease patterns in two data sets of patients admitted at a tertiary care public hospital in Karachi five years apart

    International Nuclear Information System (INIS)

    To compare the disease patterns in two data sets of patients, five years apart, at the National Institute of Cardiovascular Diseases (NICVD), a tertiary care cardiac hospital in Karachi. The underlying objective was to determine any changes in cardiovascular disease patterns at an acute cardiac unit over a period of five years. A retrospective descriptive study was conducted on patients admitted in West Ward, National Institute of Cardiovascular Diseases (NICVD), Karachi in September, 2000 and September, 2005. Patient's record files were reviewed and the relevant information was recorded on a proforma designed for the purpose. In September, 2000, a total of 414 patients were admitted. Of these 71.25% were males. Majority of patients (72.92%) were in the fifth decade of life or beyond. Acute coronary syndrome (ACS) was the commonest presentation, present in 39.8% of the patients. 27.3% had myocardial infarction (MI) while 10.34% were diagnosed with heart muscle diseases. The overall mortality was 3.4%. In September, 2005, a total of 446 patients were admitted. Of these, 63% were males. 71.29% were in the fifth, sixth, and seventh decades of life. 43.04% patients were admitted with acute coronary syndromes (ACS), 26% with myocardial infarction (MI) and 13.45% with heart muscle diseases. The overall mortality was 1.34%. The almost similar results in two data sets of patients five years apart suggests that the cardiovascular disease burden and pattern has not changed significantly at this center. There is a preponderance of cardiovascular illnesses in males and older age groups. ACS and MI account for majority of admissions. (author)

  2. Demographics of pediatric burns in Vellore, India.

    Science.gov (United States)

    Light, Timothy D; Latenser, Barbara A; Heinle, Jackie A; Stolpen, Margaret S; Quinn, Keely A; Ravindran, Vinitha; Chacko, Jacob

    2009-01-01

    The American Burn Association, Children's Burn Foundation, and Christian Medical College in Vellore, India have partnered together to improve pediatric burn care in Southern India. We report the demographics and outcomes of burns in this center, and create a benchmark to measure the effect of the partnership. A comparison to the National Burn Repository is made to allow for generalization and assessment to other burn centers, and to control for known confounders such as burn size, age, and mechanism. Charts from the pediatric burn center in Vellore, India were retrospectively reviewed and compared with data in the American Burn Association National Burn Registry (NBR) for patients younger than 16 years. One hundred nineteen pediatric patients with burns were admitted from January 2004 through April 2007. Average age was 3.8 years; average total body surface area burn was 24%: 64% scald, 30% flame, 6% electric. Annual death rate was 10%, with average fatal total body surface area burn was 40%. Average lengths of stay for survivors was 15 days. Delay of presentation was common (45% of all patients). Thirty-five of 119 patients received operations (29%). Flame burn patients were older (6.1 years vs 2.6 years), larger (30 vs 21%), had a higher fatality rate (19.4 vs 7.7%), and more of them were female (55 vs 47%) compared with scald burn patients. Electric burn patients were oldest (8.3 years) and all male. When compared with data in the NBR, average burn size was larger in Vellore (24 vs 9%). The mortality rate was higher in Vellore (10.1 vs 0.5%). The average mortal burn size in Vellore was smaller (40 vs 51%). Electric burns were more common in Vellore (6.0 vs 1.6%). Contact burns were almost nonexistent in Vellore (0.9 vs 13.1%). The differences in pediatric burn care from developing health care systems to burn centers in the US are manifold. Nonpresentation of smaller cases, and incomplete data in the NBR explain many of the differences. However, burns at this

  3. AN OBSERVATIONAL STUDY REGARDING PREVALENCE OF S UPERSTITIOUS BELIEFS AMONG PATIENTS ADMITTED AT A TERTIARY HOSPITAL IN INDORE

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    Bansal

    2015-03-01

    Full Text Available INTRODUCTION: Superstitions have always been deep rooted in the Indian culture, and an integral part of everyday lives. Moreover, the people are t ightly locked up in religious taboos thus taking useless Practices. A ny cure for this disease brought about by means other than medical treatment, has a dramatic effect on people and strengthens their belief in supernatural powers. Ignorance of scientific reasons behind these phenomena increases the mystery and consequently gives a boost to superstition. MATERIALS AND METHODS: The present study was conducted to find out the prevalence of superstitious practices pertaining to medical conditions - i.e. typhoid, jaundice and psychiatric illness among 300 patients admitted at tertiary care hospital as studied in an interval of 3 months. A pre tested semi - structured questionnaire framed to assess the prevalence of superstitious practices in them. RESULTS: Superstit ious practices were found more common in literate /Uneducated/Unemployed peoples. The most common age group involved was found to be 20 - 40 yr. group. Males are more involved in superstitious practices. The main reason found for the ignorance of scientific m edical care are like - large distance from medical care, poor financial condition, fear of investigations, less trust on doctors, more belief on faith healing mid - way . However at last they convinced that the cure of any grave illness is not possible with me ans of faith healing alone. CONCLUSION: The present study clearly shows that superstitious beliefs still prevail in this modern world. This prevalence may block the wellbeing of the individuals and hinder their positive personal growth. Thus, steps should be taken to alleviate or at least reduce such superstitious beliefs, thus urging the people to think rationally and logically.

  4. Antibiotic resistance of Helycobacter pylori isolated from patients admitted to Imam Hospital, Sari, IRAN, 2002-2003

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    F. Naghshvar

    2005-01-01

    Full Text Available Background and purpose : -Helicobacter pylori is a gram negative spiral bacilus which infects gastric mucosa and causes a wide range of gastro intestinal diseases.Unfortunately the prevalence of the infection by this organism in developing countries is high and despite numerous existing drug regimens, treatment fails to eradicate the organism in many occasions. To reach an effective and curative regimen, invitro determination of suscepibility and resistance of the organism, to various antimicrobials, is pradent. The goal of this study was to determine the prevalence of antimicrobial resistance in Helicobacter pylori,s isolated from cultures. Biopsies from 67 patients admitted to the Sari Imam Hospital were used to cultur Helicobacter pylori and determine their susceptibility and resistance to metronidazole, claritromycin and amoxycillin.Materials and methods : Disc diffusion tecniqu was used to determine the minimum inhibitory concentration , (MIC and resistance pattern of the isolated Helicobacter pylori.In this method we used the cutoff point of MIC 90 ie , a concentration at which 90% or more of culture plates show inhibition zone around the antimicrobial test disc. Results : MIC 90 for amoxycillin and claritramycin in our study was 0.25 g/ml and all isolates were susceptible to amoxycillin. Only one isolate was resistant to claritramycin. MIC 90 for metronidzole was 16 and 4 resistant cases were isolated.Conclusion : This stndy showed low level of resistance to metronidazole and claritramycin which were comparable to the reported results from other studies. No resistance was observed to amoxycillin which was also the same as other reported results. According to the pattern of antimicrobial resistance, we can recommend the studied drugs, against Helicobacter pylori.

  5. Reimbursement for out-of-state burn patients is not always lower than that for in-state patients at regional burn centers.

    Science.gov (United States)

    Peck, Michael D; Pressman, Melissa A; Caruso, Daniel M; Edelman, Linda S; Holmes, James H; Hughes, William B; Korentager, Richard A; Saffle, Jeffrey R; Voigt, David W

    2010-01-01

    Because burn care in the United States is regionalized, burn patients are often transported across state lines to receive their burn treatment. The authors hypothesized that there are differences between in-state and out-of-state reimbursement for burn care. This project was conducted by the American Burn Association (ABA) Government Affairs Committee through the ABA Multicenter Trials Group. Participation was open to any member of the ABA. This retrospective observational study was approved by the institutional review boards of each participating institution. Subjects were identified using registry of each site, selecting patients hospitalized for burn injuries during FY2004-FY2006 of the hospitals. Once identified by the registry, the ID numbers were used to collect billing and reimbursement data from the financial offices. Data were sorted by age (adult and pediatric), location (in state and out of state), and payor source (Medicare, Medicaid, commercial, workers compensation, and self-pay). The rate of reimbursement was calculated based on charges and recoveries. Comparisons on data of each center were performed using Student's t-test with type I error <1%. Six facilities contributed data. A total of 4850 burn patients were reviewed, of whom 3941 were in-state burn patients and 909 were out-of-state burn patients. When the results from all six states were analyzed together, reimbursement for adults from Medicaid and Medicare was higher for in-state patients than for out-of-state patients. However, when analyzed by state, Medicare reimbursement between in-state and out-of-state patients did not differ significantly. In one state (Kansas), in-state Medicaid reimbursement was higher, but in two others (Arizona and Pennsylvania), in-state Medicaid reimbursement was lower than that for out-of-state reimbursement. Reimbursement for the care of children did not differ significantly based on state of residence. From these data, we conclude that there are indeed

  6. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

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    Kobra Gaseminegad

    2012-04-01

    Full Text Available There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20. We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05. The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.

  7. Impact of hyperhydration on the mortality risk in critically ill patients admitted in intensive care units: comparison between bioelectrical impedance vector analysis and cumulative fluid balance recording

    OpenAIRE

    Samoni, Sara; Vigo, Valentina; Reséndiz, Luis Ignacio Bonilla; Villa, Gianluca; De Rosa, Silvia; Nalesso, Federico; Ferrari, Fiorenza; Meola, Mario; Brendolan, Alessandra; Malacarne, Paolo; Forfori, Francesco; Bonato, Raffaele; Donadio, Carlo; Ronco, Claudio

    2016-01-01

    Background Studies have demonstrated a positive correlation between fluid overload (FO) and adverse outcomes in critically ill patients. The present study aims at defining the impact of hyperhydration on the Intensive Care Unit (ICU) mortality risk, comparing Bioelectrical Impedance Vector Analysis (BIVA) assessment with cumulative fluid balance (CFB) recording. Methods We performed a prospective, dual-centre, clinician-blinded, observational study of consecutive patients admitted to ICU with...

  8. Factors affecting the discharge destination of hip fracture patients who live alone and have been admitted to an inpatient rehabilitation unit

    OpenAIRE

    Hayashi, Hiroyuki; Iwai, Midori; Matsuoka, Hiroka; Nakashima, Daiki; Nakamura, Shugo; Kubo, Ayumi; Tomiyama, Naoki

    2016-01-01

    [Purpose] (1) The aim of this study was to examine relations between clinical and functional assessment and discharge destination and (2) to identify the optimal cutoff point for estimating discharge to home after inpatient rehabilitation. [Subjects] The subjects were 54 hip fracture patients (15 males, 39 females; mean age 81.3 ± 7.4 years) living alone. [Methods] The patients were classified into two groups: those discharged to home and those admitted to an institution. Age, gender, side of...

  9. Pharmacokinetic/pharmacodynamic profiling of imipenem in patients admitted to an intensive care unit in India: A nonrandomized, cross-sectional, analytical, open-labeled study

    OpenAIRE

    B Abhilash; Chakra Dhar Tripathi; Anoop Raj Gogia; Girish Gulab Meshram; Manu Kumar; Suraj, B.

    2015-01-01

    Background and Aim: Widespread use of imipenem in intensive care units (ICUs) in India has led to the development of numerous carbapenemase-producing strains of pathogens. The altered pathophysiological state in critically ill patients could lead to subtherapeutic antibiotic levels. Hence, the aim of this study was to investigate the variability in the pharmacokinetic and pharmacodynamic profile of imipenem in critically ill patients admitted to an ICU in India. Materials and Methods: Plasma ...

  10. The Feasibility of Computer-Based Prism Adaptation to Ameliorate Neglect in Sub-Acute Stroke Patients Admitted to a Rehabilitation Center

    OpenAIRE

    Smit, Miranda; Van der Stigchel, Stefan; Visser-Meily, Johanna M. A.; Kouwenhoven, Mirjam; Eijsackers, Anja L. H.; Nijboer, Tanja C. W.

    2013-01-01

    Introduction: There is wide interest in transferring paper-and-pencil tests to a computer-based setting, resulting in more precise recording of performance. Here, we investigated the feasibility of computer-based testing and computer-based prism adaptation (PA) to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center. Methods: Thirty-three neglect patients were included. PA was performed with a pair of goggles with wide-field point-to-point prismatic lenses in...

  11. The feasibility of computer-based prism adaptation to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center.

    OpenAIRE

    Miranda Smit; Johanna MA Visser-Meily; Tanja CW Nijboer

    2013-01-01

    Abstract Introduction: There is wide interest in transferring paper-and-pencil tests to a computer-based setting, resulting in more precise recording of performance. Here, we investigated the feasibility of computer-based testing and computer-based prism adaptation (PA) to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center. Methods: 33 neglect patients were included. PA was performed with a pair of goggles with wide-field point-to-point prismatic lens...

  12. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    OpenAIRE

    Nilgün Aksoy; Senay Arli; Ozlem Yigit

    2014-01-01

    Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ r...

  13. Effect of Antioxidants on the Incidence of Wound Infection in Burn Patients

    OpenAIRE

    Sahib, A.S.; Al-Jawad, F.H.; Alkaisy, A.A.

    2010-01-01

    Background. Thermal injury causes the destruction of the physical skin barrier that normally protects the body from invasion by micro-organisms and induces an immunocompromised state that predisposes burn patients to infection, sepsis, and multiple organ failure. Reactive oxygen species contribute to burn-mediated immune suppression, and as the use of antioxidants has a positive effect on immune function, this may reduce the incidence of wound infection and related complications in burn patie...

  14. Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

    Science.gov (United States)

    Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

    2016-07-01

    Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns. PMID:26997326

  15. Substance use and misuse in burn patients: Testing the classical hypotheses of the interaction between post-traumatic symptomatology and substance use.

    Science.gov (United States)

    Eiroa-Orosa, Francisco Jose; Giannoni-Pastor, Anna; Fidel-Kinori, Sara Guila; Argüello, José María

    2016-01-01

    The authors aimed to test whether the three classical hypotheses of the interaction between post-traumatic symptomatology and substance use (high risk of trauma exposure, susceptibility for post-traumatic symptomatology, and self-medication of symptoms), may be useful in the understanding of substance use among burn patients. Substance use data (nicotine, alcohol, cannabis, amphetamines, cocaine, opiates, and tranquilizers) and psychopathology measures among burn patients admitted to a burn unit and enrolled in a longitudinal observational study were analyzed. Lifetime substance use information (n = 246) was incorporated to analyses aiming to test the high risk hypothesis. Only patients assessed for psychopathology in a 6-month follow-up (n = 183) were included in prospective analyses testing the susceptibility and self-medication hypotheses. Regarding the high risk hypothesis, results show a higher proportion of heroin and tranquilizer users compared to the general population. Furthermore, in line with the susceptibility hypothesis, higher levels of symptomatology were found in lifetime alcohol, tobacco, and drug users during recovery. The self-medication hypothesis could be tested partially due to the hospital stay "cleaning" effect, but severity of symptoms was linked to the amount of caffeine, nicotine, alcohol, and cannabis use after discharge. It was found that the 3 classical hypotheses could be used to understand the link between traumatic experiences and substance use explaining different patterns of burn patient's risk for trauma exposure and emergence of symptomatology. PMID:26670348

  16. Elbow Reconstruction Using Island Flap for Burn Patients

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    Gi Yeun Hur

    2012-11-01

    Full Text Available Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposureof deep structures. Adequate wound coverage of this area requires thin, pliable, and durabletissue, while optimal functional recovery requires early coverage and functional rehabilitation.We have found 3 types of island flaps that provide reliable coverage for the elbow.Methods A retrospective study was performed on all patients who underwent flap coverageof an elbow defect at our hospital. The patients’ data including age, sex, cause of injury, wounddimensions, timing of flap coverage, postoperative elbow motion, and complications wereinvestigated.Results Between 2001 and 2012, 16 patients were treated at our hospital. The mean agewas 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral armflaps, and 4 radial forearm flaps. The average defect size was 183.5 cm2 (range, 28 to 670cm2. Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days.The mean postoperative active elbow flexion was 98° (range, 85° to 115°. Partial flap failureoccurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%,hematoma (23.5%, seroma (35.3%, and wound infection (5.9%.Conclusions Flap selection for elbow reconstruction is determined by the defect size andthe extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a singlestaged,reliable, and relatively simple procedure that permits initiation of early rehabilitation,thereby improving a patient’s functional outcome.

  17. HYPOGLYCEMIA IS ASSOCIATED WITH INCREASED POST-BURN MORBIDITY AND MORTALITY IN PEDIATRIC PATIENTS

    Science.gov (United States)

    Jeschke, Marc G; Pinto, Ruxandra; Herndon, David N; Finnerty, Celeste C; Kraft, Robert

    2014-01-01

    Objective The objective of this study was to determine the incidence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased post-burn morbidity and mortality. Design Cohort analysis. Setting Academic pediatric burn hospital. Patients This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (<60 mg/dl glucose) they experienced while in the intensive care unit. Clinical outcomes as well as metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and main results Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization as well as more frequent infections, sepsis, multiple organ failure (MOF), and death (p<0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, incidence of sepsis, MOF, and mortality than burn patients without hypoglycemic (p<0.05). Conclusions Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher post-burn morbidity and mortality. PMID:24368343

  18. Intensive Insulin Therapy in Severely Burned Pediatric Patients: A Prospective Randomized Trial

    OpenAIRE

    Jeschke, Marc G.; Kulp, Gabriela A; Kraft, Robert; Finnerty, Celeste C.; Mlcak, Ron; Lee, Jong O; Herndon, David N

    2010-01-01

    Rationale: Hyperglycemia and insulin resistance have been shown to increase morbidity and mortality in severely burned patients, and glycemic control appears essential to improve clinical outcomes. However, to date no prospective randomized study exists that determines whether intensive insulin therapy is associated with improved post-burn morbidity and mortality.

  19. Opioid Analgesics and Depressive Symptoms in Burn Patients: What Is the Real Relationship?

    Science.gov (United States)

    Hong, Narei; Jung, Myung Hun; Kim, Jee Wook; Chun, Wook; Choi, Ihn-Geun; Kang, Tae-Cheon; Kee, Baik Seok; Lee, Boung-Chul

    2016-01-01

    Objective Major burn injuries are strongly associated with both psychological trauma and severe pain, and opioids are the mainstay analgesics for the treatment of severe burn pain. The objectives of this study are to find the complex relationship between opioid dose, depression, and post-traumatic stress disorder (PTSD) symptoms during the acute management of pain in burn patients. Methods The symptoms of depression and PTSD were assessed in 43 burn patients immediately following wound stabilization and 2 weeks after the initial evaluation. Results Total opioid doses and Hamilton Depression Scale (HAMD) scores obtained during the second evaluation were positively but weakly correlated after controlling for age and total burn surface area (R=0.33, p=0.03). Moreover, pain management with opioids was significantly more common in burn patients with low Clinician Administered PTSD Scale scores (evaluation 1) and high HAMD scores (evaluation 2) (F=6.66, p=0.001). Conclusion High opioid dose following acute burn trauma might have correlation with depressive symptoms. Monitoring of depressive symptoms may be important following acute burn trauma and consequent opioids pain management, particularly when PTSD symptoms appear minimal during the early stabilization of patients. PMID:27489384

  20. Care of burns in Scotland: 3-year data from the managed clinical network national registry

    OpenAIRE

    Gilhooly, Charlotte; Kinsella, John

    2014-01-01

    Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 o...

  1. Burns, hypertrophic scar and galactorrhea

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    Hamid Karimi

    2013-07-01

    Full Text Available An 18-year old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs .At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected. She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

  2. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    OpenAIRE

    Gauglitz, Gerd G.; Finnerty, Celeste C.; Herndon, David N; Mlcak, Ronald P.; Jeschke, Marc G.

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different s...

  3. [The treatment of burn patients. What are the prospects for the northern area of Portugal?].

    Science.gov (United States)

    Santa-Comba, A; Amarante, J; Malheiro, E

    1993-11-01

    The AA studied the distribution of age, sex, aetiology, and destiny of the 173 in-patients at the S. João Hospital (Central hospital that has no Burn Unit). In what concerns age, 38.1% are children less than 10 years old; the male/female ratio was 1.7:1. The fire and scalds are the most important aetiology. These findings are similar to those found in other countries (except in the Arabian Countries). Of these 99 burn patients have been treated in S. João Hospital, 71 patients were sent to the Burn Unit of Prelada Hospital and 3 to the Burn Unit of Coimbra University Hospital. These findings were compared to a Burn Unit of a Spanish Hospital (Alicante) which has 18 beds for adults and children, normally interning 132 patients per year. As the WHO suggest one special bed per 30,000 persons, we should be expected to have at least 110 beds for burn patients (we only have 9 beds at Prelada Hospital), the AA suggest the establishment of a Burn Unit at S. João Hospital, also due to the fact that is the only hospital that has a permanent emergency care for Plastic Surgery. PMID:8140918

  4. The study of the intoxiation cases of the patients (0-18 years) admitting to pediatric emergency unit

    OpenAIRE

    Dilek Aygin; Hande Açıl

    2014-01-01

    Objective: This study has been held descriptively with the aim of analyzing the acute intoxication cases of the ones (0-18 years) applying to Pediatric Emergency Unit. Material and Method: Permission is obtained from the institution before starting the study. 110 children admitting to pediatric emergency unit with the problem of intoxication have been included in the study after their family signed the consent form by being informed about the aim of the study. Descriptive and parametric t...

  5. The results of a national survey regarding nutritional care of obese burn patients.

    Science.gov (United States)

    Coen, Jennifer R; Carpenter, Annette M; Shupp, Jeffrey W; Matt, Sarah E; Shaw, Jesse D; Flanagan, Katherine E; Pavlovich, Anna R; Jeng, James C; Jordan, Marion H

    2011-01-01

    Little is known about the nutritional needs of obese burn patients. Given the impact of obesity on the morbidity and mortality of these patients, a uniform understanding of perceptions and practices is needed. To elucidate current practices of clinicians working with the obese burn population, the authors constructed a multidisciplinary survey designed to collect this information from practitioners in United States burn centers. An electronic approach was implemented to allow for ease of distribution and completion. A portable document format (pdf) letter was e-mailed to the members of the American Burn Association and then mailed separately to additional registered dietitians identified as working in burn centers. This letter contained a link to a 29-question survey on the SurveyMonkey.com server. Questions took the form of multiple choice and free text entry. Responses were received from physicians, mid-level practitioners, registered dietitians, and nurses. Seventy-five percent of respondents defined obesity as body mass index >30. The Harris-Benedict equation was identified as the most frequently used equation to calculate the caloric needs of burn patients (32%). Fifty-eight percent indicated that they alter their calculations for the obese patient by using adjusted body weight. Calculations for estimated protein needs varied among centers. The majority did not use hypocaloric formulas for obese patients (79%). Enteral nutrition was initiated within the first 24 hours for both obese and nonobese patients at most centers. Sixty-three percent suspend enteral nutrition during operative procedures for all patients. Oral feeding of obese patients was the most preferred route, with total parenteral nutrition being the least preferred. Longer length of stay, poor wound healing, poor graft take, and prolonged intubation were outcomes perceived to occur more in the obese burn population. In the absence of supporting research, clinicians are making adjustments to the

  6. Determination of Potential Parameters Effective on the Outcomes of Admitted Patients with Primary Varicella Infections in Tehran Aliasghar Children Hospital (1996-2009

    Directory of Open Access Journals (Sweden)

    A.R. Nateghian

    2011-07-01

    Full Text Available Introduction & Objective: There is a need to study the outcomes of admitted patients with primary varicella infections especially for immunocompromised cases like patients with various cancers in our country in which there is no routine vaccination against such a virus.Materials & Methods: We performed a retrospective descriptive-analytic study on the admitted cases with primary varicella infections in Aliasghar children hospital, Tehran, since 1996 to 2009;The patients were put in two different groups for comparison:1Immunosuppressed patients including patients with acute lymphoblastic leukemia ,patients with other types of cancers ,and patients who were receiving high doses of corticosteroids 2previously healthy patients. Demographic as well as some indicators of poor general condition on admission like respiratory distress ,hypotension and decreased level of consciousness were compared within the groups; we also looked for ataxia as an important indication of admission and the time period since the onset of disease up to admission in each group; appropriate statistical methods were used for statistical analysis.Results: 88 cases including 24 cases of ALL (27%,9 cases with various types of cancers (10.5%,and 13 cases who were receiving high dose of corticosteroid were included. Mean age of the patients was 6 years(SD=3.5.47 cases(53.4%were male. Hypotension on admission was significantly more common in patients under four years of age(P=0.006; The patients in the first 3 groups were admitted significantly earlier(P=0.027; Hypotension and ataxia were more significantly seen in the previously healthy group(P=0.01 and 0.04 respectively. Just one case of mortality occurred in a case of ALL during the study period.Conclusion: We concluded that immunocompromised cases comprise more than half of the admissions due to primary varicella infections in our referral center; interestingly ,however, in comparison with previously healthy cases they have been

  7. Medical Treatment for Burn Patients with Eating Disorders: A Case Report

    Directory of Open Access Journals (Sweden)

    Minekatsu Akimoto

    2011-01-01

    Full Text Available There have been many cases of burn patients who also suffer from psychiatric problems, including eating disorders. We present a case of a 38-year-old female with an eating disorder and depression who became light-headed and fell, spilling boiling water from a kettle on herself at home sustaining partial thickness and full thickness burns over 5% of her total body surface area: left buttock and right thigh and calf. Eating disorders (in the present case, anorexia nervosa cause emaciation and malnutrition, and consent for hospitalization from the patient and/or family is often difficult. During the medical treatment of burns for these patients, consideration not only of physical symptoms caused by malnutrition but also the psychiatric issues is required. Therefore, multifaceted and complex care must be given to burn patients with eating disorders.

  8. Serum Interleukin-6 in Patients with Burning Mouth Syndrome and Relationship with Depression and Perceived Pain

    Directory of Open Access Journals (Sweden)

    Qianming Chen

    2007-01-01

    Conclusions. Serum interleukin-6 in patients with burning mouth syndrome is decreased and negatively correlated to chronic pain. Both psychological and neuropathic disorders might act as precipitating factors in BMS etiopathogenesis.

  9. Pulmonary Histopathologic Abnormalities and Predictor Variables in Autopsies of Burned Pediatric Patients

    Science.gov (United States)

    Sousse, Linda E.; Herndon, David N.; Andersen, Clark R.; Zovath, Andrew; Finnerty, Celeste C.; Mlcak, Ronald P.; Cox, Robert A.; Traber, Daniel L.; Hawkins, Hal K.

    2014-01-01

    Pulmonary abnormalities occur in 30–80% of fatalities after burn injury. The objective of our study is to investigate lung pathology in autopsy tissues of pediatric burn patients. METHODS Three scientists with pathology training in pediatric burn care reviewed masked autopsy slides of burned children who died after admission to a burn center from 2002–2012 (n=43). Autopsy lung tissue was assigned scores for histologic abnormalities in 9 categories, including alveolar and interstitial fibrosis, hyaline membranes, and type II epithelial cell proliferation. Scores were then tested for correlation with age, TBSA burn, number of days between burn and death, time between burn and admission, and the presence of inhalation injury using analyses with linear models. RESULTS Type II epithelial cell proliferation was significantly more common in cases with a longer time between burn and admission (p<0.02). Interstitial fibrosis was significantly more severe in cases with longer survival after burn (p<0.01). The scores for protein were significantly higher in cases with longer survival after burn (p<0.03). Enlarged air spaces were significantly more prominent in cases with longer survival after burn (p<0.01), and in cases with the presence of inhalation injury (p<0.01). CONCLUSIONS Histological findings associated with Diffuse Alveolar Damage (DAD), which is the pathological correlate of the Acute Respiratory Distress Syndrome (ARDS), were seen in approximately 42% of autopsies studied. Protein-rich alveolar edema, which is the abnormality that leads to ARDS, may occur from multiple causes, including inhalation injury. PMID:25445004

  10. Environmental decontamination following occupancy of a burns patient with multiple carbapenemase-producing organisms.

    Science.gov (United States)

    Garvey, M I; Bradley, C W; Jumaa, P

    2016-06-01

    Over the last decade, carbapenemase-producing organisms (CPOs) have spread worldwide, becoming a major public health concern. This article reports the authors' experience in dealing with a burns patient infected with CPOs, and the decontamination methods employed to render a burns shock room safe for re-use. The shock room was cleaned after being vacated, but environmental sampling cultured multiple CPOs. A second decontamination was undertaken comprising a detergent, steam and hypochlorite clean followed by hydrogen peroxide misting, and no CPOs were cultured after subsequent environmental sampling. A burns patient harbouring CPOs contaminates the surroundings heavily, so standard cleaning is insufficient to reduce the environmental bioburden. PMID:26895617

  11. Successful treatment of severe burn patients with multiple organ dysfunction syndrome:A case rep ort

    Institute of Scientific and Technical Information of China (English)

    Lingfeng Wang ∗; Yongdong Li; Xiyuan Xu; Ji Chen; Weiqing Wang; Zaiqing Huang; Lihua Zhang

    2014-01-01

    Multiple organ dysfunction syndrome is the presence of altered organ function of two or more organ systems in acute ill patients with severe trauma, burn, shock and infection. In this case, the patient with burn area amounted to 95%and the third-degree burn was up to 90%. He underwent gastrointestinal tract, blood clotting, lung, brain, heart, liver dysfunction, and cardiac arrest for 30 minutes during the courses of treatment, and was discharged from the hospital after 108 days on the basis of comprehensive treatment and repeated skin grafting.

  12. Case Report: Treatment of Open Femoral Shaft Fracture in a Severely Burned Patient

    OpenAIRE

    Chang, Tai-Li; Spence, Robert J.; Mears, Simon C

    2008-01-01

    Objective: To present a case report of a patient with an open fracture and severe burns and review the literature. Methods: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. The wound over the fracture was treated with dressing changes. The fracture was treated with nail exchange and bone grafting for atrophic nonun...

  13. [Use of enterosgel in middle-aged and aged patients with medium-severity burns].

    Science.gov (United States)

    Naĭda, I V

    1994-01-01

    The comparative dynamics of intoxication and natural humoral organism resistance indexes in elderly and senile patients with burn disease of middle degree severity while application of generally used therapy and incorporating in treatment complex the enterosgel preparation prescribed since 24 hours after injury occurrence was studied. Under the enterosgel influence the intoxication syndrome intensity has been markedly decreased, what promoted the skin loss restoration, favourable burn disease course, mortality reduction, and the shortening of patients hospital stay. PMID:7799576

  14. The Effect of Shiatsu Massage on Underlying Anxiety in Burn Patients

    OpenAIRE

    Mohaddes Ardabili, Fatemeh; Purhajari, Soybeh; Najafi Ghzeljeh, Tahereh; Haghani, Hamid

    2015-01-01

    BACKGROUND Burn patients experience high levels of predictable anxiety during dressing changes while anti-anxiety drugs cannot control these anxieties. The nurses can limit the side effects of medications by undertaking complementary therapies. Hand pressure massage was introduced as a technique that can reduce these anxieties. This study aimed to investigate the effect of hand pressure massage using Shiatsu method on underlying anxiety in burn patients. METHODS In an available randomized stu...

  15. Efficacy of silver sulfadiazine phonophoresis on wound healing in acute burn patients

    DEFF Research Database (Denmark)

    Omar, Ghada Said Mohammed

    2003-01-01

    The purpose of the current study was to evaluate the efficacy of SSD phonophoresis approaches (continuous and pulsed modes on the rate of healing following acute burn injury . forty female patients with second degree burn in thrir anterior aspect of the dominant foream were divided randomly into ...... phonophoresis might be valuable for enhance acute burn healing and the pulsed SSD phonophoresis is more effective for accelerating the acute burn wound healing......The purpose of the current study was to evaluate the efficacy of SSD phonophoresis approaches (continuous and pulsed modes on the rate of healing following acute burn injury . forty female patients with second degree burn in thrir anterior aspect of the dominant foream were divided randomly into...... frequency of 1 MHz , and intensity of 1 W/cm2 . the parameters investigated inclding 1.burn surface area measured by tracing the burn wound parameters , and 2.determination of glycosaminoglycan in urine by using cetylpyridinuin chloride turbidity method . both parameters are measured 24 hours post...

  16. 老年烧伤患者流行病学分析及护理%Nursing care and epidemiological analyse of elderly burn patients

    Institute of Scientific and Technical Information of China (English)

    吕月; 凌峭; 廖青玲; 张庆庆

    2012-01-01

    目的 探讨531例老年烧伤患者的流行病学特点并提出防治经验.方法 选取2002-2010年收治于某两家医院烧伤科的531例年龄在60岁以上老年烧伤患者为对象,对其一般资料、致伤原因、占同期入院人数比例和疾病转归等进行回顾性分析,总结流行病学特点并提出防治措施.结果 在531例患者中,患者的平均年龄为72.86岁;家庭烧伤患者占72.50%,意外事故伤占16.70%;老年烧伤的临床治愈率为82.11%,死亡率为2.33%;老年烧伤入院患者占同期总住院人数比例从2002年的5.13%上升至2010年的5.64%;患者的平均年龄从2002年的72.53岁上升到2010年的73.58岁.结论 2002-2010年老年烧伤住院患者人数占同期总住院人数比例和平均住院年龄整体呈上升趋势,家庭生活烧伤是老年患者烧伤的主要原因,需要加强对家庭生活烧伤的预防和宣传教育.%Objective To explore the epidemiological character of elderly burn patients and to provide the experience of prevention and treatment.Methods The retrospective study method was used,and totals of 531 elderly patients with burn from January 2002 to December 2010 in two hospitals were selected.Cases information such as demographics,clinical diagnosis,treatments,causes of injury,mortality rate and causes of death since admission and so on was recorded and analysed,then,the epidemiological character was summarized and the prevention and treatment were proposed.Results Among 531 patients with burn,the average age was 72.86,the rate of burn in home was 72.5% and in accident was 16.70%.The clinical cure rate was 82.11%and the mortality rate was 2.33%.The proportion of the elderly burn patients account for the total admitted patients in the same period was 5.13% in 2002 and 5.64% in 2010,and the average age of elderly burn patients was higher from 72.53 years old in 2002 to 73.58 years old in 2010.Conclusions The proportion of the elderly

  17. The effect of levamisole on mortality rate among patients with severe burn injuries

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    Mohammad Javad Fatemi

    2013-01-01

    Full Text Available Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years was 33.29 ± 11.39 years (Mean ± SD, and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8% patients in the control group and 50 (58.8% patients in the treatment group (P = 0.8. Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.

  18. Burn injuries in eastern Zambia: impact of multidisciplinary teaching teams.

    Science.gov (United States)

    Edwards, Dianna; Heard, Jason; Latenser, Barbara A; Quinn, Keely Y; van Bruggen, Jaap; Jovic, Goran

    2011-01-01

    The American Burn Association/Children's Burn Foundation (ABA/CBF) sponsors teams who offer burn education to healthcare providers in Zambia, a sub-Saharan country. The goals of this study are 1) to acquire burn-patient demographics for the Eastern Province, Zambia and 2) to assess the early impact of the ABA/CBF-sponsored burn teams. This is a retrospective chart review of burn patients admitted in one mission hospital in Katete, Zambia, July 2002 to June 2009. July 2002 to December 2006 = data before ABA/CBF burn teams and January 2007 to June 2009 = burn care data during/after burn outreach. There were 510 burn patients hospitalized, male:female ratio 1.2:1. Average age = 15.6 years, with 44% younger than 5 years. Average TBSA burned = 11% and mean fatal TBSA = 25%. Average hospital length of stay = 16.9 days survivors and 11.6 days nonsurvivors. Most common mechanisms of burn injuries: flame (52%) and scald (41%). Ninety-two patients (18%) died and 23 (4.5%) left against medical advice. There were 191 (37.4%) patients who underwent 410 surgical procedures (range 1-13/patient). There were 138 (33.7%) sloughectomies, 118 (28.7%) skin grafts, 39 (9.5%) amputations, and 115 (28.1%) other procedures. Changes noted in the 2007 to 2009 time period: more patients had burn diagrams (48.6 vs 27.6%, P set for a sub-Saharan region in Africa. There has been a statistically significant improvement in documentation of burn size as well as administration of analgesics, validating the efficacy of the ABA/CBF-sponsored burn teams. Continued contact with burn teams may lead to increased use of resuscitation fluids, topical antimicrobials, and more patients undergoing operative intervention, translating into improved burn patient outcomes. PMID:21131848

  19. Comparison of the General Health, Self-Esteem and Social Support in Self-Inflicted Burn Patients and Non Self Inflicted Burn Patients of the Choromy Accidental and Burning Hospital of Ganaveh

    Directory of Open Access Journals (Sweden)

    MS Enayati

    2006-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Self-inflicted burn is a violent method of suicide. Since our society faces lots of psychological, social, personal and economical problems due to self-inflicted burn, more survey for this event can assist us to know its causes and prevent from its occurrence. This research was carried out to compare general health, self- esteem and social support in patient's self-inflicted burn and non-self-inflicted burn of the Choromy accidental and burning hospital in Ganaveh. Materials & Methods: This is a descriptive – analytic study. The sample consisted of 60 inpatients burnt (males & females of the Choromy accidental and burning hospital (Ganaveh. The method of sampling was simple random. Participants completed the General Health Questionnaire (G.H.Q- 28 of Goldberg, Cooper Smith’s questionnaire of self–esteem and Philip’s social support scale. Multivariate analysis of variance (MANOVA and T-test were the major statistical analysis in this research. Results: The mean and standard deviation of the general health were 44.57 ± 14.65 for self-inflicted burn persons and for non - self inflicted burn they were 10.83 ± 6.27. In the self–esteem variable, the mean and the standard deviation were 57.90 ± 4.94 for self-inflicted burn persons and 55.47 ± 6.04 for non-self inflicted burn ones. Mean and standard deviation of whole social supporting were 20.40 ± 4.94 for self-inflicted burn persons and 23.73 ± 1.17 for non-self inflicted burn group. The findings showed significant differences between the two groups from viewpoint of general health and social supporting while there were no significant differences between two groups in case of self–esteem. Conclusion: There are a significant relationship between general health, social supporting and self-inflicted burn.Therefore, in order to prevent self inflicted burn it is suggested that we make a relationship between persons and societies, families, groups and

  20. Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries

    Energy Technology Data Exchange (ETDEWEB)

    Psoter, Kevin J., E-mail: kevinp2@u.washington.edu [Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 (United States); Roudsari, Bahman S., E-mail: roudsari@u.washington.edu [Department of Radiology, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Graves, Janessa M., E-mail: janessa@u.washington.edu [Department of Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Mack, Christopher, E-mail: cdmack@uw.edu [Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Jarvik, Jeffrey G., E-mail: jarvikj@u.washington.edu [Department of Radiology and Department of Neurological Surgery, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States)

    2013-06-15

    Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.

  1. Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries

    International Nuclear Information System (INIS)

    Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period

  2. CLINICAL PRESENTATION, RADIOLOGICAL FEATURES AND COURSE OF THE DISEASE IN SWINE FLU POSITIVE PATIENTS ADMITTED IN THE RESPIRATORY INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Aruna

    2015-06-01

    Full Text Available BACKGROUND : Since the 2009 pandemic of H1N1 or Swine Flu influenza , there have been respiratory emergencies every year throughout India , but in the early part of this year that is between January and April 2015 an explosion of cases was seen throughout the country , and so also in our state , Andhra Pradesh. The study of clinical presentation , radiological features and course of the disease helps in early suspicion , isolation , detection and institution of treatment in swine flu positive patients so that further spread of the disease can be co ntrolled and the patients saved . MATERIAL AND METHODS : This is a cross - sectional study conducted at the Department of Pulmonary Medicine , S.V.R.R. Govt. General Hospital , Tirupathi , between January 2015 and April 2015. Study sample was the total number of swine flu suspects who were admitted in the Respiratory Intensive Care Unit and swine flu wards of the Department of Pulmonary Medicine. SUMMARY : Out of 32 suspects admitted , 13 tested positive for swine flu. 8 of the 13 were females (61% and 5 were males (39%. Cold , cough and breathlessness were present in all the patients (100%. Sore throat was present in only 4 patients (30%. 11 out of the 13 patients were in respiratory failure (85%. 9 out of the 13 had comorbidities like diabetes , bronchial asthma and chronic kidney disease (70%. Chest X - ray and CT chest showed ARDS like pic ture and pneumonia in 11 out of the 13 patients (85%.

  3. Infection control in burn patients: are fungal infections underestimated?

    OpenAIRE

    Struck Manuel F

    2009-01-01

    Abstract With great interest, I read the paper of David J. Dries about recent developments, infection control and outcomes research in the management of burn injuries 1. I have some comments about an important, however missing, topic in the paragraphs concerning infection control.

  4. Profile of patients acometidos for head injury admitted in the public hospital of the city of Jequié in the Bahia

    OpenAIRE

    Indira de Oliveira Gomes; Luciana Araújo dos Reis; Claudio Henrique Meira Mascarenhas

    2011-01-01

    This study aimed to draw the profile of patients affected by traumatic brain injury admitted to a hospital in the Jequié, BA. This is a cross-sectional epidemiological study conducted in clinical medicine and surgery of a public hospital, through a structured questionnaire concerning sociodemographic, lifestyle and issues related to traumatic brain injury. 15 patients were victims of traumatic brain injury, are more frequent in males (86.67%), ages 20 to 39 years (33.33%), education for the 2...

  5. Improvement of survival in patients with extensive burns involving the perineum with use of a faecal management system

    OpenAIRE

    Farroha, A.; Frew, Q.; Philp, B.; Dziewulski, P.

    2014-01-01

    The purpose of this study is to assess the effectiveness of faecal management systems in improving survival of patients with extensive burns involving the perineum. All adults with burns of more than 30% total body surface area (TBSA) who were actively treated in our regional burn service between December 2008 and July 2012 were reviewed and compared to an historical cohort of 18 adult patients with similar injury involving the perineum, treated in our regional burn service between 1999 and 2...

  6. Gender differences in resilience and psychological distress of patients with burns.

    Science.gov (United States)

    Masood, Afsheen; Masud, Yusra; Mazahir, Shama

    2016-03-01

    This research explored the gender differences in resilience and psychological distress of patients with burns. In Pakistan, psychological states of patients with burns have not been widely studied, women making up as the neglected section of society lag far behind in availing the needful health facilities. It was hypothesized that there would be significant gender differences in resilience and psychological distress of patients with burns. The sample of the study consisted of 50 patients with burns, obtained from four different hospitals of Lahore. In order to investigate resilience and psychological distress, the State Trait Resilience Scales (Hiew, 2007) and Kessler Psychological Distress Scale (Kessler, 2001) were used. In addition to these, self-constructed demographic questionnaire was administered. The data was analyzed using SPSS version 16.0. Independent sample t-test was conducted to find gender differences in resilience and psychological distress. The findings from the current research revealed that there were significant gender differences in resilience and psychological distress of patients with burns. The insightful findings from the current research carry strong implications for the clinicians, psychologists and policy makers who can help to develop and implement the rehabilitation programs for the affected population and can launch resilience promoting programs that would help them in coping with burns in effective manner. PMID:26796239

  7. Early markers of renal injury in predicting outcome in thermal burn patients

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) is a well known complication of severe burn and is an important factor that can increase mortality. To determine the predictors of acute renal failure that occur in major burns, we studied 40 patients with moderate to severe thermal burn injury - second to third degree with > 20% of total body surface area. All patients were subjected to routine investigations including: Serum creatinine, blood urea nitrogen, fractional excretion of sodium, uri-nary malondialdehyde and microalbuminuria on day 0, 3, 7, 14 and 21 of hospitalization. Nine patients (22.5 %) developed acute renal failure; 4 patients required supportive dialysis. The group that developed ARF showed an increase of markers of glomerular damage with appearance of microalbuminuria on day 0 that reached 3 - 4 folds above its normal level on day 14 and remained constant with elevated serum creatinine and burn size in the 3 rd week of ARF, and progressed to overt proteinuria in 3 cases. Urinary malondialdehyde increased 3 folds above normal values before developing acute renal failure, and gradually increased on day 14, which coincided with the increased of microalbuminuria. Two cases (22.2%) in the ARF group who developed septicemia and required dialysis died on the 32nd and 36th days post-burn. Burn size and occurrence of septicemia were the only predictors of acute renal failure using multiple regression analysis (P value < 0.001 and < 0.0371, respectively). We conclude that acute renal failure complicates burn patients and is related to the size and depth of burn and occurrence of septicemia. Microalbuminuria and urinary malondialdehyde are useful markers for prediction of renal outcome in such group of patients. (author)

  8. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  9. Regulation of the insulin-like growth factor system by insulin in burn patients.

    Science.gov (United States)

    Lang, C H; Fan, J; Frost, R A; Gelato, M C; Sakurai, Y; Herndon, D N; Wolfe, R R

    1996-07-01

    The aim of the present investigation was to determine whether there is a net uptake of insulin-like growth factor I (IGF-I) or IGF-binding proteins (IGFBPs) by the leg after burn injury and to elucidate the regulatory role of insulin exerted on this system under in vivo conditions in burn patients. Studies were performed on nine patients after burn injury (approximately 60% body surface area). Each patient was studied twice during a continuous infusion of a carbohydrate-rich enteral diet. Blood was collected simultaneously from the femoral artery and vein for the measurement of various elements of the IGF system after 7 days of enteral diet alone (basal period) and after 7 days of the enteral diet plus the infusion of insulin (insulin period). Data from these patients were compared to values in age-matched fed healthy volunteers. During the basal period, burn patients demonstrated a significant reduction in the venous concentration of IGF-I and an increase in both IGFBP-1 and -2 compared to control values. Insulin produced a significant 15% increase in the IGF-I concentration in burn patients, but decreased the circulating levels of IGFBP-1 by 50%. The IGF-I and IGFBP-1 concentrations at the end of the insulin period were still significantly different from those in control subjects. Burn patients also exhibited a marked reduction in intact IGFBP-3 and the acid-labile subunit under basal conditions, and these alterations were not reversed by insulin. Under basal conditions, all burn patients had a positive arterio-venous (A-V) difference for IGF-I across the leg. The A-V difference was increased 50% in response to insulin. The net uptake of IGF-I by the leg was 2.4 micrograms/min under basal conditions, and as leg blood flow also tended to increase in response to insulin, IGF-I uptake was elevated more than 3-fold during the insulin period. No A-V difference across the leg was detected for IGFBP-1, -2, or -3 in burn patients. In conclusion, burn injury in humans

  10. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    Science.gov (United States)

    Finnerty, Celeste C; Jeschke, Marc G; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in children. We enrolled 25 adults and 24 children who survived a flame burn covering more than 20% of total body surface area (TBSA). The concentrations of 22 cytokines were measured using the Linco multiplex array system (St. Charles, MO, USA). Large perturbations in the expression of pro- and anti-inflammatory cytokines were seen following thermal injury. During the first week following burn injury, IFN-γ, IL-10, IL-17, IL-4, IL-6, and IL-8 were detected at significantly higher levels in adults compared with children, P < 0.05. Significant differences were measured during the second week post-burn for IL-1β (higher in children) and IL-5 (higher in adults), P < 0.05. IL-18 was more abundant in children compared with adults during the third week post-burn, P < 0.05. Between post-burn d 21 and d 66, IL-1α was detected at higher concentrations in pediatric compared with adult patients, P < 0.05. Only GM-CSF expression was significantly different at all time points; it was detected at lower levels in pediatric patients, P < 0.05. Eotaxin, G-CSF, IL-13, IL-15, IP-10, MCP-1, and MIP-1α were detected at significantly different concentrations in adult compared with pediatric patients at multiple time points, P < 0.05. There were no differences in IL-12, IL-2, IL-7, or TNF levels in adult compared with pediatric burn patients at any of these time points. Following severe flame burns, the cytokine profiles in pediatric patients differ compared with those in adult patients, which may

  11. Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Alexander Blacklock

    2015-01-01

    Full Text Available Background and objectives: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines. Design: All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes. Results: A total of 798 patients were admitted, of whom 443 (55.5% were female. There were 18 deaths (2.3%. Assessment of dehydration status was recorded in 517 (64.8% of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%. Intravenous (IV fluids were prescribed to 767 patients (96.1%, including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS was given to 629 (78.8% patients. Doxycycline was given to 380 (47.6% patients, erythromycin to 34 (4.3%, and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%. Discussion: This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping. Conclusions: Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement.

  12. Heart Rate Variability as a Predictor of Death in Burn Patients.

    Science.gov (United States)

    Loguidice, Michael J; Schutt, Robert C; Horton, Jureta W; Minei, Joseph P; Keeley, Ellen C

    2016-01-01

    Heart rate variability (HRV), a noninvasive technique used to quantify fluctuations in the interval between normal heart beats (NN), is a predictor of mortality in some patient groups. The aim of this study was to assess HRV in burn trauma patients as a predictor of mortality. The authors prospectively performed 24-hour Holter monitoring on burn patients and collected demographic information, burn injury details, and in-hospital clinical events. Analysis of HRV in the time and frequency domains was performed. A total of 40 burn patients with a mean age of 44 ± 15 years were enrolled. Mean %TBSA burn was 27 ± 22% for the overall population and was significantly higher in those who died compared with those who survived (55 ± 23% vs 19 ± 13%; P < .0001). There was a statistically significant inverse linear correlation between SD of NN intervals and %TBSA (r = -.337, R = 0.113, 95% CI = -0.587 to -0.028, two-tailed P = .034), as well as with ultra low frequency power and %TBSA burn (r = -0.351, R = 0.123, 95% CI = -0.152 to -0.009; P = .027). The receiver-operator characteristic showed the area under the curve for %TBSA as a predictor of death was 0.82 (P < .001), for SDANN was 0.94 (P < .0001), and for ultra low frequency power was 0.96 (P < .0001). Deranged HRV in the early postburn period is a strong predictor of death. PMID:26061155

  13. Comparison of the nutritional status and outcome in thermal burn patients receiving vegetarian and non-vegetarian diets

    OpenAIRE

    Samira Sharma; Ramesh K Sharma; Atul Parashar

    2014-01-01

    Background: The importance of adequate nutritional support in burned patients cannot be overemphasised. For adequate long-term compliance by the patients, diet should be formulated in accordance with their pre-burn dietary habits, religious beliefs, and tastes. Patients and Methods: A study was conducted in 42 consecutive patients suffering from 10% to 50% of 2 nd and 3 rd degree thermal burns with the aim to compare nutritional status, clinical outcome, and cost-effectiveness of vegetarian a...

  14. Post-burn facial contractures in pediatric patients: Challenging aspects of difficult airway management

    OpenAIRE

    Sukhminder Jit Singh Bajwa; Jasbir Kaur; Amarjit Singh; Gurpratap Singh

    2012-01-01

    Pediatric burn injuries are the most challenging to handle especially when they involve the face as the airway compromise invariably occurs due to edema and inflammation of the soft tissues of pharynx and larynx. The healing of the facial burns causes development of contractures and deformities after survival from the initial insults. Such patients when presented for surgery of the affected area or for that matter any surgery under general anesthesia, poses unique challenges to the attending ...

  15. The influence of episodic mood disorders on length of stay among patients admitted to private and non-profit hospitals with alcohol dependence syndrome

    Directory of Open Access Journals (Sweden)

    Justin B. Dickerson

    2011-02-01

    Full Text Available Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358. Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (b=0.31, P=0.001, referral to a hospital by a physician (b=0.35, P=0.014, and increasing age (b= 0.01, P=0.001 were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62. Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

  16. Long-Term Administration of Oxandrolone Improves Lung Function in Pediatric Burned Patients.

    Science.gov (United States)

    Sousse, Linda E; Herndon, David N; Mlcak, Ronald P; Lee, Jong O; Andersen, Clark R; Zovath, Andrew J; Finnerty, Celeste C; Suman, Oscar E

    2016-01-01

    Pulmonary dysfunction is a significant contributor to morbidity and mortality in the pediatric burned population. We have previously reported that the administration of a synthetic testosterone derivative, oxandrolone, significantly reduced hypermetabolism, and significantly increased height percentile, bone mineral content, lean body mass, and strength in pediatric burned patients. We hypothesize that the administration of oxandrolone will improve pulmonary function in burned pediatric subjects. A subset of severely burned pediatric subjects from a prospective clinical trial (n = 222) were included in our study (n = 54, 7-18 years, ≥30% TBSA burn). The subjects were previously randomized to either the control arm (n = 35) or the oxandrolone arm (0.1 mg/kg twice/day for 12 months, n = 19). Maximum voluntary ventilation, the ratio between forced expiratory volume and forced vital capacity, and diffusion capacity were measured 6 months following burn injury, and results were compared between burned subjects with and without oxandrolone administration. Maximum expired ventilation (VEmax) was also measured in a subset of burned subjects. Subjects treated with oxandrolone had a significantly higher maximum voluntary ventilation (98 ± 53 L/min vs 115 ± 56 with treatment, P = .03). During maximal exercise, subjects treated with oxandrolone had a significantly higher VEmax compared with untreated subjects (32.0 ± 8.7 L/min vs 43.7 ± 13.6 with treatment, P = .02). The administration of oxandrolone was associated with improved lung function in pediatric burned patients. PMID:27171844

  17. Pharmacokinetic/pharmacodynamic profiling of imipenem in patients admitted to an intensive care unit in India: A nonrandomized, cross-sectional, analytical, open-labeled study

    Directory of Open Access Journals (Sweden)

    B Abhilash

    2015-01-01

    Full Text Available Background and Aim: Widespread use of imipenem in intensive care units (ICUs in India has led to the development of numerous carbapenemase-producing strains of pathogens. The altered pathophysiological state in critically ill patients could lead to subtherapeutic antibiotic levels. Hence, the aim of this study was to investigate the variability in the pharmacokinetic and pharmacodynamic profile of imipenem in critically ill patients admitted to an ICU in India. Materials and Methods: Plasma concentration of imipenem was determined in critically ill patients using high performance liquid chromatography, at different time points, by grouping them according to their locus of infection. The elimination half-life (t΍ and volume of distribution (V d values were also computed. The patients with imipenem trough concentration values below the minimum inhibitory concentration (MIC and 5 times the MIC for the isolated pathogen were determined. Results: The difference in the plasma imipenem concentration between the gastrointestinal and the nongastrointestinal groups was significant at 2 h (P = 0.015 following drug dosing; while the difference was significant between the skin/cellulitis and nonskin/cellulitus groups at 2 h (P = 0.008, after drug dosing. The imipenem levels were above the MIC and 5 times the MIC for the isolated organism in 96.67% and 50% of the patients, respectively. Conclusions: The pharmacokinetic profile of imipenem does not vary according to the locus of an infection in critically ill patients. Imipenem, 3 g/day intermittent dosing, maintains a plasma concentration which is adequate to treat most infections encountered in patients admitted to an ICU. However, a change in the dosing regimen is suggested for patients infected with organisms having MIC values above 4 mg/L.

  18. Pharmacokinetic/pharmacodynamic profiling of imipenem in patients admitted to an intensive care unit in India: A nonrandomized, cross-sectional, analytical, open-labeled study

    Science.gov (United States)

    Abhilash, B.; Tripathi, Chakra Dhar; Gogia, Anoop Raj; Meshram, Girish Gulab; Kumar, Manu; Suraj, B.

    2015-01-01

    Background and Aim: Widespread use of imipenem in intensive care units (ICUs) in India has led to the development of numerous carbapenemase-producing strains of pathogens. The altered pathophysiological state in critically ill patients could lead to subtherapeutic antibiotic levels. Hence, the aim of this study was to investigate the variability in the pharmacokinetic and pharmacodynamic profile of imipenem in critically ill patients admitted to an ICU in India. Materials and Methods: Plasma concentration of imipenem was determined in critically ill patients using high performance liquid chromatography, at different time points, by grouping them according to their locus of infection. The elimination half-life (t΍) and volume of distribution (Vd) values were also computed. The patients with imipenem trough concentration values below the minimum inhibitory concentration (MIC) and 5 times the MIC for the isolated pathogen were determined. Results: The difference in the plasma imipenem concentration between the gastrointestinal and the nongastrointestinal groups was significant at 2 h (P = 0.015) following drug dosing; while the difference was significant between the skin/cellulitis and nonskin/cellulitus groups at 2 h (P = 0.008), after drug dosing. The imipenem levels were above the MIC and 5 times the MIC for the isolated organism in 96.67% and 50% of the patients, respectively. Conclusions: The pharmacokinetic profile of imipenem does not vary according to the locus of an infection in critically ill patients. Imipenem, 3 g/day intermittent dosing, maintains a plasma concentration which is adequate to treat most infections encountered in patients admitted to an ICU. However, a change in the dosing regimen is suggested for patients infected with organisms having MIC values above 4 mg/L. PMID:26628823

  19. Factors associated with nursing home placement of all patients admitted for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005: a disease stratified analysis.

    Directory of Open Access Journals (Sweden)

    Cynthia Chen

    Full Text Available OBJECTIVES: To (1 identify social and rehabilitation predictors of nursing home placement, (2 investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore. DESIGN: National data were retrospectively extracted from medical records of community hospital. DATA SOURCES: There were 12,506 first admissions for rehabilitation in four community hospitals. Of which, 8,594 (90.3% patients were discharged home and 924 (9.7% patients were discharged to a nursing home. Other discharge destinations such as sheltered home (n = 37, other community hospital (n = 31, death in community hospital (n = 12, acute hospital (n = 1,182 and discharge against doctor's advice (n = 24 were excluded. OUTCOME MEASURE: Nursing home placement. RESULTS: Those who were discharged to nursing home had 33% lower median rehabilitation effectiveness and 29% lower median rehabilitation efficiency compared to those who were discharged to nursing homes. Patients discharged to nursing homes were significantly older (mean age: 77 vs. 73 years, had lower mean Bathel Index scores (40 vs. 48, a longer median length of stay (40 vs. 33 days and a longer time to rehabilitation (19 vs. 15 days, had a higher proportion without a caregiver (28 vs. 7%, being single (21 vs. 7% and had dementia (23 vs. 10%. Patients admitted for lower limb amputation or falls had an increased odds of being discharged to a nursing home by 175% (p<0.001 and 65% (p = 0.043 respectively compared to stroke patients. CONCLUSIONS: In our study, the odds of nursing home placement was found to be increased in Chinese, males, single or widowed or separated/divorced, patients in high subsidy wards for hospital care, patients with dementia, without caregivers, lower functional scores at admission, lower rehabilitation effectiveness or efficiency at discharge and primary diagnosis groups such

  20. Long-Term Propranolol Use in Severely Burned Pediatric Patients: A Randomized Controlled Study

    Science.gov (United States)

    Herndon, David N.; Rodriguez, Noe A.; Diaz, Eva C.; Hegde, Sachin; Jennings, Kristofer; Mlcak, Ronald P.; Suri, Jaipreet S.; Lee, Jong O.; Williams, Felicia N.; Meyer, Walter; Suman, Oscar E.; Barrow, Robert E.; Jeschke, Marc G.; Finnerty, Celeste C.

    2012-01-01

    Objective To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective randomized single-center controlled study in pediatric patients with large burns. Summary Background Data Severe burns trigger a hypermetabolic response that persists for up to 2 years after burn. Propranolol given for 1 month post burn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods One-hundred seventy nine pediatric patients with >30% total body surface area burns were randomized to receive control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months after burn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjust for non-normality, repeated measures, and regression analyses. P <0.05 was considered significant. Results Long-term propranolol treatment significantly reduced the percent of the predicted heart rate and percent of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions Propranolol treatment for 12 months, following thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients. This study is registered at clinicaltrials.gov, NCT00675714. PMID:22895351

  1. The role of antioxidant micronutrients in the rate of recovery of burn patients: a systematic review.

    Science.gov (United States)

    Adjepong, Mary; Agbenorku, Pius; Brown, Patricia; Oduro, Ibok

    2016-01-01

    Burn injury can be detrimental to the health of individuals, meanwhile victims lose proteins and micronutrients in wound exudates. Victims also experience extensive protein catabolism. These make them prone to malnutrition. Burn patients also suffer a lot of emotional trauma that reduce nutrient intake. The aim of this paper was to review primary evidence on the effect of antioxidant micronutrients on the recovery rate of burn patients. Electronic databases such as PubMed, BioMed, and Cochrane were systematically searched between January 1, 2014, and January 30, 2014. Keywords include vitamin A, vitamin C, vitamin E, ascorbic acid, zinc, copper, selenium, tocopherol, carotenoids, dietary intake, supplementation, wound healing, infection, recovery rate, and burn patients. The systematic search was done to retrieve all published data from 1990 to 2013. A total of 518 journal articles were obtained, and after the removal of duplicates, reviews, commentaries, and studies with non-human subjects, 11 papers were accepted for review. The review considered only papers that were published, and there might be some unpublished data that may have been omitted. Generally, the wound healing time and infection rates were reduced by the administration of the antioxidant micronutrients. The review revealed that there was no such published work in developing countries and children were excluded from most studies. It was also stated clearly that there was no uniformity in burn management; hence, there is a need for more studies on burn management in various populations. PMID:27574687

  2. Establishment and assessment of new formulas for energy consumption estimation in adult burn patients.

    Directory of Open Access Journals (Sweden)

    Peng Xi

    Full Text Available An accurate knowledge of energy consumption in burn patients is a prerequisite for rational nutrition therapy. This study sought to create a formula that accounts for the metabolic characteristics of adult burn patients to accurately estimate energy consumption of patients with different areas and extents of burn and at different times after injury.Resting energy expenditure (REE data on 66 burn patients, with total body surface area (TBSA of burns ranging from 4% to 96%, were evaluated at different times after injury. REE values were determined in patients using indirect calorimetry at days 1, 2, 3, 7, 14, 21, and 28 after injury. We then constructed a mathematical model of REE changes post-burn. Next, established two new formulas (one non-linear and the other linear for energy consumption estimation using model-based analytical solution and regression analysis. The new formulas were compared with measured REE and commonly used formulas including those of Carlson, Xie, Curreri, and Milner to determine accuracy and reliability.Comparative analysis showed that the new formulas offered significantly higher accuracy and reliability than the Milner formula, which is considered the most accurate of commonly used burn energy consumption estimate formulas. The accuracy of the new nonlinear formula (94.29% and that of the linear formula (91.43% were significantly higher than that of Milner formula (72.86% when compared to measured REE (χ2  =  11.706, P  =  0.001; χ2  =  8.230, P  =  0.004, respectively. The reliabilities of the new estimation formulas were both 100% and that of Milner formula was 74.24% (χ2  =  19.513, P  =  0.000.The new formulas constructed in this study provide reliable simulation of the impact of the degree of burn and post-burn days on energy consumption and offer notably higher accuracy and reliability than other formulas. These formulas will help determine nutritional needs of burn patients.The study

  3. Serum IL-18 Is Increased at Early Postburn Period in Moderately Burned Patients

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available A severe systemic inflammatory response is usually seen after burn injury. IL-18 enhances the Th1 immune responses in bacterial andviral infections. In order to evaluate the IL-18 serum levels as well as IL-6 and TNF-α at the 48th hour postburn, serial serum samples of 8 burned patients were analyzed. 8 moderately burned patients were included into the study. Serum samples were taken at admission at the 48th hour of postburn. IL-6, IL-18, and TNF-α serum levels were analyzed. Total mean burned surface area (TBSA was 24.6±5.7% and mean BMI (body mass index was 24.5±3.4. The patients' age ranged from 17 to 38 (mean 26.3±7.4 years. An increase in sera IL-6, IL-18, and TNF-α was detected at the 48th hour postburn (.0001$"> P<.0001. All patients survived. A marked increase in serum levels of IL-18 as well as the other cytokines evaluated was observed in the moderately burned patients. These three parameters were highly correlated with each other (r>0.9 and .001$">P<.001. This is the first study that shows an increase in serum IL-18 levels at the early postburn period.

  4. Optimal blood glucose control in severely burned patients: a long way to go, but one step closer

    OpenAIRE

    Kamolz, Lars-Peter; Pieber, Thomas; Smolle-Jüttner, Freyja M; Lumenta, David B

    2013-01-01

    Over the past years there has been a significant decrease in mortality and morbidity in patients suffering from severe burns due to improved burn wound management and approaches in critical care. Survival is no longer the exception, but unfortunately death still occurs. One of the key elements concerning state-of-the-art burn care is blood glucose control and insulin therapy; it is well known that burn-induced hyperglycaemia is associated with adverse clinical outcomes. However, controversy f...

  5. Antimicrobial resistance pattern of bacterial isolates from burn wounds in an Iranian University Hospital

    OpenAIRE

    Sabzghabaee, Ali Mohammad; Abedi, Daryoush; Fazeli, Hossein; Javadi, Abbasali; Jalali, Mohammad; Maracy, Mohammad Reza; Soltani, Rasool; Karamyafti, Mohammad Javad

    2012-01-01

    Objective: About 73% of death cases in the first 5 days after burning are due to infection complications. The aim of this study was to identify the causing agents of infections in burn patients and the sensitivity pattern of them to the commonly used antimicrobials in an Iranian Burn center University Hospital. Methods: In this cross-sectional study, patients who were admitted to one of the Iranian Burn center University hospitals in 2009 and had nosocomial infection due to burn wound, whom r...

  6. Risk factors for burn-out in caregivers of stroke patients, and possibilities for intervention

    NARCIS (Netherlands)

    van den Heuvel, ETP; de Witte, LP; Schure, LM; Sanderman, R; Meyboom-de Jong, B

    2001-01-01

    Objective: To identify which caregivers of stroke patients living at home experience the highest levels of strain and are at risk of burn-out, and to investigate how support for caregivers of stroke patients could best be organized, and when this support should be offered. Design and setting: Caregi

  7. Focused sonographic examination of the heart, lungs and deep veins in an unselected population of acute admitted patients with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    symptoms, can be diagnosed with sonography. The protocol describes a prospective, blinded, randomised controlled trial that aims to assess the diagnostic impact of a pragmatic implementation of focused sonography of the heart, lungs and deep veins as a diagnostic modality in acute admitted patients with...... respiratory symptoms. METHODS AND ANALYSIS: The primary outcome of the study is the number of patients with a correct presumptive diagnosis within 4 h of admission to the emergency department. The patient is randomised to either an intervention or a control group. In the intervention group, the usual initial...... Committee for Southern Denmark and the Danish Data Protection Agency. The results of the trial will be published according to the CONSORT statement with the extension for pragmatic trials. The results of the trial will be published in a peer-reviewed scientific journal regardless of the outcome. TRIAL...

  8. tcpC as a prospective new virulence marker in blood Escherichia coli isolates from sepsis patients admitted to the intensive care unit

    Directory of Open Access Journals (Sweden)

    D. Nagarjuna

    2015-09-01

    Full Text Available The prevalence of the tcpC in the blood Escherichia coli isolates collected from the sepsis patients admitted to the intensive care unit was investigated for the first time. The blood and faecal samples were collected from sepsis and nonsepsis patients, respectively. The prevalence of the tcpC and phylogroups was confirmed by gene-specific PCR. The occurrence of the tcpC in the blood E. coli isolates from sepsis patients was significantly higher than the faecal isolates. The higher prevalence of blood E. coli isolates among the pathogenic groups (B2, D compared to the commensal groups (A, B1 suggests tcpC as a prospective new virulence marker for sepsis.

  9. Does informed consent influence therapeutic outcome? A clinical trial of the hypnotic activity of placebo in patients admitted to hospital.

    OpenAIRE

    Dahan, R.; Caulin, C; Figea, L; Kanis, J. A.; Caulin, F; Segrestaa, J M

    1986-01-01

    To examine whether written informed consent might influence the results of clinical trials the effect of placebo when given with or without informed consent to patients suffering from insomnia was studied. The study was a single blind observer blinded trial, and patients were paired according to sex, age, and hospital environment. Randomisation assigned the first patient of each pair to the control group (without informed consent) or the group to give informed consent. Of the 56 patients, 26 ...

  10. Pain and anxiety experiences of South African adult burn injury patients during physiotherapy management

    Directory of Open Access Journals (Sweden)

    L.D. Morris

    2010-02-01

    Full Text Available A dequate management of procedural pain during physiotherapy management plays an important role in building a trusting relationship betweenthe burn victim and the physiotherapist, and in ensuring desirable functional outcomes. However, the burn pain management regimens currently utilized inburn units, primarily consist of traditional pharmacologic analgesics which areassociated with numerous side-effects and alone are often reported as inadequateto alleviate procedural pain, warranting safer and effective adjunct therapies.Prior to the introduction and implementation of adjunct therapies into a developing world, it is imperative that the current situation in a burn unit, in terms of whether or not the pain management regimens in place are adequate, is first assessed, due to cost concerns. The following short report exemplifies the pain and anxiety experiences of a small number of burn injury patients during physiotherapy at the Tygerberg Hospital adult burn unit, South A frica.  It was hypothesized that the results of this study would underpin whether adult burn injury patients in a developing countryrequire adjunct therapies during physiotherapy management to supplement traditional pharmacologic analgesics inmanaging their procedural pain and subsequent anxiety.

  11. The effect of obesity on adverse outcomes and metabolism in pediatric burn patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N.; Williams, Felicia N.; Al-Mousawi, Ahmed M; Finnerty, Celeste C.; Jeschke, Marc G

    2011-01-01

    Hypothesis Obesity influences metabolism and increases the incidence of clinical complications and worsens outcomes in pediatric burn patients. Design Retrospective, single-center study. Subjects Five hundred ninety-two severely burned pediatric patients who had burns covering more than 30% of the total body surface area and who were treated between 2001 and 2008 were enrolled in this study. Patients were divided into ≥ 85th percentile (n = 277) and normal (n = 315) weight groups based on body mass index percentiles. Results Patients stratified below (normal) and ≥ 85th percentile had similar age, gender distribution, and total burn size. No significant differences were detected in the incidence of sepsis (11% for obese vs. 10% for normal), the incidence of multiple organ failure (21% for obese and 16% for normal), or mortality (11% for obese vs. 8% for normal). Compared to the normal group, the ≥ 85th percentile group had low levels of constitutive proteins (α2macroglobulin and Apolipoprotein A-1) (p < 0.05 for both) as well as high levels of triglycerides and the acute-phase protein, C-reactive protein (p < 0.05 for both) up to 60 days after injury. Patients ≥ 85th percentile showed a significant higher loss of bone mineral density and lipolysis compared to normal individuals. Stepwise logistic regression analysis revealed that body mass index had a positive predictive value towards the maximum DENVER2 score, an index of organ failure (p < 0.001). Conclusions BMI ≥ 85th percentile altered the post-burn acute phase and catabolic response but did not increase the incidence of sepsis, multiple organ failure, or mortality in pediatric burn patients. Our results suggest that impaired metabolism and an altered inflammatory response occurs already in patients starting at the 85th percentile BMI. PMID:22143622

  12. Epidemiology of Pediatric Burn Injuries in Isfahan, Iran

    OpenAIRE

    Rafii, Mohammad Hadi; Saberi, Hamid Reza; Hosseinpour, Mehrdad; Fakharian, Esmaeil; Mohammadzadeh, Mahdi

    2012-01-01

    Background Burns are major cause of death and disability worldwide, particularly in the developing countries. Objectives The aim of this study was to determine the incidence and causes of burns in children under the age of 15 years in Isfahan province, Iran. Patients and Methods All children admitted to the burn center of Isfahan, the largest city in central Iran, between 2007 and 2009 were enrolled in this study. We analyzed the data on age, sex, location, cause and spread of the burn, durat...

  13. Analysis of predictor factors of limb amputation in patients with high-voltage electrical burns

    OpenAIRE

    Guillermo García Álvarez; Guillermo Wiegering Cecchi

    2015-01-01

    Background: Limb amputation is considered one of the most devastating consequences of electrical injury. Any factors that correlate with the degree of muscle damage can be used to predict the necessity of limb amputation. The aim of this study was to determine the factors that can be used to predict limb amputation in high-voltage electrically injured patients. Methods: Eighty-two high-voltage electrically injured patients were admitted to the Department of Plastic and Reconstructive Surg...

  14. [Review and prospect of parenteral nutrition support for burn patients in China].

    Science.gov (United States)

    Deng, Shi-lin

    2008-10-01

    Parenteral nutrition support for burn injury in China began to develop in 1970s along with improvement in burn foundational research of burn injury and the marketing of parenteral nutrition solutions manufactured by Chinese amino acids pharmaceutical industry. Up to 1980s many kinds of parenteral nutrition products were used in clinical therapy, and they were proved to be effective and safe. Meanwhile the guide for parenteral nutrition support of China was drafted to ensure standardized administration. Some problems should be called for attention in present practice of parenteral nutrition support. First, immuno nutrients have been proved to possess synergistic effect on parenteral/enteral nutrition support. But for those critical patients in sepsis/MODS period, more attention should be paid to the use of immuno nutrients in time of administration and optimal dosage because of the complicate physiopathologic reactions. Secondly, the use of growth hormone has been proved to be effective for promoting healing in patients with burn in many cases. However, the indications of growth hormone should be strictly observed and the regime of a low dose and short course should be adopted 7 days after burn for ensuring safety. Thirdly, we should pay attention to the best path of giving nutrition, whether enteral or parenteral. Parenteral nutrition support should be adopted for critical burn patients in early period with intestinal dysfunction, and enteral nutrition support should be used when intestinal functions recover partially. For patients with burn hypermetabolism, the application of enteral and parenteral nutrition support is complimentary, and it is aptly called total nutrition. PMID:19103029

  15. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure. An ACAP-HF data analysis

    Directory of Open Access Journals (Sweden)

    Marrick L. Kukin

    2011-06-01

    Full Text Available Malnutrition is common at hospital admission and tends to worsen during hospitalization. This controlled population study aimed to determine if serum albumin or moderate and severe nutritional depletion by Nutritional Risk Index (NRI at hospital admission are associated with increased length of hospital stay (LOS in patients admitted with acute decompensated heart failure (ADHF. Serum albumin levels and lymphocyte counts were retrospectively determined at hospital admission in 1740 consecutive patients admitted with primary and secondary diagnosis of ADHF. The Nutrition Risk Score (NRI developed originally in AIDS and cancer populations was derived from the serum albumin concentration and the ratio of actual to usual weight, as follows: NRI = (1.519 × serum albumin, g/dL + {41.7 × present weight (kg/ideal body weight(kg}. Patients were classified into four groups as no, mild, moderate or severe risk by NRI. Multiple logistic regressions were used to determine the association between nutritional risk category and LOS. 381 Patients (34% were at moderate or severe nutritional risk by NRI score. This cohort had lower BMI (24 ± 5.6 kg/m2, albumin (2.8±0.5 g/dL, mean NRI (73.5±9 and Lower eGFR (50±33 mL/min per 1.73 m2. NRI for this cohort, adjusted for age, was associated with LOS of 10.1 days. Using the Multiple Logistic regression module, NRI was the strongest predictor for LOS (OR 1.7, 95% CI: 1.58-1.9; P=0.005, followed by TIMI Risk Score [TRS] (OR 1.33, 95% CI: 1.03-1.71; P=0.02 and the presence of coronary artery disease (OR 2.29, 95%CI: 1.03-5.1; P=0.04. Moderate and severe NRI score was associated with higher readmission and death rates as compared to the other two groups. Nutritional depletion as assessed by Nutritional Risk Index is associated with worse outcome in patients admitted with ADHF. Therefore; we recommend adding NRI to further risk stratify these patients.

  16. Herpes simplex virus infection in burned patients: epidemiology of 11 cases.

    Science.gov (United States)

    Bourdarias, B; Perro, G; Cutillas, M; Castede, J C; Lafon, M E; Sanchez, R

    1996-06-01

    Burned patients suffer significant immunosuppression during the first 3 or 4 weeks after hospitalization. Herpes simplex virus (HSV) infections are commonly seen in immunosuppressed patients and may account for considerable morbidity and some mortality. We studied retrospectively 11 patients with severe burn injury who became infected with HSV. We determined the prevalence of viral infection in this group of patients. Serological testing and viral culture was used to diagnose HSV infection. No general complications appeared in these 11 patients in association with HSV but two patients died of multiorgan failure. Locally, areas of active epidermal regeneration were most commonly affected. Acyclovir therapy was not used and the duration of hospitalization was normal in these 11 patients. PMID:8781721

  17. A drug utilization study of analgesics for management of postoperative pain in patients admitted at a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Jignesh S. Chaudhari

    2013-12-01

    Conclusions: 112 patients from diclofenac only received group and 13 patients from diclofenac + tramadol received group complain of post operative pain. Post-operative pain control at 12 hours is sufficient but high post-operative pain scores at 18 hour of post-operative time interval suggesting needs of additional pain control. Majority of study patients received single analgesic (Diclofenac sodium. [Int J Basic Clin Pharmacol 2013; 2(6.000: 757-762

  18. Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals

    OpenAIRE

    Sherine M. Elbanouby, Sarah A.Hamza,Samia A. Abdel Rahman and Ahmed Kamel Mortagy

    2013-01-01

    Background: Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients. Objectives: The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients. Design: A prospective cohor...

  19. Feasibility of telecare solution for patients admitted with COPD exacerbation: screening data from a pulmonary ward in a university hospital

    DEFF Research Database (Denmark)

    Gottlieb, Magnus; Marså, Kristoffer; Andreassen, Helle;

    2014-01-01

    to assess the reasons for the exclusion of patients, and the reasons for patients not consenting to participate, as well as to identify the predictors for consenting or not consenting among the subgroup of eligible patients. Methods: In this study, all data in the screening log were collected over a...... help patients manage their disease at home and thereby possibly reduce the risk of readmission. Purpose: The primary aim of this study is to assess the feasibility of a telehealth care solution when offered in connection with discharges from a pulmonary ward at a university hospital. Secondary aims are...

  20. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  1. [Fatal hyperpyrexia in an adolescent patient with severe burns after a traffic accident].

    Science.gov (United States)

    Jaehn, T; Sievers, R; Junger, A; Graunke, F; Blings, A; Reichert, B

    2016-07-01

    After a motorcycle accident a 16-year-old patient suffered severe burns to 40.5 % of the total body surface area (TBSA) of which 37 % were deep subdermal burns. After tangential and partly epifascial necrosectomy, Integra® was used as a temporary dermis replacement material for the lower extremities, combined with extensive negative pressure wound therapy (NPWT). In the further course of the treatment the patient developed uncontrollable hyperpyrexia with a fatal outcome. Possible influencing factors, such as the dermis replacement material combined with NPWT over large areas as well as the differential diagnoses propofol infusion syndrome, heatstroke and malignant hyperthermia are discussed. PMID:26767381

  2. Stress-Induced Hyperglycemia as a Risk Factor for Surgical-Site Infection in Non-diabetic Orthopaedic Trauma Patients Admitted to the Intensive Care Unit

    Science.gov (United States)

    Richards, Justin E; Kauffmann, Rondi M; Obremskey, William T; May, Addison K

    2012-01-01

    Objectives To evaluate the association between stress-induced hyperglycemia and infectious complications in non-diabetic orthopaedic trauma patients admitted to the Intensive Care Unit (ICU). Design Retrospective review. Setting Academic Level-1 Trauma Center. Patients One hundred and eighty-seven consecutive trauma patients with isolated orthopaedic injuries. Intervention Blood glucose values during initial hospitalization were evaluated. The admission blood glucose (BG) and Hyperglycemic Index (HGI) were determined for each patient. Main Outcome Measures Perioperative infectious complications: pneumonia, urinary tract infection (UTI), surgical-site infection (SSI), sepsis. Results An average of 21.5 BG values was obtained for each patient. Mean ICU and hospital length of stay was 4.0±4.9 and 10.0±8.1 days, respectively. Infections were recorded in 43/187 patients (23.0%) and SSI’s specifically documented in 16 patients (8.6%). Open fractures were not associated with SSI (8/83, 9.6% vs. 8/104, 7.7%). There was no difference in admission BG or HGI and infection. However, there was a significant difference in HGI when considering SSI alone (2.1±1.7 vs. 1.2±1.1). Patients with an SSI received a greater amount of blood transfusions (14.9±12.1 vs. 4.9±7.6). No patient was diagnosed with a separate infection (i.e. pneumonia, UTI, bacteremia) prior to SSI. There was no significant difference in Injury Severity Score among patients with an SSI (11.1±4.0 vs. 9.6±3.0). Multivariable regression testing with HGI as a continuous variable demonstrated a significant relationship (OR: 1.8, 95% CI: 1.3–2.5) with SSI after adjusting for blood transfusions (OR: 1.1, 95% CI: 1.1–1.2). Conclusions Stress-induced hyperglycemia demonstrated a significant independent association with SSI’s in non-diabetic orthopaedic trauma patients who were admitted to the ICU. PMID:22588532

  3. Short-term and long-term mortality in very elderly patients admitted to an intensive care unit

    NARCIS (Netherlands)

    de Rooij, S. E.; Govers, A.; Korevaar, J C; Abu-Hanna, A; Levi, M; de Jonge, E

    2006-01-01

    OBJECTIVE: To report short-term and long-term mortality of very elderly ICU patients and to determine independent risk factors for short-term and long-term mortality DESIGN AND SETTING: Retrospective cohort study in the medical/surgical ICU of a tertiary university teaching hospital. PATIENTS: 578 c

  4. A comparison of severely injured trauma patients admitted to level 1 trauma centres in Queensland and Germany

    NARCIS (Netherlands)

    Nijboer, Johanna M. M.; Wullschleger, Martin E.; Nielsen, Susan E.; McNamee, Anitia M.; Lefering, Rolf; ten Duis, Hendrik-Jan; Schuetz, Michael A.

    2010-01-01

    Background: The allocation of a trauma network in Queensland is still in the developmental phase. In a search for indicators to improve trauma care both locally as state-wide, a study was carried out comparing trauma patients in Queensland to trauma patients in Germany, a country with 82.4 million i

  5. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: A systematic review

    DEFF Research Database (Denmark)

    Kruse, Ole; Grunnet, Niels; Barfod, Charlotte

    2011-01-01

    setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit. 2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting. METHODS: We performed a systematic search using Pub...

  6. Evaluation of the Risk of Sleep Obstructive Apnea Syndrome (SOAS in Patients Admitted in a Slimming Spa

    Directory of Open Access Journals (Sweden)

    Lorenzetti, Fabio Tadeu Moura

    2009-12-01

    Full Text Available Introduction: The association between Sleep Obstructive Apnea Syndrome (SOAS and the obesity has been highly studied. The SOAS is characterized by the repetitive obstruction of the upper airways during the sleep, many times accompanied by snores, oxygen desaturation, sleep fragmentation and excessive daytime somnolence (EDS. Type of Study: Prospective Transversal. Objective: To analyze the results of the Berlin Questionnaire (BQ and the Epworth Somnolence Scale (ESS completed by the patients interned in the Spa Med Campus Sorocaba, attempting to find who has daytime somnolence and high risk for SOAS. Method: The patients completed the Berlin Questionnaire and the ESS voluntarily. The study was of transversal type with analysis of the questionnaires completed during the year of 2008. Results: We obtained a total of 276 patients with a total of 183 women and 93 men. The prevalence of obese patients was of 111 patients (40.2%. In the positive BQ group, we obtained a total of 84 patients; 34 male; as to the positive ESS group, we found a total of 67 patients, 24 male. Conclusion: The ESS and the BQ have been useful currently for selection of the sleep disorders and may serve as a possible indicator for polysonography. The questionnaires' results show us the high prevalence of individuals interned in SPA with the risk of having SOAS, specially the obese ones.

  7. Can selection of mechanical ventilation mode prevent increased intra-abdominal pressure in patients admitted to the intensive care unit?

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Rafiei

    2013-01-01

    Conclusions: There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension.

  8. Proposed protocol for realization of abdominal CT in patients admitted to the emergency room for trauma in HSJD

    International Nuclear Information System (INIS)

    A protocol is established for computed tomography in trauma patients treated in emergency of Hospital San Juan de Dios. A literature review is conducted on abdominal CT protocols in specialized databases. The criteria, scanning, parameters and delay time are established for realization of abdominal CT in patients with traumatic emergencies in HSJD. Taking the thickness of the sections, the thickness of the sections in reconstruction, the quantities of contrast and the speed of injection in patients, have been standardized for the realization of abdominal CT in HSJD. Computed tomography should be preferably performed of routine in portal phase and the late from 5 minutes in patients with abdominal trauma, contributing in this phase as much information regarding the extent of abdominal injury

  9. 'The time it takes…' How doctors spend their time admitting a patient during the acute medical take.

    Science.gov (United States)

    Sabin, Jodie; Khan, Waleed; Subbe, Christian P; Franklin, Marc; Abulela, Iman; Khan, Anwar; Mohammed, Hassan

    2016-08-01

    Patient safety depends on adequate staffing but the number of doctors required for safe staffing for medical emergencies is not known. We measured the duration of the admission process for patients seen by medical teams in emergency departments (EDs) and acute medical units. History taking and examination by a core medical trainee took 22 minutes for a patient referred from the ED and 21 minutes for a patient referred from primary care. A complete admission clerking with prescription and ordering of investigations ranged from a mean of 15 minutes for a consultant in acute medicine to a mean of 55 minutes for a foundation year 1 trainee. The duration of post-take ward rounds also showed significant variability.Our data can be used to model staffing patterns if combined with information about admission numbers and local set up. PMID:27481373

  10. A Study on Clinical Features and Cost Incurred by Dengue Syndrome Patients Admitted to a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Sathish Chandra MR, Ashwath Narayana DH, Manjunath M

    2014-01-01

    Conclusion: Professionals and public should be made aware of common clinical manifestations of dengue syndrome for early reporting and seeking prompt treatment there by reducing the case fatality rate and the economic loss to the patients and country at large.

  11. Clinical profile of dengue fever infection in patients admitted in tertiary care centre Agroha, Hisar, Haryana, India

    OpenAIRE

    Mohd Younus Shah; Mohd Mubarak Naqash; Goel, R.K.; Deepak Galhan; Sunil Kumar; Vivek Chhabra; Abhishek Saini; K. L. Jaggal

    2016-01-01

    Background: Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at MAMC. Methods: This retrospective study included 188 patients infected with dengue virus, age 6 years to 70 years. Laboratory and haematological data were include...

  12. Mental adjustment to cancer and survival of patients admitted for allogenic hemopoietic stem cell transplantation - a prospective cohort study

    OpenAIRE

    Grulke, Norbert; Bailer, Harald; Larbig, Wolfgang; Kächele, Horst

    2006-01-01

    Objective: The Mental Adjustment to Cancer Scale (MAC scale) has evolved to a standard measure in the field of psycho-oncology. In this context an attitude called "fighting spirit" gained much attention as a coping style. Some reports suggest that coping efforts as measured by the MAC scale are predictive for survival of breast cancer patients. We explored the predictive power of the MAC scale by using a sample of patients with haematological malignancies undergoing allogenic hemopoietic stem...

  13. Inappropriate prescribing to older patients admitted to hospital: A comparison of different tools of misprescribing and underprescribing

    OpenAIRE

    San-José, Antonio; Agustí, Antonia; Vidal, Xavier; Formiga Pérez, Francesc; López-Soto, Alfonso; Fernández Moyano, Antonio; García, Juana; Ramírez Duque, Nieves; Torres, Olga H.; Barbé, José

    2014-01-01

    Purpose: This study aims to assess inappropriate prescribing (IP) to elderly patients during the month prior to hospitalization and to compare different IP criteria. Methods: An observational, prospective and multicentric study was carried out in the internal medicine services of seven Spanish hospitals. Patients aged 75 years and older were randomly selected after hospital admission for a year. To assess potentially inappropriate medicines (PIMs), the Beers and STOPP criteria were used and t...

  14. Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit

    Science.gov (United States)

    Rafinazari, Niloofar; Abbasi, Saeed; Farsaei, Shadi; Mansourian, Marjan; Adibi, Peyman

    2016-01-01

    Objective: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admission, at ICU discharge and determine the adherence to American Society of Health-System Pharmacists (ASHP) guideline during ICU stay. Methods: In this study, 200 patients were randomly selected from all ICU admissions during 9 months. Risk factors of stress ulcer were recorded daily during ICU stay and appropriateness of SUP administration was assessed according to the ASHP criteria. Findings: Of all 160 (80%) patients who received SUP, 44.4% did not have indication; and among 95 patients with an indication for SUP administration, 6.3% did not receive it upon ICU admission. Consequently, 77 (38.5%) of 200 patients received inappropriate prophylaxis on ICU admission. In addition, 53.5% of patients had appropriate adherence to ASHP guideline during all days of ICU stay (44% and 2.5% of patients received SUP more than 120% and administration included both overutilization and underutilization in this ICU, but high prevalence of SUP overutilization caused unnecessary hospital costs, personal monetary burden, and may increase adverse drug reactions. Therefore, educating physicians and cooperation of clinical pharmacists regarding implementing standard protocols could improve patterns of SUP administration.

  15. Antibacterial susceptibility of bacteria isolated from burns and wounds of cancer patients

    Directory of Open Access Journals (Sweden)

    Sulaiman A. Alharbi

    2014-01-01

    Full Text Available In this study 540 burns and wound swabs were collected from cancer patients of some Egyptian hospitals. The single infection was detected from 210, and 70 cases among wounded and burned patients, while mixed infection was 30 and 45, respectively. We recovered where 60 isolates of Pseudomonas aeruginosa, 60 isolates of Staphylococcus aureus, 7 isolates of Staphylococcus epidermidis, 4 isolates of Streptococcus pyogenes, 25 isolates of Escherichia coli, 23 isolates of Klebsiella pneumoniae and 27 isolates of Proteus vulgaris from 355 burn and surgical wound infections . All bacterial isolates showed high resistance to the commonly used β-lactams (amoxycillin, cefaclor, ampicillin, vancomycin, amoxicillin/clavulonic, and low resistance to imepenim and ciprofloxacin. Plasmid analysis of six multidrug resistant and two susceptible bacterial isolates revealed the same plasmid pattern. This indicated that R-factor is not responsible for the resistance phenomenon among the isolated opportunistic bacteria. The effect of ultraviolet radiation on the isolated bacteria was studied.

  16. A clinical observation of early short-term use of potent antibiotics in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    RONG Xin-zhou; ZHANG Wen-zhen; REN Jia-liang; ZHOU Wei-ming

    2001-01-01

    Objective: To evaluate the effect of early and short-term use of potent antibiotics following extensive severe burn injury. Methods: Seventeen severely burned patients hospitalized in the same period (Nov.,1998 to Oct., 2000) wer esame treatment in Group 2 (n=8) was discontinued until day 15 postburn. The survival rate, blood bacterial culture, body temperature and white blood cell and platelet counts were compared between the 2 groups. Results: All the 17 patients survived and all blood bacterial cultures were negative. No significant difference of body temperature and white blood cell and platelet counts between the 2 groups was observed (P>0.05). Conclusion: Early use of high-potency antibiotics at short treatment course after extensive severe burn is effective to prevent infection and reduce the cost.

  17. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

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    Nilgün Aksoy

    2014-08-01

    Full Text Available Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ referred to the emergency department (ED of Akdeniz hospital, Turkey, 2008. Demographic data, the season, place, reason, anatomical sites, total body surface area, degrees, proceeding treatment, and admission time were recorded. Multinomial logistic regression was used to compare frequencies’ differences among single categorized variables. Stepwise logistic regression was applied to develop a predictive model for hospitalization. P<0.05 was defined as a significant level. Results: Two hundred thirty patients were enrolled (53.9% female. The mean of patients' ages was 25.3 ± 22.3 years. The most prevalence of burn were in the 0-6 age group and most of which was hot liquid scalding (71.3%. The most affected parts of the body were the left and right upper extremities. With increasing the severity of triage level (OR=2.2; 95% CI: 1.02-4.66; p=0.046, intentional burn (OR=4.7; 95% CI: 1.03-21.8; p=0.047, referring from other hospitals or clinics (OR=3.4; 95% CI: 1.7-6.6; p=0.001, and percentage of burn (OR=18.1; 95% CI: 5.42-62.6; p<0.001 were independent predictive factor for hospitalization. In addition, odds of hospitalization was lower in patients older than 15 years (OR=0.7; 95% CI: 0.5-0.91; p=0.035. Conclusion: This study revealed the most frequent burns are encountered in the age group of 0-6 years, percentage of <10%, second degree, upper extremities, indoor, and scalding from hot liquids. Increasing ESI severity, intentional burn, referring from

  18. The view of severely burned patients and healthcare professionals on the blind spots in the aftercare process: a qualitative study

    OpenAIRE

    Christiaens, Wendy; Van de Walle, Elke; Devresse, Sophie; Van Halewyck, Dries; Benahmed, Nadia; Paulus, Dominique; Van den Heede, Koen

    2015-01-01

    Background In most Western countries burn centres have been developed to provide acute and critical care for patients with severe burn injuries. Nowadays, those patients have a realistic chance of survival. However severe burn injuries do have a devastating effect on all aspects of a person’s life. Therefore a well-organized and specialized aftercare system is needed to enable burn patients to live with a major bodily change. The aim of this study is to identify the problems and unmet care ne...

  19. Dysrhythmias Induced by Streptokinase Infusion in Patients with Acute Myocardial Infarction Admitted to Cardiac Care Units in the Northwest of Iran

    Directory of Open Access Journals (Sweden)

    Parizad Razieh

    2014-01-01

    Full Text Available Objective: Currently, the most common cause of death in the world is cardiovascular disease, particularly myocardial infarction. Myocardial infarction is caused by reducing or cutting off the blood supply to the heart muscle due to obstruction caused by the presence of plaque or thrombus. The first step for the treatment of acute myocardial infarction is using thrombolytic drugs. By the analysis of plaque and removing the blockage, the blood flows to the affected area again. The most important thrombolytic agent is streptokinase; however, in addition to its therapeutic effect it also has some complications and by identifying them mortality and disability can be prevented. The present study aimed to investigate the most common arrhythmia after infusion of streptokinase in patients with acute myocardial infarction (AMI. Materials and Methods: This research was a descriptive study. The study population included patients admitted to the cardiac care unit of Shahid Madani Hospital, Tabriz, Iran, with a diagnosis of AMI from September 2012 until March 2014. Data were collected by using a checklist and the findings of the study were analyzed by SPSS software. Results: Of the 116 hospitalized patients, 78 (67.5% were male and 37 (32.5% were female, and the largest percentage of infected patients was in the age group of 60-70 years [n = 38 (33%]. Regarding cardiac risk factors, 57 (49% of patients were hyperlipidemic, 36 (31% were diabetic, 34 (30% had high blood pressure, 25 (21% were smokers, and 21 (18% had a positive family history of cardiac problems. Patients who were admitted with a diagnosis of AMI, in 53 (46% cases had streptokinase injection, and in 86 (74% complications had occurred during drug injection; 87 (75% patients had dysrhythmia and 29 (25% had bleeding. Common dysrhythmia was premature ventricular contraction (PVC with 90 (78.2% cases. Moreover, 53 (46% patients had slow ventricular tachycardia (VT, 18 (16% had premature atrial

  20. Application of Silver Sulfadiazine Cream With Early Surgical Intervention in Patients Suffering From Combined Burn-Blast Injury Facial Tattoos

    OpenAIRE

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied...

  1. Nosocomial Infections in Iranian Pediatric Patients With Burn Injuries: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2015-07-01

    Full Text Available Context: Nosocomial infections (NIs are the most common life-threatening complications and leading cause of morbidity and mortality in pediatric patients with burn injuries. It is estimated that annually two million infections, 90000 deaths, and 4.5 billion USD in excess healthcare costs are imposed by NIs. Herein, we reviewed the articles related to NIs in Iranian pediatric patients with burn injuries. Evidence Acquisition: A review of epidemiologic studies on NI in pediatric patients with burn injuries in Iran was performed by searching studies indexed in PubMed, Google scholar, Iranmedex, Magiran, SID databases, published in English language in 2014. Keywords for searching included “Nosocomial Infections”, “Hospital- acquired infection”, “Healthcare- associated infections”, “burn”, “children”, “pediatric”, and “Iran”. All articles related to NIs in pediatric patients with burn injuries or about general population with burn injuries, which included pediatric population up to the age 18 years in Iran, were included. Articles out of the definition for age group or lack of significant data, outpatients, and patients selected for reconstructive surgeries were excluded. Results: Of 43 reviewed articles, nine eligible articles were selected. The male to female ratio was 1.6:1. The age ranged from birth to 18 years with the mean of 3.4 years. Overall incidence of NIs was 20.94%. Pseudomonas aeruginosa (30.39%, Klebsiella pneumonia (17.54%, Acinetobacter (17.47%, and Staphylococcus aureus (14.98% were the most common prominent isolates with high antibiotic resistance isolated from the cultures of different sites of infections including burn wound. Vancomycin was highly specific antibiotic against Gram-positive bacteria isolates. All spices of Acinetobacter were multidrug resistant. The mean of mortality rate was 8.75%. Conclusions: In spite of higher incidence of NIs in children with burn injuries, there are no well

  2. The prevalence of post-traumatic stress disorder symptoms in relatives of severe trauma patients admitted to the intensive care unit

    Directory of Open Access Journals (Sweden)

    Pillai L

    2006-01-01

    Full Text Available Aim: To study the prevalence of symptoms suggestive of post-traumatic stress disorder in relatives of severe trauma patients admitted to the ICU. Materials and Methods: 177 relatives of trauma patients admitted to the ICU were studied to evaluate the negative psychological impact resulting from this admission by using the impact of event scale-revised [IES-R]. About 76 of these relatives could be followed up again with questionnaire after 2 years. Result: Of the 177 relatives, 85 (48% were males and 92 (52% females with no statistically significant difference in their scores. About 7 days after admission, 34-54% of the 177 relatives had moderate and 19-41% had severe symptoms suggestive of PTSD. For the 76 relatives who participated in both 2002 and 2004, symptoms suggestive of PTSD were moderate in 39-61% and severe in 12-39% initially. After 2 years the scores were moderate in 12-14% and severe in 4-5%. Maximum scores amongst the three subscales were for hyperarrousal symptom with mean scores of 2.1±1. In the group-which could be followed up after 2 years, initially 79% of the respondents had sum of IES-R scores ?26 suggesting severe symptoms, which declined to 14% after 2 years. Conclusion: Findings of this study suggest that 79% of the relatives of severe trauma patients develop PTSD symptoms following ICU admission. In most, the scores reduced with time but 14% continued to have severe scores at the end of 2 years suggesting the presence of persisting psychological disturbance in them.

  3. Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia

    DEFF Research Database (Denmark)

    Hvidberg, A; Christensen, N J; Hilsted, Jannik

    1998-01-01

    and 30-120 min after treatment. Pre-treatment counterregulatory hormone concentrations were significantly lower than hormone concentrations during induced hypoglycaemia in healthy control subjects but significantly higher than healthy fasting concentrations for plasma adrenaline (p = 0.020), glucagon......, although to a lesser degree than might be expected. Plasma glucose did not differ significantly between the two treatments at any time point. Despite access to food, one of four patients in group B and one of five patients in group A had plasma glucose below 4.0 mmol l(-1) after 120 min. In conclusion, low...

  4. [A clinical study on tuberculosis among young adults in Japan: analysis on patients admitted to national hospitals in Kanto- and Kinki-areas in the year 2000].

    Science.gov (United States)

    Yotsumoto, Hideki; Yonemaru, Makoto; Suzuki, Katsuhiro; Kawabe, Yoshiko; Sasaki, Yuka; Toyoda, Emiko; Yamagishi, Fumio; Kudoh, Koichiro; Kurasawa, Takuya; Ito, Masami; Kawashiro, Takeo; Sakatani, Mitsunori; Mori, Masashi

    2003-08-01

    Considering the high social activity, the trend of tuberculosis among young adults appears to be one of the key factors that influence the future morbidity rate of tuberculosis in Japan. To investigate its current characteristics, we analyzed new cases of tuberculosis aged 20 to 29 who were admitted to 7 national hospitals in Kanto- and Kinki-areas during the period of January 1st to December 31st, 2000. Data on the following items were compiled: sex, age, body height and weight, nationality; background factors such as life style, complications; course of the disease before the diagnosis; result of PPD skin test; severity of the disease estimated by the amount of M. tuberculosis in sputum and the grade of chest X-ray findings; therapeutic regimens and the response rate. Data were collected from 234 patients (129 males and 105 females) and the results were as follows: 1) about 80% of the patients were symptomatic and in 50% of patients who presented with cough, more than one month was needed before establishing the diagnosis as TB, 2) the disease was found in advanced stage in more than half of the patients, 3) foreigner patients, most of them were from Kanto-area, accounted for 11%, and were in advanced stage, some with drug-resistant tuberculosis, 4) INH resistance was noted in 7.7%, 5) pyrazinamide was included in the therapeutic regimens in 84.0% of the smear positive patients, 6) the admission period was within 90 days in 63.7% of the patients, however, the duration of treatment was 6 months in only 48.0% of patients who were treated with regimens containing pyrazinamide. More efforts for early detection of patients is needed to prevent the transmission of the disease, and more extensive use of directly observed therapy is essential for the prevention of dropout. We also argued about the shortening of the admission and duration of treatment in these patients. PMID:14509224

  5. Study of patterns of prescribing antibiotics in geriatric patients admitted to the medical wards in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Ankita Bist

    2016-02-01

    Conclusions: Polypharmacy is commonly observed practice in geriatric patients. Apart from increasing the cost of treatment it also promotes irrational prescription of drugs. Most of the prescriptions were in adherence with the WHO's Essential Medicine List but antibiotics were mainly prescribed empirically. [Int J Basic Clin Pharmacol 2016; 5(1.000: 155-158

  6. Effectiveness of a Cognitive Behavioral Therapy for Dysfunctional Eating among Patients Admitted for Bariatric Surgery: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hege Gade

    2014-01-01

    Full Text Available Objective. To examine whether cognitive behavioral therapy (CBT alleviates dysfunctional eating (DE patterns and symptoms of anxiety and depression in morbidly obese patients planned for bariatric surgery. Design and Methods. A total of 98 (68 females patients with a mean (SD age of 43 (10 years and BMI 43.5 (4.9 kg/m2 were randomly assigned to a CBT-group or a control group receiving usual care (i.e., nutritional support and education. The CBT-group received ten weekly intervention sessions. DE, anxiety, and depression were assessed by the TFEQ R-21 and HADS, respectively. Results. Compared with controls, the CBT-patients showed significantly less DE, affective symptoms, and a larger weight loss at follow-up. The effect sizes were large (DE-cognitive restraint, g=-.92, P≤.001; DE-uncontrolled eating, g=-.90, P≤.001, moderate (HADS-depression, g=-.73, P≤.001; DE-emotional eating, g=-.67, P≤.001; HADS-anxiety, g=-.62, P=.003, and low (BMI, g=-.24, P=.004. Conclusion. This study supports the use of CBT in helping patients preparing for bariatric surgery to reduce DE and to improve mental health. This clinical trial is registered with NCT01403558.

  7. Antimicrobial resistance in Salmonella spp. recovered from patients admitted to six different hospitals in Tehran, Iran from 2007 to 2008

    DEFF Research Database (Denmark)

    Tajbakhsh, Mercedeh; Hendriksen, Rene S.; Nochi, Zahra;

    2012-01-01

    The objective of this study was to assess the genotypic diversity associated with antimicrobial susceptibility of Salmonella serovars isolated from patients arriving with diarrhoea to six hospitals of Tehran, Iran. During 2007–2008, a cross-sectional convenience study was performed. Stool samples...

  8. Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Leah Schinasi

    Full Text Available BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011. METHODS: Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR estimates of association between MRSA carriage and medical and household exposures. RESULTS: In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI: 1.24-8.57 and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23. A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87. CONCLUSION: These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.

  9. Factors Related to Postoperative Pain Trajectories following Total Knee Arthroplasty: A Longitudinal Study of Patients Admitted to a Russian Orthopaedic Clinic.

    Science.gov (United States)

    Kornilov, Nikolai; Lindberg, Maren Falch; Gay, Caryl; Saraev, Alexander; Kuliaba, Taras; Rosseland, Leiv Arne; Muniz, Konstantin; Lerdal, Anners

    2016-01-01

    This study explores sociodemographic, clinical, and surgical factors in relation to pain trajectories during the first 3 days following total knee arthroplasty (TKA). 100 patients (mean age 63.5 ± 7.8 years and 93% female) consecutively admitted for uncomplicated primary TKA were prospectively included. Postoperative pain was assessed using pain diaries. Measures of preoperative pain, symptoms, daily functioning, quality of life, comorbidities, knee function, perioperative characteristics, and physical/biochemical parameters were also evaluated. All pain ratings decreased in the three days following surgery (p cohabitation, or any patient clinical and biochemical characteristics but were significantly related to preoperative anxiety (p = .029). Patients reporting moderate/severe pain prior to surgery also reported more hours in moderate/severe pain on days 0-3 postoperatively (p = .029). Patients with surgeries longer than 90 min reported more hours of moderate/severe pain compared with patients who had shorter surgeries (p = .008), and similar results were observed for ratings of pain with activity (p = .012). In this sample, only female gender, higher levels of preoperative pain and anxiety, and longer surgical duration were associated with increased pain after TKA. PMID:26885390

  10. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    OpenAIRE

    Traber, Maret G.; Leonard, Scott W.; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G.; Finnerty, Celeste C.; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status.

  11. Randomized-controlled trial of esomeprazole in functional dyspepsia patients with epigastric pain or burning

    DEFF Research Database (Denmark)

    Talley, N J; Vakil, N; Lauritsen, K;

    2007-01-01

    BACKGROUND: Early identification of true responders to acid suppression in functional dyspepsia patients with symptoms of epigastric pain or burning may enable clinicians to optimally tailor treatment. AIM: To evaluate whether a 1-w acid suppression trial is useful for identifying true responders...

  12. A retrospective study of drug prescribing pattern in burns patients in a tertiary care rural hospital

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    Palak Agrawal

    2015-06-01

    Conclusions: Females are more vulnerable to burn injuries. Polypharmacy was observed in prescriptions. Systemic antibiotic should be used with caution to prevent emergence of resistant microorganisms. Results of the present study indicate that some aspects of drug treatment need to be rationalized in order to achieve better patient care. [Int J Res Med Sci 2015; 3(6.000: 1446-1452

  13. A new approach: role of data mining in prediction of survival of burn patients.

    Science.gov (United States)

    Patil, Bankat Madhavrao; Joshi, Ramesh C; Toshniwal, Durga; Biradar, Siddeshwar

    2011-12-01

    The prediction of burn patient survivability is a difficult problem to investigate till present times. In present study a prediction Model for patients with burns was built, and its capability to accurately predict the survivability was assessed. We have compared different data mining techniques to asses the performance of various algorithms based on the different measures used in the analysis of information pertaining to medical domain. Obtained results were evaluated for correctness with the help of registered medical practitioners. The dataset was collected from SRT (Swami Ramanand Tirth) Hospital in India, which is one of the Asia's largest rural hospitals. Dataset contains records of 180 patients mainly suffering from burn injuries collected during period from the year 2002 to 2006. Features contain patients' age, sex and percentage of burn received for eight different parts of the body. Prediction models have been developed through rigorous comparative study of important and relevant data mining classification techniques namely, navie bayes, decision tree, support vector machine and back propagation. Performance comparison was also carried out for measuring unbiased estimate of the prediction models using 10-fold cross-validation method. Using the analysis of obtained results, we show that Navie bayes is the best predictor with an accuracy of 97.78% on the holdout samples, further, both the decision tree and support vector machine (SVM) techniques demonstrated an accuracy of 96.12%, and back propagation technique resulted in achieving accuracy of 95%. PMID:20703764

  14. Colistin Pharmacokinetics in Burn Patients during Continuous Venovenous Hemofiltration

    OpenAIRE

    Akers, Kevin S.; Rowan, Matthew P.; Niece, Krista L.; Stewart, Ian J.; Mende, Katrin; Cota, Jason M.; Murray, Clinton K.; Chung, Kevin K.

    2014-01-01

    While colistin is considered a last resort for the treatment of multidrug-resistant Gram-negative bacterial infections, there has been an increase in its use due to the increasing prevalence of drug-resistant infections worldwide. The pharmacology of colistin is complex, and pharmacokinetic data are limited, especially in patients requiring renal replacement therapy. As a result, dosing for patients who require renal replacement remains a challenge. Here, we present pharmacokinetic data for c...

  15. INCIDENCE OF FLUOROQUINOLONES INDUCED PSYCHOTIC DISORDERS IN PATIENTS ADMITTED TO DEPARTMENT OF MEDICINE IN A GENERAL HOSPITAL SETUP

    Directory of Open Access Journals (Sweden)

    Dnyanda V

    2015-10-01

    Full Text Available Toxic psychosis in adults although it is relatively uncommon side-effect in proportion to the large worldwide consumption of the drugs, there has been a number of case reports of Fluoroquinolone-associated psychosis. Our study was first of its kind as no other prospective cohort study on the use of fluoroquinolones and its relation to development of psychosis has yet been carried out. 2007 patients who were prescribed fluoroquinolones were followed for one month for development of any signs of psychosis out of which 22 patients that is 1.11% was found to have fluoroquinolones induced psychosis. We also discuss the possible neurophysiological mechanisms behind fluoroquinolones induced psychosis.

  16. Chronic pain patients with possible co-morbid post-traumatic stress disorder admitted to multidisciplinary pain rehabilitation

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Andersen, Lou-Ann Christensen; Andersen, Per Grünwald

    2014-01-01

    BACKGROUND: Although post-traumatic stress disorder (PTSD) is a common co-morbidity in chronic pain, little is known about the association between PTSD and pain in the context of chronic pain rehabilitation. OBJECTIVE: The aim of the present study was two-fold: (1) to investigate the association of...... consecutively referred cohort of 194 patients completed a baseline questionnaire at admission covering post-traumatic stress, pain symptoms, physical and mental functioning, as well as self-reported sleep quality and cognitive difficulties. Medication use was calculated from their medical records. A total of 95...... well as inferior social functioning compared to patients without PTSD. Possible co-morbid PTSD did not result in higher use of opioids or sedatives. Surprisingly, possible co-morbid PTSD at admission was not associated with lower levels of symptom reduction from pre- to post-treatment. CONCLUSIONS...

  17. Comparison of Plasma BNP and ET-1 Levels With Hemodynamics in Patients Admitted for Decompensated Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Hu Yongmei; Zhao Siqin; Li Qiu; Nie Xiaoli; Wu Tao; Liu Xiaorong; Wang Mian

    2005-01-01

    Objectives This study addressed to compare plasma B-type natriuretic peptide (BNP) and endothelin-1 (ET-l) levels with hemodynamics in heart failure (HF) patients. Methods Plasma BNP and ET-1 levels were obtained from 75patients with HF by rapid immunofluorescence assay and radio-immunity method, respectively, and left ventricular end-diastolic diameter (LVEDD) were observed by echocardiogram. Hemodynamic data of 53HF patients were determined by Swan-Ganz catheterization. Results Hemodynamics (PCWP,MPAP and RAP) and plasma BNP, ET-1 levels were proportional to New York Heart Association (NYHA)class (P< 0.001-0.05). Both BNP and ET-1 had positive linear relations with PCWP, MPAP, RAP (P< 0.05-001). Moreover, plasma ET-1 was an independent and significant predictor of BNP (P<0.001). Plasma levels of BNP (968.23±478.63 pg/ml)and ET-1 (129.45±88.56 pg/ml)in group with LVEDD (n=31) ≥60 mm were much higher than those in LVEDD(n = 44) < 60mm group (BNP:286.26 ±156.89 pg/mL,ET-1:87.45±43.65 pg/mL, P< 0.001). Conclusions BNP level is as a direct result of ventricular volume expansion and pressure overload. BNP is a sensitive biochemical maker of left ventricular injury and ET-1may stimulate the secretion of cardiac BNP independent of hemodynamics in patients with HF.

  18. Are AMI patients with comorbid mental illness more likely to be admitted to hospitals with lower quality of AMI care?

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    Xueya Cai

    Full Text Available OBJECTIVE: Older patients with comorbid mental illness are shown to receive less appropriate care for their medical conditions. This study analyzed Medicare patients hospitalized for acute myocardial infarction (AMI and determined whether those with comorbid mental illness were more likely to present to hospitals with lower quality of AMI care. METHODS: Retrospective analyses of Medicare claims in 2008. Hospital quality was measured using the five "Hospital Compare" process indicators (aspirin at admission/discharge, beta-blocker at admission/discharge, and angiotension-converting enzyme inhibitor or angiotension receptor blocker for left ventricular dysfunction. Multinomial logit model determined the association of mental illness with admission to low-quality hospitals (rank of the composite process score 90(th percentile, compared to admissions to other hospitals with medium quality. Multivariate analyses further determined the effects of hospital type and mental diagnosis on outcomes. RESULTS: Among all AMI admissions to 2,845 hospitals, 41,044 out of 287,881 patients were diagnosed with mental illness. Mental illness predicted a higher likelihood of admission to low-quality hospitals (unadjusted rate 2.9% vs. 2.0%; adjusted odds ratio [OR]1.25, 95% confidence interval [CI] 1.17-1.34, p<0.01, and an equal likelihood to high-quality hospitals (unadjusted rate 9.8% vs. 10.3%; adjusted OR 0.97, 95% CI 0.93-1.01, p = 0.11. Both lower hospital quality and mental diagnosis predicted higher rates of 30-day readmission, 30-day mortality, and 1-year mortality. CONCLUSIONS: Among Medicare myocardial infarction patients, comorbid mental illness was associated with an increased risk for admission to lower-quality hospitals. Both lower hospital quality and mental illness predicted worse post-AMI outcomes.

  19. INCIDENCE OF FLUOROQUINOLONES INDUCED PSYCHOTIC DISORDERS IN PATIENTS ADMITTED TO DEPARTMENT OF MEDICINE IN A GENERAL HOSPITAL SETUP

    OpenAIRE

    Dnyanda V; Vidyut A; Shrikant B.; Ashish V

    2015-01-01

    Toxic psychosis in adults although it is relatively uncommon side-effect in proportion to the large worldwide consumption of the drugs, there has been a number of case reports of Fluoroquinolone-associated psychosis. Our study was first of its kind as no other prospective cohort study on the use of fluoroquinolones and its relation to development of psychosis has yet been carried out. 2007 patients who were prescribed fluoroquinolones were followed for one month for develo...

  20. Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

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    S.E. Mataloun

    2006-10-01

    Full Text Available The objective of the present study was to assess the incidence, risk factors and outcome of patients who develop acute renal failure (ARF in intensive care units. In this prospective observational study, 221 patients with a 48-h minimum stay, 18-year-old minimum age and absence of overt acute or chronic renal failure were included. Exclusion criteria were organ donors and renal transplantation patients. ARF was defined as a creatinine level above 1.5 mg/dL. Statistics were performed using Pearsons' chi2 test, Student t-test, and Wilcoxon test. Multivariate analysis was run using all variables with P < 0.1 in the univariate analysis. ARF developed in 19.0% of the patients, with 76.19% resulting in death. Main risk factors (univariate analysis were: higher intra-operative hydration and bleeding, higher death risk by APACHE II score, logist organ dysfunction system on the first day, mechanical ventilation, shock due to systemic inflammatory response syndrome (SIRS/sepsis, noradrenaline use, and plasma creatinine and urea levels on admission. Heart rate on admission (OR = 1.023 (1.002-1.044, male gender (OR = 4.275 (1.340-13642, shock due to SIRS/sepsis (OR = 8.590 (2.710-27.229, higher intra-operative hydration (OR = 1.002 (1.000-1004, and plasma urea on admission (OR = 1.012 (0.980-1044 remained significant (multivariate analysis. The mortality risk factors (univariate analysis were shock due to SIRS/sepsis, mechanical ventilation, blood stream infection, potassium and bicarbonate levels. Only potassium levels remained significant (P = 0.037. In conclusion, ARF has a high incidence, morbidity and mortality when it occurs in intensive care unit. There is a very close association with hemodynamic status and multiple organ dysfunction.

  1. Microbiological profile of hospital acquired blood stream infections in seriously ill medical patients admitted in tertiary care hospital

    OpenAIRE

    Preeti Raheja; Antarikshdeep; Uma Chaudhary

    2016-01-01

    Background: Hospital acquired infections (HAIs) are those which are acquired in hospital either due to any intervention or directly through various routes of entry into the body. Nosocomial infection not only adds to functional disability to patients but also increases associated cost of treatment. Major categories of HAIs include pneumonia, urinary tract infections (UTIs), blood stream infections (BSIs), and surgical site infections (SSIs). Methods: The study was conducted to know the in...

  2. Outcome and predictors of cardiopulmonary resuscitation among patients admitted in Medical Intensive Care Unit in North India

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    Amit Bansal

    2016-01-01

    Full Text Available Background: Outcome and predictors of survival after cardiopulmonary resuscitation (CPR in Intensive Care Units (ICUs have been extensively studied in western world, but data from developing countries is sparse. Objectives: To study the outcome and predictors of survival after CPR in a Medical ICU (MICU of a tertiary level teaching hospital in North India. Materials and Methods: A 1-year prospective cohort study. Results: Of 105 in-MICU CPRs, forty patients (38.1% achieved return of spontaneous circulation (ROSC. Only one patient (0.9% survived up to hospital discharge. The predictors of ROSC were ventricular tachycardia/ventricular fibrillation as first monitored rhythm, intubation during CPR and CPR duration ≤ 10 min. CPR duration > 10 min was a significant factor for resuscitation failure. Conclusions: The rate of survival to hospital discharge after in-MICU CPRs is extremely poor. Our data may aid treating physicians, resuscitation teams, and families in understanding the likely outcome of patients after in-MICU CPRs.

  3. Medical Treatment for Burn Patients with Eating Disorders: A Case Report

    OpenAIRE

    Minekatsu Akimoto; Akira Takeda; Kazutaka Nagashima; Rie Uehara; Mitsuru Nemoto; Eiju Uchinuma

    2011-01-01

    There have been many cases of burn patients who also suffer from psychiatric problems, including eating disorders. We present a case of a 38-year-old female with an eating disorder and depression who became light-headed and fell, spilling boiling water from a kettle on herself at home sustaining partial thickness and full thickness burns over 5% of her total body surface area: left buttock and right thigh and calf. Eating disorders (in the present case, anorexia nervosa) cause emaciation and ...

  4. Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study

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    Printzen Gert

    2007-02-01

    Full Text Available Abstract Background The epidemiology of liver disease in patients admitted to emergency rooms is largely unknown. The current study aimed to measure the prevalence of viral hepatitis B and C infection and pathological laboratory values of liver disease in such a population, and to study factors associated with these measurements. Methods Cross-sectional study in patients admitted to the emergency room of a university hospital. No formal exclusion criteria. Determination of anti-HBs, anti-HCV, transferrin saturation, alanine aminotransferase, and obtaining answers from a study-specific questionnaire. Results The study included 5'036 patients, representing a 14.9% sample of the target population during the study period. Prevalence of anti-HBc and anti-HCV was 6.7% (95%CI 6.0% to 7.4% and 2.7% (2.3% to 3.2%, respectively. Factors independently associated with positive anti-HBc were intravenous drug abuse (OR 18.3; 11.3 to 29.7, foreign country of birth (3.4; 2.6 to 4.4, non-white ethnicity (2.7; 1.9 to 3.8 and age ≥60 (2.0; 1.5 to 2.8. Positive anti-HCV was associated with intravenous drug abuse (78.9; 43.4 to 143.6, blood transfusion (1.7; 1.1 to 2.8 and abdominal pain (2.7; 1.5 to 4.8. 75% of all participants were not vaccinated against hepatitis B or did not know their vaccination status. Among anti-HCV positive patients only 49% knew about their infection and 51% reported regular alcohol consumption. Transferrin saturation was elevated in 3.3% and was associated with fatigue (prevalence ratio 1.9; 1.2 to 2.8. Conclusion Emergency rooms should be considered as targets for public health programs that encourage vaccination, patient education and screening of high-risk patients for liver disease with subsequent referral for treatment if indicated.

  5. Pattern and risk factors of stroke in the young among stroke patients admitted in medical college hospital, Thiruvananthapuram

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    Praveen Prasannakumar Subha

    2015-01-01

    Full Text Available Background: Stroke in the young is particularly tragic because of its potential to create a long-term burden on the victims, their families, and the community. There had been relatively few studies on young stroke in Kerala′s socio-economic setup, that too encapsulating the mentioned apparently relevant dimensions of stroke in the young . Objective: To study the prevalence, patterns and risk factors of young stroke. Settings and Design: A cross-sectional study with case control comparison at Government Medical College Hospital, Thiruvananthapuram, Kerala, India. Materials and and Methods: Total 100 stroke patients were identified over a period of 2 months, and data were collected on the basis of questionnaire developed for the purpose. Results: Of 100 stroke patients, 15 had stroke in the young, among which 9 (60% had ishaemic stroke. Hypertension was the most common risk factor. Smoking, alcohol, atrial fibrillation, and hyperlipidemia were found to be more common in cases (young stroke when compared with controls. Alcohol use and atrial fibrillation were significantly higher among young stroke patients. Physical inactivity was significantly lesser in those with stroke in the young than elderly. Atrial fibrillation emerged as an independent risk factor of stroke in the young with adjusted odds ratio of 6.18 (1.31-29.21. Conclusion: In all, 15% of total stroke occurred in young adults <50 years. The proportion of hemorrhagic stroke in young adults is higher than in elderly. Atrial fibrillation is identified as an independent risk factor of stroke in the young. Compared with stroke in elderly alcohol use, smoking, hyperlipidemia, and cardiac diseases, which are known risk factors, are higher in young stroke.

  6. Usefulness of Combining Galectin-3 and BIVA Assessments in Predicting Short- and Long-Term Events in Patients Admitted for Acute Heart Failure

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    Benedetta De Berardinis

    2014-01-01

    Full Text Available Introduction. Acute heart failure (AHF is associated with a higher risk for the occurrence of rehospitalization and death. Galectin-3 (GAL3 is elevated in AHF patients and is an indicator in predicting short-term mortality. The total body water using bioimpedance vector analysis (BIVA is able to identify mortality within AHF patients. The aim of this study was to evaluate the short- and long-term predictive value of GAL3, BIVA, and the combination of both in AHF patients in Emergency Department (ED. Methods. 205 ED patients with AHF were evaluated by testing for B type natriuretic peptide (BNP and GAL3. The primary endpoint was death and rehospitalization at 30, 60, 90, and 180 days and 12 and 18 months. AHF patients were evaluated at the moment of ED arrival with clinical judgment and GAL3 and BIVA measurement. Results. GAL3 level was significantly higher in patients >71 years old, and with eGFR17.8 ng/mL shows significant survival difference. At multivariate Cox regression analysis GAL3 is an independent variable to predict death + rehospitalization with a value of 32.24 ng/mL at 30 days (P<0.005. Conclusion. In patients admitted for AHF an early assessment of GAL3 and BIVA seems to be useful in identifying patients at high risk for death and rehospitalization at short and long term. Combining the biomarker and the device could be of great utility since they monitor the severity of two pathophysiological different mechanisms: heart fibrosis and fluid overload.

  7. Profile of patients acometidos for head injury admitted in the public hospital of the city of Jequié in the Bahia

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    Indira de Oliveira Gomes

    2011-01-01

    Full Text Available This study aimed to draw the profile of patients affected by traumatic brain injury admitted to a hospital in the Jequié, BA. This is a cross-sectional epidemiological study conducted in clinical medicine and surgery of a public hospital, through a structured questionnaire concerning sociodemographic, lifestyle and issues related to traumatic brain injury. 15 patients were victims of traumatic brain injury, are more frequent in males (86.67%, ages 20 to 39 years (33.33%, education for the 2nd degree (46.66% , unmarried (53.33% and income of up to one minimum salary (86.67%. Regarding life habits, most of the sample were alcoholics, non-smoker (66.67%. The cause of traumagreater frequency were motorcycle accidents ( 53.33 %,with clinical diagnoses of the largest distribution mild Traumatic brain injury (26.67 %. The occurrence of death was present in 13.33% of patients affected by brain trauma. Thus, it becomes clear that the victims of head trauma patients are mostly men, young adults, and that alcoholics are the leading cause automobile accidents.

  8. Effects of early physiotherapy with respect to severity of pneumonia of elderly patients admitted to an intensive care unit: a single center study in Japan.

    Science.gov (United States)

    Chigira, Yusuke; Takai, Tomoko; Igusa, Hironobu; Dobashi, Kunio

    2015-07-01

    [Purpose] We performed early physiotherapy for elderly patients with pneumonia admitted to an intensive care unit (ICU), and examined the effects of this early physiotherapy on the severity of pneumonia. [Subjects and Methods] Patients for whom physiotherapy was started the day after admission to the ICU (acute phase) were assigned to the early intervention group and compared with patients in the standard intervention group. All patients were divided into three groups (Groups I, II, and III) based on the severity of pneumonia. We evaluated the ICU admission period, hospitalization period, and activities of daily living (ADL) before and after admission. [Results] With respect to the severity of pneumonia, Group II showed significant differences in the ICU admission period and rates of change in the operating range, cognitive domain, and Functional Independence Measure (FIM). Group III showed significant differences in the ICU admission period and rate of change in the cognitive domain (FIM item). The results were more favorable in the early intervention group than in the standard intervention group. [Conclusion] The ICU admission period was shorter and a reduction in the ADL level was prevented in Groups II, and III compared to Group I. This may have occurred because of the early rehabilitation. PMID:26311924

  9. Assessment of noninvasive acoustic respiration rate monitoring in patients admitted to an Emergency Department for drug or alcoholic poisoning.

    Science.gov (United States)

    Guechi, Youcef; Pichot, Amélie; Frasca, Denis; Rayeh-Pelardy, Fatima; Lardeur, Jean-Yves; Mimoz, Olivier

    2015-12-01

    To compare respiration rate measurement by an acoustic method and thoracic impedance to capnometry as the reference method, in patients at the Emergency Department after drug or alcoholic poisoning. In this observational study, 30 patients aged 18 or older, hospitalized at the Emergency Department for drug or alcoholic poisoning, without any contraindication to a face mask and/or a cervical acoustic sensor, were included in the study. They benefited from a simultaneous recording of their respiration rate by the acoustic method (RRa(®), Masimo Corp., Irvine, CA, USA), by thoracic impedance (Philips Intellivue(®) MP2, Suresnes, France) and by capnometry (Capnostream(®) 20, Oridion, Jerusalem, Israël) through a face mask (Capnomask(®), Mediplus Ltd, Raleigh, NC, USA) for 40-60 min. Of the 86,578 triplets collected, 77,155 (89.1%) were exploitable. Median (range) respiration rate measured by capnometry was 18 (7-29) bpm. Compared to capnometry, bias and limits of agreement were 0.1 ± 3.8 bpm for the acoustic method and 0.3 ± 5.5 bpm for thoracic impedance. The proportions of RR values collected by acoustic method or by thoracic impedance which differed over 10 or 20% during more than 15 s, compared to capnometry, were 8.3 versus 14.3, and 1.5 versus 3.8%, respectively (p face mask capnometry. PMID:25614223

  10. Effect of Foot Massage on Physiologic Indicators in Critically Ill Patients Admitted in the I.C.U

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    H Alavi- Majd

    2006-10-01

    Full Text Available Introduction: Intensive care unit is one of the most stressful wards for patients and it is estimated that 30 to70 percent of patients experience severe physiologic stress during admission. Some of the physiologic responses to stress include increase in metabolic rate with consequent increase in body temperature, increase in cardiac output and contraction power and subsequently increase in blood pressure, heart rate and sodium accumulation, bronchodilation and increase in respiration rate. Control of homodynamic condition and vital signs is an essential and important practice in intensive care units for stabilizing physiologic indicators. Massage is one of the methods that can be used for this purpose. The purpose of this research was to determine the effect of foot massage on physiologic indicators including pulse, respiration rate, mean arterial pressure, temperature and arterial blood oxygen saturation. Methods: 46 patients with brain stroke who were hospitalized in the intensive care unit of Tajrish Shohada hospital were studied.The validity of information record form was determined with content validity and the validity of instruments was established using valid marks. The reliability of instruments was assessed with test-re-test after calibration. Information was collected on second, third and fourth days after ICU admission at 4 to 6 pm. For this purpose, the physiologic indicators were controlled and after 10 minute, the patients underwent 5-minute foot stroke massage and then at 10 and 30-minute intervals, physiologic indicators were controlled again. Data was analyzed by ANOVA statistical method. Results: Findings showed that pulse rate, respiratory rate and mean arterial blood pressure significantly decreased after 5 minute foot massage (p< 0.001 and the value of these indicators 10 minutes after foot massage was less than the values 10 minute before massage. Also, arterial oxygen conc. 10 minute after foot massage was more than the

  11. The Role of Coping Behavior in Severely Burned Patients With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Cheng, Hua; Li, Xiaojian; Miao, Huilai; Li, Ruijun

    2015-01-01

    This multicenter cross-sectional study investigates the role of coping behaviors of inpatients with severe burn injuries that determined their development of post-traumatic stress disorder (PTSD) in burn specialty center in South China. Sixty-four subjects who were in their rehabilitation period were enrolled in the study. Self-report scales, such as the Post-traumatic Stress Disorder Checklist-Civilian Version and the Medical Coping Mode Questionnaire, were applied for evaluating PTSD symptoms with the severity and classifying coping behaviors. Regression analysis evaluated the association of severity of PTSD with coping behaviors. Outcomes indicated that coping behaviors could diagnose PTSD symptoms and predict the severity of PTSD to some extent. It suggested coping behaviors might intermediate the psychological outcomes of the severely burned patients. PMID:25959038

  12. Epidemiology of elderly patients' burns in the South West of France.

    Science.gov (United States)

    Cutillas, M; Sesay, M; Perro, G; Bourdarias, B; Castede, J C; Sanchez, R

    1998-03-01

    A retrospective study of 716 patients aged 60 years and above (324 men, 392 women) was undertaken in order to determine quality control in burns management in the South West of France. The following epidemiological data was obtained: high hospitalization rate (7 per cent of the general admissions); monthly and seasonal periodicity; predominance of indoor accidents (86 per cent) with domestic accidents being more frequent in women (63 vs. 37 per cent). Outdoor accidents were mainly recreational and were five times more frequent in men than in women. The overall mortality was 39 per cent and was influenced by the burns extent, depth, predisposing factors and early management. More burns occurred in urban areas (53 per cent) but mortality was higher in patients from rural areas (62 vs. 38 per cent). It was observed that delay in management, especially fluid resuscitation of patients from the rural areas, was partly responsible for this outcome. Propositions were made to diffuse more information on the importance of early management of burns in rural areas. PMID:9625238

  13. [Investigation of human herpesvirus-8 seroprevalence in blood donors and HIV-positive patients admitted to Ege University Medical School Hospital, Turkey].

    Science.gov (United States)

    Altuğlu, İmre; Yolcu, Ayfer; Öcek, Zeliha Aslı; Yazan Sertöz, Rüçhan; Gökengin, Deniz

    2016-01-01

    Human herpesvirus 8 (HHV-8), classified in Herpesviridae family, is the etiological agent of Kaposi's sarcoma (KS), primary effusion lymphoma and multicentric Castleman's disease. In contrast to the other herpesviruses, HHV-8 seroprevalence is low in general populations; however, the higher prevalence observed in individuals with immunodeficiencies such as AIDS poses an increased risk for KS. The global distribution of HHV-8 shows great variations, with the highest seroprevalence seen in Africa. The number of studies on the seroprevalence of HHV-8 in Turkey are limited. The aim of this study was to determine the HHV-8 seroprevalences in healthy blood donors and HIV-positive patients, that will contribute HHV-8 seroepidemiological data in our country. This study was designed as a cross-sectional study. A total of 551 healthy donors (76 female, 475 male; age range: 18-65 years) admitted to Ege University Medical School Hospital, Blood Center for blood donation between December 2013-January 2014, and 173 HIV-positive patients (30 female, 143 male; age range: 18-65 years) admitted to infectious diseases outpatient clinic between October 2013-January 2014, were included in the study. A commercial ELISA method (KSHV/HHV-8 IgG ELISA Kit, Advanced Biotechnologies Inc, USA) was used for the detection of IgG antibodies that were structured against HHV-8 lytic antigens. In the study, 29 (29/551, 5.3%) of blood donors and 44 (44/173, 25.4%) of HIV-positive patients, with a total of 73 (73/724, 10.1%) cases were found as HHV-8 seropositive. The difference between blood donors and HIV-positive patients in terms of HHV-8 seropositivity rates was statistically significant (5.3% versus 25.4%; pHIV-positive patients, no statistically significant difference was observed between HHV-8 seropositivity with the duration of anti-HIV positivity, CD4(+) T cell count, HIV-RNA status and history of having sexually transmitted disease. As a result, HHV-8 seroprevalence rate detected in our

  14. Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change

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    Arthur Halley Barbosa do Vale

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Thermal injuries and injured areas management are important causes of pain in burned patients, requiring that these patients are constantly undergoing general anesthesia for dressing change. Nitrous oxide (N2O has analgesic and sedative properties; it is easy to use and widely available. Thus, the aim of this study was to evaluate the analgesic effect of N2O combined with fentanyl in burned patients during dressing change. METHOD: After approval by the institutional Ethics Committee, 15 adult burned patients requiring daily dressing change were evaluated. Patient analgesia was controlled with fentanyl 0.0005% administered by intravenous pump infusion on-demand. Randomly, in one of the days a mixture of 65% N2O in oxygen (O2 was associated via mask, with a flow of 10 L/min (N2O group and on the other day only O2 under the same flow (control group. RESULTS: No significant pain reduction was seen in N2O group compared to control group. VAS score before dressing change was 4.07 and 3.4, respectively, in N2O and control groups. Regarding pain at the end of the dressing, patients in N2O group reported pain severity of 2.8; while the control group reported 2.87. There was no significant difference in fentanyl consumption in both groups. CONCLUSIONS: The association of N2O was not effective in reducing opioid consumption during dressing changes.

  15. Use of negative pressure wound therapy in burn patients.

    Science.gov (United States)

    Teng, Shou-Cheng

    2016-09-01

    According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability. PMID:27547959

  16. [Atherosclerosis of the lower extremities as a linked comorbidity in Patients Admitted for cardiac rehabilitation (THINKPAD): rationale, design, and study group].

    Science.gov (United States)

    Ambrosetti, Marco; Diaco, Tommaso; Febo, Oreste; Calisi, Pasqualina; Favretto, Giuseppe; Carlon, Roberto; Temporelli, Pier Luigi

    2012-03-01

    Peripheral arterial disease (PAD) is a frequent comorbidity among patients entering cardiac rehabilitation (CR) programmes and an important source of disability and impaired prognosis. The prevalence of PAD across the wide range of conditions for CR is poorly understood, as far as its impact on drug optimization and intervention delivered. The "ATHerosclerosis of the lower extremities as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) study was carried out by the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) in order to explore PAD both as a comorbidity and a primary indication at the entry of CR. The study was a retrospective case series. In the study period (from May 1, 2012 to June 30, 2012), data on consecutive patients discharged from 17 CR units in Northern Italy were collected. Web-based electronic case report forms (e-CRF), accessible in a dedicated section of the IACPR website (www.iacpr.it), were used for data entry, and data were transferred via web to a central database. The data collection instrument was designed with a multiple choice format, with jump menus or select boxes and obligatory items. A sample size of 1,300 subjects is expected, with first data available by the end of 2012. PMID:22928398

  17. Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Shin Hye; You, Je Sung; Choi, Jin-Young; Kim, Myeong-Jin; Chung, Yong Eun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of); Song, Mi Kyong [Yonsei University, Biostatistics Collaboration Unit, College of Medicine, Seoul (Korea, Republic of)

    2015-04-01

    To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. (orig.)

  18. Cyst infection in hospital-admitted autosomal dominant polycystic kidney disease patients is predominantly multifocal and associated with kidney and liver volume

    International Nuclear Information System (INIS)

    Positron-emission tomography/computed tomography (PET/CT) has improved cyst infection (CI) management in autosomal dominant polycystic kidney disease (ADPKD). The determinants of kidney and/or liver involvement, however, remain uncertain. In this study, we evaluated clinical and imaging factors associated with CI in kidney (KCI) and liver (LCI) in ADPKD. A retrospective cohort study was performed in hospital-admitted ADPKD patients with suspected CI. Clinical, imaging and surgical data were analyzed. Features of infected cysts were evaluated by PET/CT. Total kidney (TKV) and liver (TLV) volumes were measured by CT-derived multiplanar reconstruction. CI was detected in 18 patients who experienced 24 episodes during an interval of 30 months (LCI in 12, KCI in 10 and concomitant infection in 2). Sensitivities of CT, magnetic resonance imaging and PET/CT were 25.0, 71.4, and 95.0%. Dysuria (P<0.05), positive urine culture (P<0.01), and previous hematuria (P<0.05) were associated with KCI. Weight loss (P<0.01) and increased C-reactive protein levels (P<0.05) were associated with LCI. PET/CT revealed that three or more infected cysts were present in 70% of the episodes. TKV was higher in kidney-affected than in LCI patients (AUC=0.91, P<0.05), with a cut-off of 2502 mL (72.7% sensitivity, 100.0% specificity). TLV was higher in liver-affected than in KCI patients (AUC=0.89, P<0.01) with a cut-off of 2815 mL (80.0% sensitivity, 87.5% specificity). A greater need for invasive procedures was observed in LCI (P<0.01), and the overall mortality was 20.8%. This study supports PET/CT as the most sensitive imaging method for diagnosis of cyst infection, confirms the multifocal nature of most hospital-admitted episodes, and reveals an association of kidney and liver volumes with this complication

  19. Nonalcoholic Fatty Liver Disease Is Associated With Higher 1-year All-Cause Rehospitalization Rates in Patients Admitted for Acute Heart Failure.

    Science.gov (United States)

    Valbusa, Filippo; Bonapace, Stefano; Grillo, Cristina; Scala, Luca; Chiampan, Andrea; Rossi, Andrea; Zoppini, Giacomo; Lonardo, Amedeo; Arcaro, Guido; Byrne, Christopher D; Targher, Giovanni

    2016-02-01

    Repeat hospitalization due to acute heart failure (HF) is a global public health problem that markedly impacts on health resource use. Identifying novel predictors of rehospitalization would help physicians to determine the optimal postdischarge plan for preventing HF rehospitalization. Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for many heart diseases, including HF. We assessed whether NAFLD at hospital admission predicts 1-year all-cause rehospitalization in patients with acute HF. We enrolled all patients consecutively admitted for acute HF to our General Medicine Division, from January 2013 to April 2014, after excluding patients with acute myocardial infarction, severe heart valve diseases, malignancy, known liver diseases, and those with volume overload related to extracardiac causes. NAFLD was diagnosed by ultrasonography and exclusion of competing etiologies. The primary outcome of the study was the 1-year all-cause rehospitalization rate. Among the 107 patients enrolled in the study, the cumulative rehospitalization rate was 12.1% at 1 month, 25.2% at 3 months, 29.9% at 6 months, and 38.3% at 1 year. Patients with NAFLD had markedly higher 1-year rehospitalization rates than those without NAFLD (58% vs 21% at 1 y; P < 0.001 by the log-rank test). Cox regression analysis revealed that NAFLD was associated with a 5.5-fold increased risk of rehospitalization (adjusted hazard ratio 5.56, 95% confidence interval 2.46-12.1, P < 0.001) after adjustment for multiple HF risk factors and potential confounders. In conclusion, NAFLD was independently associated with higher 1-year rehospitalization in patients hospitalized for acute HF. PMID:26886619

  20. Bioactive substance accumulation and septic complications in a burn trauma patient: effect of perioperative blood transfusion?

    DEFF Research Database (Denmark)

    Nielsen, H J; Reimert, C M; Dybkjaer, E;

    1997-01-01

    have been shown. The potential adverse effects of these bioactive substances were analysed in a burn trauma patient. A patient with 40 per cent second and third degree burn trauma without other injuries underwent a two-step transplantation operation. Samples for analyses of histamine, eosinophil......Evidence has emerged that suggests adverse effects to perioperative homologous blood transfusion are related to the age of the blood products. Recently, time-dependent accumulation of bioactive substances in red cell suspensions, standard platelet concentrates and fresh frozen plasma during storage...... cationic protein (ECP), eosinophil protein X (EPX), neutrophil myeloperoxidase (MPO) and interleukin 6 (IL-6) were drawn frequently from the patient before, during and after the operations, and from all transfused red cell, platelet and fresh frozen plasma units. Urine was sampled every hour during the...

  1. The practical evaluation and management of patients with symptoms of a sore burning mouth.

    Science.gov (United States)

    Steele, John C

    2016-01-01

    There are many etiologic factors to consider in a patient who presents with symptoms or sensations of a sore burning mouth. These range from local causes within the oral cavity to underlying systemic disease, including psychologic factors. This paper aims to describe the different clinical presentations and to outline a systematic approach to the evaluation and management of such patients. The clinician will be directed to the relevant diagnosis by following the traditional medical model of taking a focused history, performing a thorough clinical examination, considering the potential differential diagnoses, and requesting pertinent and appropriate investigations. The various differential diagnoses and broad treatment options will also be discussed and outlined. This paper will not, however, discuss burning mouth syndrome (oral dysesthesia), which is a diagnosis of exclusion, whereby the oral mucosa is clinically normal and there are no identifiable medical or dental causes to account for the patient's symptoms. PMID:27343959

  2. Persistent candidemia in major burn patients: radiologic findings of the thorax

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eil Seong; Lee, Kwan Seop; Kang, Ik Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    To describe radiologic findings of burn-associated persistent candidemia of the thorax. This study included 42 patients with major burns in whom blood culture had shown the presence for more than 24 hours of persistent candidemia. The duration of positive culture for candidiasis ranged from two to 67 days(mean, 15 days). Radiographic(n=42) and thin-section CT findings(n=13) were retrospectively analyzed. The onset, pattern, size, distribution and persistence of parenchymal abnormalities as well as the presence or absence of pleural effusions, mediastinal lymphadenopathy and cardiomegaly were assessed. On chest radiographs, positive findings were noticed in 61.9%(26/42) and on thin-section CT, in 76.9%(10/13). The most frequent radiographic finding was pulmonary nodule(s), observed in 14 patients(33.3%); in 13, these were bilateral. Bronchovascular bundle thickening(n=6, 14.3%), consolidation(n=4, 9.5%), cardiomegaly(n=6, 14.3%) and pleural effusion(n=4, 9.5%) were also observed. Those lesions appeared eight to 129 days(mean, 33 days) after the burn. Radiographic abnormalities persisted for seven to 115(mean, 35) days, regardless of the treatment. Thin-section CT showed parenchymal abnormalities in 10/13 patients(76.9%) and subpleural nodules of less than 1cm in diameter and without halo in all patients. Cardiomegaly, pleural effusion and mediastinal adenopathy were observed on CT in 5(38.5%), 4(30.8%) and 2(15.4%) of the 13 patients, respectively. In a high proportion of patients with burn-associated candidemia, chest radiograph and thin-section CT findings were positive. The most frequent radiographic parenchymal abnormality was multiple bilateral nodules.

  3. Persistent candidemia in major burn patients: radiologic findings of the thorax

    International Nuclear Information System (INIS)

    To describe radiologic findings of burn-associated persistent candidemia of the thorax. This study included 42 patients with major burns in whom blood culture had shown the presence for more than 24 hours of persistent candidemia. The duration of positive culture for candidiasis ranged from two to 67 days(mean, 15 days). Radiographic(n=42) and thin-section CT findings(n=13) were retrospectively analyzed. The onset, pattern, size, distribution and persistence of parenchymal abnormalities as well as the presence or absence of pleural effusions, mediastinal lymphadenopathy and cardiomegaly were assessed. On chest radiographs, positive findings were noticed in 61.9%(26/42) and on thin-section CT, in 76.9%(10/13). The most frequent radiographic finding was pulmonary nodule(s), observed in 14 patients(33.3%); in 13, these were bilateral. Bronchovascular bundle thickening(n=6, 14.3%), consolidation(n=4, 9.5%), cardiomegaly(n=6, 14.3%) and pleural effusion(n=4, 9.5%) were also observed. Those lesions appeared eight to 129 days(mean, 33 days) after the burn. Radiographic abnormalities persisted for seven to 115(mean, 35) days, regardless of the treatment. Thin-section CT showed parenchymal abnormalities in 10/13 patients(76.9%) and subpleural nodules of less than 1cm in diameter and without halo in all patients. Cardiomegaly, pleural effusion and mediastinal adenopathy were observed on CT in 5(38.5%), 4(30.8%) and 2(15.4%) of the 13 patients, respectively. In a high proportion of patients with burn-associated candidemia, chest radiograph and thin-section CT findings were positive. The most frequent radiographic parenchymal abnormality was multiple bilateral nodules

  4. Pharmacokinetic-pharmacodynamic correlation of imipenem in pediatric burn patients using a bioanalytical liquid chromatographic method

    Directory of Open Access Journals (Sweden)

    Silvia Regina Cavani Jorge Santos

    2015-06-01

    Full Text Available A bioanalytical method was developed and applied to quantify the free imipenem concentrations for pharmacokinetics and PK/PD correlation studies of the dose adjustments required to maintain antimicrobial effectiveness in pediatric burn patients. A reverse-phase Supelcosil LC18 column (250 x 4.6 mm 5 micra, binary mobile phase consisting of 0.01 M, pH 7.0 phosphate buffer and acetonitrile (99:1, v/v, flow rate of 0.8 mL/min, was applied. The method showed good absolute recovery (above 90%, good linearity (0.25-100.0 µg/mL, r2=0.999, good sensitivity (LLOQ: 0.25 µg/mL; LLOD: 0.12 µg/mL and acceptable stability. Inter/intraday precision values were 7.3/5.9%, and mean accuracy was 92.9%. A bioanalytical method was applied to quantify free drug concentrations in children with burns. Six pediatric burn patients (median 7.0 years old, 27.5 kg, normal renal function, and 33% total burn surface area were prospectively investigated; inhalation injuries were present in 4/6 (67% of the patients. Plasma monitoring and PK assessments were performed using a serial blood sample collection for each set, totaling 10 sets. The PK/PD target attained (40%T>MIC for each minimum inhibitory concentration (MIC: 0.5, 1.0, 2.0, 4.0 mg/L occurred at a percentage higher than 80% of the sets investigated and 100% after dose adjustment. In conclusion, the purification of plasma samples using an ultrafiltration technique followed by quantification of imipenem plasma measurements using the LC method is quite simple, useful, and requires small volumes for blood sampling. In addition, a small amount of plasma (0.25 mL is needed to guarantee drug effectiveness in pediatric burn patients. There is also a low risk of neurotoxicity, which is important because pharmacokinetics are unpredictable in these critical patients with severe hospital infection. Finally, the PK/PD target was attained for imipenem in the control of sepsis in pediatric patients with burns.

  5. Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

    Directory of Open Access Journals (Sweden)

    Xi Zheng

    Full Text Available BACKGROUND: The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. METHODS: We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. RESULTS: The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. CONCLUSIONS: Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake

  6. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Alfredo Pereira Leite de Albuquerque Filho

    2011-12-01

    Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001. Best sensitivity (85.3% and specificity (68.2% combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  7. Antimicrobial Resistance Patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus Isolated From Patients With Nosocomial Infections Admitted to Tehran Hospitals

    Directory of Open Access Journals (Sweden)

    Fallah

    1970-01-01

    Full Text Available Background Nosocomial infections constitute a global health problem, leading to a high rate of morbidity and mortality. The choice of antimicrobial treatment for nosocomial infections is often empirical and based on the knowledge of local antimicrobial activity patterns of the most common bacteria causing such infections. Objectives The aim of this study was to determine the 3 most prevalent bacterial pathogens including Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus causing nosocomial infections and their antimicrobial resistant profiles in patients admitted to three hospitals in Tehran city, Iran. Materials and Methods In this cross-sectional study, the A. baumannii, P. aeruginosa and S. aureus isolates were obtained from different samples of patients with nosocomial infections admitted to different wards of three hospitals including Milad, Motahary and Loghman from November 2014 to April 2015. Nosocomial infections were defined as a culture-proven infection, which occurred more than 48 hours after admission. Antimicrobial susceptibility testing was performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI guidelines. Results In total, 539 samples were collected during the study period from patients with nosocomial infections. Overall, 198, 75 and 98 A. baumannii, P. aeruginosa and S. aureus isolates were obtained, respectively. Cefepim and meropenem were found to be the most effective antibiotics for nosocomial infections caused by S. aureus with only 1 resistant isolate. Resistance to gentamicin and amikacin and susceptibility to cefepim was the highest compared to other antibiotics amongst P. aeruginosa isolates which is in consistent with the fact that cephalosporins remain useful agents for the management of nosocomial infections caused by P. aeruginosa. Acinetobacter baumannii isolates showed lower susceptibility rates to imipenem and ciprofloxacin than other

  8. Proline metabolism in adult male burned patients and healthy control subjects

    International Nuclear Information System (INIS)

    Postabsorptive proline flux, oxidation, and endogenous biosynthesis were determined in five severely burned intensive-care-unit patients (mean age 27 y) and in six healthy, young-adult control subjects. Continuous primed, intravenous, 160-min, dual stable-isotope-tracer infusions of L-[1-13C]proline and L-[methyl-2H3]leucine were used in conjunction with measurement of plasma proline concentration and 24-h urinary hydroxyproline output. Burn patients, compared with normal individuals, demonstrated a doubling in proline and leucine flux (P less than 0.01 for both findings), a threefold enhancement of proline oxidation (P less than 0.05), a trend toward decreased proline synthesis, and a 37% reduction in plasma proline concentrations (P less than 0.05). Further, the injured group, unlike the control group, was in a distinct negative body proline balance, as proline oxidation greatly exceeded endogenous proline biosynthesis (P less than 0.01). These studies indicate that significant proline deficits may evolve during the postabsorptive period in severely burned patients and that an exogenous supply of proline might benefit the nitrogen economy of the traumatized patient

  9. Live sibling skin allografts for severe burns in a paediatric patient: A viable option in developing countries

    Directory of Open Access Journals (Sweden)

    Basil Leodoro

    2014-11-01

    Full Text Available Severe burns in the paediatric population are associated with high mortality and morbidity in any developing countries. Children with more than 40% total body surface area burns in Fiji will succumb from complications and as a direct result of inadequate treatment and lack of resources. The surgical treatment of any severely burnt patient is not only laborious but very costly to the Fiji health system and depletes existing resources with few options for skin coverage. This is the first case report of live sibling skin allograft for severe paediatric burns and one of only few patients to have survived more than 50% burns in Fiji. We describe the technique and the role of using live sibling skin allograft as an option to improve survival in patients with severe burns in a developing country.

  10. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  11. Evaluation of the response to treatment and clinical evolution in patients with burning mouth syndrome

    OpenAIRE

    M.E. Rodríguez de Rivera Campillo; López López, José

    2013-01-01

    Objective: the aim of this study is to investigate the clinical evolution, the spontaneous remission of the symptomatology and the response to different treatments in a group of burning mouth syndrome patients. Study Design: the sample was formed by a group of patients that were visited in the Unit of Oral Medicine of the Dentistry Clinic of the University of Barcelona, from the year 2000 to 2011. After revising the clinical records of all the patients that had been under control for a period...

  12. Response to topical clonazepam in patients with burning mouth syndrome: a clinical study

    OpenAIRE

    Rodríguez de Rivera Campillo, Ma Eugenia; López López, José; Chimenos Küstner, Eduardo

    2010-01-01

    Burning Mouth Syndrome (BMS) is a difficult disease for patients and clinicians. Moreover, there is not a general consensus on how to treat the disease. The main objective of this paper is to evaluate BMS patients' response to topical clonazepam treatment. A double blind study was performed. Among a total of 66 patients, 33 were treated with tablets of clonazepam and another 33 were treated with a placebo. Symptoms were evaluated after 1 month and 6 months of treatment and scored on an analog...

  13. Fungiform papillae density in patients with burning mouth syndrome and xerostomia

    OpenAIRE

    Camacho-Alonso, Fabio; López-Jornet, Pía; Molino-Pagán, Diana

    2011-01-01

    Objective: The aim of this study was to analyze fungiform papillae density in patients with burning mouth syndrome (BMS) and xerostomia. Study design: In this cross-sectional clinical study, sixty patients were included (20 with BMS, 20 with xerostomia and 20 healthy controls). The fungiform papillae density was analyzed over a small region on the anterior tip of the tongue with the aid of a digital camera. The number of papillae was measured in an area of 19 mm2. Results: The patients with B...

  14. Investigated of ampC in Carbapenem Resistant Gram-Negative Bacteria Isolated from Burned Patients

    OpenAIRE

    Leila Azimi; Malihe Talebi; Parviz Owlia; Abdolaziz Rastegar-Lari

    2015-01-01

    Background: Gram-Negative bacteria are the most cause of nosocomial infection especially in burned patients. Carbapenem resistant strains can limit seriously the choice of antibiotic therapy. AmpC can make resistance to carbapenem and detection of that can be useful for identification ofcarbapenem resistant. The aim of this study was identification of ampC in most prevalent cause of nosocomial infection.Methods: boronic acid combined with meropenem in combination disc method was used for phen...

  15. Delayed rupture of a pseudoaneurysm in the brachial artery of a burn reconstruction patient

    OpenAIRE

    Lee, Jun Yong; Kim, Hyeri; Kwon, Ho; Jung, Sung-No

    2013-01-01

    A brachial artery pseudoaneurysm is a rare but serious condition that can be limb threatening. A number of reports have found that it may be the result of damage to the blood vessels around the brachial artery, either directly or indirectly, due to trauma or systemic diseases. We present our experience of delayed pseudoaneurysm rupture of the brachial artery in a rehabilitation patient with burns of the upper extremity who underwent fasciotomy and musculocutaneous flap coverage. We also provi...

  16. Closed-loop and decision-assist resuscitation of burn patients.

    Science.gov (United States)

    Salinas, Jose; Drew, Guy; Gallagher, James; Cancio, Leopoldo C; Wolf, Steven E; Wade, Charles E; Holcomb, John B; Herndon, David N; Kramer, George C

    2008-04-01

    Effective resuscitation is critical in reducing mortality and morbidity rates of patients with acute burns. To this end, guidelines and formulas have been developed to define infusion rates and volume requirements during the first 48 hours postburn. Even with these standardized resuscitation guidelines, however, over- and under-resuscitation are not uncommon. Two approaches to adjust infusion rate are decision-assist and closed-loop algorithms based on levels of urinary output. Specific decision assist guidelines or a closed-loop system using computer-controlled feedback technology that supplies automatic control of infusion rates can potentially achieve better control of urinary output. In a properly designed system, closed-loop control has the potential to provide more accurate titration rates, while lowering the incidence of over- and under-resuscitation. Because the system can self-adjust based on monitoring inputs, the technology can be pushed to environments such as combat zones where burn resuscitation expertise is limited. A closed-loop system can also assist in the management of mass casualties, another scenario in which medical expertise is often in short supply. This article reviews the record of fluid balance of contemporary burn resuscitation and approaches, as well as the engineering efforts, animal studies, and algorithm development of our most recent autonomous systems for burn resuscitation. PMID:18385584

  17. Nonpharmacological interventions for acute wound care distress in pediatric patients with burn injury: a systematic review.

    Science.gov (United States)

    Hanson, Mark D; Gauld, Mary; Wathen, C Nadine; Macmillan, Harriet L

    2008-01-01

    Acute wound care distress among burn-injured pediatric patients is of major clinical concern. This systematic review evaluates the benefits of nonpharmacological interventions to reduce this distress. MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and the Cochrane Library databases were searched using appropriate search terms for articles reporting overall psychological effects of pediatric burn injury. Key references were hand-searched. Searches yielded approximately 900 unique citations. Two authors reviewed each abstract, and 198 articles were retrieved, of which 34 were selected for full review. Of these 34 articles, 12 focused on acute wound care distress and nonpharmacological interventions. Critical appraisal of individual studies was conducted using the methods of the US Preventive Services Task Force, with a particular focus on assessing nonrandomized controlled trial designs. Twelve articles were reviewed and categorized according to intervention types child mediated (CM), parent mediated (PM), and health care provider mediated (HCPM). Using the US Preventive Services Task Force criteria, 7 of the 12 articles were rated "fair" or "good" and five were rated as having "poor" internal validity. The HCPM and CM intervention categories reported patient benefit. The two PM studies were both rated "poor." Studies of nonpharmacological interventions to reduce pediatric burn distress were few, with a significant proportion (5/12) having concerns about internal validity. Patient benefit was reported for HCPM and CM interventions. Research designs incorporating control groups in studies that are adequately powered are needed. Additional research is required in the area of PM interventions in particular. PMID:18695617

  18. Epidemiology and screening of intentional burns in children in a Dutch burn centre.

    Science.gov (United States)

    Bousema, Sara; Stas, Helene G; van de Merwe, Marjolijn H; Oen, Irma M M H; Baartmans, Martin G A; van Baar, Margriet E

    2016-09-01

    International estimates of the incidence of non-accidental burns (NAB) in children admitted to burn centres vary from 1% to 25%. Hardly any data about Dutch figures exist. The aim of this study was to evaluate the incidence, treatment and outcome of burns due to suspected child abuse in paediatric burns. We described the process of care and outcome, including the accuracy of the SPUTOVAMO screening tool and examined child, burn and treatment characteristics related to suspicions of child abuse or neglect. A retrospective study was conducted in children aged 0-17 years with a primary admission after burn injuries to the burn centre Rotterdam in the period 2009-2013. Data on patient, injury and treatment characteristics were collected, using the Dutch Burn Repository R3. In addition, medical records were reviewed. In 498 paediatric admissions, suspected child abuse or neglect was present in 43 children (9%). 442 screening questionnaires (89%) were completed. In 52 out of 442 questionnaires (12%) the completed SPUTOVAMO had one or more positive signs. Significant independent predictors for suspected child abuse were burns in the genital area or buttocks (OR=3.29; CI: 143-7.55) and a low socio-economic status (OR=2.52; 95%CI: 1.30-4.90). The incidence of suspected child abuse indicating generation of additional support in our population is comparable to studies with a similar design in other countries. PMID:27211360

  19. The feasibility of computer-based prism adaptation to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center.

    Directory of Open Access Journals (Sweden)

    Miranda eSmit

    2013-07-01

    Full Text Available AbstractIntroduction: There is wide interest in transferring paper-and-pencil tests to a computer-based setting, resulting in more precise recording of performance. Here, we investigated the feasibility of computer-based testing and computer-based prism adaptation (PA to ameliorate neglect in sub-acute stroke patients admitted to a rehabilitation center. Methods: 33 neglect patients were included. PA was performed with a pair of goggles with wide-field point-to-point prismatic lenses inducing an ipsilesional optical shift of 10 degrees. A variety of digitalized neuropsychological tests were performed using an interactive tablet immediately before and after PA.Results: All 33 patients (mean age 60.36 (SD 13.30, (mean days post-stroke 63.73 (SD 37.74 were able to work with the tablet and to understand, perform and complete the digitalized tests within the proposed time-frame, indicating that there is feasibility of computer-based assessment in this stage post-stroke. Analyses of the efficacy of PA indicated no significant change on any of the outcome measures, except time.Discussion: In conclusion, there is feasibility of computer-based testing in such an early stage, which makes the computer-based setting a promising technique for evaluating more ecologically valid tasks. Secondly, the computer-based PA can be considered as a reliable procedure. We can conclude from our analysis, addressing the efficacy of PA, that the effectiveness of single session PA may not be sufficient to produce short term effects on our static tasks. Further studies, however, need to be done to evaluate the computer-based efficacy with more ecologically valid assessments in an intensive double-blind, sham-controlled multiple PA treatment design.

  20. Treatment of acute deep burns in lower extremities of the elderly

    Institute of Scientific and Technical Information of China (English)

    Babur M. Shakirov

    2015-01-01

    Objective: To study the different surgical treatments in 154 elderly patients with acute deep burns of lower extremities admitted in Burn Department of RSCUMA.Methods:Skin grafts in extensive burns were performed in 32 patients for the purpose of achieving early closure of the burn area. In 116 patients with burn surface area of 6-25 %, skin grafting was performed on the granulating wound when the wound was ready for accepting skin graft. In these 19 cases, a stamp graft procedure was used in 12 patients and Mowlen-Jackson method of skin grafting in 7 cases.Results:Analysis of the nearest results showed that 28 out of 154 patients came back to the hospital for new surgery due to loss of ability of normal movement of their extremities.Conclusions:Careful patient selection and timing of surgery will help to avoid any adverse effect on patient outcome.

  1. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    Science.gov (United States)

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome. PMID:27209717

  2. The mortality of acutely ill medical patients for up to 60 days after admission to a resource poor hospital in sub-Saharan Africa compared with patients of similar illness severity admitted to a Danish Regional Teaching Hospital

    DEFF Research Database (Denmark)

    Nabayigga, Barbara; Kellett, John; Brabrand, Mikkel; Opio, Martin Otyek

    2016-01-01

    60days mortality of 195 Ugandan and 588 Danish acutely ill medical patients that had a NEWS >6 at the time of their admission to the hospital. The association of vital sign changes, alertness and mobility at admission on subsequent outcome was explored. RESULTS: More Kitovu (34.4%) than Danish...... patients (22.1%) died within 60days of admission (OR 1.85, 95% CI 1.27-2.71, p 0.001). However, the survival of non-comatose patients admitted without severely deranged vital signs or who were able to stand without help was identical in both cohorts (Chi square 0.32, p 0.57): these patients made up 50% of...... huge selection and treatment bias found no survival difference at 60days after admission to resource rich and resource poor hospitals for patients without severely deranged vital signs or who were able to stand without help....

  3. Cannabis abuse : a phenomenological study of the causative factors as perceived by patients with a history of Cannabis use, admitted at Bophelong Psychiatric Hospital in the North West Province / Boitumelo Susan Patricia Ramphomane

    OpenAIRE

    Ramphomane, Boitumelo Susan Patricia

    2005-01-01

    A phenomenological study was carried out to find out from patients with a history of cannabis use. admitted at Bophelong Psychiatric Hospital, reasons or factors that caused them to use/abuse cannabis. An original sample of 30 male patients between the ages of 16-30 years was selected from chronic (rehabilitation) wards of mentally stable patients awaiting discharge. Out of the 30 subjects, 10 protocols were selected for phenomenological explication. An unstructured type of interview was c...

  4. Fatal myocardial microabscesses caused by methicillin-resistant Staphylococcus aureus in a burn patient

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    Hsiang-Wei Huang

    2014-03-01

    Full Text Available Bacteremia- or sepsis-associated myocardial abscess is often an incidental postmortem diagnosis in patients who die of overwhelming septicemia. Myocardial abscess is more rarely the immediate cause of death as a consequence of abscess rupture or the cause of arrhythmia. We report a 66-year-old female who succumbed to sudden cardiac death with a hemodynamically stable methicillin-resistant Staphylococcus aureus (MRSA bacteremia, while in recovery after an accidental thermal burn. Autopsy revealed extensive myocardial abscesses and an abscess in the pineal gland. Myocardial microabscesses should be considered a rare cause of sudden cardiac death in patients with hemodynamically stable MRSA bacteremia.

  5. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    Science.gov (United States)

    Jeschke, Marc G; Finnerty, Celeste C; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an extensive literature search to identify models that other groups have developed to determine the effects of CRP levels postburn to assess the value of these parameters as predictors of sepsis or severe infection. Statistical analysis was performed using ANOVA and regression analysis where appropriate. Three-hundred fifteen female and 603 male pediatric patients were enrolled in this study. Average total body surface area (TBSA) burn was 45±23%, with full thickness burn over 32±27% TBSA, and patients were 7±6 years old. CRP values significantly correlated with burn size, survival and gender. Significantly higher levels of CRP were found in large burns, in non-survivors, and in females, p<0.05. Using various described models to determine whether CRP levels change before and after an event can predict sepsis or severe infection, we found that CRP cannot predict severe infection or sepsis. Although CRP is a marker of the inflammatory response postburn, CRP fails to predict infection or sepsis in severely burn patients. PMID:23875119

  6. Review of therapeutic agents for burns pruritus and protocols for management in adult and paediatric patients using the GRADE classification

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    Goutos Ioannis

    2010-10-01

    Full Text Available To review the current evidence on therapeutic agents for burns pruritus and use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE classification to propose therapeutic protocols for adult and paediatric patients. All published interventions for burns pruritus were analysed by a multidisciplinary panel of burns specialists following the GRADE classification to rate individual agents. Following the collation of results and panel discussion, consensus protocols are presented. Twenty-three studies appraising therapeutic agents in the burns literature were identified. The majority of these studies (16 out of 23 are of an observational nature, making an evidence-based approach to defining optimal therapy not feasible. Our multidisciplinary approach employing the GRADE classification recommends the use of antihistamines (cetirizine and cimetidine and gabapentin as the first-line pharmacological agents for both adult and paediatric patients. Ondansetron and loratadine are the second-line medications in our protocols. We additionally recommend a variety of non-pharmacological adjuncts for the perusal of clinicians in order to maximise symptomatic relief in patients troubled with postburn itch. Most studies in the subject area lack sufficient statistical power to dictate a ′gold standard′ treatment agent for burns itch. We encourage clinicians to employ the GRADE system in order to delineate the most appropriate therapeutic approach for burns pruritus until further research elucidates the most efficacious interventions. This widely adopted classification empowers burns clinicians to tailor therapeutic regimens according to current evidence, patient values, risks and resource considerations in different medical environments.

  7. Parasuicide and drug self-poisoning: analysis of the epidemiological and clinical variables of the patients admitted to the Poisoning Treatment Centre (CAV, Niguarda General Hospital, Milan

    Directory of Open Access Journals (Sweden)

    Manfré Sergio

    2005-04-01

    Full Text Available Abstract Epidemiological knowledge of parasuicides and drug self-poisoning is still limited by a lack of data. A number of preliminary studies, which require further analysis, evidenced that parasuicidal acts occur more often among females, that the peak rate is generally recorded between the ages of 15 and 34 years and psychotropic medications seems to be the most frequently used. The aim of this study was to describe the demographic and clinical variables of a sample of subjects admitted to the Posisoning Treatment Centre (CAV, Niguarda General Hospital, Milan, following drug self-poisoning. Furthermore, this study is aimed to identify the risk factors associated to parasuicidal gestures, with special care for the used drugs, the presence of psychiatric or organic disorders, alcoholism and drug addiction. The study included the 201 patients attending the CAV in 1999 and 2000 who satisfied the criteria of self-poisoning attempts: 106 cases in 1999 and 95 in 2000. The sample had a prevalence of females (64%. The peak rates of parasuicides from drug self-poisoning were reached between 21 and 30 years among the females, and 31 and 40 years among the males. 81.6% of the patients used one or more psychoactive drugs, the most frequent being the benzodiazepines (58.7%, classic neuroleptics (16.9% and new-generation antidepressants (SSRIs, SNRIs, NARIs (12.9%. The prevalence of mood disorders was higher among females (64% vs 42%, whereas schizophrenia was more frequently diagnosed in males (22% vs 10%. 61% (33% had a history of previous attempted suicides. The presence of clinically relevant organic diseases was observed in 24.9% of the sample.

  8. Faecal Escherichia coli isolates show potential to cause endogenous infection in patients admitted to the ICU in a tertiary care hospital.

    Science.gov (United States)

    Nagarjuna, D; Mittal, G; Dhanda, R S; Verma, P K; Gaind, R; Yadav, M

    2015-09-01

    Nosocomial infections are acquired during hospital treatment or in a hospital environment. One such infecting agent, Escherichia coli, harbours many virulence genes that enable it to become pathogenic, causing damage to the host. The mechanism of the E. coli virulence factors provenance to cause infection in host environments is not clearly elucidated. We investigated the virulence and pathogenicity of E. coli affected by the host environment. For this, blood (n = 78) and faecal (n = 83) E. coli isolates were collected from patients with and without sepsis, respectively, who had been admitted to the intensive care unit. The E. coli genomic DNA was isolated; the phylogenetic grouping was conducted by triplex PCR. The occurrence of nine virulence genes among the all the isolates was confirmed by gene-specific PCR. The prevalence of E. coli in blood isolates was more in phylogenetic groups B2 and D compared to groups A and B1. However, in faecal isolates, there was no significant difference. The prevalence of adhesin and toxin (papG, sfa, afa, cnf1, hlyA) genes was higher in blood compared to faecal E. coli isolates. However, the prevalence of aer, traT and PAI was similar as well as higher among both of these groups. These observations indicate a role of external environment (hospital setting) on host susceptibility (development of infection) in the faecal E. coli isolates, thereby making the patient prone to a sepsis condition. PMID:26257914

  9. Faecal Escherichia coli isolates show potential to cause endogenous infection in patients admitted to the ICU in a tertiary care hospital

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    D. Nagarjuna

    2015-09-01

    Full Text Available Nosocomial infections are acquired during hospital treatment or in a hospital environment. One such infecting agent, Escherichia coli, harbours many virulence genes that enable it to become pathogenic, causing damage to the host. The mechanism of the E. coli virulence factors provenance to cause infection in host environments is not clearly elucidated. We investigated the virulence and pathogenicity of E. coli affected by the host environment. For this, blood (n = 78 and faecal (n = 83 E. coli isolates were collected from patients with and without sepsis, respectively, who had been admitted to the intensive care unit. The E. coli genomic DNA was isolated; the phylogenetic grouping was conducted by triplex PCR. The occurrence of nine virulence genes among the all the isolates was confirmed by gene-specific PCR. The prevalence of E. coli in blood isolates was more in phylogenetic groups B2 and D compared to groups A and B1. However, in faecal isolates, there was no significant difference. The prevalence of adhesin and toxin (papG, sfa, afa, cnf1, hlyA genes was higher in blood compared to faecal E. coli isolates. However, the prevalence of aer, traT and PAI was similar as well as higher among both of these groups. These observations indicate a role of external environment (hospital setting on host susceptibility (development of infection in the faecal E. coli isolates, thereby making the patient prone to a sepsis condition.

  10. Characterization of Pseudomonas aeruginosa in Burn Patients Using PCR- Restriction Fragment Length Polymorphism and Random Amplified Polymorphic DNA Analysis

    OpenAIRE

    Abdolaziz Rastegar Lari; Bagher Yakhchali; Parviz Owlia; Hassan Salimi

    2010-01-01

    One of the major opportunistic pathogens in patients with burninjuries is Pseudomonas aeruginosa, which causes severe infectionsin burned patients. The objective of the study was to examinethe molecular epidemiology of P. aeruginosa colonization inthe burn unit of Shahid Motahari Hospital in Tehran, Iran. Restrictionfragment length polymorphism (RFLP) and random amplifiedpolymorphic DNA (RAPD) analysis were employed tostudy 127 clinical and two environmental P. aeruginosa isolatescollected fr...

  11. The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns

    OpenAIRE

    Reid, Robert Darren; Jayamaha, John

    2007-01-01

    A case of initial resuscitation of a patient with severe burns is described. Such patients can have hypotension and reduced organ perfusion for a number of reasons, and can remain in the emergency department for many hours while awaiting transfer to specialist centres. The case provides a comparison between resuscitation using traditional burns formulae and a relatively new and simple‐to‐use cardiac output (CO) monitor—the Vigileo monitor (Edwards Lifesciences, Irvine, California, USA). The c...

  12. Detection of AmpC-β-lactamases producing isolates among carbapenem resistant P. aeruginosa isolated from burn patient.

    OpenAIRE

    Akbar Mirsalehian; Davood Kalantar-Neyestanaki; Keramat Nourijelyani; Kheirollah Asadollahi; Morovat Taherikalani; Mohammad Emaneini; Fereshteh Jabalameli

    2014-01-01

    Background and Objectives Pseudomonas aeruginosa is responsible for devastating nosocomial infections among severely burn patients. Class C of cephalosporinase (AmpC-β-lactamases) is important cause of multiple β-lactam resistance in P. aeruginosa. The aim of this study was to detect the AmpC-β-lactamases producing isolates among carbapenem resistant P. aeruginosa isolated from burn patient. Material and Methods a total of 100 isolates of carbapenem resistant P. aeruginosa isolates from diffe...

  13. Cost analysis of a major burn.

    Science.gov (United States)

    Lofts, J A

    1991-11-27

    A retrospective review was undertaken of 26 patients admitted to Middlemore Hospital between January 1986 to July 1989 with burns totalling more than 30% of total body surface area. An attempt was made to estimate the total cost of successful inpatient management of a major burn using known and assumed values. The new schedule of interboard hospital charges was also employed for greater accuracy. The 20 survivors had a mean initial hospital stay of 68.7 days at a cost of between $37,077 and $40,702 (1989 values) and $46,069 (1991 values). This latter figure equates to an average cost of $647 per patient per day or, alternatively, $927 per % burn. Suggestions to reduce costs and improve treatment include: earlier excision and grafting; the establishment of a regional skin bank and keratinocyte culture facility to aid wound closure; and guidelines on antibiotic prescribing. PMID:1745459

  14. A RETROSPECTIVE ANALYSIS OF CLINICAL DIAGNOSIS, PREDICTABILITY AND FETO MATERNAL OUTCOME IN A CRITICAL PATIENT S ADMITTED IN OBSTETRIC INTENSIVE CARE UNIT IN A TERTIARY CARE CENTRE

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    Vijayasree

    2014-01-01

    Full Text Available INTRODUCTION: Care of the critically ill parturient is a unique challenge in obstetrics particularly because of its unpredictability. Hemorrhage , toxemia , anemia and septicemia are common causes of mortality and morbidity in these patients. Obstetric critical care in developing countries continues to be ra dically different from developed countries. AIMS AND OBJECTIVES: To analyze all cases of critically ill obstetric patients admitted to an obstetric intensive care unit in relation to causes for admissions, interventions required, course during their ICU st ay and fetal maternal outcome. MATERIALS AND METHODS : A one year retrospective analysis of all obstetric admissions to the ICU at our referral hospital was conducted, observations made and results were analyzed . RESULTS AND ANALYSIS : There were 24 ICU admi ssions with mean age of 25.21±4.075 years and mean gestational age of 36.04±3.862 weeks. Postpartum admissions were significantly higher (83.33%, n=20, P <0.05 with more patients presenting with obstetric complications (91.66%, n=22, P <0.01 as compared to medical complications (8.32%, n=2. Obstetric hemorrhage (n=15, 62.5% and hemodynamic instability (n=20, 83.33% were considered to be significant risk factors for ICU admission ( P =0.000. Inotropic support was required in 22 patients (91.66% while 17 p atients (70.83% required ventilatory support. The mean duration of ventilation (30.17±21.65 h and ICU stay (39.42±33.70 h were of significantly longer duration in survivors ( P =0.01, P =0.00 respectively versus non - survivors. The observed mortality n=10, 41.67% was significantly higher since ours is a referral tertiary center and delay in reaching the tertiary center from the place of occurrence of the mishap is a usual occurrence. CONCLUSION: Obstetric hemorrhage leading to hemodynamic instability remains the leading cause of ICU admissions and maternal mortality.

  15. High Recovery Rate of Non-albicans Candida Species Isolated From Burn Patients With Candidemia in Iran

    Science.gov (United States)

    Lotfi, Nazanin; Shokohi, Tahereh; Nouranibaladezaei, Seyed Zahra; Nasrolahi Omran, Ayatollah; Kondori, Nahid

    2015-01-01

    Background: Blood stream infections (BSIs) are major causes of morbidity and mortality in burn patients. Microorganisms responsible for BSI are generally bacteria; however, Candida spp. are the infection agents in as many as 8% of all cases. Burn wound colonization and infections are generally the first steps to systemic infection. Candidemia in burn patients has been associated with high mortality and a prolonged hospital stay. Objectives: Candidemia in burn patients has been defined as a preterminal event, leading to high morbidity and mortality rates among these patients. The aim of this study was to establish the incidence of candidemia in burn patients in Iran. Patients and Methods: We consecutively collected 405 blood samples from 113 burn patients. The yeast isolates were identified to the species level using conventional procedures. In vitro antifungal susceptibility of the Candida isolates to amphotericin B, fluconazole, voriconazole and caspofungin was performed using the Etest. Results: Twenty-seven samples (6.7%) of the blood cultures from 13 patients (12%) were positive for Candida species. Candida parapsilosis (38%) and C. tropicalis (38%) were the most commonly found Candida species, followed by C. albicans (15%) and C. guilliermondii (15%) in the patients. The incidence of candidemia was significantly correlated with increased duration of hospitalization, increased time of stay in the intensive care unit, and higher mortality. The antifungal susceptibility tests demonstrated that amphotericin B and voriconazole had the lowest minimum inhibitory concentrations (MICs) against Candida spp. Conclusions: Non-albicans Candida should be considered as significant pathogens in burned patients with candidemia. PMID:26587207

  16. Effect of immune-enhancing diets on the outcomes of patients after major burns.

    Science.gov (United States)

    Mahmoud, W H; Mostafa, W; Abdel-Khalek, A H; Shalaby, H

    2014-12-31

    The use of immune-enhancing diets (IEDs) has been shown to be beneficial in some categories of critically ill patients. This study aimed to evaluate the effect of early enteral feeding supplemented with glutamine and omega-3 fatty acids, as immune-enhancing diets, on the outcomes of patients after major burns. Forty thermally injured adult patients with 30-50% total body surface area (TBSA) burns, including deep areas ranging from 5-20%, were randomized into a prospective, double-blind, controlled clinical trial. They were placed into two equal groups: group A (IED group), in which patients received early enteral feeding supplemented with glutamine and omega-3 fatty acids as immune-enhancing diets; and group B (control group), in which patients received early enteral feeding not supplemented with immune-enhancing diets. Laboratory assessment of serum albumin, serum C-reactive protein, total lymphocytic count and serum immunoglobulins (IgA, IgG and IgM) was performed at admission, and on days 4, 7 and 14. Finally, outcomes were assessed by monitoring the survival rate, the length of hospital stay and the incidence of infection. There were no significant differences between the IED and control group regarding age (28.7±5.32 versus 29.85±5.94), sex, weight, %TBSA (37.75±4.4 versus 38.3±4.84) and %burn depth (11.7±2.36 versus 10.7±2.036). The incidence of infection (2 versus 8) and the length of hospital stay (16.3±0.92 days versus 17.95±2.96 days) were decreased significantly in the IED group versus the control group. There was no significant difference between the survival rates in both groups as there was only one death in the control group. Thanks to IEDs, patient outcome was improved and infectious morbidity and length of hospital stay were reduced, but there was no effect on the survival rates following major burns. PMID:26336366

  17. BACTERIOLOGICAL STUDY OF BURNS INFECTION

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    Shareen

    2015-10-01

    Full Text Available A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1 OBJECTIVE : The present study was therefore undertaken to isolate and identify the aerobic bacterial flora in burn patients and its antibiotic susceptibility pattern. MATERIAL & METHODS : A total of 100 patients admitted with different degree of burns were studied. Wound swabs were taken with aseptic precautions by dry sterile cotton swab sticks. These swabs were transported to the microbiology laboratory and the isolates were identified based on standard microbiological methods. Antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. RESULT : A total of 127 bacterial pathogens were isolated from 100 patients. Of these, 69% were monomicrobial in nature and 28% wer e polymicrobial. The most frequent cause of infection was found to be Staphylococcus aureus (39.4%, followed by Pseudomonas aeruginosa (14.2%, Klebsiella pneumonia (13.4%, E.coli (8.7% and Acinetobacter species (7.9%.Out of the total Staphylococcus au reus isolates, 19 were Methicillin sensitive and 31 were Methicillin resistant (MRSA. All the MRSA strains were 100% sensitive to Vancomycin and Linezolid. The Pseudomonas aeruginosa isolates were most sensitive to Amikacin (9 4.4%, Fluroquinolones (61.1% . CONCLUSION : Staphylococcus aureus and Pseudomonas aeruginosa were major causes of infection in burn wounds. Therefore it is necessary to implement urgent measures for restriction of nosocomial infections, sensible limitation on the use of antimicrobial agents, strict disinfection and hygiene.

  18. OCCURRENCE OF MULTI-ORGAN DYSFUNCTION IN PEDIATRIC BURN PATIENTS - INCIDENCE AND CLINICAL OUTCOME

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Shahrokhi, Shahriar; Jeschke, Marc G

    2013-01-01

    Objective To examine the incidence of single or multiple organ failure postburn and its resultant clinical outcomes during acute hospitalization. Summary Background Data Patient outcomes are inherently dependent on intact organ function; however, burn injury affects the structure and function of almost every organ, but especially lung, liver, kidney and heart. Therefore, single-organ failure and/or multiorgan failure (MOF) are thought to contribute significantly to postburn morbidity and mortality but to date no large trial examining the effects of MOF on postburn outcomes exists. Methods Incidence of MOF was monitored in 821 pediatric burn patients during acute hospitalization. Patients were divided into groups based on the incidence of single organ specific failure, MOF, and non-MOF. The DENVER2 score was used to assess organ specific scores for lung, liver, kidney and heart. The patient’s demographics, injury characteristics, and outcome parameters were recorded. Results Respiratory failure has the highest incidence in the early phase of postburn injury, and decreases starting 5 days postburn. Cardiac failure was noted to have the highest incidence throughout hospital stay. Incidence of hepatic failure increases with the length of hospital stay and is associated with a high mortality during the late phase of the acute hospital stay. Renal failure has an unexpectedly low incidence but is associated with a high mortality during the first three weeks postburn injury. Three or more organ failure is associated with very high mortality. Conclusion This is the first large study in burn patients to determine the incidence of organ specific failure and outcome. The results of this study confirmed the expected chronologic incidence of organ-specific failure and yield the long-term mortality of liver and renal failure. (NCT00673309) PMID:23511841

  19. Correlation between Burning Mouth Syndrome and Psychological Symptoms in Patients Attending to Zahedan Dental School

    Directory of Open Access Journals (Sweden)

    NM Bakhshan

    2012-06-01

    Full Text Available Introduction: Burning mouth syndrome is characterized by an oral burning sensation , usually in the absence of clinical and laboratory findings. BMS is estimated to involve 1 to 5% of the adult population and is mostly reported within middle-aged women. The etiology of this disease is not thoroughly identified yet and there is a debate over the significance of Psychological factors in creating BMS. This study intended to examine the relationship between psychological factors with pain reports and psychosocial profiles of BMS patients to determine whether psychological factors are related to pain reports and burning mouth of patients. Therefore frequencies of psychological factors were analyzed. Methods: 30 patients with BMS participated in this study. They were homogenous regarding age, sex with the control group. In addition, education was possibly homogenized. The participants completed SCL-90 questionnaire for their anxiety, depression, somatic and psychotic symptoms to be scrutinized. Then, t-test was applied to analyze the research data. Results: Mean of anxiety(case20/8, control 9/53, depression(case 26/53, control 13/40, somatic(case 23/7, control 15/26 and psychotic(case 19/60, control 8/10 symptoms were higher in BMS group rather than in control groups. T-test results indicated there was no statically significant difference between BMS and control group in regard to psychological symptoms(p< 0.0001. Conclusion: The study findings indicate that psychological disorders may predispose the patients to the development of BMS.

  20. Laboratory-based evaluation of MDR strains of Pseudomonas in patients with acute burn injuries

    Science.gov (United States)

    Zhang, Hong-Tu; Liu, Hui

    2015-01-01

    Localization of burn was variable: head and face in 76 patients (29%), trunk in 58 (49%), upper limb in 37 (52%), lower limbs in 44 (41%), hands in 16 (15%), perinea area in 26 (5.5%) and whole body except perinea area in 10 (9%) patients. Inhalation syndrome was present in 56 (44%) patients. Ninety patients (82%) had indwelling venous catheters, 83 (75.5%) patients’ arterial catheter and 86 (78%) patients’ urinary catheters. By multivariate analysis: age ≤4 years, Garcés 4, colistin use in documented multiresistant infections, and mechanical ventilation were independent variables related with mortality and graft requirement was a protective factor for mortality. Despite advances in care, gram negative bacterial infections and infection with Pseudomonas aeruginosa remain the most common cause of bacteria related mortality early in the hospital course. Viral infections are also associated with mortality and numbers have remained stable when compared to data from prior years. PMID:26629178

  1. Tratamento da dor em queimados Tratamiento del dolor en quemados Pain management in burn patients

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    Rodrigo José Alencar de Castro

    2013-02-01

    paciente en tratamiento de quemadura es el primer paso para alcanzar el éxito en su manejo analgésico.BACKGROUND AND OBJECTIVES: Despite advances, inappropriate analgesic treatment for burn patients is still seen. The objective of this review was to collect data on pain management in burn patients. CONTENT: We reviewed the mechanisms of pain, burn patient assessment, as well as pharmacological and non-pharmacological treatment. CONCLUSION: Pain management in burn patients is still a challenge for the multidisciplinary team. Frequent and continuous evaluation of the patient's response is very important due to the various stages that the hospitalized burn patient goes through, as well as a combination therapy with analgesic and non-pharmacological measures. Understanding the complexity of the pathophysiological, psychological, and biochemical changes a burn patient presents is the first step to achieve success in analgesic management.

  2. Monoblock Expanded Full-thickness Graft for Resurfacing of the Burned Face in Young Patients.

    Science.gov (United States)

    Allam, A M; El Khalek, A E A; Mustafa, W; Zayed, E

    2007-12-31

    It has been emphasized by many authors that to obtain better aesthetic results in a burned facial area to be resurfaced - if it extends into more than one aesthetic territory - the units involved should be combined into a single large composite unit allowing the largest possible skin graft to be used. Unfortunately, the donor site for full-thickness grafts is limited in young patients and hence tissue expansion is used. A monoblock expanded full-thickness skin graft for facial resurfacing after post-burn sequelae excision was used in 12 young patients after expansion of the superolateral aspect of the buttock. Females made up the majority of the patients (75%) and the ages ranged between 8 and 18 yr. The operating time was 3-3.5 hours, in two sessions. Post-operatively, we recorded partial graft necrosis in two cases (16.7%) and infection in one (8.3%), and some minor donor-site-related complications were reported, such as haematoma in one patient (8.3%), wound infection in one patient (8.3%), and wide scarring in two patients (16.7%). At follow-up, eight of the patients (66.7%) were satisfied with their new facial look as the mask effect of facial scarring had been overcome. With monoblock expanded full-thickness graft we were able to resurface the face in nine cases (75%). A second complementary procedure to reconstruct the eyebrows or reshape the nose was required in two cases (16.7%). We concluded that the monoblock expanded full-thickness graft was a suitable solution for limitation of the donor site in young patients, as the resulting wound could be closed primarily with a scar that could be concealed by the underwear, with lim. PMID:21991093

  3. Measuring coping behavior in patients with major burn injuries: a psychometric evaluation of the BCOPE.

    Science.gov (United States)

    Amoyal, Nicole R; Mason, Shawn T; Gould, Neda F; Corry, Nida; Mahfouz, Soad; Barkey, Adam; Fauerbach, James A

    2011-01-01

    Burn injuries involve significant physiological, psychological, and social challenges with which individuals must cope. Although the brief COPE (BCOPE) is frequently used, knowledge of its factor structure and construct validity is limited, thus limiting confidence with interpreting results. This study assessed psychometric properties of the BCOPE in hospitalized patients with burn injury. Participants had a major burn injury (n = 362). Measures assessed coping behavior and physical, psychological, and social functioning. Exploratory factorial analysis was conducted to evaluate patterns of coping strategies. To assess construct validity, the BCOPE scale scores were correlated with the distress measures across time points. Exploratory factorial analysis revealed seven factors accounting for 51% of total variance. The pattern matrix indicated four items loaded onto factor 1 (active coping = 0.47-0.80) and four onto factor 2 (avoidant coping = 0.59-0.73). The remaining factors were consistent with original scale assignments reported by Carver (Int J Behav Med 1997;4:92-100). Construct validity of BCOPE scales (active and avoidant) was demonstrated by their association with the Davidson trauma scale, short form-12, and satisfaction with appearance scale. The results indicate that the BCOPE is valid, reliable, and can be meaningfully interpreted. Research using these factors may improve knowledge about interrelationships among stress, coping, and outcome, thus building the evidence base for managing distress in this population. PMID:21562462

  4. Self-Burns in Fars Province, Southern Iran

    Science.gov (United States)

    Mohammadi, Ali Akbar; Tohidinik, Hamid Reza; Zardosht, Mitra; Seyed Jafari, Seyed Morteza

    2016-01-01

    BACKGROUND The alarming incidence of self- burning provoked to set up a multidisciplinary preventive program to decrease the incidence and complications of this harmful issue. This study investigated the incidence and the preventive measures in self-burn in Fars Province, southern Iran. METHODS This study was a longitudinal prospective design on trend of self-inflicted burn injuries in Fars province after setting up a regional multidisciplinary preventive plan (2009-2012). RESULTS From 18862 admitted patients, 388 (2%) committed self-burning. While the incidence showed a constant decrease in proportion of suicidal cases among all admitted patients (2.5% to 1.6%). The mean age of self-burning victims ranged from 28.3±10.8 to 30.3±11.7 years. The female victims comprised 67.4% of all suicidal burn patients (Female to male ratio: 2.18). The leading causes of suicide commitment were familial conflicts (75.6%) and psychological problems (16.7%) CONCLUSION It is crucial to continue the regional preventive programs and pave the way to set up national, and even international collaborations to alleviate relevant financial, social, cultural and infrastructural difficulties in order to have lower incidence for this dramatic issue. PMID:27308238

  5. INFARTO AGUDO DE MIOCARDIO EN PACIENTES JÓVENES INGRESADOS EN CUIDADOS INTENSIVOS / Acute myocardial infarction in young patients admitted to the Intensive Care Unit

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    Ricardo Grau Ávalos

    2012-01-01

    factors, the most common topographic locations, treatment used, and to analyze mortality. Method: A descriptive, retrospective and longitudinal study was performed in patients under 45 years of age with acute myocardial infarction, admitted to the Intensive Care Units of "Celestino Hernández Robau" and "Arnaldo Milian Castro" University Hospitals in Santa Clara, Villa Clara, between January 1995 and December 2006. Results: 202 patients under 45 years of age accounted for 4,6 % of total cases, 81,2 % were male sex, smoking was the most prevalent risk factor (68,8 %, followed by hypertension (56,4 %. The inferior infarct location was found in 85 patients (42,0 %, followed by extensive anterior and antero-septal infarct location with 49 (24,2 % and 45 (22,3 % cases, respectively. 126 patients received thrombolytic therapy (62,4 %, only 1 of them (0,8 % died, the other 4 dead (5,3 % had not received such treatment. Conclusions: Male sex, smoking, myocardial infarction with ST elevation, inferior infarct location and the administration of thrombolytic therapy were predominant.

  6. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    Science.gov (United States)

    Leonard, Scott W; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G; Finnerty, Celeste C; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status. Objective: To test the hypothesis that thermal injury depletes body stores of vitamin E, α-tocopherol concentrations were measured in adipose tissue samples. Design: Pediatric patients (n = 8) were followed up to 1 y after burn injury. Surgically obtained samples were collected at various intervals and stored at −80°C in a biorepository. α- and γ-Tocopherols, cholesterol, and triglycerides were measured in the same tissue aliquot. Results: During the first week after injury, adipose tissue α-tocopherol concentrations were within the expected normal range of 199 ± 40 nmol/g adipose tissue but were substantially lower at weeks 2 and 3 (133 ± 13 and 109 ± 8 nmol/g adipose tissue, respectively). Individual rates of decrease, estimated by linear regression, showed that adipose tissue α-tocopherol decreased by an average of 6.1 ± 0.6 nmol/g daily. During the first month after injury, adipose tissue triglyceride concentrations also decreased, whereas no changes in cholesterol concentrations occurred. Conclusions: These data emphasize that the burn injury experienced by these pediatric patients altered their metabolism such that vitamin E status diminished during the month after injury. Further studies are needed to evaluate the mechanism and consequences of the observed vitamin E depletion. This trial was registered at clinicaltrials.gov as NCT00675714. PMID:20881067

  7. Admit: Alma Data Mining Toolkit

    Science.gov (United States)

    Friedel, Douglas; Looney, Leslie; Xu, Lisa; Pound, Marc W.; Teuben, Peter J.; Rauch, Kevin P.; Mundy, Lee; Kern, Jeffrey S.

    2015-06-01

    ADMIT (ALMA Data Mining Toolkit) is a toolkit for the creation and analysis of new science products from ALMA data. ADMIT is an ALMA Development Project written purely in Python. While specifically targeted for ALMA science and production use after the ALMA pipeline, it is designed to be generally applicable to radio-astronomical data. ADMIT quickly provides users with a detailed overview of their science products: line identifications, line 'cutout' cubes, moment maps, emission type analysis (e.g., feature detection), etc. Users can download the small ADMIT pipeline product (data mining between many astronomical sources and line transitions will be possible. Users will also be able to enhance the capabilities of ADMIT by creating customized ADMIT tasks satisfying any special processing needs. Future implementations of ADMIT may include EVLA and other instruments.

  8. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    Science.gov (United States)

    Gauglitz, Gerd G; Finnerty, Celeste C; Herndon, David N; Mlcak, Ronald P; Jeschke, Marc G

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different serum cytokine profile compared with burn patients with inhalation injury who survived. Early identification followed by appropriate management of these high-risk patients may lead to improved clinical outcome. Methods Thirteen severely burned children with inhalation injury who did not survive and 15 severely burned pediatric patients with inhalation injury who survived were enrolled in the study. Blood was collected within 24 hours of admission and 5 to 7 days later. Cytokine levels were profiled using multiplex antibody coated beads. Inhalation injury was diagnosed by bronchoscopy during the initial surgery. The number of days on the ventilator, peak inspiratory pressure rates, arterial oxygen tension (PaO2)/fraction of inspired oxygen (FiO2) ratio and incidence of acute respiratory distress syndrome were recorded for those patients. Results Significantly altered levels of IL-4, IL-6, IL-7, IL-10, and IL-13 were detected within the first 7 days after admission in serum from burn pediatric patients with concomitant inhalation injury who did not survive when compared with similar patients who did (P < 0.05). Alterations in these cytokines were associated with increased incidence of acute respiratory distress syndrome, number of days under ventilation, increased peak inspiratory pressure, and lower PaO2/FiO2 ratio in this patient population. Multiple logistic regression analysis revealed that patients with increased IL-6 and IL-10 as well as decreased IL-7 serum levels had a

  9. Tabagismo em idosos internados em instituições de longa permanência Smoking in elderly patients admitted to long-term care facilities

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    Anderson Albuquerque de Carvalho

    2010-06-01

    Full Text Available OBJETIVO: Determinar a prevalência de tabagismo entre idosos internados em instituições de longa permanência para idosos (ILPIs e verificar a associação do grau de dependência nicotínica com variáveis sociodemográficas, vínculo afetivo, motivação para cessação e depressão. MÉTODOS: Estudo transversal de base populacional, incluindo 573 idosos com idade > 60 anos, internados em 13 ILPIs no Distrito Federal. Foram analisadas as seguintes variáveis: tipo de ILPI, gênero, idade, escolaridade, renda mensal, estado civil, condição previdenciária, vínculo afetivo, motivação para a cessação, depressão provável e o grau de dependência nicotínica. Para a obtenção dos dados, foram utilizados os seguintes instrumentos: questionário sociodemográfico, Escala de Qualidade de Vida de Flanagan, Miniexame do Estado Mental, Escala de Depressão Geriátrica, teste de Richmond e Teste de Fagerström para Dependência de Nicotina. RESULTADOS: A prevalência geral de fumantes na amostra (573 indivíduos foi de 23,0%. Dos 132 fumantes, havia 81 homens (24,9% e 35 mulheres (20,1%. Foram incluídos no estudo 116 fumantes, dos quais 70 (60,3% apresentavam depressão provável. Houve significativas associações entre o grau de dependência nicotínica e as seguintes variáveis: escolaridade, renda mensal, vínculo afetivo, motivação para a cessação e depressão provável. Não houve associações significativas entre a dependência de nicotina e as seguintes variáveis: tipo de ILPI, gênero, idade, condição previdenciária e estado civil. CONCLUSÕES: Nos idosos institucionalizados em ILPIs no Distrito Federal, constatamos uma elevada prevalência de tabagismo, havendo entre eles baixa motivação para a cessação tabágica.OBJECTIVE: To determine the prevalence of smoking among elderly patients admitted to long-term care facilities (LTCFs and to determine whether the degree of nicotine dependence is associated with

  10. The Impact of Cannabis Use on the Dosage of Antipsychotic Drugs in Patients Admitted on the Psychiatric Ward at the University Hospital of the West Indies

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    P Thomas

    2015-03-01

    Full Text Available Objective: To assess the impact of cannabis use on the efficacy of antipsychotic drugs in male subjects presenting to the University Hospital of the West Indies (UHWI with psychotic episodes. Methods: Male subjects, 18–40 years old, admitted to the psychiatric ward of the UHWI between February 2013 and May 2013, diagnosed with schizophrenia, schizophreniform disorder and who tested positive for ∆9-tetrahydrocannabinol were recruited for the study. On day one, consenting subjects were assessed using the Brief Psychiatric Rating Scale (BPRS. Patients were prescribed seven days of an oral antipsychotic medication (haloperidol, chlorpromazine, risperidone, quetiapine, olanzapine. Medicated subjects were then reassessed using the BPRS on days three and seven. Statistical analysis involved the use of Student’s t-test and repeated measure analysis of variance. Results: In total, 20 subjects were recruited (mean age = 26.00 ± 5.96 years. Subjects were grouped based on the daily chlorpromazine equivalent (CPZE dose given on day one into CPZE1 (CPZE dose of 100–300mg; n = 8 and CPZE2 (CPZE dose of 400–1250 mg; n = 12. There was no significant difference in the total BPRS score between the groups on day one (CPZE1 = 41.38 ± 16.47 versus CPZE2 = 49.42 ± 25.58; p = 0.44; similar findings were obtained for the positive (26.75 ± 9.27 versus 31.83 ± 17.30; p = 0.46 and negative (14.63 ± 7.73 versus 17.58 ± 9.74; p = 0.48 symptom component on the BPRS. For subjects in CPZE1, there was no significant decrease in total BPRS score [F(2,21 = 0.07, p = 0.93] over the study period. For CPZE2, significant reduction in total BPRS scores was achieved [F(2,33 =7.12, p = 0.01], contributed by significant decrease in the positive [F(2,33 = 5.64, p = 0.02 and negative [F(2,33 = 7.53, p = 0.01 symptom components of the BPRS. Conclusion: The findings of this study purport that male cannabis users presenting with psychotic disorders may not achieve optimal

  11. The effect of inhalation aromatherapy with damask rose (Rosa damascena) essence on the pain intensity after dressing in patients with burns: A clinical randomized trial

    OpenAIRE

    Bikmoradi, Ali; Harorani, Mehdi; Roshanaei, Ghodratollah; Moradkhani, Shirin; Falahinia, Golam Hossein

    2016-01-01

    Background: Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing. Materials and Methods: A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing r...

  12. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    OpenAIRE

    Jeschke, Marc G.; Finnerty, Celeste C.; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an ...

  13. Predictive factors of mortality in burn patients Fatores preditivos de mortalidade em queimaduras

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    Jefferson Lessa Soares de Macedo

    2007-12-01

    Full Text Available Burn mortality statistics may be misleading unless they account properly for the many factors that can influence outcome. Such estimates are useful for patients and others making medical and financial decisions concerning their care. This study aimed to define the clinical, microbiological and laboratorial predictors of mortality with a view to focus on better burn care. Data were collected using independent variables, which were analyzed sequentially and cumulatively, employing univariate statistics and a pooled, cross-sectional, multivariate logistic regression to establish which variables better predict the probability of mortality. Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Mortality rate was 5.0%. Higher age, larger burn area, presence of fungi in the wound, shorter length of stay and the presence of multi-resistant bacteria in the wound significantly predicted increased mortality. The authors conclude that those patients who are most apt to die are those with age > 50 years, with limited skin donor sites and those with multi-resistant bacteria and fungi in the wound.As estatísticas de mortalidade em queimaduras podem ser incompletas se não levarem em consideração vários fatores que podem influenciar o óbito. Tradicionalmente, apenas a extensão da queimadura e a idade do paciente têm sido usadas como preditores de mortalidade em vítimas de queimaduras. Estas estimativas são úteis na assistência aos pacientes, interferindo em decisões médicas e financeiras no cuidado desses doentes. O objetivo desse estudo foi definir os preditores clínicos, microbiológicos e laboratoriais de mortalidade em pacientes queimados. Os autores realizaram uma análise univariada e multivariada de várias variáveis independentes para determinar os fatores preditivos de mortalidade em queimados. A taxa de mortalidade foi de 5,0%. A idade mais avançada, a extensão das queimaduras, a

  14. Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review

    Directory of Open Access Journals (Sweden)

    CESAR PEDREROS P

    2007-06-01

    Full Text Available Cada año casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos años. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y son temas desconocidos para la mayoría de los médicos. En el contexto de la próxima incorporación de este tipo de dolencias en el plan de garantías explícitas en la salud chilena hemos realizado una actualización del temaEvery year almost three thousand people get burned in Chile. In this group, about 40% of the critical burned patients also suffer inhalation injury. This number is expected to grow bigger among the adult population in the next few years. Inhalation injury significantly increases mortality in burned patients. The prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of Chilean medical schools. Therefore, this subject is pooly known by most of our physicians. Because this disease will be included in the explicit warranties health plan of the public health care system in Chile, we decide to write this review about this pathological condition

  15. Fluid resuscitation protocols for burn patients at intensive care units of the United Kingdom and Ireland

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    Al-Benna, Sammy

    2011-01-01

    Full Text Available Introduction: The objective of this study was to determine the thermal injury fluid resuscitation protocols at intensive care units (ICUs in the United Kingdom and Ireland. Materials and methods: A telephone questionnaire was designed to survey the fluid resuscitation protocols of ICUs at all hospitals with plastic/burn surgery departments in the British Isles in 2010. The feedback from the questionnaire was from the senior nurse in charge of the ICUs. Results: 32/64 (50% of these ICUs had provided care to burns patients. A 100% response from these 32 units was obtained. 71.4% commence fluid resuscitation at 15% total body surface area burn (TBSA, 21.4% at 20% TBSA and 7.1% at 10% TBSA in adults. The estimated resuscitation volume was most often calculated using the Parkland/Modified Parkland formula (87.5% or the Muir and Barclay formula (12.5%. Interestingly, of the ICUs using formulae, two had recently moved from using the Muir and Barclay formula to Parkland formula and one had recently moved from using the Parkland formula to Muir and Barclay formula. Despite this, 37.5% of ICUs using a formula did not rigidly follow it exactly. The most commonly used resuscitation fluid was Ringer’s lactate solution (46.9% and Human Albumin Solution was used in 12.5%. No ICU used red cell concentrate as a first line fluid. 18.8% used a central line. 40.6% ICUs considered changing the IV solution during resuscitation. 78.1% ICUs consider urine output to be the most important factor in modifying resuscitation volumes. 59.4% ICUs calculate a maintenance fluid rate after completion of resuscitation. The endpoint for resuscitation was at 24 h in 46.9% ICUs and at 36 h in 9.4%. 5/32 (16% felt their protocol gave too little and 6/32 (19% felt their protocol gave too much. 59.3% ICUs gave oral/enteral fluids by naso-gastric or naso-jejenal tubes. 21.9% felt that oral/enteral resuscitation worked. Exactly half of the units believed that the formula that they used

  16. Grey matter changes of the pain matrix in patients with burning mouth syndrome.

    Science.gov (United States)

    Sinding, Charlotte; Gransjøen, Anne Mari; Schlumberger, Gina; Grushka, Miriam; Frasnelli, Johannes; Singh, Preet Bano

    2016-04-01

    Burning mouth syndrome (BMS) is characterized by a burning sensation in the mouth, usually in the absence of clinical and laboratory findings. Latest findings indicate that BMS could result from neuropathic trigeminal conditions. While many investigations have focused on the periphery, very few have examined possible central dysfunctions. To highlight changes of the central system of subjects with BMS, we analysed the grey matter concentration in 12 subjects using voxel-based morphometry. Data were compared with a control group (Ct). To better understand the brain mechanisms underlying BMS, the grey matter concentration of patients was also compared with those of dysgeusic patients (Dys). Dysgeusia is another oral dysfunction condition, characterized by a distorted sense of taste and accompanied by a reduced taste function. We found that a major part of the 'pain matrix' presented modifications of the grey matter concentration in subjects with BMS. Six regions out of eight were affected [anterior and posterior cingulate gyrus, lobules of the cerebellum, insula/frontal operculum, inferior temporal area, primary motor cortex, dorsolateral pre-frontal cortex (DLPFC)]. In the anterior cingulate gyrus, the lobules of the cerebellum, the inferior temporal lobe and the DLPFC, pain intensity correlated with grey matter concentration. Dys also presented changes in grey matter concentration but in different areas of the brain. Our results suggest that a deficiency in the control of pain could in part be a cause of BMS and that BMS and dysgeusia conditions are not linked to similar structural changes in the brain. PMID:26741696

  17. The Use of Scalp as a Donor Site for Pediatric Burn Patients to Obtain Split Thickness Skin Graft

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    Fuat Yüksel

    2009-06-01

    Full Text Available Aim: To treat the pediatric burn patients, split thickness skin grafting (STSG is used widespreadly. STSG is frequently taken from the thigh or buttock. Some serious donor site morbidities such as long healing period and permanent scars are seen in these patients. Materials and Method: We retrospectively analyzed 86 pediatric burn patients in wich scalp was used as a donor-site of STSG between January 2002 and November 2008. Results: We determined that the healing time of the scalp is more rapid than conventional STSG donor site. Furthermore, this technique had important advantages such as to minimize postoperative discomforts, to allow repetitive graft harvesting and to camouflage visible scar. Conclusion: In our study, we revealed that scalp donor sites were dependable areas with low morbidity in pediatric burn patients. (Journal of Current Pediatrics 2009; 7: 1-6

  18. Prevalence of extended spectrum beta lactamases among strains of Pseudomonas aeruginosa isolated from burn patients

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    Mirsalehian

    2008-08-01

    Full Text Available Background: The resistance of Pseudomonas aeruginosa strains to broad spectrum cephalosporins may be mediated by extended spectrum b-lactamases (ESBLs. These enzymes are encoded by different genes located either on chromosome or plasmids. In this study, we determined the antimicrobial resistance patterns of P. aeruginosa isolates and screened for ESBL production. Methods: After isolation from burn patients in Tehran Hospital, identification of P. aeruginosa isolates were assessed using biochemical tests. We then performed disk agar diffusion (DAD according to CLSI guidelines to determine the pattern of antimicrobial resistance. The frequency of ESBLs and prevalence of the OXA-10 and PER-1 genes were determined with combined disk and polymerase chain reaction (PCR methods, respectively. Results: One hundred strains of P. aeruginosa were isolated. The resistance of these strains to cephpodoxime, aztreonam, ciprofloxacin, ofloxacin, ceftazidime, cefepime, imipenem, meropenem, cefotaxime, levofloxacin, piperacilin- tazobactam and ceftriaxon was 100%, 90%, 83%, 92%, 85%, 88%, 63%, 66%, 98%, 89%, 70% and 91%, respectively. Of these, 40 strains (40% were ESBL positive, 29 strains (29% were OXA-10 positive and 18 strains (18% were PER-1 positive. Conclusion: Our results confirm the need for proper antimicrobial therapy in burn hospitals, considering the resistance pattern and frequency of strains producing ESBLs and the presence of the OXA-10 and PER-1 genes. Since an increase in the prevalence of ESBL in P. aeruginosa strains might lead to the transfer of these ESBL genes to other gram-negative bacteria, we recommend the use of appropriate drugs, especially cephalosporins, in burn hospitals.

  19. Three Years After Black Saturday: Long-Term Psychosocial Adjustment of Burns Patients as a Result of a Major Bushfire.

    Science.gov (United States)

    Pfitzer, Birgit; Katona, Lynda Jane; Lee, Stuart J; O'Donnell, Meaghan; Cleland, Heather; Wasiak, Jason; Ellen, Steve

    2016-01-01

    Despite increasing evidence that burn injuries can result in multiple psychological sequelae, little is known about the long-term psychosocial adjustment to burns sustained in a major bushfire. The aim of the present study was to assess long-term psychological distress and health-related quality of life in Australian burns patients as a result of the 2009 Black Saturday bushfires. Eight male and five female burns patients with a mean age of 53.92 (SD = 11.82) years who received treatment at a statewide burns service participated in the study. A battery of standardized questionnaires was administered to assess general psychological distress, burns-specific and generic health-related quality of life, alcohol use, and specific psychological symptoms of posttraumatic stress disorder, depression, and anxiety. The results revealed that more than 3 years after Black Saturday 33% of the burns patients still suffered "high" to "very high" levels of general distress, whereas 58% fulfilled partial or full criteria for posttraumatic stress disorder. Furthermore, participants still experienced significantly impaired physical health functioning as compared to their preinjury status including limitations in work-based activities, increased bodily pain, and lower vitality overall. The trajectory of distress varied for participants. Some individuals experienced little distress overall, whereas others displayed a decline in their stress levels over time. Notwithstanding, some patients maintained high levels of distress throughout or experienced an increase in distress at a later stage of recovery. The results point to the importance of psychosocial screening to identify distress early. Follow-up assessments are crucial to diagnose individuals with chronic or late onset of distress. PMID:25501772

  20. Optimization of burn referrals

    DEFF Research Database (Denmark)

    Reiband, Hanna K; Lundin, Kira; Alsbjørn, Bjarne;

    2014-01-01

    INTRODUCTION: Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmar...

  1. Effect of Patient Sex on the Severity of Coronary Artery Disease in Patients with Newly Diagnosis of Obstructive Sleep Apnoea Admitted by an Acute Coronary Syndrome

    Science.gov (United States)

    Sánchez-de-la-Torre, Alicia; Abad, Jorge; Durán-Cantolla, Joaquín; Mediano, Olga; Cabriada, Valentín; Masdeu, María José; Terán, Joaquín; Masa, Juan Fernando; de la Peña, Mónica; Aldomá, Albina; Worner, Fernando; Valls, Joan; Barbé, Ferran; Sánchez-de-la-Torre, Manuel

    2016-01-01

    Background The cardiovascular consequences of obstructive sleep apnoea (OSA) differ by sex. We hypothesized that sex influences the severity of acute coronary syndrome (ACS) in patients with OSA. OSA was defined as an apnoea–hypopnoea index (AHI)>15 events·h-1. We evaluated the severity of ACS according to the ejection fraction, Killip class, number of diseased vessels, number of stents implanted and plasma peak troponin level. Methods We included 663 men (mean±SD, AHI 37±18 events·h-1) and 133 women (AHI 35±18 events·h-1) with OSA. Results The men were younger than the women (59±11 versus 66±11 years, p<0.0001), exhibited a higher neck circumference (p<0.0001), and were more likely to be smokers and alcohol users than women (p<0.0001, p = 0.0005, respectively). Body mass index and percentage of hypertensive patients or diabetics were similar between sexes. We observed a slight tendency for a higher Killip classification in women, although it was not statistically significant (p = 0.055). For men, we observed that the number of diseased vessels and the number of stents implanted were higher (p = 0.02, p = 0.001, respectively), and a decrease in the ejection fraction (p = 0.002). Conclusions This study shows that sex in OSA influences the severity of ACS. Men show a lower ejection fraction and an increased number of diseased vessels and number of stents implanted. PMID:27416494

  2. Profile of burn sepsis challenges and outcome in an exclusive children's hospital in Chennai, India

    OpenAIRE

    Ramakrishnan, K.M.; Jayaraman, V.; Mathivanan, T.; Babu, M.; B. Ramachandran; Sankar, J.

    2012-01-01

    A group of 273 paediatric patients admitted to Kanchi Kamakoti Childs Trust Hospital Burn Unit, Chennai, India between the years 2004 to 2010 were analysed retrospectively. Of these, 89 were suffering from sepsis and septic shock and 15 died. Strict adherence to antibiotic administration and to the Paediatric Intensive Care Unit (PICU) and management protocol improved the outcome, especially in 2009 and 2010.

  3. Post-burn facial contractures in pediatric patients: Challenging aspects of difficult airway management

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available Pediatric burn injuries are the most challenging to handle especially when they involve the face as the airway compromise invariably occurs due to edema and inflammation of the soft tissues of pharynx and larynx. The healing of the facial burns causes development of contractures and deformities after survival from the initial insults. Such patients when presented for surgery of the affected area or for that matter any surgery under general anesthesia, poses unique challenges to the attending anesthesiologists. Not only there are technical difficulties, but the socio-behavioral aspects related to pediatric age group and the various side-effects of anesthetic drugs are the main concerns for the anesthesiologist during the entire operative intervention. We are presenting a case of an infant who was brought to our institute by his parents for the cosmetic correction of the contractures and deformities of the lower face and the neck and in whom we faced extensive airway challenges because of the nature of the surgery.

  4. Wide Distribution of Carbapenem Resistant Acinetobacter baumannii in Burns Patients in Iran

    Directory of Open Access Journals (Sweden)

    zahra eFarshadzadeh

    2015-10-01

    Full Text Available Antimicrobial resistance in carbapenem non-susceptible Acinetobacter baumannii (CNSAb is a major public health concern globally. This study determined the antibiotic resistance and molecular epidemiology of CNSAb isolates from a referral burn center in Tehran, Iran.Sixty-nine CNSAb isolates were tested for susceptibility to antimicrobial agents using the E-test methodology. Multiple locus variable number tandem repeat analysis (MLVA, Multilocus sequence typing and multiplex PCR were performed. PCR assays tested for ambler classes A, B, and D β-lactamases. Detection of ISAba1, characterization of integrons, and biofilm formation were investigated.Fifty-three (77% isolates revealed XDR phenotypes. High prevalence of blaOXA-23-like (88% and blaPER-1 (54% were detected. ISAba1 was detected upstream of blaADC, blaOXA-23-like and blaOXA51-like genes in, 97, 42 and 26% of isolates, respectively. Thirty-one (45% isolates were assigned to International Clone (IC variants. MLVA identified 56 distinct types with 6 clusters and 53 singleton genotypes. Forty previously known MLST sequence types forming 5 clonal complexes were identified. The Class 1 integron (class 1 integrons gene was identified in 84% of the isolates. The most prevalent (33% cassette combination was aacA4-catB8-aadA1. The IC variants were predominant in the A. baumannii lineage with the ability to form strong biofilms.The XDR-CNSAb from burned patients

  5. Selection of antifungal agents for burn patients%烧伤患者抗真菌药物的选择

    Institute of Scientific and Technical Information of China (English)

    郇京宁

    2013-01-01

    Fungal infection is one of the serious complications of severely burned patients with high mortality.Application of antifungal agents timely and rationally is very important to control the infection.Antifungal agents including polyenes,triazoles,and echinocandins have been used widely in burned patients and are proved to be effective.Since diagnosis of fungal infection remains difficult,prophylactic and empirical therapies appear to be particularly necessary.In order to improve the efficacy and safety of antifungal agents,the factors of fungal strains,infection sites,hepatic and renal functions,and age,etc.should be considered in selecting antifungal agents.

  6. Beneficial effects of silver foam dressing on healing of wounds with ulcers and infection control of burn patients

    OpenAIRE

    Yang, Bo; Wang, Xudong; Li, Zhonghua; Qu, Qi; Qiu, Yan

    2015-01-01

    Objective: To assess the beneficial effects of silver foam dressing on the healing of wounds with ulcers and infection control of burn patients. Methods: Eighty-four second-degree burn patients were selected and divided into a study group and a control group (n=42). After disinfection and cleaning, wound beds of the study group were covered with silver-containing soft-silicone foam dressing, and wound surfaces of the control group were wiped with 1% silver sulfadiazine cream (60 g/100 cm2). T...

  7. Comparison of the nutritional status and outcome in thermal burn patients receiving vegetarian and non-vegetarian diets

    Directory of Open Access Journals (Sweden)

    Samira Sharma

    2014-01-01

    Full Text Available Background: The importance of adequate nutritional support in burned patients cannot be overemphasised. For adequate long-term compliance by the patients, diet should be formulated in accordance with their pre-burn dietary habits, religious beliefs, and tastes. Patients and Methods: A study was conducted in 42 consecutive patients suffering from 10% to 50% of 2 nd and 3 rd degree thermal burns with the aim to compare nutritional status, clinical outcome, and cost-effectiveness of vegetarian and non-vegetarian diets. The patients were divided into two groups depending upon their pre-injury food habits. Total calories were calculated by Curreri formula. Both groups were compared by various biochemical parameters, microbiological investigations, weight , status of wound healing, graft take, and hospital stay and they were followed for at least 60 days postburn. Results: The results were comparable in both groups. Vegetarian diet was found to be more palatable and cost-effective. Conclusion: Vegetarian diet is a safe and viable option for the patients suffering from burn injury. The common belief that non-vegetarian diet is superior to vegetarian diet is a myth.

  8. Characteristics of middle-aged and older patients with temporomandibular disorders and burning mouth syndrome.

    Science.gov (United States)

    Honda, Mika; Iida, Takashi; Komiyama, Osamu; Masuda, Manabu; Uchida, Takashi; Nishimura, Hitoshi; Okubo, Masakazu; Shimosaka, Michiharu; Narita, Noriyuki; Niwa, Hideo; Kubo, Hideyuki; De Laat, Antoon; Kawara, Misao; Makiyama, Yasuhide

    2015-01-01

    The aim of this study was to evaluate the relationship between pain intensities and psychosocial characteristics in middle-aged and older patients with temporomandibular disorders (TMDs) and burning mouth syndrome (BMS). Subjects were selected according to the Research Diagnostic Criteria for TMD (n = 705) and International Association for the Study of Pain criteria for BMS (n = 175). Patients were then divided into two age groups: 45-64 years (middle-aged, Group A) and 65-84 years (older, Group B). Pain intensity and depression and somatization scores were evaluated in both groups. In BMS patients, present and worst pain intensities were significantly higher in Group B than in Group A {4.6 [95% confidence interval (CI) = 4.0-5.2] vs. 3.5 [95% CI = 3.1-3.9] and 5.9 [95% CI = 5.2-6.4] vs. 5.0 [95% CI = 4.5-5.6], respectively; P < 0.05}, with no difference observed in TMD patients. The depression and somatization scores were significantly higher in Group A than in Group B among BMS patients [0.57 (95% CI = 0.45-0.69) vs. 0.46 (95% CI = 0.34-0.59) and 0.537 (95% CI = 0.45-0.63) vs. 0.45 (95% CI = 0.34-0.55); P < 0.05], with no difference observed in TMD patients. The results of the present study indicate that pain intensities and psychosocial characteristics in BMS appear to differ between middle-aged and older patients. PMID:26666859

  9. High voltage electrical burn injuries in teenage children: case studies with similarities (an indian perspective)

    Science.gov (United States)

    Mathangi Ramakrishnan, K.; Babu, M.; Mathivanan; Ramachandran, B.; Balasubramanian, S.; Raghuram, K.

    2013-01-01

    Summary From 1992 to 2012, a total of 911 paediatric burns were admitted and treated at Kanchi Kamakoti Childs Trust Hospital Intensive Burn Care Unit, of these 28 children had suffered electrical injuries and burns. 7 teenagers suffered high voltage electrical burn injuries: 2 were involved in train accidents which caused fatal electrical injuries, and 5 had electrical burn injuries caused by similar types of accidents, requiring Paediatric Intensive Care Unit (PICU) care, repeated surgeries and extensive rehabilitation. A common factor among these latter 5 patients was that they were injured by overhead high electrical voltage cables. Their management was labour intensive and highly costly. In this report, the type of accident, the electrical voltage that produced burns and the treatment details are elaborated. Findings included similarities in age and type of accident, and failure to implement safety procedures and apply standard norms of high voltage transmission feeder lines. PMID:24563637

  10. Antibiotic Resistance Pattern of Pseudomonas Aeruginosa, Isolated from Patient with Burn Wound Infection in Guilan,Iran

    Directory of Open Access Journals (Sweden)

    Iraj Nikokar

    2013-03-01

    Full Text Available Background and Objectives: Antibiotic resistance of Pseudomonas aeruginosa remains a major problem in burn patients. The main objective of this study was to determine the antibiotic resistance pattern and frequency of class 1 integrons among P. aeruginosa strains isolated from patients with burn wound infections in a new Burn Centre in Guilan, Iran.Materials and Methods: The bacterial isolates were collected from 182 patients with burn wound infections and P. aeruginosa species were identified by standard bacteriological methods. The drug susceptibility test, using 11 antimicrobial agents, was performed for all the isolates via agar disk diffusion method. PCR was carried out for the detection of integrons.Results: Out of a total of 182 hospitalized patients in the burn center assessed, 86 (47% found to have P. aeruginosa in their isolates. Resistance rates to various antibiotics were as follows: cloxacillin (91.8%, cotrimoxazole (86%, cephazolin (83.7%, carbenicillin (74.4%, piperacillin (69.9%, ceftazidime (68.8%, ciprofloxacin (66.3%, tobramycin (58.2%, amikacin (48.8% and gentamicin (37.2%, while the most effective antibiotic was imipenem with a resistance rate of 23.3%. Thirty nine (45.3% isolates were detected as multi-drug resistant. The PCR results showed that 37 (43% P. aeruginosa isolates and 27 (69.2% multi-drug resistant strains harbored class 1 integrons. A significant correlation was obtained between the presence of integrons and resistance against imipenem, ceftazidime, piperacillin and ciprofloxacin (P < 0.001.Conclusion: Optimization of using antimicrobial agents and control of infection is recommended to prevent the increasing population of drug resistant organisms in the new burn centre setting in this study. Furthermore, the high frequency of class 1 integrons among multi-drug resistant strains might be responsible for dissemination of antibiotic resistance gene.

  11. Treatment strategies for mass burn casualties

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHENG Zhi-yong; YANG Hong-ming; HAO Dai-feng; SHEN Chuan-an; JIA Xiao-ming; LI Feng; JING Sa; LI Li-gen; SONG Hui-feng; JIA Chi-yu; TUO Xiao-ye; SUN Tian-jun; HU Quan

    2009-01-01

    Background Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.Methods Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province,were admitted 48 hours post-injury. All patients were male with a mean age of (22.4±8.7) years. The burn extent ranged from 4% to 75% ((13.6±12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.Results These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver,kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.Conclusions A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of

  12. Long-term persistance of the pathophysiologic response to severe burn injury.

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    Marc G Jeschke

    Full Text Available BACKGROUND: Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. METHODOLOGY/PRINCIPAL FINDINGS: PATIENTS: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. CONCLUSIONS: Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified

  13. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    Science.gov (United States)

    Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Suman, Oscar E.; Mlcak, Ronald P.; Herndon, David N.

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. Methodology/Principal Findings Patients: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. Conclusions Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for

  14. Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado.

    Science.gov (United States)

    Bell, Cameron; Slim, Jessica; Flaten, Hanna K; Lindberg, Gordon; Arek, Wiktor; Monte, Andrew A

    2015-12-01

    Butane hash oil (BHO), also known as "amber," "dab," "glass," "honey," "shatter," or "wax," is a potent marijuana concentrate, containing up to 90 % tetrahydrocannabinol (THC). BHO is easily manufactured using highly volatile butane as a solvent. Our objective was to characterize hydrocarbon burns associated with BHO manufacture in Colorado. This was a cross-sectional study utilizing the National Burn Repository to capture all hydrocarbon burns reported to the local burn center from January 1st, 2008, through August 31st, 2014. We abstracted demographic and clinical variables from medical records for patients admitted for hydrocarbon burns associated with butane hash oil extraction. Twenty-nine cases of BHO burns were admitted to the local burn center during the study period. Zero cases presented prior to medical liberalization, 19 (61.3 %) during medical liberalization (Oct 2009-Dec 2013), and 12 (38.7 %) in 2014 since legalization. The majority of cases were Caucasian (72.4 %) males (89.7 %). Median age was 26 (range 15-58). The median total-body-surface-area (TBSA) burn size was 10 % (TBSA range 1-90 %). Median length of hospital admission was 10 days. Six required intubation for airway protection (21 %). Nineteen required skin grafting, eight wound care only, one required surgical fracture repair, and one required surgical debridement. Hydrocarbon burns associated with hash oil production have increased since the liberalization of marijuana policy in Colorado. A combination of public health messaging, standardization of manufacturing processes, and worker safety regulations are needed to decrease the risks associated with BHO production. PMID:26289652

  15. Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Krarup, Annabel Lee;

    1999-01-01

    burn surface area. Histamine, interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were analysed in plasma or serum collected from all patients 30 min before skin incision, at skin incision and 5, 10 and 30 min and thereafter every...

  16. Outbreak of infection in a burns unit due to Pseudomonas aeruginosa originating from contaminated tubing used for irrigation of patients

    DEFF Research Database (Denmark)

    Kolmos, H J; Thuesen, B; Nielsen, S V;

    1993-01-01

    water used for irrigation of the burns, as part of the first-aid treatment which the patients received when entering the hospital. Contamination was restricted to showers and tubing that were permanently connected to the taps, and the outbreak stopped after they had been disinfected. Tubing and showers...

  17. Epidemiology and mortality of burns in a general hospital of Eastern Sri Lanka.

    OpenAIRE

    Laloë, V

    2002-01-01

    This 2-year prospective study examined the epidemiology and mortality of 345 patients admitted with burn injuries. Sixty-four percent of all burns were accidental in nature and at least 25% were self-inflicted. The rest were due to assaults or had a doubtful cause. The median age was 22 years. Forty-one percent of the accidents were due to the fall of a homemade kerosene bottle lamp. The main cause was flames, followed by scalds. Females outnumbered males in all categories of burns except cas...

  18. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    OpenAIRE

    Finnerty, Celeste C.; Jeschke, Marc G.; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G.

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in chi...

  19. Assessment of anxiety and depression in patients with burning mouth syndrome: A clinical trial

    OpenAIRE

    Malik, Rohit; Goel, Sumit; Misra, Deepankar; Panjwani, Sapna; Misra, Akansha

    2012-01-01

    Introduction: Burning mouth syndrome is a chronic pain syndrome primarily affecting elderly women with hormonal changes or psychological disorders. It is multifactorial in origin, often idiopathic and its etiopathogenesis, majorly being neuropathic, largely remains enigmatic. Aim: To determine the prevalence of burning mouth symptom, in elderly women and evaluate local and systemic causes responsible for burning sensation. Materials and Methods: 100 elderly postmenopausal women were included ...

  20. The Role of the Nurse in the Rehabilitation of Patients with Radical Changes in Body Image Due to Burn Injuries

    OpenAIRE

    Aacovou, I.

    2005-01-01

    Burn injuries are among the most serious causes of radical changes in body image. The subject of body image and self-image is essential in rehabilitation, and the nurse must be aware of the issues related to these concepts and take them seriously into account in drafting out the nursing programme. This paper defines certain key words related to body image and discusses the social context of body image. Burn injuries are considered in relation to the way each of these affects the patient's bod...

  1. Persistent lactic acidosis after chronic topical application of silver sulfadiazine in a pediatric burn patient: a review of the literature

    OpenAIRE

    Willis, Monte S.; Cairns, Bruce A; Purdy, Ashley; Bortsov, Andrey V; Jones, Samuel W.; Ortiz-Pujols, Shiara M; Willis, Tina M Schade; Jr, Benny L Joyner

    2013-01-01

    A 3-year old male who sustained 2nd and 3rd degree burns that covered approximately 60% TBSA presented to a large adult and pediatric verified burn center. On hospital day (HD) 26 of his stay, Candida fungemia was identified by blood culture, delaying operative management until HD 47. On HD 47, after his first operative intervention, the patient developed a persistent metabolic and lactic acidosis. On HD 66, a search for a cause of his osmol gap of 56 mOsm/kg revealed a potential source-propy...

  2. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  3. 连续多批次大面积烧伤患者救治体会%Experience in the medical care of multiple batches of extensive burn patients

    Institute of Scientific and Technical Information of China (English)

    王鹏; 黄勇; 林立新; 王学明

    2014-01-01

    Objective To summarize experience in the medical care of multiple batches of extensive burn patients .Methods Retrospective analysis was made in the 4 batches of 27 cases of extensive burn patients admitted in our hospital from May 26, 2009 to June 28, 2009.Results The twenty-seven cases of burn patients were all saved , the trauma surfaces at hand , face and joints were all successfully repaired and their functions recovered quite satisfactorily .Conclusion In successive and multiple burn casualty care , strong organization and coordination were important guarantee for successful medical care of mass casualties .Efforts should be made to give patients with massive areas of burns and shock personalized fluid resuscitation .Medical people should do every thing possible to save their lives , and in the meantime , they should do their utmost to restore the functions of joins and repair lesions of the trauma sur -faces.Maintaining effective respiration , proper wound surface debridement and the prevention and treatment of invasive infection were vital to the saving of burn victims .%目的:总结连续多批次大面积烧伤患者集中救治的经验。方法对2009年5月26日至6月28日先后收治的4批次27例大面积烧伤患者的集中救治进行回顾性总结。结果27例患者全部救治成功,手、面部、关节功能部位创面得到较好的修复,功能及外观恢复较满意。结论在连续多批烧伤的集中救治中,强有力的组织协调是救治成功的重要保证;大面积烧伤休克期应强调“个体化液体复苏”;对连续多批烧伤患者在抢救生命的同时,要有恢复关节功能的理念,可以使功能部位创面得到很好的修复;维持有效的呼吸功能和加强创面处理、防治烧伤侵袭性感染是救治的重要环节。

  4. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part III)*

    OpenAIRE

    Atiyeh, B.S.; Gunn, S.W.A.; Dibo, S.A.

    2008-01-01

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing,...

  5. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part 1)

    OpenAIRE

    Atiyeh, B.S.; Gunn, S.W.A.; Dibo, S.A.

    2008-01-01

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing,...

  6. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part II)*

    OpenAIRE

    Atiyeh, B.S.; Gunn, S.W.A.; Dibo, S.A.

    2008-01-01

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing,...

  7. Factores de riesgo para el desarrollo de infecciones intrahospitalarias en pacientes quemados. Hospital S. Juan de Dios, Costa Rica: Enero 2003-Diciembre 2005. Parte I Risk factors for development of intrahospitalary infections in burned patients. Hospital S. Juan de Dios, Costa Rica: January 2003-December 2005. Part I

    Directory of Open Access Journals (Sweden)

    S. Vargas Naranjo

    2009-09-01

    Full Text Available La infección intrahospitalaria es una de las principales causas de morbilidad y mortalidad en los pacientes quemados. El presente estudio caracteriza a los ingresados por quemadura(s y la presencia de esta clase de infección en la Unidad Nacional de Quemados del Hospital San Juan de Dios, en Costa Rica, entre los años 2003 y 2005. Realizamos un análisis descriptivo de la infección intrahospitalaria en el sitio de la quemadura según las características de los pacientes y de la quemadura así como el total de días de estancia hospitalaria, utilizando para ello un diseño de estudio tipo cohorte retrospectiva. La incidencia acumulada de la infección intrahospitalaria en el sitio de la quemadura fue de 19.0%. Los meses posteriores al ingreso a clases presentaron un mayor número de hospitalizaciones por quemaduras. La edad, la superficie corporal total quemada, el número de segmentos corporales quemados, la profundidad de la quemadura y los días de estancia hospitalaria presentaron diferencias significativas entre los individuos infectados y no infectados. El tipo de accidente que produjo la quemadura y el sexo no presentaron diferencias significativas entre ambos grupos de pacientes. La electricidad fue el agente causal más frecuente en los pacientes con infección, mientras que el agua caliente lo fue en los pacientes sin infección. Concluimos que las características fisiopatológicas de las quemaduras favorecen infección en los pacientes quemados; asimismo, existen factores que pueden y deben ser tomados en cuenta para controlar y prevenir la infección y sus efectos.Intrahospitalary infection in burned patients is one of the most important causes of morbidity and mortality. This study characterizes the admitted burn victims and the presence of inner-hospital infection at the National Burn Victims Unit , San Juan de Dios Hospital, Costa Rica, between 2003 and 2005. We made a descriptive analyze of intrahospital infection in the

  8. Reducing the Indication for Ventilatory Support in the Severely Burned Patient: Results of a New Protocol Approach at a Regional Burn Center.

    Science.gov (United States)

    Gille, Jochen; Bauer, Nicole; Malcharek, Michael J; Dragu, Adrian; Sablotzki, Armin; Taha, Hischam; Czeslick, Elke

    2016-01-01

    Initial management of the severely injured routinely includes sedation and mechanical ventilatory support. However, nonjudiciously applied mechanical ventilatory support can itself lead to poorer patient outcomes. In an attempt to reduce this iatrogenic risk, a standardized, in-house, five-point protocol providing clinical guidance on the use and duration of ventilation was introduced and analyzed, and the impact on patient outcomes was assessed. In 2007, a protocol for early spontaneous breathing was introduced and established in clinical practice. This protocol included: 1) early extubation (≤6 hours after admission) in the absence of absolute ventilatory indication; 2) avoidance of "routine intubation" in spontaneously breathing patients; 3) early postoperative extubation, including patients requiring multiple surgical interventions; 4) intensive chest and respiratory physiotherapy with routine application of expectorants; and 5) early active mobilization. A retrospective clinical study compared patients (group A) over a 2-year period admitted under the new protocol with a historical patient group (group B). Patients in group A (n = 38) had fewer ventilator days over the time-course of treatment (3 [1; 5.8] vs 18.5 days [0.5; 20.5]; P = .0001) with a lower rate of tracheostomies (15.8 vs 54%; P = .0003). Patients on ventilation at admission in group A had shorter ventilation periods after admission (4.75 [4; 22.25] vs 378 hours [8.5; 681.5]; P = .0003), and 66.7% of these patients were extubated within 6 hours of admission (vs 9.1% in group B). No patients fulfilling the inclusion criteria required re- or emergency intubation. In the first 5 days of treatment, significantly lower Sequential Organ Failure Assessment scores were recorded in group A. There was also a trend for lower mortality rates (0 [0%] vs 6 [14%]), sepsis rates (24 [63.2%] vs 37 [88.1%]), and cumulative fluid balance on days 3 and 7 in group A. In contrast, group A demonstrated an elevated

  9. Analgesic and antisympathetic effects of clonidine in burn patients, a randomized, double-blind, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Ostadalipour Abbas

    2007-01-01

    Full Text Available Objectives: Unlike most other Analgesic drugs, α2 adrenoceptor agonists are capable of producing analgesia. The aim of this study was to evaluate the Analgesic and antisympathetic effects of clonidine, an α2 adrenoceptor agonist in burn patients. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial performed on one hundred burn patients in Zarea Hospital, Mazandaran, Iran from august 2004 to July 2005. All patients divided in two groups. Case group (n=50 received oral clonidine, 3.3μg/kg TDS and controls (n=50 received placebo. Heart rate and systolic blood pressure and pain severity Visual analogue score (VAS, were recorded after clonidine administration. Statistical analysis was done by means of Mann Witney U test. Results: 50 patients (mean age 28.96±10 years in case group, and 50 patients (mean age 27.60±11.4 years in control group were studied. VAS pain scores and heart rate in the clonidine group were significantly lower than the control group (P< 0.0001, P< 0.02.there were no significant difference in systolic blood pressure between the two groups on the first and second day but on third day the systolic blood pressure in clonidine group, was lower than controls significantly (P=0.002. Conclusion: This study demonstrates that the use of oral clonidine affects the hemodynamic response to pain in burn patients. Our study demonstrated that clonidine can produce good analgesia and decreased in sympathetic over activity in burn patients, and also reduce opioid dose requirements.

  10. Patients admitted in an Intensive Care Unit with severe clinical manifestations of Influenza, october-december 2009 Pacientes ingresados con formas graves de Enfermedad Tipo Influenza en una Unidad de Cuidados Intensivos, octubre a diciembre 2009

    OpenAIRE

    Octavio Rivero Rodríguez; Diley Moreno Ruiz; Yanli Vázquez Villazón; Pablo Rodríguez Díaz; Alfredo Dario Espinosa Brito; Jaime Geroy Gómez; Francisco García Valdés; Ramón E Álvarez Cepero; Rudis Monzón Rodríguez; Jorge Luis Ulloa Capestani; Yenisey Quintero Mendez

    2011-01-01

    A descriptive study of a series of cases was carried out, where 109 patients with the presumptive diagnosis of severe clinical pictures of Influenza were included, the total of them admitted in one of our Intensive Care Units (ICU), prepared for that purpose during the recent pandemic, during the period comprised between October 1 and December 31, 2009. There were 62 women (56,9%), of which 19 were pregnant or postpartum women (17,4%). The mean age of the sick persons of this serie was of 52,...

  11. Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru; Achados tomograficos de pacientes submetidos a tomografia de cranio no pronto-socorro do Hospital Universitario Cajuru

    Energy Technology Data Exchange (ETDEWEB)

    Lara Filho, Lauro Aparecido; Omar, Samir Sari; Biguelini, Rodrigo Foletto; Santos, Rony Augusto de Oliveira, E-mail: samir176@gmail.com [Pontificia Universidade Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Cuso de Medicina

    2013-05-15

    Objective: to identify and analyze the prevalence of cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitario Cajuru. Materials and methods: cross-sectional study analyzing 200 consecutive non contrast-enhanced cranial computed tomography reports of patients admitted to the emergency unit of Hospital Universitario Cajuru. Results: alterations were observed in 76.5% of the patients. Among them, the following findings were most frequently observed: extracranial soft tissue swelling (22%), bone fracture (16.5%), subarachnoid hemorrhage (15%), nonspecific hypodensity (14.5%), paranasal sinuses opacification (11.5%), diffuse cerebral edema (10.5%), subdural hematoma (9.5%), cerebral contusion (8.5%), hydrocephalus (8%), retractable hypodensity /gliosis/ encephalomalacia (8%). Conclusion: the authors recognize that the most common findings in emergency departments reported in the literature are similar to the ones described in the present study. This information is important for professionals to recognize the main changes to be identified at cranial computed tomography, and for future planning and hospital screening aiming at achieving efficiency and improvement in services. (author)

  12. How important is hydrotherapy? Effects of dynamic action of hot spring water as a rehabilitative treatment for burn patients in Switzerland

    OpenAIRE

    Moufarrij, S.; Deghayli, L.; Raffoul, W.; Hirt-Burri, N.; Michetti, M; de Buys Roessingh, A.; Norberg, M; Applegate, L.A.

    2014-01-01

    Burn rehabilitation using hydrotherapy can have multiple benefits for the burn patient. The therapy uses specific mineral enriched hot spring water and water jets with varied hydro-pressure to combat hypertrophy, inflammatory reaction signs, abnormal pigmentation, and, more specifically, redness and scarring. Standard operating procedures for burn rehabilitation have been developed and integrated into the Standard of Care at the CHUV hospital using localized hydro-mechanical stimulation of bu...

  13. Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Krarup, Annabel Lee; Nielsen, L M; Reimert, C M; Pedersen, A N; Dybkjaer, E; Partoft, S; Alsbjørn, B

    1999-01-01

    Adverse effects of perioperative blood transfusion appear to be storage-time-dependent and may be related to extracellular accumulation of bioactive substances in blood products. In this study the clinical effects of leukofiltered and non-filtered blood products in patients undergoing surgery for...... burn trauma are investigated. 24 consecutive patients were randomly selected to receive transfusion with non-filtered blood components (group A, n = 12) or similar products, which were prestorage leukofiltered (group B, n = 12). The burn injury was scored using the Bull and Fischer index of age and...... 30 min after skin incision until the grafts were secured by wrapping. Samples were also taken 8 h after skin incision and in the morning of postoperative days 1-5. The amount of blood products transfused from admission until day 5 postoperatively was recorded. All patients were followed until...

  14. The Effects of Music Intervention on Background Pain and Anxiety in Burn Patients: Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Najafi Ghezeljeh, Tahereh; Mohades Ardebili, Fatimah; Rafii, Forough; Haghani, Hamid

    2016-01-01

    This study aimed to investigate the effect of music on the background pain, anxiety, and relaxation levels in burn patients. In this pretest-posttest randomized controlled clinical trial, 100 hospitalized burn patients were selected through convenience sampling. Subjects randomly assigned to music and control groups. Data related to demographic and clinical characteristics, analgesics, and physiologic measures were collected by researcher-made tools. Visual analog scale was used to determine pain, anxiety, and relaxation levels before and after the intervention in 3 consecutive days. Patients' preferred music was offered once a day for 3 days. The control group only received routine care. Data were analyzed using SPSS-PC (V. 20.0). According to paired t-test, there were significant differences between mean scores of pain (P music group. Independent t-test indicated a significant difference between the mean scores of changes in pain, anxiety, and relaxation levels before and after intervention in music and control groups (P music intervention. Music is an inexpensive, appropriate, and safe intervention for applying to burn patients with background pain and anxiety at rest. To produce more effective comfort for patients, it is necessary to compare different types and time lengths of music intervention to find the best approach. PMID:26132048

  15. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    Science.gov (United States)

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems. PMID:16843945

  16. Growth factor therapy in patients with partial-thickness burns: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Yi; Wang, Tao; He, Jinguang; Dong, Jiasheng

    2016-06-01

    Growth factor (GF) therapy has shown promise in treating a variety of refractory wounds. However, evidence supporting its routine use in burn injury remains uncertain. We performed this systematic review and meta-analysis assessing randomised controlled trials (RCTs) to investigate efficacy and safety of GFs in the management of partial-thickness burns. Electronic searches were conducted in PubMed and the Cochrane databases. Endpoint results analysed included wound healing and scar formation. Thirteen studies comprising a total of 1924 participants with 2130 wounds (1131 GF receiving patients versus 999 controls) were identified and included, evaluating the effect of fibroblast growth factor (FGF), epidermal growth factor (EGF) and granulocyte macrophage-colony stimulating factor (GM-CSF) on partial-thickness burns. Topical application of these agents significantly reduced healing time by 5·02 (95% confidence interval, 2·62 to 7·42), 3·12 (95% CI, 1·11 to 5·13) and 5·1 (95% CI, 4·02 to 6·18) days, respectively, compared with standard wound care alone. In addition, scar improvement following therapy with FGF and EGF was evident in terms of pigmentation, pliability, height and vascularity. No significant increase in adverse events was observed in patients receiving GFs. These results suggested that GF therapy could be an effective and safe add-on to standard wound care for partial-thickness burns. High-quality, adequately powered trials are needed to further confirm the conclusion. PMID:25040572

  17. Investigated of ampC in Carbapenem Resistant Gram-Negative Bacteria Isolated from Burned Patients

    Directory of Open Access Journals (Sweden)

    Leila Azimi

    2015-10-01

    Full Text Available Background: Gram-Negative bacteria are the most cause of nosocomial infection especially in burned patients. Carbapenem resistant strains can limit seriously the choice of antibiotic therapy. AmpC can make resistance to carbapenem and detection of that can be useful for identification ofcarbapenem resistant. The aim of this study was identification of ampC in most prevalent cause of nosocomial infection.Methods: boronic acid combined with meropenem in combination disc method was used for phenotypic method and PCR was used for molecular identification of ampC.Results: Fifty one strains showed positive results in phenotypic method but 119 strains were harbored ampC gene. Combination disc method with meropenem and boronic acid showed 34.4% sensitivity and 78.5% specificity according to the results of this study.Conclusions: the results of this study were indicated the more prevalent of ampC in carbapenem resistant Gram-Negative bacteria. On the other hand use of boronic acid combined with meropenem showed low sensitivity for detection of ampC.

  18. EFFECTS OF CARDIOVASCULAR REHABILITATION IN PATIENTS ADMITTED TO THE “Dr Benedek Geza” Hospital of Rehabilitation IN CARDIOVASCULAR Diseases, COVASNA

    OpenAIRE

    Suceveanu Mihaela; Pop Dana; Suceveanu Paul; Sitar Tǎut Adela Viviana; Zdrenghea Dumitru; Hâncu Nicolae

    2015-01-01

    Background. Cardiovascular rehabilitation is an important objective of the treatment of cardiovascular patients in general, and ischemic heart disease patients in particular. The aim of the study is to monitor the effects of long-term cardiovascular rehabilitation in patients readmitted to the “Dr Benedek Geza” Hospital of Rehabilitation in Cardiovascular Diseases Covasna. Material and methods. The study included 92 patients with a mean age of 66.31±9 years, of which 63% women, who had...

  19. Enteral nutrition support and nursing to batched severe burn patients caused by explosions%成批爆炸致特重度烧伤患者肠内营养支持的护理

    Institute of Scientific and Technical Information of China (English)

    王静云; 李小珍

    2015-01-01

    目的:探讨成批爆炸致特重度烧伤患者肠内营养支持护理要点。方法对本科室收治的15例特重度烧伤患者进行肠内营养支持治疗,并配合做好护理工作。结果5例患者伤后45~87 d因缺少自体皮源,并发脓毒血症死亡,10例患者经过肠内营养支持、抗感染等治疗护理,营养状况得到改善,安全度过感染期,进入恢复期;患者ICU住院时间54~115 d,平均(90.63±30.37)d。结论特重度烧伤患者采取早期肠内营养支持及护理,能够有效改善患者营养状况,促进患者康复。营养支持期间应做好管饲护理,预防早期肠内营养发生的并发症等,其是顺利完成肠内营养支持的重要措施。%Objective To explore nursing points on the enteral nutrition support to batched patients with severe burn caused by explosion. Method An enteral nutrition support was carried out for 15 patients with severe burns admitted in our department and pertinent nursing was performed. Results Five patients died because of lack of autologous skin sources and complications of sepsis in 45~87 d after burn. Ten patients got a good recovery after enteral nutrition support, anti-infection treatment and nursing. They lived through the infection period, went into the recovery period. The hospital stay of these patients in ICU was 54~115 d with an average of (90.63 ± 30.37)d. Conclusion Early enteral nutrition support and nursing to the patients with severe burn can improve the nutritional status of patients effectively and promote the rehabilitation of patients.

  20. Burns and epilepsy.

    Science.gov (United States)

    Berrocal, M

    1997-01-01

    This is a report of the first descriptive analytic study of a group of 183 burn patients, treated in the Burn Unit at the University Hospital of Cartagena, Colombia during the period since January 1985 until December 1990. There is presented experience with the selected group of 24 patients in whom the diagnosis of burn was associated with epilepsy. There is also analysed and described the gravity of the scars sequels, neurological disorders, the complication of the burn and an impact of this problem on the patient, his (her) family and the community. It is very important to report that there was found Neurocisticercosis in 66.6% of the group of burn patients with epilepsy, and it is probably the first risk factor of burn in this group. PMID:9212488