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Sample records for burn patients measured

  1. A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients

    Science.gov (United States)

    2016-10-01

    participating sites provided didactic and hands-on training in cutaneokinematics and goniometric techniques . • Monthly teleconferences provide the...population. Hypothesis: Significant statistical differences in patient joint angle measurements will be found between SG techniques compared to RG... techniques which incorporate CKM and CFU principles. Specific Aim 1: Statistically compare SG measurements obtained using the traditional technique

  2. A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients

    Science.gov (United States)

    2017-10-01

    conducted on 166 data points. Data was analyzed using a repeated measures ANOVA taking into account the 3 repeated measures for each GM measurement...taking into account the 3 repeated measures to ensure the significance is the same as the interim analysis. In addition the final analysis will be...rehabilitation: A new horizon ” by Reg Richard, PI from ISR. The presentation related to the study by describing the versatility of CFUs and how they

  3. A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients

    Science.gov (United States)

    2015-10-01

    didactic and hands-on training in cutaneokinematics and goniometric techniques. 9  Monthly teleconferences provide the opportunity for small group...Training  4. SCREENING, ENROLLMENT, WITHDRAWL          15  Recruitment  strategies   Subject Screening and Enrollment Process   Eligibility Log...ENROLLMENT, WITHDRAWL    Recruitment  Strategies  ‐ Informational flyers (Appendix I) may be placed in various locations to  make patients aware of the

  4. Measuring the amount of serum albumin in burn patients and the relationship between the burned area and length of hospital stay

    Directory of Open Access Journals (Sweden)

    Maryam Roham

    2017-08-01

    Methods: This cross-sectional study was conducted on patients aged over 16 years who referred to the Motahari Hospital of September 2014 to February 2015 in the first 24 hours of their referral. The amount of Albumin was measured in two groups of discharged patients and patients who died while hospitalized, one week after hospital stay and in the time of discharge and death; and its relationship in terms of each other was determined by statistical analysis. We also assessed the relationship between burn and duration of hospital stay with the amount of Albumin on the day of patient’s admission. Results: This study showed that the average amount of albumin in the group of discharged patients in the time of admission, one week after and during admission was significantly higher than the group of expired patients (P<0.0001. Also there was a significant relation between the burned area and the amount of albumin (P<0.0001. The more the burned area, the less the amount of Albumin. But there was no significant relationship between the amount of albumin with age and length of hospital stay. Conclusion: Measuring the level of Albumin is one of the yardsticks that can be used for prognosis of recovery or death of burn patients, and its assessment at regular intervals in burn patients is essential.

  5. Nanocrystalline silver dressings significantly influence bioimpedance spectroscopy measurements of fluid volumes in burns patients.

    Science.gov (United States)

    Grisbrook, Tiffany L; Kenworthy, Pippa; Phillips, Michael; Wood, Fiona M; Edgar, Dale W

    2016-11-01

    Bioimpedance spectroscopy (BIS) is a tool utilized in health care to investigate body composition and fluid distribution. Limited research has addressed the clinical use of BIS in burns. This study aimed to examine the effects of silver dressings on BIS measurements in burns patients. BIS measurements were collected during two dressing conditions: no dressing (ND), and; Acticoat™ dressing (AD). Wilcoxon sign-ranks tests determined if there were any significant differences in BIS measures between the dressing conditions. Multilevel mixed-effects linear regressions examined the effect of %TBSA and body mass on BIS variables across the dressing conditions. The mean age of the patients (n=31) was 34.90 years; with a median TBSA of 15%. There was a significant increase in extracellular fluid (ECF) (pdressing condition, %TBSA and body mass, whereby the difference in ECF, ICF and TBW between the ND and AD conditions were increased as %TBSA and body mass increased. Algorithms were developed subsequently to adjust BIS outputs for use when AD is in place. Clinician's may continue to use BIS in real-time using the predictive algorithms established during this study. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. The effect of Burns & Wounds (B&W)/burdock leaf therapy on burn-injured Amish patients: a pilot study measuring pain levels, infection rates, and healing times.

    Science.gov (United States)

    Kolacz, Nicole M; Jaroch, Mark T; Bear, Monica L; Hess, Rosanna F

    2014-12-01

    The purposes of this pilot study were to measure pain associated with dressing changes, assess the presence of infection, and document healing times of burn-injured Amish in central Ohio using an herbal therapy consisting of Burns and Wounds™ ointment (B&W) and burdock (Arctium ssp.) leaves. B&W contains honey, lanolin, olive oil, wheat germ oil, marshmallow root, Aloe vera gel, wormwood, comfrey root, white oak bark, lobelia inflata, vegetable glycerin, bees wax, and myrrh. A prospective, case series design guided the study within a community-based participatory research framework. Amish burn dressers provided burn care. Registered nurses monitored each case and documented findings. Pain scores were noted and burns were inspected for infection during dressing changes; healing times were measured from day of burn to complete closure of the skin. All cases were photographed. Between October 2011 and May 2013, five Amish were enrolled. All had first- and second-degree burns. B&W/burdock leaf dressing changes caused minimal or no pain; none of the burns became infected, and healing times averaged less than 14 days. The use of this herbal remedy appears to be an acceptable alternative to conventional burn care for these types of burns. The trauma of dressing changes was virtually nonexistent. Nurses working in communities with Amish residents should be aware of this herbal-based method of burn care and monitor its use when feasible. © The Author(s) 2014.

  7. 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

  8. Candidiasis in the Burned Patient

    Science.gov (United States)

    1981-03-01

    Candidemia was present in 52 patients and 76.9% of these died. Candida infection was seen as a preterminal phenomenon, coincident with a generalized...8217andid, burn wound infection 75; may be required (16l. Bacterial sepsis, topical antimicro- also had candidemia . Considering all sources, a total of...manifested candidemia and burn wound inva- (-8) sion bv other noncandidal fungal organisms. Candidemia Colonization always preceded invasive sepsis, but 80’r

  9. Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: an audit of 698 patients.

    Science.gov (United States)

    Harish, Varun; Raymond, Andrew P; Issler, Andrea C; Lajevardi, Sepehr S; Chang, Ling-Yun; Maitz, Peter K M; Kennedy, Peter

    2015-02-01

    The purpose of this study was to compare burn size estimation between referring centres and Burn Units in adult patients transferred to Burn Units in Sydney, Australia. A review of all adults transferred to Burn Units in Sydney, Australia between January 2009 and August 2013 was performed. The TBSA estimated by the referring institution was compared with the TBSA measured at the Burns Unit. There were 698 adults transferred to a Burns Unit. Equivalent TBSA estimation between the referring hospital and Burns Unit occurred in 30% of patients. Overestimation occurred at a ratio exceeding 3:1 with respect to underestimation, with the difference between the referring institutions and Burns Unit estimation being statistically significant (Pburn-injured patients as well as in patients transferred more than 48h after the burn (Pburn (Pburns (≥20% TBSA) were found to have more satisfactory burn size estimations compared with less severe injuries (burn size assessment by referring centres. The systemic tendency for overestimation occurs throughout the entire TBSA spectrum, and persists with increasing time after the burn. Underestimation occurs less frequently but rises with increasing time after the burn and with increasing TBSA. Severe burns (≥20% TBSA) are more accurately estimated by the referring hospital. The inaccuracies in burn size assessment have the potential to result in suboptimal treatment and inappropriate referral to specialised Burn Units. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  10. Bacteriological profile of burn patients at Yekatit 12 Hospital Burn ...

    African Journals Online (AJOL)

    Introduction: Burn is one of the most common devastating and a very painful form of trauma. Significant thermal injuries induce a state of immune-suppression that predisposes burn patients to infection complications. Materials and methods: A prospective hospital based study was carried out from December 2010 to ...

  11. 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. Copyright © 2009 Elsevier Ltd and ISBI. All rights reserved.

  12. 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. © 2016 Blackwell Verlag GmbH.

  13. Burn site groundwater interim measures work plan.

    Energy Technology Data Exchange (ETDEWEB)

    Witt, Jonathan L. (North Wind, Inc., Idaho Falls, ID); Hall, Kevin A. (North Wind, Inc., Idaho Falls, ID)

    2005-05-01

    This Work Plan identifies and outlines interim measures to address nitrate contamination in groundwater at the Burn Site, Sandia National Laboratories/New Mexico. The New Mexico Environment Department has required implementation of interim measures for nitrate-contaminated groundwater at the Burn Site. The purpose of interim measures is to prevent human or environmental exposure to nitrate-contaminated groundwater originating from the Burn Site. This Work Plan details a summary of current information about the Burn Site, interim measures activities for stabilization, and project management responsibilities to accomplish this purpose.

  14. Matrix metalloproteinase-2 and its correlation with basal membrane components laminin-5 and collagen type IV in paediatric burn patients measured with Surface Plasmon Resonance Imaging (SPRI) biosensors.

    Science.gov (United States)

    Weremijewicz, Artur; Matuszczak, Ewa; Sankiewicz, Anna; Tylicka, Marzena; Komarowska, Marta; Tokarzewicz, Anna; Debek, Wojciech; Gorodkiewicz, Ewa; Hermanowicz, Adam

    2018-01-30

    The purpose of this study was the determination of matrix metalloproteinase-2 and its correlation with basal membrane components laminin-5 and collagen type IV in the blood plasma of burn patients measured with Surface Plasmon Resonance Imaging (SPRI) biosensors. 31 children scalded by hot water who were managed at the Department of Paediatric Surgery between 2014-2015, after primarily presenting with burns in 4-20% TBSA were included into the study (age 9 months up to 14 years, mean age 2,5+1 years). There were 10 girls and 21 boys. Venous blood samples were drawn 2-6h, and 12-16h after the thermal injury, and on the subsequent days 3, 5 and 7. The matrix metalloproteinase-2, collagen type IV and laminin-5 concentrations were assessed using Surface Plasmon Resonance Imaging by the investigators blinded to the other data. The MMP-2, laminin-5 and collagen type IV concentrations in the blood plasma of patients with burns, were highest 12-16h after thermal injury, the difference was statistically significant. The MMP-2, laminin-5 and collagen type IV concentrations measured 3 days, 5 days and 7 days after the thermal injury, slowly decreased over time, and on the 7th day reached the normal range, when compared with the concentration measured in controls. Current work is the first follow-up study regarding MMP-2 in burns. MMP-2, laminin-5 and collagen type IV levels were elevated early after burn injury in the plasma of studied patients, and were highest 12-16h after the injury. MMP-2, laminin-5 and collagen type IV levels were not proportional to the severity of the burn. We believe in the possibility that the gradual decrease of MMP-2, collagen type IV and laminin-5 concentrations could be connected with the process of healing, but to prove it, more investigation is needed in this area. The SPR imaging biosensor is a good diagnostic tool for determination of MMP-2, laminin-5 and collagen type IV in blood plasma of patients with burns. Copyright © 2017 Elsevier Ltd

  15. Inappropriate Vasopressin Secretion (SIADH) in Burned Patients

    Science.gov (United States)

    1983-03-01

    reportedly elevated in burned patients (12). Because further dilution of plasma, with a fall in urine concentra- of increased gluconeogenesis , burned patients... dogs , apparently through alterations seen in burned patients, tachycardia does not explain the in AVP secretion (24). Hypothyroidism is associated with...806, 27. Spielman, W.S., Davis. J.O., Gotshall, R.W.: Hypersecretion of 1967. renin in dogs with a chronic aorto-caval fistula and high-output 5

  16. Physical functional outcome assessment of patients with major burns admitted to a UK Burn Intensive Care Unit.

    Science.gov (United States)

    Smailes, Sarah T; Engelsman, Kayleen; Dziewulski, Peter

    2013-02-01

    Determining the discharge outcome of burn patients can be challenging and therefore a validated objective measure of functional independence would assist with this process. We developed the Functional Assessment for Burns (FAB) score to measure burn patients' functional independence. FAB scores were taken on discharge from ICU (FAB 1) and on discharge from inpatient burn care (FAB 2) in 56 patients meeting the American Burn Association criteria for major burn. We retrospectively analysed prospectively collected data to measure the progress of patients' physical functional outcomes and to evaluate the predictive validity of the FAB score for discharge outcome. Mean age was 38.6 years and median burn size 35%. Significant improvements were made in the physical functional outcomes between FAB 1 and FAB 2 scores (pburn patients. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  17. The NBT test in burned patients.

    Science.gov (United States)

    Roe, E. A.; Jones, R. J.

    1979-01-01

    The number of polymorphs which stained with the dye nitro-blue tetrazolium (NBT "Positive") increased sharply during the first week after burning, reaching levels 4--5 times above values for healthy volunteers. In burns of more than 20% of the body surface a second, smaller increase in the number of NBT "positives" occurred 4 to 6 weeks after burning. The high levels of NBT "positive" polymorphs occurred independently of infection on the burns. A burned patient who died from septicaemia had very low numbers of NBT "positive" polymorphs for 3 weeks before death. PMID:444418

  18. Nosocomial infections in pediatric patients with burns.

    Science.gov (United States)

    Weber, J M; Sheridan, R L; Pasternack, M S; Tompkins, R G

    1997-06-01

    Nosocomial infections (NI) are believed to occur more commonly in patients with burns than in patients undergoing surgery, but benchmark rates have not been well described, and widely accepted definitions of NI in patients with burns are not available. We present a clinically useful set of definitions for NI for the pediatric burn population and provide benchmark infection rates for NI at selected sites. Centers for Disease Control and Prevention definitions were modified to more accurately describe nosocomial burn infection and secondary bloodstream infections (BSI) in the burn population. A surveillance system was developed and included calculation of NI rates by 1000 patient or device days, stratified into one of three risk groups (burn injury, 30% to 60% burn injury, and > 60% burn injury). All patients with acute burns admitted from January 1990 to December 1991 were included, and NI rates were calculated for burn infection, primary and secondary BSI, ventilator-related pneumonia and urinary catheter-related urinary tract infection (UTI). Overall 12.5% of patients with central venous catheters had development of primary BSI for a rate of 4.9/1000 central venous catheter-days. Incidence of secondary BSI was 5.8% of patients for a rate of 5.3/1000 patient-days. Incidence of burn infection was 10.1% of patients for a rate of 5.6/1000 patient-days. Incidence of ventilator-related pneumonia was 17.5% of patients for a rate of 11.4/1000 ventilator-days. Incidence of urinary catheter-related UTI was 17.9% of patients, for a rate of 13.2/1000 urinary catheter-days. When rates were stratified by risk groups, incidence increased with increasing burn size for secondary BSI (p number of patient-days or device-days more accurately reflected risk of infection over time. Infection remains a cause of significant morbidity and death for patients with burns. The definitions and benchmark rates reported here may be useful in evaluation of NI surveillance strategies and

  19. 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...

  20. Galactorrhea and amenorrhea in burn patients.

    Science.gov (United States)

    Goyal, Navin; Gore, Madhuri A; Shankar, Ravi

    2008-09-01

    Galactorrhea and/or amenorrhea, although uncommonly reported in post-burn patients, is a complex problem to treat. Patient is reluctant to volunteer history of these symptoms, unless asked specifically. To study profile of adult female patients with galactorrhea and/or amenorrhea in post burn period. A prospective study of all adult female patients presenting with or detected to have galactorrhea and/or amenorrhea in post burn period was conducted over 6 month's period. Detailed clinical examination, estimation of LH, FSH, Prolactin levels and X-ray of skull was done in all patients. The data collected was analyzed. Patients with hyperprolactinemia and galactorrhea were treated with Bromocriptine for 3 weeks to 3 months. In all patients with amenorrhea, pregnancy was ruled out by gynecological examination and urine pregnancy test. During this period, 30 patients (15.15%) were detected to have galactorrhea and/or amenorrhoea. The extent of burn in these patients was 20-65%of body surface area. Out of 30 patients, 5 had galactorrhea and amenorrhea, 1 galactorrhea alone and 24 had amenorrhea alone. Analysis of voluntary disclosures and detection on interrogation was done. Till the end of study, 4 patients with galactorrhea had complete relief, 2 patients reported reduction in discharge. Galactorrhea was distressing for all and was always associated with high prolactine levels .The reverse was not true. All the patients had chest burns besides other body areas. Association was noted between menstrual aberration and ovulatory phase at the time of burn. Galactorrhea and menstrual disturbances do exist in female patients in reproductive age group in post burn period and patients should be especially interrogated for these symptoms by the burn care providers.

  1. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    Deep and severe burns often present with the exposure of musculoskeletal structures and severe deformities. Skeletal fixation, suspension and/or traction are part of their comprehensive treatment. Several factors put burn patients at risk for osteomyelitis, osteosynthesis material being one of them.

  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. Factors Influencing Resilience of Burn Patients in South Korea.

    Science.gov (United States)

    Jang, Mi Heui; Park, Jongui; Chong, Mi Kyong; Sok, Sohyune R

    2017-09-01

    To examine and identify the factors influencing the degree of resilience among Korean burn patients. A cross-sectional descriptive design was employed. The study sample consisted of 138 burn patients recovering from the acute phase in H hospital, Seoul. The male patient participants numbered 93 (67.4%) and the female participants numbered 45 (32.6%). The average age of the participants was 46.79 years. Measures used were the Beck Depression Inventory, State Trait Anxiety Inventory, self-esteem scale, family support scale, and resilience scale. The analyses showed that the prediction model for resilience among burn patients was significant (F = 33.94, p resilience among burn patients was self-esteem (β = .35), followed by family support (β = .29). This study provides preliminary evidence that self-esteem is a major and primary predictor of resilience among burn patients, next followed by family support. In the nursing practice, nurses need to pay attention to the burn patient's self-esteem and family support. Concrete interventions and strategies to improve the resilience of burn patients are needed. © 2017 Sigma Theta Tau International.

  4. [Energy expenditure prediction equations in burn patients; bibliographic review].

    Science.gov (United States)

    Núñez-Villaveirán, Teresa; Sánchez, Manuel; Millán, Pablo; Martínez-Méndez, Jose Ramón; Iglesias, Carmen; Casado-Pérez, César; García-de-Lorenzo, Abelardo

    2014-06-01

    The estimation of the caloric requirements of the burn patient is based on the measurement of his resting energy expenditure (REE) via indirect calorimetry, which is not available in all Burn Units, or its estimation by means of predictive equations. we analyze the history and state of art of the use of REE predictive equations in burn patients, and determine their validity. bibliographic review of the studies and reviews written in English and Spanish between 1989 and 2013. More than 190 equations have been designed to estimate energy expenditure. These equations can be imprecise because they are based on measurements with a heterogeneous methodology and in heterogeneous groups. We describe the different parameters that are used in the different equations (stress and activity factors, total burn surface area, post-burn day, lean body mass), the influence of age in the calculation of the caloric requirements, and the most commonly used equations nowadays. We also describe the articles that evaluate the accuracy of the predictive equations when compared to REE indirect calorimetry measurements. Predictive equations are not precise in general in the burn patient. Until more accurate predictive equations are developed, we recommend calculation of the nutritional requirements in burn patients based on the energy expenditure measurement via indirect calorimetry. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  5. Burn-up measurements coupling gamma spectrometry and neutron measurement

    International Nuclear Information System (INIS)

    Toubon, H.; Pin, P.; Lebrun, A.; Oriol, L.; Saurel, N.; Gain, T.

    2006-01-01

    The need to apply for burn-up credit arises with the increase of the initial enrichment of nuclear fuel. When burn-up credit is used in criticality safety studies, it is often necessary to confirm it by measurement. For the last 10 years, CANBERRA has manufactured the PYTHON system for such measurements. However, the method used in the PYTHON itself uses certain reactor data to arrive at burn-up estimates. Based on R and D led by CEA and COGEMA in the framework of burn-up measurement for burn-up credit and safeguards applications, CANBERRA is developing the next generation of burn-up measurement device. This new product, named SMOPY, is able to measure burn-up of any kind of irradiated fuel assembly with a combination of gamma spectrometry and passive neutron measurements. The measurement data is used as input to the CESAR depletion code, which has been developed and qualified by CEA and COGEMA for burn-up credit determinations. In this paper, we explain the complementary nature of the gamma and neutron measurements. In addition, we draw on our previous experience from PYTHON system and from COGEMA La Hague to show what types of evaluations are required to qualify the SMOPY system, to estimate its uncertainties, and to detect discrepancies in the fuel data given by the reactor plant to characterize the irradiated fuel assembly. (authors)

  6. 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...... management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units. METHOD: The study had...... a comparative retrospective design using combined methodology of instrument appraisal and thematic analysis. Three investigators appraised guidelines from burn units in Denmark (DK), Sweden (SE), New Zealand (NZ), and USA using the AGREE Instrument (Appraisal of Guidelines for Research & Evaluation), version II...

  7. Healthcare costs of burn patients from homes without fire sprinklers.

    Science.gov (United States)

    Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A; Jeschke, Marc G

    2015-01-01

    The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage, and environmental toxins. This study's aim was to conduct a cost analysis of patients with burn or inhalation injuries caused by residential fires and to compare this with the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995-2012). Patient demographics and injury characteristics were collected from medical records and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period, there were 1557 residential fire-related deaths province-wide and 1139 patients were admitted to our provincial burn center as a result of a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers.

  8. Psychiatric Assessment and Rehabilitation of Burn Patients

    Directory of Open Access Journals (Sweden)

    Süleyman Akarsu

    2017-03-01

    Full Text Available Objective: Psychiatric rehabilitation has gained significance owing to improved healthcare facilities for burn injuries and decreased mortality/ morbidity rates. Burn traumas may result in psychiatric signs such as denial, anger, guilt, confusion, disgrace, anxiety, distress, and nervousness. Psychiatric disorders such as delirium, depression, anxiety, post-traumatic stress disorder, and sexual problems can also be encountered. Therefore, it is necessary to look for these signs and disorders through regular sessions with burn patients and appropriate psychometric tests. This study aims at examining the process of psychological rehabilitation for burn patients in light of the current literature. Material and Methods: This study has been carried out in the light of the main and current literature review. The study intends to put forth the data observed in the course of the psychological diagnosis, treatment and rehabilitation of burn patients. The study has been conducted in accordance with the Helsinki Declaration Guidelines. Results: Treatment and rehabilitation process requires a multidisciplinary teamwork that consists of physicians, dieticians, psychologists, social service specialists, and other healthcare workers who can meet the needs of burn patients and their families. It is necessary for the team to contribute both to the hospitalization process and the social environment of the patients and their families. Conclusion: It is observed that the quality of life of these patients can be considerably improved with the effective assessment of psychiatric signs that occur during or after the injury and with appropriate treatment methods.

  9. Insulin and the Burned Patient

    Science.gov (United States)

    2007-01-01

    Substrate mobilization by glycogenolysis and gluconeogenesis is similarly up- regulated in the face of high serum glu- cose (26). The complete mechanism of...Akt/PKB regulates skeletal muscle growth or loss, providing a link between insulin resistance and cat - abolic muscle wasting in burns (27). Other

  10. Development of a nursing workload measurement instrument in burn care

    NARCIS (Netherlands)

    Jong, A.E.; Leeman, J.; Middelkoop, E.

    2009-01-01

    Existing workload measurement instruments fail to represent specific nursing activities in a setting where patients are characterized by a diversity of cause, location, extent and depth of burns, of age and of history. They also do not include educational levels and appropriate time standards. The

  11. Epidemiology and outcome of 2,590 burned patients in Northwest Iran.

    Science.gov (United States)

    Hosseini, S N; Rashtchi, V; Kamali, K; Moghimi, M H

    2017-06-30

    Burns are calamities with considerable morbidity and mortality rates. We attempted to examine the epidemiology of burns in Zanjan city, in northwest Iran, by a systematic study of existing information. The medical files of 2,590 thermal burn patients treated in our hospital in Zanjan city, Iran, from December 2010 to November 2016 were studied. Patient information, including age, sex, burn degree, season, cause of burn, hospital stay and treatment results were analyzed. About 65% of the patients were male (n=1691). Most burns (92.8%) were less than 30% total body surface area. Mean age and hospital stay were 25.4 years old and 9.1 days, respectively. The most common causes of burn were hot liquids, gas explosion and fire, respectively. Except for self-immolation, which was more common among men, there was no significant relationship between cause of burn and the studied variables. The six-year mortality rate was 2.9%, and was more common in the years 2011 to 2013. In addition, distribution of causes of burn had a significant trend (variation). Fire burn had a decreasing trend and gas and chemical burn had increasing trends in this period. In northwest Iran the causes of burn changed over the six years. Chemical burns, gas explosion burns and burn mortality increased. Some of these results were due to economic and pharmaceutical sanctions in Iran. Because of Iran's industrial development, it is recommended that preventive measures for chemical, gas and electrical burns be conducted.

  12. Orthostatic convulsive syncope in a burn patient.

    Science.gov (United States)

    Primrose, Matthew; McDermid, Robert C; Tredget, Edward E; Khadaroo, Rachel G

    2012-01-01

    Orthostatic convulsive syncope is defined as a decrease in cerebral blood supply resulting in convulsive, seizure-like symptoms. The authors present the first case report of orthostatic convulsive syncope in a burn patient. There are many causes of transient loss of consciousness in patients. An algorithm is presented to aid in the workup and management strategies for this diagnosis. This approach in conjunction with a neurology consult should add in the assessment and treatment of transient loss of consciousness and orthostatic convulsive syncope in a burn patient.

  13. Body composition changes with time in pediatric burn patients.

    Science.gov (United States)

    Przkora, Rene; Barrow, Robert E; Jeschke, Marc G; Suman, Oscar E; Celis, Mario; Sanford, Arthur P; Chinkes, David L; Mlcak, Ronald P; Herndon, David N

    2006-05-01

    Major trauma and burns are associated with whole body catabolism which can persist for 1 or more years after injury. This study investigates body composition in massively burned children for up to 2 years. Twenty-five pediatric patients with greater than 40% total body surface area burns were studied. At discharge, 6, 12, 18, and 24 months after burn height, weight, body composition, resting energy expenditure (REE), serum growth hormone, insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), insulin, cortisol, parathyroid hormone, and thyroid hormones were measured. Tukey's test was used for analysis. Significance was accepted at p < 0.05. Lean body mass, fat mass, bone mineral content, height, and weight increased significantly during the second year after burn. Percent predicted REE decreased significantly, whereas IGFBP-3 and parathyroid hormone levels increased significantly over time. Insulin and T3 uptake were significantly higher at discharge. Body composition of severely burned children significantly improved in the second year compared with the first year after injury. This demonstrates a need for long-term rehabilitation in these burn patients.

  14. Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.

    Science.gov (United States)

    Strassle, Paula D; Williams, Felicia N; Napravnik, Sonia; van Duin, David; Weber, David J; Charles, Anthony; Cairns, Bruce A; Jones, Samuel W

    Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.

  15. Stress Ulcer Disease in the Burned Patient

    Science.gov (United States)

    1981-03-01

    administered and the patient is carefully monitored. In our experi - ence, it is advisable to use both cimetidine and ant - acid prophylaxis in patients...course be drained. Our operative experience reveals that similar re- sults have been obtained with both subtotal gastrec- lomy and with...intervention had resumed alimentation , and the cause of death in those patients was related to some other complica- tion of their burn injury. When

  16. 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.

  17. Rehabilitation of burn patients: an underestimated socio-economic burden.

    Science.gov (United States)

    Mirastschijski, Ursula; Sander, Jan-Thorben; Weyand, Birgit; Rennekampff, Hans-Oliver

    2013-03-01

    Patients with burns utilise intensive medical care and rehabilitation. Deep dermal burns lead to scar contractures. Virtually no published data exists on costs for treatment of acute burns in comparison to burn sequelae. Our purpose was to collect financial data on burn therapy to estimate the socio-economic burden of thermal injuries. German-DRG for in-patient treatment of burns was collected from our burn center. DRG-related T95.- coding served as a search tool for burn associated sequelae. To include rehabilitation costs, data from the largest health care insurance and a workmen compensation fund were acquired. Acute burn treatment comprised 92% of costs for intensive care with approximately 4.600 EUR per percent total burned surface area (TBSA). Expenses for non-intensive care patients were significantly lower than for burn sequelae. Rehabilitation expenses were 4.4-fold higher than costs for acute burns including 59% for manual therapy and 37% for auxiliary material. TBSA multiplied by factor 4600 could serve for cost calculation of severely burned patients. Approximately 0.3 billion EUR in total or 270.000 EUR per patient/year were spent on burn sequelae. Early admission to specialized burn centers is advocated with state-of-the-art treatment to minimize burn sequelae and health care expenses. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  18. Burn septicaemia: an analysis of 79 patients.

    Science.gov (United States)

    Bang, R L; Gang, R K; Sanyal, S C; Mokaddas, E; Ebrahim, M K

    1998-06-01

    Out of 943 patients treated from June 92 to May 96 at the burns unit of the Al-Babtain Centre for Plastic Surgery and Burns, Kuwait, 280 (30%) required admission to the burns intensive care unit (ICBU) and were studied retrospectively. Seventy-nine (28.2%) developed clinically and microbiologically proven septicaemia. Forty-four (56%) were males, 35 (44%) females with a mean age of 26 years (range 45 days to 75 years) and mean total body surface area burn (TBSA) of 46% (range 10-90%). Sixty-two had flame burns, 16 a scald and one had an electric burn. These 79 patients had a total of 118 septicaemic episodes. Sixty (76%) had only one and 19 (24%) had multiple episodes of septicaemia. Fifty-four (68%) had their first episode within 2weeks, though the maximum number of episodes was between 6 and 10 days postburn. Septicaemia was also observed in 13% of patients within 3 days postburn. Out of the 118 episodes, 48 were due to methicillin resistant Staphylococcus aureus (MRSA), 17 due to methicillin resistant Staphylococcus epidemidis (MRSE), 15 to Pseudomonas, 12 to Acinetobacter, four to Streptococcus, another four to Enterococci, two to Klebsiella, one due to Serratia and 15 to more than one organism. Once the septicaemia was diagnosed appropriate therapy was instituted. Fifty-six (71%) patients had 143 sessions of skin grafting and the mortality was low in operated patients. Twenty-three (29.1%) patients died. The low mortality rate was probably due to factors such as continuous clinical and microbiological surveillance leading to quick detection of aetiology, appropriate antibiotic therapy, care for nutrition and early wound cover. This study suggests that flame burn patients are more vulnerable to sepsis. Onset of septicaemia may be as early as 3 days and commonly within 2 weeks. A surface wound is the likely source of entry to the blood stream. Gram positive organisms are dominant in the aetiology. Early detection and appropriate treatment including wound

  19. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    Create ectropion by blepharoplasty in New Zealand white rabbits. Assess epithelial defects and corneal ulcers . Measure inflammatory cytokines and...7, with corneal ulceration developing in the most severe cases by week 3. Histopathological results revealed epithelium infiltrated by heterophilic...excellent surgical model of evaporative dry eye. Damage to the cornea and conjunctiva manifesting as punctate epithelial erosions and corneal ulceration is

  20. No influence of burn size on ventilator-associated pneumonia in burn patients with inhalation injury.

    Science.gov (United States)

    Tanizaki, Shinsuke; Suzuki, Koichiro

    2012-12-01

    Burn size and inhalation injury are important predictors of mortality following burn. The important factors for predicting ventilator-associated pneumonia (VAP) following burn remain unclear. The aim of our study was to investigate the effect of burn size on VAP in burn patients with inhalation injury. We retrospectively studied 52 burn patients with inhalation injury requiring mechanical ventilation admitted to the Department of Acute Medicine, Kawasaki Medical School Hospital, Okayama, Japan, between June 2007 and October 2010. The overall mortality for all patients was 15%. Twenty-six patients (50%) developed VAP. Patients with VAP required longer ICU stay and mechanical ventilation than those without VAP. There was no difference in age, gender, mortality, and TBSA between burn patients with inhalation injury with and Without VAP. VAP rate had no difference with increasing TBSA in burn patients with inhalation injury. Our data indicated that burn size had no relationship with the development of VAP in burn patients with inhalation injury. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  1. 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]…

  2. 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

  3. 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

    2013-05-01

    One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on body weight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is inadequate and that over- and under-resuscitations are associated with increased morbidity and mortality. We hypothesize that optimizing fluid administration during the critical initial phase using a transcardiopulmonary thermodilution monitoring device (pulse contour cardiac output [PiCCO]; Pulsion Medical Systems, Munich, Germany) would have beneficial effects on the outcome of burned patients. A cohort of 76 severely burned pediatric patients with burns over 30% of the total body surface area who received adjusted fluid resuscitation using the PiCCO system were compared with 76 conventionally monitored patients (C). Clinical hemodynamic measurements, organ function (DENVER2 score), and biomarkers were recorded prospectively for the first 20d after burn injury. 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 in the PiCCO 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). Fluid resuscitation guided by transcardiopulmonary thermodilution during hospitalization represents an effective adjunct and is associated with beneficial effects on postburn morbidity. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. 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

  5. Predicting and managing sepsis in burn patients: current perspectives

    Directory of Open Access Journals (Sweden)

    Nunez Lopez O

    2017-08-01

    Full Text Available Omar Nunez Lopez,1,2 Janos Cambiaso-Daniel,1–3 Ludwik K Branski,1,2 William B Norbury,1,2 David N Herndon1,2,4 1Department of Surgery, University of Texas Medical Branch, 2Shriners Hospitals for Children, Galveston, TX, USA; 3Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; 4Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA Abstract: Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction. The management of a septic burn patient represents a challenging scenario that is commonly encountered by providers caring for burn patients despite preventive efforts. Here, we discuss the current perspectives in the diagnosis and treatment of sepsis and septic shock in burn patients. Keywords: burn injury, thermal injury, burn sepsis, procalcitonin, antibiotics, biomarkers, cytokines

  6. Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza ...

    African Journals Online (AJOL)

    BACKGROUNG: Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza. METHODS: This was a ...

  7. Blood transfusion in burn patients: Triggers of transfusion in a referral burn center in Iran.

    Science.gov (United States)

    Tavousi, S H; Ahmadabadi, A; Sedaghat, A; Khadem-Rezaiyan, M; Yaghoubi Moghaddam, Z; Behrouzian, M J; Nemati, S; Saghafi, H

    2018-02-01

    Blood and its derivatives are one of the most lifesaving products in the modern medicine practice. However, it is not an absolutely safe prescription. Many adverse effects such as infection, transfusion-related acute lung injury, immunosuppression, multi-organ dysfunction, acute respiratory syndrome, transfusion errors, transmission of infectious agents such as HIV, HBV, HCV are attributable to blood transfusion. The aim of this study was to describe how and when blood products were transfused in a referral burn center. This cross-sectional study was performed on medical records of all admitted patients in the Department of Burns and Reconstructive Surgery of Imam Reza Hospital, Mashhad, Iran during September 2014 up to August 2015. Transfusion measures such as Hb, Hct and demographic data were extracted from patient records. SPSS version 11.5 was used for data analysis. During the study period, 701 acute burnt patients were admitted with the mean age of 25.5±20.5 years. Sixty-four percent were male and burnt percentage of total body surface area (TBSA) was 30.9±24.3%. About one third (240) of patients received at least one blood product. Mean of the transfused packed red blood cell was 274.1±674.6mL per patient and 8.85mL per 1% of burnt TBSA. Anemia was the most common transfusion trigger. Mortality in burnt patients who received blood products was two folds more than patients who did not receive any blood products. We prescribed less blood products compared with other reviewed burn centers. However, following a written blood transfusion protocol by all clinicians may reduce blood transfusion in unnecessary situations even more significantly. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. [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.

  9. Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents.

    Science.gov (United States)

    Devrim, İlker; Kara, Ahu; Düzgöl, Mine; Karkıner, Aytaç; Bayram, Nuri; Temir, Günyüz; Şencan, Arzu; Sorguç, Yelda; Gülfidan, Gamze; Hoşgör, Münevver

    2017-02-01

    Infections are the leading cause of morbidity and mortality in patients with burns in burn units. Bloodstream infections (BSIs) in patients with burns may result from burn wound infection, use of invasive devices such as central venous catheters, and translocation of the gastrointestinal flora. In this study, we investigated the distribution and antimicrobial drug resistance of causative pathogens in children with burns and the durational changes of microorganisms in the distribution of BSIs in children. This study was conducted at the Pediatric Burn Unit (PBU) of Dr. Behçet Uz Children Research and Training Hospital during the period of November 2008-April 2015. The study subjects were all the patients admitted to the PBU, in whom microorganisms were isolated at least from one of the cultures, including blood and catheter cultures. Gram-positive bacteria were the most common causative agents of BSI in patients with burns (66.4%), followed by gram-negative bacteria (22.1%) and fungi (11.5%). The median duration of development of BSIs caused by gram-positive bacteria from the time of burn was 5 days (ranging from 2 to 54 days of burn), which was significantly shorter than that of BSIs caused by gram-negative bacteria (12 days) and fungal pathogens (13 days). The etiologic agents of BSIs in children may differ from those in adults. Gram-negative drug-resistant bacteria such as multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were important agents of BSI in patients with burns, especially in the long term; however, gram-positive bacteria should also be considered while deciding the antimicrobial therapy, especially in the early periods of burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

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

    Science.gov (United States)

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

    2012-12-31

    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 body surface (BBS), length of stay (LOS), and cost of hospitalization were collected by reviewing medical records and analysed by SPSS 16. The patients' mean age was 27 years. The male/female ratio in burn patients was 1.14/1. The mean BBS was 36.06%. The mean LOS was 9.04 days. Flame (67.0%) and hot liquids (21.9%) were the major causes of burn. Burn injuries were more common in the upper limbs (81.4%), lower limbs (70.9%), and head and neck (65.2%). 11.6% of patients had all the regions involved. The fatality rate was 18.8%. The mean cost per patient was 20,463,227 Iran Rials (IRR). The cost per one percentage of burn and one day of hospitalization was 562,632 IRR and 2,263,631 IRR, respectively. The main factors relevant to death were identified including the extent of burn, gender, age, causes, and degree of burn. In addition, LOS proved to have a higher impact on costs than burn percentage.

  11. Increase of the Cure Rate of Burn Patients by Improving Burn Wound Management Methods

    Science.gov (United States)

    Liu, X.; Luo, Q.; Peng, Y.; Wang, J.; Huang, Y.; Yang, Z.

    2005-01-01

    Summary In order to summarize the progress of burn wound management of the patients in our burn ward and its correlation with the improvement of treatment results in the past 44 years, the general data (hospitalization time, cure rate, operation times) of 12,568 cases were analysed in terms of three periods, namely 1958 to 1980, 1981 to 1990, and 1991 to 2002. The bene?cial effects of the systemic application of recombinant human growth hormone, post-burn immediate escharectomy en masse, the external application of epithelial growth factor, and the coverage of split-thickness skin donor sites with razor-thick skin on wound healing and overall therapeutic results were also analysed. It was found that there was an increase in the number of burn patients admitted to our burn ward in recent decades. The overall cure rate, especially that of major burn patients, increased signi?cantly with the improvement of burn wound management. Hospitalization time was shortened and wound-healing time reduced. The analysis suggested that escharectomy en masse as early as possible, systemic application of growth hormone, and external application of epithelial growth factor are bene?cial to early burn wound healing. PMID:21990972

  12. Perceived social support among patients with burn injuries: A perspective from the developing world.

    Science.gov (United States)

    Waqas, Ahmed; Turk, Marvee; Naveed, Sadiq; Amin, Atif; Kiwanuka, Harriet; Shafique, Neha; Chaudhry, Muhammad Ashraf

    2018-02-01

    Social support is among the most well-established predictors of post-burn psychopathology after burn. Despite a disproportionately large burden of burns in the developing world, the nature of social support among burn patients in this context remains elusive. We, therefore, seek to investigate social support and its biopsychosocial determinants among patients with burn injuries in Pakistan. A cross-sectional study of 343 patients presenting with burn injuries at four teaching hospitals in the Punjab province of Pakistan was conducted. Patient evaluation consisted of a multi-part survey of demographic status, clinical features, and social support as measured by the validated Urdu translation of the Multidimensional Scale of Perceived Social Support (MSPSS). Multiple regression analysis was performed to evaluate associations between patient characteristics and MSPSS score. Mean overall MSPSS score was 57.64 (std dev 13.57). Notable positive predictors of social support include male gender, Punjabi ethnicity, burn surface area, and ego resiliency. Our study reveals a troubling pattern of inadequate social support among certain subgroups of Pakistani burn patients. Addressing these inequities in the provision of social support must be prioritized as part of the global burn care agenda. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  13. How disabling are pediatric burns? Functional independence in Dutch pediatric patients with burns

    NARCIS (Netherlands)

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

    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

  14. Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

    Science.gov (United States)

    Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M

    2010-12-01

    This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  15. Epidemiology of burns in pediatric patients of Beijing City.

    Science.gov (United States)

    Wang, Shujun; Li, Dawei; Shen, Chuanan; Chai, Jiake; Zhu, Hongjuan; Lin, Yanlu; Liu, Congying

    2016-10-18

    This study aimed to assess the epidemiological characteristics of pediatric burns in Beijing City. This was a retrospective study of pediatric patients (n = 400) admitted to four burn centers in Beijing City between June 2010 and May 2011. Burn severity was determined according to total body surface area (TBSA) percentage and degree. Patients were followed up for one year. Multivariate analyses were carried out to determine the factors (burn etiology, time and place of injury, living conditions, hospital type, first-aid treatment methods, and parent/guardian knowledge of burns, educational level, occupation) affecting burn properties (severity and pigmentation/scar). 191/400 (47.8 %) patients were aged 2-3 years, and scalding was the leading etiology (355/400, 88.8 %). Burn incidence peaked in May (14.8 %), at 10:00-12:00 and 17:00-20:00. Most burn events occurred indoors (272/400, 68.0 %), especially in the kitchen (180/400, 45.0 %). Roughly half of them involved head and neck; 188 (47.0 %) patients had mild burns, 140 (35.0 %) moderate, 44 (11.0 %) extensive, and 28 (7.0 %) critical burns; 184 (46.0 %) patients were treated only with cold-water rinsing or compress; 120 (30.0 %) received no first aid. Only 32 (8.0 %) patients visited a specialized institution. 164 patients underwent surgery. Hospitalization lasted for 14.8 ± 8.1 days. Independent risk factors for burn severity were occurrence month, living conditions, occupation of the mother, and first aid. 288 (72.0 %) patients developed pigmentation and scar within a year while no independent risk factors was observed. Pediatric burns often occurred indoors, especially in the kitchen, and a substantial proportion receives no first aid.

  16. Burns

    Science.gov (United States)

    A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

  17. Autopsy audit of burn patients; the Lagos State University Teaching ...

    African Journals Online (AJOL)

    Background There are many studies detailing the improvement in the care and survival of burns patients. Very little have however been documented about the postmortem findings in patients that died after sustaining burns. This study was carried out to assess the severity of injury to skin and internal organs as revealed by ...

  18. Positive Fungal Cultures in Burn Patients: A Multicenter Review

    Science.gov (United States)

    2008-02-01

    J Che- mother 2001;13(Spec 1):12–6. 15. Charles PE, Doise JM, Quenot JP, et al. Candidemia in crit- ically ill patients: difference of outcome...patient with burns. J Burn Care Re- habil 1995;16:440–3. 35. Xiao-Wu W , Herndon DN, Spies M, Sanford AP, Wolf SE. Effects of delayed wound excision

  19. A Computer Program to Evaluate Experimental Therapies for Treating Burned Patients

    OpenAIRE

    Flora, Jairus D.; Flora, Sharyl Ann

    1980-01-01

    Determining the worth of new therapies for burn patients has been difficult because of the rarity of the burn injury and the disparate survival chances associated with different sizes of burns. Recently a burn survival model has been developed that estimates the risk of death from a burn as a function of the patient's age, sex, area of full thickness (third degree) burn, area of partial thickness burn, involvement of the perineum, and time from burn to admission. An alternative risk model use...

  20. The Phase of Illness Paradigm: A Checklist Centric Model to Improve Patient Care in the Burn Intensive Care Unit

    Science.gov (United States)

    2015-04-01

    Monitor renal function Obje Objective: Monitor Ventilation Obje Objective: Observe patient Obje Objective: Operate to Achieve a Goal Obje Objective...paradigm (POIP) (Pamplin 2011) and its effect on a variety of measures in three Burn ICUs . This paradigm describes patients with similar illness severity...measures in three Burn ICUs c. Implement the POIP to improve the multidisciplinary burn ICU team’s understanding of patient illness severity, daily care

  1. Paraquat poisoning in a burn patient.

    Science.gov (United States)

    Gear, A J; Ahrenholz, D H; Solem, L D

    2001-01-01

    Paraquat is a bipyridyl compound widely used as a contact herbicide. Since its introduction in 1962, hundreds of deaths have occurred, usually after suicidal or accidental ingestion. Death after dermal absorption of paraquat is uncommon, but has occurred after either contact with undiluted paraquat, disruption of skin integrity, or prolonged exposure. It is the purpose of this case report to describe a patient who had fatal dermal paraquat absorption after a crop-dusting accident in which he sustained 37% TBSA burns. After 9.5 hours of cutaneous exposure, a paraquat level of 0.169 mg/ml was obtained at 20 hours, the standard lethal dose at 16 hours being 0.16 mg/ml. In light of the apparently irreversible pathophysiology of paraquat poisoning with plasma levels as low as 3 mg/L, prevention and early intervention are the best treatments. Our patient may have survived an otherwise routine thermal injury had his wounds been aggressively irrigated in the field.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Emergency department management of patients with thermal burns [digest].

    Science.gov (United States)

    Tolles, Juliana; Gupta, Nachi; Nusbaum, Jeffrey

    2018-02-01

    Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes. This article reviews thermal burn classification and evidence-based treatment strategies. [Points & Pearls is a digest of Emergency Medicine Practice.].

  5. Bacteriological profile of burn patients at Yekatit 12 Hospital Burn ...

    African Journals Online (AJOL)

    admin

    Quality Control: The reliability of the study findings were guaranteed by implementing quality assurance (QA) measures throughout the whole laboratory work. Proper specimen collection was done by experienced nurses. Staining reagents, culture media and antibiotic discs were checked for their normal shelf life before use ...

  6. Coverage of extensive tibial bone exposure in burn patients with ...

    African Journals Online (AJOL)

    Covering tibial bone exposure from third degree burns to the lower limbs is a challenging task for the plastic surgeon. We present our experience of covering tibial exposure from burns in three different patients, where four limbs were involved and three muscular flaps were used in conjunction with one another; i.e. the ...

  7. Noninvasive measurement of burn wound depth applying infrared thermal imaging (Conference Presentation)

    Science.gov (United States)

    Jaspers, Mariëlle E.; Maltha, Ilse M.; Klaessens, John H.; Vet, Henrica C.; Verdaasdonk, Rudolf M.; Zuijlen, Paul P.

    2016-02-01

    In burn wounds early discrimination between the different depths plays an important role in the treatment strategy. The remaining vasculature in the wound determines its healing potential. Non-invasive measurement tools that can identify the vascularization are therefore considered to be of high diagnostic importance. Thermography is a non-invasive technique that can accurately measure the temperature distribution over a large skin or tissue area, the temperature is a measure of the perfusion of that area. The aim of this study was to investigate the clinimetric properties (i.e. reliability and validity) of thermography for measuring burn wound depth. In a cross-sectional study with 50 burn wounds of 35 patients, the inter-observer reliability and the validity between thermography and Laser Doppler Imaging were studied. With ROC curve analyses the ΔT cut-off point for different burn wound depths were determined. The inter-observer reliability, expressed by an intra-class correlation coefficient of 0.99, was found to be excellent. In terms of validity, a ΔT cut-off point of 0.96°C (sensitivity 71%; specificity 79%) differentiates between a superficial partial-thickness and deep partial-thickness burn. A ΔT cut-off point of -0.80°C (sensitivity 70%; specificity 74%) could differentiate between a deep partial-thickness and a full-thickness burn wound. This study demonstrates that thermography is a reliable method in the assessment of burn wound depths. In addition, thermography was reasonably able to discriminate among different burn wound depths, indicating its potential use as a diagnostic tool in clinical burn practice.

  8. Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war

    Directory of Open Access Journals (Sweden)

    Yucel Yuce

    2017-01-01

    Full Text Available Objectives: To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43 and most of them had burns >15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients.

  9. Etiology and characteristics of burn injuries in patients admitted at Burns Center, Civil Hospital Karachi

    Directory of Open Access Journals (Sweden)

    Muhammad Osama Anwer

    2016-01-01

    Full Text Available Background: Morbidity and mortality by burns are alarmingly high among the developing countries due to inadequate care facilities. Among these nations, Pakistan has one of the highest burn-related incidents. The dilemma is that most of these deaths and disabilities are curable and preventable. Therefore, there is an urgent need of creating an effective infrastructure to cut down these high number of cases. Methods: We conducted a cross-sectional study at Burns Center, Civil Hospital Karachi. Two hundred and seventy-five patients participated in the study. Data were analyzed using SPSS version 17.0. Results: Among these 275 patients interviewed 63.6% (n = 175 were males whereas 36.4% (n = 100 were females. The mean age of our participants was found to be 26.36 years. A large proportion of the population belonged to the urban areas, i.e. 76.4% (210, whereas only 23.6% (65 were from rural areas, with P = 0.001. About 63.6% of the burn injuries occurred at home (175 while 25.1% (69 got injured at the place of work. Most of the cases were found to be accidental 93.8% (258. About 53.1% (146 had <20% of the total body surface area effected, whereas 16.7% (46 had more than 40% burns. Conclusion: By introducing an effective awareness program regarding burns and teaching first aid techniques to general population, a high number of burn-related accidents could be prevented.

  10. Nutritional management of the burn patient

    African Journals Online (AJOL)

    decrease in the normal endogenous activity of anabolic agents, such as human growth hormone and .... glucose diminishes endogenous production by only about 50%.7 The hyperglycaemia associated with burns is ..... on morbidity and improvements in defined nutritional as well as inflammatory parameters, and the lack of ...

  11. Drug and alcohol abuse in patients with acute burn injuries.

    Science.gov (United States)

    Swenson, J R; Dimsdale, J E; Rockwell, E; Carroll, W; Hansbrough, J

    1991-01-01

    We reviewed records of adult patients admitted to our burn unit who were reported to abuse drugs or alcohol from 1985 to 1988. The proportion of patients reported as abusing drugs increased significantly from 1987 to 1988, compared to previous years. However, there was no increase in the proportion of patients reported to abuse alcohol. Patients identified as abusing drugs had longer hospital stays, compared to patients who were not reported to abuse substances. Methamphetamine and cocaine were the drugs most often abused by patients who abused drugs or both drugs and alcohol. Mechanisms of burn injury in these patients included "accidental" burn injury related to acute intoxication, and self-injury due to psychosis or depression.

  12. [Investigation and analysis of factors influencing rehabilitation of burn patients].

    Science.gov (United States)

    Li, Lin; Xu, Le; Wu, Bo-yu; Zheng, You-jin

    2009-12-01

    To study the factors influencing health of burn patients in rehabilitation period. One hundred and one patients hospitalized in burn department of Xiehe Hospital of Fujian Medical University from February 2008 to October 2008 were investigated by means of General Information Questionnaire, the Eysenck Personality Questionnaire, the Medical Coping Modes Questionnaire, and the Social Support Rating Scale. Their rehabilitation condition was scored according to the Abbreviated Burn-Specific Health Scale. Investigation data were processed by multiple linear regression analysis in order to find out the factors influencing rehabilitation of burn patients. Patients in this group were scored (57 +/- 16) points in physical function, rate [(actual score/possible highest score) x 100%, the same below] 71.1% (the lowest); (97 +/- 19) points in psychological function, rate 80.6%; (53 +/- 8) points in social function, rate 88.4% (the highest); (45 +/- 11) points in general health, rate 74.5%; (251 +/- 44) points in comprehensive health [standard score (314 +/- 55) points], rate 78.5% (upper middle). The factors included in the comprehensive health regression equation (F = 11.602, P resignation. They accounted for 46.6% of the variance of comprehensive health. Monthly income, size of burn, introverted/extroverted characteristics, living, social support, and resignation are the main factors influencing the rehabilitation level of burn patients.

  13. Ceruloplasmin and Hypoferremia: Studies in Burn and Non-Burn Trauma Patients

    Science.gov (United States)

    2015-03-06

    1509. 10. Corwin, H.L.; Krantz, S.B. Anemia of the critically ill: “Acute” anemia of chronic disease . Crit. Care Med. 2000, 28, 3098–3099. 11. Berlin... anemia and normal or elevated ferritin levels. Plasma Cp oxidase activity in burn and trauma patients were markedly lower than controls on admission...thermally injured patients and the prevalence of anemia in critically injured patients [10,12]. In addition, we observed low iron binding capacity, serum

  14. Nursing research on a first aid model of double personnel for major burn patients.

    Science.gov (United States)

    Wu, Weiwei; Shi, Kai; Jin, Zhenghua; Liu, Shuang; Cai, Duo; Zhao, Jingchun; Chi, Cheng; Yu, Jiaao

    2015-03-01

    This study explored the effect of a first aid model employing two nurses on the efficient rescue operation time and the efficient resuscitation time for major burn patients. A two-nurse model of first aid was designed for major burn patients. The model includes a division of labor between the first aid nurses and the re-organization of emergency carts. The clinical effectiveness of the process was examined in a retrospective chart review of 156 cases of major burn patients, experiencing shock and low blood volume, who were admitted to the intensive care unit of the department of burn surgery between November 2009 and June 2013. Of the 156 major burn cases, 87 patients who received first aid using the double personnel model were assigned to the test group and the 69 patients who received first aid using the standard first aid model were assigned to the control group. The efficient rescue operation time and the efficient resuscitation time for the patients were compared between the two groups. Student's t tests were used to the compare the mean difference between the groups. Statistically significant differences between the two groups were found on both measures (P's first aid model based on scientifically validated procedures and a reasonable division of labor can shorten the efficient rescue operation time and the efficient resuscitation time for major burn patients. Given these findings, the model appears to be worthy of clinical application.

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

    Directory of Open Access Journals (Sweden)

    Cen H

    2013-07-01

    Full Text Available 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 wide ultrasonography helps to find other thrombosis sites. During the acute phase, low molecular weight heparin can be used. Upon long-term anti-thrombosis treatment, combined use of herbal medicine during rehabilitation is helpful.Keywords: burn, heparin, combined treatment

  16. Emergency pre-hospital care of burn patients.

    Science.gov (United States)

    Muehlberger, Thomas; Ottomann, Christian; Toman, Nidal; Daigeler, Adrien; Lehnhardt, Marcus

    2010-04-01

    Intensive care and the surgical therapy of burn injuries have made significant advancements. The immediate care on the scene of the accident, however, is not uniform. There is no 'golden hour' which will decide the further clinical process. The acute estimate of the percentage of the extent of the burns is of little relevance and does not facilitate the admission to a burn unit. The emergency calculation of the volume of intravenous infusion is not advisable. The choice of transport has no discernible impact on the prognosis of the patient. Avoiding hypothermia and perceiving associated trauma can be of crucial prognostic importance in the pre-hospital care of burn patients. Detailed knowledge about the circumstances of the injury is of exceeding importance. Copyright 2009 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  17. Inflammatory Cytokines, Proteins, and White Blood Cells in Burned Patients Affected with Second and Third Degree of Burn

    Directory of Open Access Journals (Sweden)

    Dakhel Ghani Omran AL-Watify

    2018-03-01

    Full Text Available Burns are associated with increasing metabolic activities of the body organs. High metabolism rates are initiated by activation of different inflammatory reactions and cellular mediators( cytokines. The present research was conducted to evaluate the inflammatory markers , proteins , and white blood cells in thermal burned patients . A total number of burned patients was 60 from both sexes ( 30 males and 30 females, then , the patients were classified according to severity of burn into four subgroups , the first burned male group involved 15 burned males affected with second degree of burn, and the second burned male group( 15 was affected with third degree of burn . Similarly, the same classification was applied on burned females in this study . Thirty healthy subjects (15 males, 15 females were selected as control groups. All ages of patients and controls were ranged between 2 5-35years old.   It was well found that the levels of C- reactive protein ( CRP were markedly increased ( p 0.0 5 . Concentrations of total serum protein , albumin , and globulin were tend to decrease significantly ( p 0.05 in most burned groups except burned male group affected with third degree of burn which showed a significant increase (p<0.05 in comparison with healthy groups. Statistical analysis of t-test indicated that granulocytes pointed out a significant elevation (p<0.05   neutrophils level in all studied groups. Inversely, values of eosinophils were signifi- cantly reduced (p<0.05 in most burned groups compared to healthy control groups. Sig- nificant and insignificant decreases were found in the levels of basophils of all burned groups when compared to those of control group. 

  18. A systematic review of quantitative burn wound microbiology in the management of burns patients.

    Science.gov (United States)

    Halstead, Fenella D; Lee, Kwang Chear; Kwei, Johnny; Dretzke, Janine; Oppenheim, Beryl A; Moiemen, Naiem S

    2018-02-01

    The early diagnosis of infection or sepsis in burns are important for patient care. Globally, a large number of burn centres advocate quantitative cultures of wound biopsies for patient management, since there is assumed to be a direct link between the bioburden of a burn wound and the risk of microbial invasion. Given the conflicting study findings in this area, a systematic review was warranted. Bibliographic databases were searched with no language restrictions to August 2015. Study selection, data extraction and risk of bias assessment were performed in duplicate using pre-defined criteria. Substantial heterogeneity precluded quantitative synthesis, and findings were described narratively, sub-grouped by clinical question. Twenty six laboratory and/or clinical studies were included. Substantial heterogeneity hampered comparisons across studies and interpretation of findings. Limited evidence suggests that (i) more than one quantitative microbiology sample is required to obtain reliable estimates of bacterial load; (ii) biopsies are more sensitive than swabs in diagnosing or predicting sepsis; (iii) high bacterial loads may predict worse clinical outcomes, and (iv) both quantitative and semi-quantitative culture reports need to be interpreted with caution and in the context of other clinical risk factors. The evidence base for the utility and reliability of quantitative microbiology for diagnosing or predicting clinical outcomes in burns patients is limited and often poorly reported. Consequently future research is warranted. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  19. HYPNOTHERAPY AS A TREATMENT FOR PAIN IN PATIENTS WITH BURNS

    Directory of Open Access Journals (Sweden)

    F SHAKIBAEI

    2002-03-01

    Full Text Available Introduction. Burning is an event with many psychosomatic complications. Pain is one of the most trouble matter in these patients that affect on their psychologic features. This study presents a hypnotherapeutics intervention for controlling pain in patients suffered from burning. Methods. In a randomized clinical trial (without placebo, two 22 members group burned patients were selected. In interventional group we conduct a 5 sessions hypnotherapy course. Severity of pain and itching were assessed by visual analogue scale before and after intervention and results were compaired between two groups. Results. All pain parameters were decreased more in interventional group (P < 0.05. Discussion. It seems that hypnotherapy can playa positive role in pain reduction of patients. It is recommended that it would be applied in adjunct to current medications in these patients.

  20. Increased chromium uptake in polymorphonuclear leukocytes from burned patients

    International Nuclear Information System (INIS)

    Davis, J.M.; Illner, H.; Dineen, P.

    1984-01-01

    Following thermal injury neutrophil function is severely impaired and thought to be hypometabolic; however, the host is considered to be hypermetabolic. To further investigate the metabolism and the function of neutrophils following thermal injury, neutrophil migration and chromium uptake were studied using radio-labelled neutrophils. Random and directed migration were found to be significantly reduced compared to control values. Neutrophil lysozyme content was also reduced in these burn cells while serum lysozyme from the same patients was significantly elevated over control values. These data suggest lysozyme is released by the neutrophil into the circulatory system. The influx of chromium in cells from burned patients was much greater than the influx in normal cells used in studies for chemotaxis. Influx of chromium over time and over varying concentrations of chromium was linear in cells from burned patients and normals. Cells from burned patients, however, took up more chromium than normals. Influx velocity of chromium was also determined and found to be greater in burn cells than normal cells. Since it has been shown that chromium influx is an energy-dependent reaction it is suggested that cellular energy stores are being depleted by the influx of chromium. Whether this is a response to an intracellular deficit or uncoupling of metabolic pathways is not known at this time

  1. 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.

  2. Impact of Ulinastatin on Outcomes in Acute Burns Patients.

    Science.gov (United States)

    Abhyankar, S V; Vartak, A M

    2017-04-03

    Burns is a global health problem with significant morbidity and mortality. Ulinastatin, a serine protease inhibitor, has the potential to improve outcomes in burns. A retrospective comparative case note review analysis was performed to assess the impact of ulinastatin on the outcomes in acute burns patients. Acute burns patients, admitted to Masina hospital, Mumbai, from October 2012 to April 2015, who received ulinastatin, were identified from the hospital records. A similarly sized cohort of patients, admitted before the introduction of ulinastatin, was also identified. Relevant data were obtained from archived patient files. The outcomes, mortality and length of hospital stay, were compared across different groups and subgroups. Data of 97 patients, 48 of whom received ulinastatin (ulinastatin group) and 49 of whom did not (control group), were captured. Patients in ulinastatin group had received ulinastatin 100,000 IU, 8 to 12 hourly, during a mean period of 8.8 days, based on clinical judgment, in addition to standard hospital care. The in-hospital mortality was lower (60.4%) in ulinastatin group compared with control group (75.5%). The difference in mortality was statistically significant (50% vs 77.27%; P = .04) in those with 41 to 80% burnt BSA. Mean length of hospital stay, where shorter duration of hospitalization is usually associated with death, was higher in ulinastatin group compared with the control group. Ulinastatin appears to reduce mortality in acute burns patients, especially in those with intermediate extent (40 to 80%) of burnt BSA. It also appears to delay death in those who ultimately succumbed to their burn injuries.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the

  3. A Study on the Correlation between Pain and Pain Anxiety during Wound Care in Burn Patients

    Directory of Open Access Journals (Sweden)

    Seyed Reza Mazlom

    2017-05-01

    Full Text Available Background and Objectives: Wound care in burn patients is associated with severe anxiety that is characterized by feeling of fear and prediction of burn dressing pain. The purpose of this study was to determine the correlation between pain and pain anxiety in burn patients. Methods: In this descriptive-analytical study, 60 eligible patients hospitalized in men’s and women’s burn wards of Mashhad Imam Reza Hospital, were selected using available sampling. Pain anxiety and pain severity were measured using self-report pain anxiety questionnaire and visual analog scale, respectively, before and after burn dressing during three weeks (once a week. Data were analyzed by descriptive statistics and Pearson correlation test. Results: In this study, there was a significant linear correlation between pain and pain anxiety in the first week (r=0.512, p<0.001, but there was no significant linear correlation between these variables in the second (r=0.079, p=0.547 and third (r=0.167, p=0.203 weeks. Conclusion: According to the results of this study, assessment and treatment of pain anxiety are essential elements of pain care and management in burn patients.            

  4. Graphical Calculation of Estimated Energy Expenditure in Burn Patients.

    Science.gov (United States)

    Egro, Francesco M; Manders, Ernest C; Manders, Ernest K

    2018-03-01

    Historically, estimated energy expenditure (EEE) has been related to the percent of body surface area burned. Subsequent evaluations of these estimates have indicated that the earlier formulas may overestimate the amount of caloric support necessary for burn-injured patients. Ireton-Jones et al derived 2 equations for determining the EEE required to support burn patients, 1 for ventilator-dependent patients and 1 for spontaneously breathing patients. Evidence has proved their reliability, but they remain challenging to apply in a clinical setting given the difficult and cumbersome mathematics involved. This study aims to introduce a graphical calculation of EEE in burn patients that can be easily used in the clinical setting. The multivariant linear regression analysis from Ireton-Jones et al yielded equations that were rearranged into the form of a simple linear equation of the type y = mx + b. By choosing an energy expenditure and the age of the subject, the weight was calculated. The endpoints were then calculated, and a graph was mapped by means of Adobe FrameMaker. A graphical representation of Ireton-Jones et al's equations was obtained by plotting the weight (kg) on the y axis, the age (years) on the x axis, and a series of parallel lines representing the EEE in burn patients. The EEE has been displayed graphically on a grid to allow rapid determination of the EEE needed for a given patient of a designated weight and age. Two graphs were plotted: 1 for ventilator-dependent patients and 1 for spontaneously breathing patients. Correction factors for sex, the presence of additional trauma, and obesity are indicated on the graphical calculators. We propose a graphical tool to calculate caloric requirements in a fast, easy, and portable manner.

  5. Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study

    Science.gov (United States)

    Jain, M.; Khadilkar, N.; De Sousa, A.

    2017-01-01

    Summary Burns are physically, psychologically and economically challenging injuries, and the factors leading to them are many and under-studied. The aim of the current study was to assess level of anxiety, depression and self-esteem in burn patients, and look at various burn-related variables that affect them. This cross-sectional study included 100 patients with burn injuries admitted to a tertiary care private hospital in an urban metropolis in India. The patients were assessed for anxiety, depression and self-esteem using the Hamilton anxiety rating scale, Hamilton depression rating scale and Rosenberg self-esteem scale respectively. Assessment was carried out within 2-8 weeks of injury following medical stabilization. The data was tabulated and statistically analyzed. The study sample was predominantly male (54%), married (69%), with a mean age of 34.1 ± 10.8 years. Accidental burns (94%) were the most common modality of injury. The majority (46%) suffered burns involving 20-59% total body surface area (TBSA), and facial burns were present (57%). No significant association was found between TBSA and anxiety, depression or self-esteem, and the same was true for facial burns. Deep burns, however, were significantly associated with anxiety (p=0.03) and depression (p=0.0002). High rates of anxiety and depression are associated with burn injuries and related to burn depth. Adjustment and recovery in these patients depends on various other factors like the patient’s psychological status, nature/extent of the injury and ensuing medical care. Further research is warranted to reveal the magnitude and predictors of psychological problems in burn patients. PMID:28592931

  6. Patients' perspectives on quality of life after burn.

    Science.gov (United States)

    Kool, Marianne B; Geenen, Rinie; Egberts, Marthe R; Wanders, Hendriët; Van Loey, Nancy E

    2017-06-01

    The concept quality of life (QOL) refers to both health-related outcomes and one's skills to reach these outcomes, which is not yet incorporated in the burn-related QOL conceptualisation. The aim of this study was to obtain a comprehensive overview of relevant burn-specific domains of QOL from the patient's perspective and to determine its hierarchical structure. Concept mapping was used comprising a focus group (n=6), interviews (n=25), and a card-sorting task (n=24) in burn survivors. Participants sorted aspects of QOL based on content similarity after which hierarchical cluster analysis was used to determine the hierarchical structure of burn-related QOL. Ninety-nine aspects of burn-related QOL were selected from the interviews, written on cards, and sorted. The hierarchical structure of burn-related QOL showed a core distinction between resilience and vulnerability. Resilience comprised the domains positive coping and social sharing. Vulnerability included 5 domains subdivided in 13 subdomains: the psychological domain included trauma-related symptoms, cognitive symptoms, negative emotions, body perception and depressive mood; the economical domain comprised finance and work; the social domain included stigmatisation/invalidation; the physical domain comprised somatic symptoms, scars, and functional limitations; and the intimate/sexual domain comprised the relationship with partner, and anxiety/avoidance in sexual life. From the patient's perspective, QOL following burns includes a variety of vulnerability and resilience factors, which forms a fresh basis for the development of a screening instrument. Whereas some factors are well known, this study also revealed overlooked problem and resilience areas that could be considered in client-centred clinical practice in order to customize self-management support. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. 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...

  8. Burn patient care lost in good manufacturing practices?

    Science.gov (United States)

    Dimitropoulos, G.; Jafari, P.; de Buys Roessingh, A.; Hirt-Burri, N.; Raffoul, W.; Applegate, L.A.

    2016-01-01

    Summary Application of cell therapies in burn care started in the early 80s in specialized hospital centers world-wide. Since 2007, cell therapies have been considered as “Advanced Therapy Medicinal Products” (ATMP), so classified by European Directives along with associated Regulations by the European Parliament. Consequently, regulatory changes have transformed the standard linear clinical care pathway into a more complex one. It is important to ensure the safety of cellular therapies used for burn patients and to standardize as much as possible the cell sources and products developed using cell culture procedures. However, we can definitely affirm that concentrating the bulk of energy and resources on the implementation of Good Manufacturing Practice (GMP) alone will have a major negative impact on the care of severely burned patients world-wide. Developing fully accredited infrastructures and training personnel (required by the new directives), along with obtaining approval for clinical trials to go ahead, can be a lengthy process.We discuss whether or not these patients could benefit from cell therapies provided by standard in-hospital laboratories, thus avoiding having to meet rigid regulations concerning the use of industrial pharmaceutical products. “Hospital Exemption” could be a preferred means to offer burn patients a customized and safe product, as many adaptations may be required throughout their treatment pathway. Patients who are in need of rapid treatment will be the ones to suffer the most from regulations intended to help them. PMID:28149232

  9. Establishment and Assessment of New Formulas for Energy Consumption Estimation in Adult Burn Patients

    Science.gov (United States)

    Yong, Zhang; Hong, Yan; Chao, Wang; Lijuan, Song; Hongyu, Wang; Dan, Wu; Hua, Jiang; Shiliang, Wang

    2014-01-01

    Objective 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. Methods 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. Results 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). Conclusion 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

  10. Perioperative fasting in burn patients: Are we doing it right?

    African Journals Online (AJOL)

    wound healing, loss of body protein mass, decreased resistance to infection, impaired organ ... Nine adult patients with an average burn of 21% total body surface area (TBSA) were included, with an average starvation period of 21 hours. ... Women 655 + 9.56 (weight in kg) + 1.85 (height in cm) – 4.86 (age). Xie et al.

  11. 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.

  12. A Medical Mystery: Unexplained Renal Failure in Burn Patients.

    Science.gov (United States)

    Lands, Harrison M; Drake, David B

    The objective of this study was to review the investigation that uncovered the medical mystery of burn patients developing unexpected renal failure. The authors examined published and unpublished manuscripts and case reports, as well as conducted personal interviews with primary sources. In the late 1970s, emergence of resistant bacterial strains to the topical antimicrobial silver sulfadiazine occurred at the University of Virginia Medical Center. In the search for an alternative topical antimicrobial with known coverage of Pseudomonas aeruginosa, Furacin Soluble Dressing was substituted. However, Furacin Soluble Dressing produced an unexpected toxicity syndrome of hyperosmolality, metabolic gap acidosis, hypercalcemia, and ultimately renal failure. In a search for an antimicrobial with an improved spectrum against Pseudomonas, a Federal Drug Administration-approved product was used to treat large surface area burns. An unexpected toxicity syndrome developed which was traced to the polyethylene glycol base of Furacin Soluble Dressing. This substance was absorbed through the burn wounds, metabolized, and resulted in a toxicity syndrome leading to renal failure. The burn community should be cautious when using products that may be approved as nontoxic for small surface area application, as they may have unexpected medical side effects when used with large surface area burns.

  13. Pediatric Burns: A Single Institution Retrospective Review of Incidence, Etiology, and Outcomes in 2273 Burn Patients (1995-2013).

    Science.gov (United States)

    Lee, Christina J; Mahendraraj, Krishnaraj; Houng, Abraham; Marano, Michael; Petrone, Sylvia; Lee, Robin; Chamberlain, Ronald S

    Unintentional burn injury is the third most common cause of death in the U.S. for children age 5 to 9, and accounts for major morbidity in the pediatric population. Pediatric burn admission data from U.S. institutions has not been reported recently. This study assesses all pediatric burn admissions to a State wide Certified Burn Treatment Center to evaluate trends in demographics, burn incidence, and cause across different age groups. Demographic and clinical data were collected on 2273 pediatric burn patients during an 18-year period (1995-2013). Pediatric patients were stratified by age into "age 0 to 6," "age 7 to 12," and "age 13 to 18." Data were obtained from National Trauma Registry of the American College of Surgeons and analyzed using standard statistical methodology. A total of 2273 burn patients under age 18 were treated between 1995 and 2013. A total of 1663 (73.2%) patients were ages 0 to 6, 294 (12.9%) were 7 to 12, and 316 (13.9%) were age 13 to 18. A total of 1400 (61.6%) were male and 873 (38.4%) were female (male:female ratio of 1.6:1). Caucasians had the highest burn incidence across all age groups (40.9%), followed by African-Americans (33.6%), P burns occurred at home, P burned was 8.9%, with lower extremity being the most common site (38.5%). Scald burns constituted the majority of cases (71.1%, n = 1617), with 53% attributable to hot liquids related to cooking, including coffee or tea, P burns were the dominant cause (53.8%). Overall mean length of stay was 10.5 ± 10.8 days for all patients, and15.5 ± 12 for those admitted to the intensive care unit, P burn injuries are scald burns that occur at home and primarily affect the lower extremities in Caucasian and African-American males. Among Caucasian teenagers flame burns predominate. Mean length of stay was 10 days, 23% of patients required skin grafting surgery, and mortality was 0.9%. The results of this study highlight the need for primary prevention programs focusing on avoiding

  14. Novel Predictors of Sepsis Outperform the American Burn Association Sepsis Criteria in the Burn Intensive Care Unit Patient

    Science.gov (United States)

    2013-01-01

    pneu- monia.16 However, the most common isolate noted by Keen and colleagues16 in our burn center was Acinetobacter baumannii , yet this organism was...Albrecht MC, Albrecht MA, Griffith ME, et al. Impact of Acinetobacter infection on the mortality of burn patients. J Am Coll Surg 2006;203:546–50. 18

  15. Epidemiology of bedside stove burns in a retrospective cohort of 5089 pediatric patients.

    Science.gov (United States)

    Chen, Xiang-jun; Sun, Wei-jing; Wang, Jing; Han, De-zhi; Gao, Guo-zhen; Yan, De-xiong; Zhao, Xiao-chun; Yao, Xing-wei; Wang, Li; Wang, Gong-sheng

    2014-12-01

    To retrospectively analyze the epidemiological characteristics of pediatric bedside stove burns (PBSB) in China and to explore prevention and control measures. Data on pediatric burns from three hospitals located in the epidemic area were collected from January 1996 to December 2010 and were divided into the PBSB group and the control group. The epidemiological characteristics and related information for each patient were analyzed. A total of 16,595 pediatric burns were found, including 5089 PBSB and 11,506 other types of burns. The two groups differed significantly in terms of age, gender, body parts burned, degree of burn, delay of hospitalization, and treatment measures (Ps all<0.05). Risk factors for PBSB included being younger than 3 years old, living in a rural area, low literacy level of guardians, not receiving health education, and lack of a protective fence protection (Ps all<0.05). Furthermore, meal time and winter and spring seasons were high risk periods for PBSB. The risk factors for PBSB include age, region, time of occurrence, and literacy level of guardians. Health education and installation of a protective fence between the stove and the bed could reduce the incidence of PBSB. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  16. The treatment of extensively burned patents and β irradiational injury skin burn patients with irradiated pigskin

    International Nuclear Information System (INIS)

    Tang Zhongyi; Lu Xingan; Jing Ling; Qi Qiang

    1994-01-01

    Obvious therapeutic effects achieved by the covering of irradiation sterilized pigskin on burn wounds, escarectomized 3rd degree burn wounds β injured burns are discussed. The article also describes the manufacture processes of irradiated pigskins and the selection of surgical treatments of various burns. 5 refs., 1 tab., 4 figs

  17. clinical outcome of burns in hiv positive patients at the university ...

    African Journals Online (AJOL)

    Esem

    with burns. 3. To correlate HIV serostatus, burn wound infection,. TBSA and age with burn mortality. 4. To assess the prevalence of HIV infection among burns patients admitted to the University Teaching. Hospital, Lusaka, Zambia. Design: A prospective observational cohort, hospital- based study was performed at the UTH, ...

  18. Measuring utilities of severe facial disfigurement and composite tissue allotransplantation of the face in patients with severe face and neck burns from the perspectives of the general public, medical experts and patients.

    Science.gov (United States)

    Chuback, Jennifer; Yarascavitch, Blake; Yarascavitch, Alec; Kaur, Manraj Nirmal; Martin, Stuart; Thoma, Achilleas

    2015-11-01

    In an otherwise healthy patient with severe facial disfigurement secondary to burns, composite tissue allotransplantation (CTA) results in life-long immunosuppressive therapy and its associated risk. In this study, we assess the net gain of CTA of face (in terms of utilities) from the perspectives of patient, general public and medical expert, in comparison to the risks. Using the standard gamble (SG) and time-trade off (TTO) techniques, utilities were obtained from members of general public, patients with facial burns, and medical experts (n=25 for each group). The gain (or loss) in utility and quality adjusted life years (QALY) were estimated using face-to-face interviews. A sensitivity analysis using variable life expectancy was conducted. From the patient perspective, severe facial burn was associated with a health utility value of 0.53, and 27.1 QALYs as calculated by SG, and a health utility value of 0.57, and 28.9 QALYs as calculated by TTO. In comparison, CTA of the face was associated with a health utility value of 0.64, and 32.3 QALYs (or 18.2 QALYs years per sensitivity analysis) as calculated by SG, and a health utility value of 0.67, and 34.1 QALYs (or 19.2QALYs per sensitivity analysis) as calculated by TTO. However, a loss of 8.9 QALYs (by SG method) to 9.5 QALYs (by TTO method) was observed when the life expectancy was decreased in the sensitivity analysis. Similar results were obtained from the general population and medical experts perspectives. We found that severe facial disfigurement is associated with a significant reduction in the health-related quality of life, and CTA has the potential to improve this. Further, we found that a trade-off exists between the life expectancy and gain in the QALYs, i.e. if life expectancy following CTA of face is reduced, the gain in QALY is also diminished. This trade-off needs to be validated in future studies. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  19. Measure of tissue resistivity in experimental electrical burns.

    Science.gov (United States)

    Chilbert, M; Maiman, D; Sances, A; Myklebust, J; Prieto, T E; Swiontek, T; Heckman, M; Pintar, K

    1985-03-01

    Studies were conducted in 14 mongrel dogs to compare resistivities in normal muscle with those from muscle subjected to electrical burns. One-ampere, 60-Hz currents were passed between the hind limbs of the dogs producing injury in three measurement regions of the gracilis muscle. Histology, heart rate, body temperature, arterial and pulmonary artery pressure, cardiac output, hematocrit, leukocyte counts, fibrinogen levels, and platelet levels were determined. Muscle resistivity associated with severe tissue necrosis was 70% lower than control values. Resistivity in tissue showing edema and minimal necrosis decreased 20 to 40% from control values. Muscle showing only edema had a 10 to 30% decrease in resistivity.

  20. More Than One Third of Intubations in Patients Transferred to Burn Centers are Unnecessary: Proposed Guidelines for Appropriate Intubation of the Burn Patient.

    Science.gov (United States)

    Romanowski, Kathleen S; Palmieri, Tina L; Sen, Soman; Greenhalgh, David G

    2016-01-01

    Advanced Burn Life Support emphasizes endotracheal intubation for patients with facial burns before transfer to a burn center to prevent airway obstruction. Many patients are intubated before transport and are often extubated shortly after burn center arrival. We hypothesize that many intubations performed before burn center transport are unnecessary. We conducted a retrospective review of all adults who were intubated before burn transfer and survived to discharge from August 2003 to June 2013. Intubations that had 2 or fewer ventilator days (i.e., potentially unnecessary intubations) were compared with those lasting longer than 2 days. Data collected included age, ventilator days, length of stay, % TBSA burn, % second degree, % third degree, % second degree face burn, % third degree face burn, and origin of burns. A total of 416 patient met inclusion criteria. Of these, 129 patients (31.0%) were intubated less than or equal to 1 day, and a total of 171 (40.1%) patients remained intubated for less than or equal to 2 days. Patients who were intubated less than or equal to 2 days differed from those intubated more than 2 days with respect to % TBSA burn (10.2 ± 8.1 vs 30.8 ± 19.7, P third degree burn (2.84 ± 5.6 vs 22.5 ± 19.6, P third degree face burn (0.14 ± 0.7 vs 0.94 ± 1.9, P burn center setting (74.9% vs 51.8%, P burned outdoors (42.1% vs 24.9%; P burn. There were no reintubations in patients who were intubated 2 days or less. As a burn community, we have emphasized early intubation before transfer for those who have sustained significant burns, inhalational injury, or facial burns. Unfortunately, this has led to many potentially unnecessary intubations that expose patients to unnecessary complications. Although early intubation is a lifesaving intervention for many burn patients, criteria should be developed to determine when intubation is not needed.

  1. Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war.

    Science.gov (United States)

    Yuce, Yucel; Acar, Hakan A; Erkal, Kutlu H; Arditi, Nur B

    2017-01-01

    To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43) and most of them had burns greater than 15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients.

  2. Use of sugammadex on burn patients: descriptive study.

    Science.gov (United States)

    Rodríguez Sánchez M, Eduardo; Martínez Torres, Concepción; Herrera Calo, Pablo; Jiménez, Ignacio

    2015-01-01

    A burn patient is a challenge for any anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. The victim may have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population. It was a prospectively descriptive study, including 4 patients, and all of them were considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation. Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95min 95% CI (3.25-6.64, p=.53). The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies of larger populations would be necessary to confirm these data. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  3. [Use of sugammadex in burn patients: descriptive study].

    Science.gov (United States)

    Rodríguez Sánchez M, Eduardo; Martínez Torres, Concepción; Herrera Calo, Pablo; Jiménez, Ignacio

    2015-01-01

    The burn patient is a challenge for the anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. They have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population. Prospectively descriptive study including four patients, all of them considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation. Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95minutes 95% CI (3.25-6.64, p=.53); The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies, of larger populations would be necessary to confirm this data. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Use of sugammadex on burn patients: descriptive study

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez Sánchez M.

    2015-08-01

    Full Text Available OBJECTIVES: A burn patient is a challenge for any anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. The victim may have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population.MATERIALS AND METHODS: It was a prospectively descriptive study, including 4 patients, and all of them were considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation.RESULTS: Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95 min 95% CI (3.25-6.64, p= .53.CONCLUSIONS: The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies of larger populations would be necessary to confirm these data.

  5. Biomass burning fuel consumption rates: a field measurement database

    NARCIS (Netherlands)

    van Leeuwen, T.T.; van der Werf, G.R.; Hoffmann, A.A.; Detmers, R.G.; Ruecker, G.; French, N.H.F.; Archibald, S.; Carvalho Jr., J.A.; Cook, G.D.; de Groot, J.W.; Hely, C.; Kasischke, E.S.; Kloster, S.; McCarty, J.L.; Pettinari, M.L.; Savadogo, P.

    2014-01-01

    Landscape fires show large variability in the amount of biomass or fuel consumed per unit area burned. Fuel consumption (FC) depends on the biomass available to burn and the fraction of the biomass that is actually combusted, and can be combined with estimates of area burned to assess emissions.

  6. Grip and Muscle Strength Dynamometry Are Reliable and Valid in Patients With Unhealed Minor Burn Wounds.

    Science.gov (United States)

    Gittings, Paul; Salet, Myrthe; Burrows, Sally; Ruettermann, Mike; Wood, Fiona M; Edgar, Dale

    Small burns are common and can cause disproportionate levels of disability. The ability to measure muscle impairment and consequent functional disability is a necessity during rehabilitation of patients. This study aimed to determine the reliability and validity of grip and muscle strength dynamometry in patients with unhealed, minor burn wounds. Grip and muscle strength were assessed three times on each side. Assessment occurred at presentation for the initial injury and again every other day (or every 5 days beyond 10 days post injury) until discharge from the service. Reliability was assessed using intraclass correlation. Minimum detectable differences were calculated for each muscle group. Validity was assessed using regression analysis, incorporating appropriate burn severity measures and patient demographics. Thirty patients with TBSA ≤15% were assessed. Both grip and muscle strength demonstrated very good reliability (intraclass correlation coefficient: 0.85-0.96). Minimum detectable differences ranged from 3.8 to 8.0 kg. Validity of both forms of dynamometry was confirmed through associations with gender for all muscle groups (P dynamometry are reliable and valid assessments of strength and are applicable for clinical use in patients who have unhealed, minor burn wounds.

  7. Phenotypic detection of Klebsiella pneumoniae carbapenemase among burns patients: first report from Iran.

    Science.gov (United States)

    Rastegar Lari, Abdolaziz; Azimi, Leila; Rahbar, Mohammad; Fallah, Fatemeh; Alaghehbandan, Reza

    2013-02-01

    Resistance to antimicrobial agents such as carbapenems among enterobacteriacea has been increasing, especially in Klebsiella pneumonia that produces variety of enzymes including Klebsiella pneumoniae carbapenemase (KPC). This study is the first report of its kind investigating the resistance to carbapenems among burns patients in Iran. During a 6-month period, 28 hospitalized burn patients who required to be placed on broad spectrum antibiotics were studied. Isolated species identified by routine biochemical test. Susceptibility testing for these species was performed by recommended the CLSI guidelines method. The tested antibiotics included cefotaxime, cefepime, aztreonam, imipenem, amoxicillin+clavulonic acid, gentamicin, amikacin, tobramycin, tetracycline, and trimethoprim-sulfamethoxazole, and chloramphenicol. For determination of KPC in phenotypical forms, Modified Hodge Test was utilized as per CLSI recommendation. Thirty-five Klebsiella spp. were isolated from 28 hospitalized patients. Nineteen out of 35 Klebsiella isolates were resistant to imipenem and that all of them had positive KPC. Nine of imipenem resistant isolates were also resistant to all tested antibiotics. Mortality rate among patients with positive KPC was 33%. High rate of multi-drug resistant (MDR) strains in isolates with positive KPC is a major challenge in Iran and that it could cause an increase in both mortality and morbidity among burn patients. Thus, appropriate infection control measures and guidelines are needed to prevent such infections among burn patients. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  8. Drug resistance analysis of bacterial strains isolated from burn patients.

    Science.gov (United States)

    Wang, L F; Li, J L; Ma, W H; Li, J Y

    2014-01-22

    This study aimed to analyze the spectrum and drug resistance of bacteria isolated from burn patients to provide a reference for rational clinical use of antibiotics. Up to 1914 bacterial strain specimens isolated from burn patients admitted to hospital between 2001 and 2010 were subjected to resistance monitoring by using the K-B paper disk method. Retrospective analysis was performed on drug resistance analysis of burn patients. The top eight bacterium strains according to detection rate. A total of 1355 strains of Gram-negative (G(-)) bacteria and 559 strains of Gram-positive (G(+)) bacteria were detected. The top eight bacterium strains, according to detection rate, were Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis, Klebsiella pneumoniae, Enterobacter cloacae, and Enterococcus. Drug resistance rates were higher than 90% in A. baumannii, P. aeruginosa, S. epidermidis, and S. aureus, which accounted for 52.2, 21.7, 27.8, and 33.3%, respectively, of the entire sample. Those with drug resistance rates lower than 30% accounted for 4.3, 30.4, 16.7, and 16.7%, respectively. Multidrug-resistant S. aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) accounted for 49.2 and 76.4% of the S. epidermis and S. aureus resistance, respectively. Antibacterial drugs that had drug resistance rates to MRSE and MRSA higher than 90% accounted for 38.9 and 72.2%, respectively, whereas those with lower than 30% drug resistance rates accounted for 11.1 and 16.7%, respectively. The burn patients enrolled in the study were mainly infected with G(-) bacteria. These results strongly suggest that clinicians should practice rational use of antibiotics based on drug susceptibility test results.

  9. 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%.

  10. Workplace-related burns.

    Science.gov (United States)

    Mian, M A H; Mullins, R F; Alam, B; Brandigi, C; Friedman, B C; Shaver, J R; Hassan, Z

    2011-06-30

    Introduction. The key element of a safe workplace for employees is the maintenance of fire safety. Thermal, chemical, and electrical burns are common types of burns at the workplace. This study assessed the epidemiology of work-related burn injuries on the basis of the workers treated in a regional burn centre. Methods. Two years' retrospective data (2005-2006) from the Trauma Registry of the American College of Surgeons of the Joseph M. Still Burn Center at Doctors Hospital in Augusta, Georgia, were collected and analysed. Results. During the time period studied, 2510 adult patients with acute burns were admitted; 384 cases (15%) were work-related. The average age of the patients was 37 yr (range, 15-72 yr). Males constituted the majority (90%) of workrelated burn injury admissions. The racial distribution was in accordance with the Centre's admission census. Industrial plant explosions accounted for the highest number of work-related burns and, relatively, a significant number of patients had chemical burns. The average length of hospital stay was 5.54 days. Only three patients did not have health insurance and four patients (1%) died. Conclusion. Burn injuries at the workplace predominantly occur among young male workers, and the study has shown that chemical burns are relatively frequent. This study functions as the basis for the evaluation of work-related burns and identification of the causes of these injuries to formulate adequate safety measures, especially for young, male employees working with chemicals.

  11. Health-related quality of life 6 months after burns among hospitalized patients: Predictive importance of mental disorders and burn severity.

    Science.gov (United States)

    Palmu, Raimo; Partonen, Timo; Suominen, Kirsi; Saarni, Samuli I; Vuola, Jyrki; Isometsä, Erkki

    2015-06-01

    Major burns are likely to have a strong impact on health-related quality of life (HRQoL). We investigated the level of and predictors for quality of life at 6 months after acute burn. Consecutive acute adult burn patients (n=107) admitted to the Helsinki Burn Centre were examined with a structured diagnostic interview (SCID) at baseline, and 92 patients (86%) were re-examined at 6 months after injury. During follow-up 55% (51/92) suffered from at least one mental disorder. The mean %TBSA was 9. TBSA of men did not differ from that of women. Three validated instruments (RAND-36, EQ-5, 15D) were used to evaluate the quality of life at 6 months. All the measures (RAND-36, EQ-5, 15D) consistently indicated mostly normal HRQoL at 6 months after burn. In the multivariate linear regression model, %TBSA predicted HRQoL in one dimension (role limitations caused by physical health problems, p=0.039) of RAND-36. In contrast, mental disorders overall and particularly major depressive disorder (MDD) during follow-up (p-values of 0.001-0.002) predicted poor HRQoL in all dimensions of RAND-36. HRQoL of women was worse than that of men. Self-perceived HRQoL among acute burn patients at 6 months after injury seems to be mostly as good as in general population studies in Finland. The high standard of acute treatment and the inclusion of small burns (%TBSAburn itself on HRQoL. Mental disorders strongly predicted HRQoL at 6 months. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. Predisposing factors for candidemia in patients with major burns.

    Science.gov (United States)

    Fochtmann, Alexandra; Forstner, Christina; Hagmann, Michael; Keck, Maike; Muschitz, Gabriela; Presterl, Elisabeth; Ihra, Gerald; Rath, Thomas

    2015-03-01

    Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns. A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia. Twenty (11%) patients developed candidemia on median day 16 after ICU admission associated with an increased overall mortality (30% versus 10%). Statistical analysis identified the following factors associated with proven candidemia: younger age (years) odds ratio (OR):0.96, 95% confidence interval (95% CI):0.92-1.0, female gender (reference male) OR:5.03, 95% CI:1.25-24.9, gastrointestinal (GI) complications requiring surgery (reference no GI complication) OR:20.37, 95% CI:4.25-125.8, non-gastrointestinal thromboembolic complications (reference no thromboembolic complication) OR:17.3, 95% CI:2.57-170.4 and inhalation trauma (reference no inhalation trauma) OR:7.96, 95% CI:1.4-48.4. Above-mentioned patient groups are at considerably high risk for candidemia and might benefit from a prophylactic antifungal therapy. Younger age as associated risk factor is likely to be the result of the fact that older patients with a great extent of burn body surface have a lower chance of survival compared to younger patients with a comparable TBSA. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  13. Acute Acalculous Cholecystitis in a Severely Burned Patient : A Case Report

    OpenAIRE

    NISHINA, Masayoshi; FUJII, Chiiho; SUZUKI, Koichiro; KOHAMA, Akitsugu

    1989-01-01

    A 56-year-old woman, suffering from major third degree burns, had right hypochondric pain and fever on her 57th post-burn day. A diagnosis of acute acalculous cholecystitis was established by ultrasonography. Despite effective drainage of the gallbladder through PTGBD, the patient died of ARDS and septic shock on the 73rd post-burn day. Acute acalculous cholecystitis is an uncommon but potentially lethal complication in severely burned patients. Ultrasonography is helpful in early diagnosis a...

  14. Wound healing trajectories in burn patients and their impact on mortality.

    Science.gov (United States)

    Nitzschke, Stephanie L; Aden, James K; Serio-Melvin, Maria L; Shingleton, Sarah K; Chung, Kevin K; Waters, J A; King, Booker T; Burns, Christopher J; Lundy, Jonathan B; Salinas, José; Wolf, Steven E; Cancio, Leopoldo C

    2014-01-01

    The rate of wound healing and its effect on mortality has not been well described. The objective of this article is to report wound healing trajectories in burn patients and analyze their effects on in-hospital mortality. The authors used software (WoundFlow) to depict burn wounds, surgical results, and healing progression at multiple time points throughout admission. Data for all patients admitted to the intensive care unit with ≥ 20% TBSA burned were collected retrospectively. The open wound size (OWS), which includes both unhealed burns and unhealed donor sites, was measured. We calculated the rate of wound closure (healing rate), which we defined as the change in OWS/time. We also determined the time delay (DAYS) from day of burn until day on which there was a reduction in OWS healing (H), and 13 did not (NH). H differed from NH on age (38 years [32-57] vs 63 [51-74]), body mass index (27 [21-28] vs 32 [19-52]), 24-hour fluid resuscitation (12 L [10-16] vs 18 [15-20]), pressors during first 48 hours (72% vs 100%), use of renal replacement therapy (32% vs 92%), and mortality (4% vs 100%). Repeated measures analysis of covariance showed a significant difference between survivors and nonsurvivors on OWS as a function of time (Phealing rate (+2%/day) after postburn day 20 had 100% survival whereas those with a negative healing rate (-2%/day) had 100% mortality. For H patients, median DAYS was 41 (28-54); median DAYS/TBSA was 1.3 (1.0-1.9). Survivors had a 0.62% drop in OWS/day, or 4.3%/week. In this cohort of patients with ≥ 20% TBSA, there was a difference in mortality after postburn day 20, between patients with a positive healing rate (+2%/day, 100% survival) and those with a negative healing rate (-2%/day, 100% mortality, P < .05).

  15. Comparison of four measures in reducing length of stay in burns: An Asian centre's evolved multimodal burns protocol.

    Science.gov (United States)

    Chong, Si Jack; Kok, Yee Onn; Choke, Abby; Tan, Esther W X; Tan, Kok Chai; Tan, Bien-Keem

    2017-09-01

    Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre. A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database. There was no statistically significant difference for comorbidities, age and percentage (%) TBSA between the new protocol and control groups. The protocol group had shorter mean time to surgery (23.5-38.5h) (pmicrograft/allograft, early CRRT and surgery within 24h were successfully introduced. These are useful adjuncts in the armamentarium to be considered for any burns centre. Copyright © 2017. Published by Elsevier Ltd.

  16. Pre-existing psychiatric disorder in the burn patient is associated with worse outcomes.

    Science.gov (United States)

    Hudson, Alexandra; Al Youha, Sarah; Samargandi, Osama A; Paletz, Justin

    2017-08-01

    To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality. A retrospective chart review of 479 consecutive patients admitted to the Burn Unit of an academic hospital in Halifax, Nova Scotia between March 2nd 1995 and June 1st 2013 was performed. Extensive data regarding patient and burn characteristics and outcomes was collected. Patients with and without pre-existing psychiatric diagnoses at the time of hospital admission were compared. Sixty-three (13%) patients had a psychiatric diagnosis, with the most common being depression (52%). Forty-percent (n=25/63) of these patients had multiple pre-existing psychiatric diagnoses. Patients with a psychiatric diagnosis had a greater total-body-surface-area (TBSA)% covered by a third-degree burn (p=0.001), and were more likely to have an inhalation injury (pBurn Unit (p=0.01). The risk of death in burn patients with pre-existing psychiatric disorders was about three times the risk of death in patients with no psychiatric disorders when adjusting for other potential confounders (95% CI, 1.13-9.10; p-value 0.03). Presence of a pre-existing psychiatric disorder in the burn patient was associated with worse outcomes and was a significant predictor of death. Psychiatric diagnoses should be identified early in burn treatment and efforts should be made to ensure a comprehensive approach to inpatient support and patient discharge to reduce unfavorable burn outcomes and placement issues. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  17. Micrografting in the treatment of severely burned patients.

    Science.gov (United States)

    Zermani, R G; Zarabini, A; Trivisonno, A

    1997-01-01

    The micrografting technique, employed to treat patients with extensive TBSA burns and reduced areas of healthy donor skin, was assessed simultaneously with traditional mesh grafts (STSG) or Tiersch grafts in the treatment five severely burned subjects (average TBSA burned 35.6 per cent; average per cent of full thickness wounds 32.6 per cent). At the first clinical control on day 6 post-surgery, 93 per cent of the micrografted area was in situ and health; epithelialization of the wound sites was complete at day 21. Meshed STSG yielded 90 per cent attachment at day 6 post-surgery, with epithelialization complete at 12 +/- 2 days post-surgery. Functional results were equivalent no matter what technique was used, while aesthetic results were better in the areas where micrografting was carried out. Although the micrograft technique is labour-intensive, if the expansion needed is at least 1:6, the aesthetic and functional results obtained are comparable to, or better than, those with meshed grafts. Also, large segments of micrograft are not compromised if a small area of mesh becomes detached, and epithelialization is faster and more uniform, enabling a reduction in both infection and length of hospital stay.

  18. The radiographic spectrum of pulmonary complications in major burn patient

    International Nuclear Information System (INIS)

    Jung, Hae Kyoung; Lee, Eil Seong; Park, Ju Youn; Kim, Soo Hyun; Hong, Sung Hwan; Park, Hong Suk; Lee, Kwan Seop; Kang, Ik Won

    2000-01-01

    In recent years, improved antibiotic care and physiologic fluid replacement in cases involving burn wounds have led to a decrease in the rate of fatalities caused by wound sepsis and shock. There has, however, been an upsurge and relative increase in the frequency (15-25%) and mortality rate (50-89%) of pulmonary complications. Since pulmonary lesions may result from direct injury to the respiratory tract caused by smoke inhalation, from circulatory, metablic or infectious complications in cases involving cutaneous burns, or may develop during the therapeutic management of these lesions, a wide spectrum of pulmonary abnormalities can occur during the post-burn period. There is considerable overlap between their radiographic appearances, which are often nonspecific. Since the successful management of these patients is based on the early recognition and vigorous treatment of lesions, famikiarity with all facets of these complications, based on a pathophysiology of the injury and on the knowledge of the clinical setting, enables radiologists to make more specific diagnoses. (author)

  19. Chemical composition of wildland and agricultural biomass burning particles measured downwind during the BBOP study

    Science.gov (United States)

    Onasch, T. B.; Shilling, J. E.; Wormhoudt, J.; Sedlacek, A. J., III; Fortner, E.; Pekour, M. S.; Chand, D.; Zhou, S.; Collier, S.; Zhang, Q.; Kleinman, L. I.; Lewis, E. R.; Yokelson, R. J.; Adachi, K.; Buseck, P. R.; Freedman, A.; Williams, L. R.

    2017-12-01

    The Biomass Burning Observation Project (BBOP), a Department of Energy (DOE) sponsored study, measured emissions from wildland fires in the Pacific Northwest and agricultural burns in the Central Southeastern US from the DOE Gulfstream-1 airborne platform over a four month period in 2013. Rapid physical, chemical and optical changes in biomass burning particles were measured downwind (tar balls and SP-AMS OA quantification while operating with both laser and tungsten vaporizers.

  20. [The present status, counter-measures and new trends on burn infection].

    Science.gov (United States)

    Xiao, Guang-xia

    2007-04-01

    In recent fifty years, Pseudomonas aeruginosa and Staphylococcus aureus were continuously the predominant in burn infections, the only change seen was a rapid increase in their drug-resistance. Under the pressure of antibiotics, Some opportunistic bacteria that were resistant to all available antibiotics emerged, such as Acinetobacter baumanii and Maltophilia stenotrophomonas. For critically burn patients, basing on early surgical intervention, early and short-term use of broad-spectrum antibiotic is advisable, and it may control the infection promptly, prevent further inflammatory reaction, as well as minimize the emergence of antibacterial resistance. To control infections due to pandrug-resistant bacteria, cyclic use of some old antibiotics may be helpful. In dealing with severe infection, a combination of anti-pathogen and anti-inflammatory reaction measures should be considered.

  1. Temporomandibular disorders in burning mouth syndrome patients: an observational study.

    Science.gov (United States)

    Corsalini, Massimo; Di Venere, Daniela; Pettini, Francesco; Lauritano, Dorina; Petruzzi, Massimo

    2013-01-01

    Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis.

  2. The effect of a rehabilitation nursing intervention model on improving the comprehensive health status of patients with hand burns.

    Science.gov (United States)

    Li, Lin; Dai, Jia-Xi; Xu, Le; Huang, Zhen-Xia; Pan, Qiong; Zhang, Xi; Jiang, Mei-Yun; Chen, Zhao-Hong

    2017-06-01

    To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns. Most studies of hand-burn patients have focused on functional recovery. There have been no studies involving a biological-psychological-social rehabilitation model of hand-burn patients. A randomized controlled design was used. Patients with hand burns were recruited to the study, and sixty patients participated. Participants were separated into two groups: (1) The rehabilitation intervention model group (n=30) completed the rehabilitation intervention model, which included the following measures: enhanced social support, intensive health education, comprehensive psychological intervention, and graded exercise. (2) The control group (n=30) completed routine treatment. Intervention lasted 5 weeks. Analysis of variance (ANOVA) and Student's t test were conducted. The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health. The differences between the index scores of the two groups were statistically significant. The rehabilitation intervention improved the comprehensive health status of patients with hand burns and has favorable clinical application. The comprehensive rehabilitation intervention model used here provides scientific guidance for medical staff aiming to improve the integrated health status of hand-burn patients and accelerate their recovery. What does this paper contribute to the wider global clinical community? Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Prevalence and pattern of facial burns: a 5-year assessment of 808 patients.

    Science.gov (United States)

    Kalantar Motamedi, Mohammad Hosein; Heydari, Misaq; Heydari, Milad; Ebrahimi, Ali

    2015-04-01

    Retrospective studies on the types and causes of facial burns are important because the patterns might vary in different societies. Our aim was to assess the burn-related factors of significance that might be useful in healthcare planning and implementing preventive strategies, adding to the body of current data on the subject. A retrospective cross-sectional study was conducted to assess the data from a major burns referral center during a 5-year period (2009 to 2013). The data relevant to age, gender, cause, source, location, burn degree, extent (body surface area [BSA]) of the burns, and mortality were gathered from comprehensive patient medical records, recorded, and analyzed using SPSS, version 20, software (SPSS, Chicago, IL). Within the study period, we found 808 documented cases of second- and third-degree facial burns. These burns were more common in men (81.9%) and in the 16- to 35-year age group (42.3%). The mean hospitalization was 9.85 ± 8.94 days. In 443 patients (54.83%), 10 to 19% of their BSA was burned, and 3.06% had associated inhalation burns. The most common burn was scalding (19%), and the deadliest was burns from acid, with a mortality rate of 7.4%. Accidents accounted for 776 burns (96.03%). Other causes were attempted homicide (16 cases, 1.98%) and suicide attempts (16 cases, 1.98%). The overall mortality was 1.6%. The key findings were that second- and third-degree facial burns were more common in males aged 16 to 35 years with burns covering 10 to 19% of the BSA. Accidental scalding was commonly responsible for the second-degree burns, and electrical accidents were commonly responsible for third-degree facial burns. Burn accidents occurred more often at the patient's home. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Examining the Correlation between Objective Injury Parameters, Personality Traits and Adjustment Measures among Burn Victims

    Directory of Open Access Journals (Sweden)

    Josef Mordechai Haik

    2015-03-01

    Full Text Available Background: Burn victims experience immense physical and mental hardship during their process of rehabilitation and regaining functionality. We examined different objective burn related factors as well as psychological ones, in the form of personality traits, that may affect the rehabilitation process and its outcome. Objective: To assess the influence and correlation of specific personality traits and objective injury related parameters on the adjustment of burn victims post-injury. Methods: 62 male patients admitted to our burn unit due to burn injuries were compared with 36 healthy male individuals by use of questionnaires to assess each group's psychological adjustment parameters. Multivariate and hierarchical regression analysis was conducted to identify differences between the groups. Results: A significant negative correlation was found between the objective burn injury severity (e.g. TBSA and burn depth and the adjustment of burn victims (p<0.05, p<0.001, table 3. Moreover, patients more severely injured tend to be more neurotic (p<0.001, and less extroverted and agreeable (p<0.01, table 4. Conclusions: Extroverted burn victims tend to adjust better to their post-injury life while the neurotic patients tend to have difficulties adjusting. This finding may suggest new tools for early identification of maladjustment-prone patients and therefore provide them with better psychological support in a more dedicated manner.

  5. Burns injuries among in-patients at Moi Teaching and Referral ...

    African Journals Online (AJOL)

    Background: Africa contributes 12.2% to the total global deaths due to burn injuries. There are no data on burns in the Western region of Kenya Objectives: To determine the causes and outcome of burns injuries among in-patients at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Study design: Retrospective ...

  6. PIV Measurements of Gas Flow Fields from Burning End

    Science.gov (United States)

    Huang, Yifei; Wu, Junzhang; Zeng, Jingsong; Tang, Darong; Du, Liang

    2017-12-01

    To study the influence of cigarette gas on the environment, it is necessary to know the cigarette gas flow fields from burning end. By using PIV technique, in order to reveal velocity characteristics of gas flow fields, the velocities of cigarette gas flow fields was analyzed with different stepping motor frequencies corresponding to suction pressures, and the trend of velocity has been given with image fitting. The results shows that the velocities of the burning end increased with suction pressures; Between velocities of the burning end and suction pressures, the relations present polynomial rule; The cigarette gas diffusion in combustion process is faster than in the smoldering process.

  7. Anti-HLA sensitization in extensively burned patients: extent, associated factors, and reduction in potential access to vascularized composite allotransplantation.

    Science.gov (United States)

    Duhamel, Patrick; Suberbielle, Caroline; Grimbert, Philippe; Leclerc, Thomas; Jacquelinet, Christian; Audry, Benoit; Bargues, Laurent; Charron, Dominique; Bey, Eric; Lantieri, Laurent; Hivelin, Mikael

    2015-05-01

    Extensively burned patients receive iterative blood transfusions and skin allografts that often lead to HLA sensitization, and potentially impede access to vascularized composite allotransplantation (VCA). In this retrospective, single-center study, anti-HLA sensitization was measured by single-antigen-flow bead analysis in patients with deep, second- and third-degree burns over ≥40% total body surface area (TBSA). Association of HLA sensitization with blood transfusions, skin allografts, and pregnancies was analyzed by bivariate analysis. The eligibility for transplantation was assessed using calculated panel reactive antibodies (cPRA). Twenty-nine patients aged 32 ± 14 years, including 11 women, presented with a mean burned TBSA of 54 ± 11%. Fifteen patients received skin allografts, comprising those who received cryopreserved (n = 3) or glycerol-preserved (n = 7) allografts, or both (n = 5). An average 36 ± 13 packed red blood cell (PRBC) units were transfused per patient. In sera samples collected 38 ± 13 months after the burns, all patients except one presented with anti-HLA antibodies, of which 13 patients (45%) had complement-fixing antibodies. Eighteen patients (62%) were considered highly sensitized (cPRA≥85%). Cryopreserved, but not glycerol-preserved skin allografts, history of pregnancy, and number of PRBC units were associated with HLA sensitization. Extensively burned patients may become highly HLA sensitized during acute care and hence not qualify for VCA. Alternatives to skin allografts might help preserve their later access to VCA. © 2015 Steunstichting ESOT.

  8. 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-...

  9. IASI measurements of reactive trace species in biomass burning plumes

    Directory of Open Access Journals (Sweden)

    P.-F. Coheur

    2009-08-01

    Full Text Available This work presents observations of a series of short-lived species in biomass burning plumes from the Infrared Atmospheric Sounding Interferometer (IASI, launched onboard the MetOp-A platform in October 2006. The strong fires that have occurred in the Mediterranean Basin – and particularly Greece – in August 2007, and those in Southern Siberia and Eastern Mongolia in the early spring of 2008 are selected to support the analyses. We show that the IASI infrared spectra in these fire plumes contain distinctive signatures of ammonia (NH3, ethene (C2H4, methanol (CH3OH and formic acid (HCOOH in the atmospheric window between 800 and 1200 cm−1, with some noticeable differences between the plumes. Peroxyacetyl nitrate (CH3COOONO2, abbreviated as PAN was also observed with good confidence in some plumes and a tentative assignment of a broadband absorption spectral feature to acetic acid (CH3COOH is made. For several of these species these are the first reported measurements made from space in nadir geometry. The IASI measurements are analyzed for plume height and concentration distributions of NH3, C2H4 and CH3OH. The Greek fires are studied in greater detail for the days associated with the largest emissions. In addition to providing information on the spatial extent of the plume, the IASI retrievals allow an estimate of the total mass emissions for NH3, C2H4 and CH3OH. Enhancement ratios are calculated for the latter relative to carbon monoxide (CO, giving insight in the chemical processes occurring during the transport, the first day after the emission.

  10. The effect of shiatsu massage on pain reduction in burn patients.

    Science.gov (United States)

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

    2014-07-01

    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. 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 patients was evaluated. The visual analog scale (VAS) was used to assess pain in burn patients. Pain intensity in the control group before and after the intervention was not statistically significant (p=1). In all massage groups, the difference for pain intensity before and after the intervention was statistically significant. According to our data, shiatsu method over both hands and legs were effective in pain reduction and can be recommended together with analgesics to decrease the dose.

  11. Sepsis in burned patients Sepse em pacientes queimados

    Directory of Open Access Journals (Sweden)

    Jefferson Lessa S. de Macedo

    2003-12-01

    Full Text Available A prospective study was conducted from June 2001 to May 2002 at the Burns Unit of Hospital Regional da Asa Norte, Brasília, Brazil. During the period of the study, 252 patients were treated at the Burns Unit, 49 (19.4% developed clinically and microbiologically proven sepsis. Twenty-six (53.1% were males and 23 (46.9% females with a mean age of 22 years (range one to 89 years and mean burned body surface area of 37.7 ± 18.4% (range 7 to 84%. Forty-three patients had flame burns, five a scald and one an electric burn. These 49 patients had a total of 62 septic episodes. Forty (81.6% patients had only one and nine (18.4% had up to three episodes of sepsis. Thirty (61.2% patients had their first septicemic episode either earlier or by one week postburn. Out of 62 septic episodes, 58 were due to bacteria and four due to Candida sp. The most common bacteria isolated from blood culture were Staphylococcus aureus, coagulase-negative Staphylococcus, Acinetobacter baumannii, Enterobacter cloacae and Klebsiella pneumoniae. Eleven (18.9% episodes were due to oxacillin resistant Staphylococcus aureus. Acinetobacter baumannii was sensitive to ampicillin/sulbactam in 71.4% and to imipenem in 85.7% of the cases. The primary foci of sepsis were the burn wound in 15 ( 24.2% episodes. The most common clinical findings of sepsis in these patients were fever, dyspnea, hypotension and oliguria. The most common laboratory findings of these patients were anemia, leukocytosis, hypoalbuminemia and thrombocytopenia. Twelve (24.5% patients died. The appropriate knowledge of clinical, epidemiological, laboratorial and microbiological aspects of sepsis in burned patients permits an adequate diagnosis and treatment of this complication.Um estudo prospectivo foi realizado de junho de 2001 a maio de 2002, na Unidade de Queimados do Hospital Regional da Asa Norte, Brasília, Brasil. Durante o período do estudo, 252 pacientes foram tratados na Unidade de Queimados, 49 (19

  12. An audit of patients' experiences and opinions concerning mirrors in a UK burns service.

    Science.gov (United States)

    Redstone, L; Shepherd, L; Bousfield, C; Brooks, P

    2011-11-01

    Patients' experiences of and opinions concerning the presence of mirrors in burns services are unknown. The prevalence of mirrors and associated nursing practice in UK burns services is also unclear. Recently discharged burns patients (n=60) completed a questionnaire and representatives from all 18 adult burns inpatient services in the UK were surveyed. Results suggested that 90% of patients with facial burns viewed their injuries in a mirror before discharge compared to 15% of patients with burns elsewhere. Thirty-six percent of patients reported they were informed that they could request a mirror if desired and 30% were asked whether they would like a mirror. Only 22% of patients reported that they would not have liked mirrors in their rooms/ward area and 14% reported that this would have distressed them. It was patients who most often decided to view their injuries for the first time and nurses were most commonly present. Mirrors were present in most UK burns services but none had protocols to guide staff in helping patients view their injuries. In conclusion, concealable mirrors should be present in burns services but patients should be psychologically prepared about their presence. Protocols should be developed to provide optimal burn care. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  13. Effect of perceived social support and dispositional optimism on the depression of burn patients.

    Science.gov (United States)

    He, Fei; Zhou, Qin; Zhao, Zhijing; Zhang, Yuan; Guan, Hao

    2016-06-01

    Burn wounds have a significant impact on the mental health of patients. This study aimed to investigate the impact of perceived social support and dispositional optimism on depression of burn patients. A total of 246 burn patients accomplished the Multidimensional Scale of Perceived Social Support, the Revised Life Orientation Test, and Depression Scale. The results revealed that both perceived social support and optimism were significantly correlated with depression. Structural equation modeling indicated that optimism partially mediated the relationship between perceived social support and depression. Implications for prevention of depression in burn patients were discussed. © The Author(s) 2014.

  14. Cognitive distortions in recovered burn patients: the emotional Stroop task and autobiographical memory test.

    Science.gov (United States)

    Willebrand, Mimmie; Norlund, Fredrika; Kildal, Morten; Gerdin, Bengt; Ekselius, Lisa; Andersson, Gerhard

    2002-08-01

    The aim of the study was to explore cognitive distortions in recovered burn patients. Previous studies in trauma patients have shown trauma-specific attentional bias, long response latencies, and deficits in memory specificity. Eighteen former patients, burn injured 5-19 years ago and 18 matched controls performed the emotional Stroop task, including burn and general trauma-related words, and the autobiographical memory test (AMT). In addition, verbal fluency, life events, and current mood were assessed. Regarding the Stroop task, the recovered patients had longer response latencies to burn words than to neutral and trauma words, a difference not seen in the control subjects. Regarding the AMT, the memory specificity did not differ between the groups. Overall, the former patients had longer latencies than the controls and poorer verbal fluency. The present study showed that recovered burn patients display a moderate Stroop effect, i.e. an attentional bias, in spite of the fact that the injury occurred several years before the testing. This may imply that the recovered burn patients consider the burn an important issue in life. The post-burn patients also presented signs of a slight cognitive slowness as compared to the controls. This finding deserves further attention in the rehabilitation of burn patients.

  15. To heal and restore broken bodies: a retrospective, descriptive study of the role and impact of pastoral care in the treatment of patients with burn injury.

    Science.gov (United States)

    Hultman, Charles Scott; Saou, Michael A; Roach, S Tanner; Hultman, Suzanne Cloyd; Cairns, Bruce A; Massey, Shirley; Koenig, Harold G

    2014-03-01

    Despite advances in resuscitation, resurfacing, and reconstruction, recovery in burn patients often depends upon emotional, psychosocial, and spiritual healing. We characterized the spiritual needs of burn patients to help identify resources necessary to optimize recovery. We performed a retrospective review of all patients admitted to a regional, accredited burn center, in 2011. We accessed multiple clinical, financial, and administrative databases, collected demographic data, including religious affiliation, and recorded the number and type of pastoral care visits. Outcome measures included length of stay (LOS), physician and facility charges, and mortality. We compared patients who had a pastoral care visit with those who did not, as well as patients with a religious affiliation with those who had no or an unknown affiliation. During the study period, our burn center admitted 1338 patients, 314 of whom were visited by chaplains, for a total of 1077 encounters (3.43 visits per patient seen). Most frequent interventions were prayer, social support, and spiritual counseling. Compared to patients who had no visit, patients who saw a chaplain had a larger total body surface area burn, longer LOS, higher charges, and higher mortality (10.2% vs. 0.78%, P pastoral care appears to be linked to size of burn, financial charges, and length of stay, with religious affiliation serving as a possible marker for improved survival. Plastic surgeons and burn providers should consider and address the spiritual needs of burn patients, as a component of recovery.

  16. 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

    2012-09-01

    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. Severe burns trigger a hypermetabolic response that persists for up to 2 years postburn. Propranolol given for 1 month postburn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. One-hundred seventy-nine pediatric patients with more than 30% total body surface area burns were randomized to control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months postburn. 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 adjusted for non-normality, repeated-measures, and regression analyses. P < 0.05 was considered significant. Long-term propranolol treatment significantly reduced the percentage of the predicted heart rate and percentage 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. Propranolol treatment for 12 months after thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients. This study is registered at clinicaltrials.gov: NCT00675714.

  17. Challenges of assessing fire and burn severity using field measures, remote sensing and modelling

    Science.gov (United States)

    Penelope Morgan; Robert E. Keane; Gregory K. Dillon; Theresa B. Jain; Andrew T. Hudak; Eva C. Karau; Pamela G. Sikkink; Zachery A. Holden; Eva K. Strand

    2014-01-01

    Comprehensive assessment of ecological change after fires have burned forests and rangelands is important if we are to understand, predict and measure fire effects. We highlight the challenges in effective assessment of fire and burn severity in the field and using both remote sensing and simulation models. We draw on diverse recent research for guidance on assessing...

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. The effect of shiatsu massage on underlying anxiety in burn patients.

    Science.gov (United States)

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

    2015-01-01

    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. In an available randomized study, 60 burn patients with underlying pain were enrolled. They were randomly allocated in two groups of hand massage and the control. The anxiety of underlying burn pain before and after the massage was evaluated using Burn Specific Pain Anxiety Scale (BSPAS). The difference for anxiety scores in the hand Shiatsu massage group before and after massage were statistically significant, but in the control group was not significant. Based on our findings, 20 minutes of hand Shiatsu massage in conjunction with analgesic medications can be beneficial to control the anxiety of burn patients.

  1. Beneficial effects of extended growth hormone treatment after hospital discharge in pediatric burn patients.

    Science.gov (United States)

    Przkora, Rene; Herndon, David N; Suman, Oscar E; Jeschke, Marc G; Meyer, Walter J; Chinkes, David L; Mlcak, Ronald P; Huang, Ted; Barrow, Robert E

    2006-06-01

    To study the efficacy of growth hormone given to severely burned children from discharge to 12 months after burn and for 12 months after the drug was discontinued. We have previously shown that low-dose recombinant human growth hormone (rhGH), given to children after a severe thermal injury, successfully improved lean muscle mass, bone mineral content, and growth. The aim of the present study was to investigate long-term functional improvements after treatment. Forty-four pediatric patients with over 40% total body surface area burns were studied for 24 months after burn. Patients were randomized to receive either rhGH (0.05 mg/kg body weight) or placebo. Height, weight, body composition, serum hormones, resting energy expenditure, cardiac function, muscle strength, and number of reconstructive procedures performed were measured during rhGH treatment and for 12 months after treatment was discontinued. Statistical analysis used Tukey's multiple comparison test. Significance was accepted at P < 0.05. Height, weight, lean body mass, bone mineral content, cardiac function, and muscle strength significantly improved during rhGH treatment compared with placebo (P < 0.05). This treatment significantly increased GH, IGF-I, and IGFBP-3, whereas serum cortisol decreased (P < 0.05). The number of operative reconstructive procedures was significantly lower with rhGH (P < 0.05). Improvements in height, bone mineral content, and IGF-1 concentrations persisted after rhGH treatment (P < 0.05). No side effects with rhGH were observed. Administration of rhGH for 1 year after burn was safe and improved recovery. These salutary effects continued after rhGH treatment was discontinued.

  2. Use of the CONUT index as a predictor of integration of cutaneous grafts in burn patients

    OpenAIRE

    Jaime Aron Garcia-Espinoza; Verónica Belem Aguilar-Aragón; Sergio García-Méndez

    2017-01-01

    Objective: To present the initial experience of 12 patients with burns treated with cutaneous grafts and to analyse the variables that influence their integration. Materials and Methods: We analysed data from 12 patients seen in a year in the regional hospital of high speciality of Oaxaca. Quantified variables: Age, sex, burned body surface, depth of burn, airway injury, nutritional status by CONUT index, type of graft, development of local infection and days of hospital stay. Results: We inc...

  3. Application of reactivity method to MTR fuel burn-up measurement

    International Nuclear Information System (INIS)

    Zuniga, A.; Ravnik, M.; Cuya, R.

    2001-01-01

    Fuel element burn-up has been measured for the first time by reactivity method in a MTR reactor. The measurement was performed in RP-10 reactor of Peruvian Institute for Nuclear Energy (IPEN) in Lima. It is a pool type 10MW material testing reactor using standard 20% enriched uranium plate type fuel elements. A fresh element and an element with well defined burn-up were selected as reference elements. Several elements in the core were selected for burn-up measurement. Each of them was replaced in its original position by both reference elements. Change in excess reactivity was measured using control rod calibration curve. The burn-up reactivity worth of fuel elements was plotted as a function of their calculated burnup. Corrected burn-up values of the measured fuel elements were calculated using the fitting function at experimental reactivity for all elements. Good agreement between measured and calculated burn-up values was observed indicating that the reactivity method can be successfully applied also to MTR fuel element burn-up determination.(author)

  4. Inter-Facility Transfer of Pediatric Burn Patients from U.S. Emergency Departments

    Science.gov (United States)

    Johnson, Sarah A.; Shi, Junxin; Groner, Jonathan I.; Thakkar, Rajan K.; Fabia, Renata; Besner, Gail E.; Xiang, Huiyun; Wheeler, Krista K.

    2016-01-01

    Purpose To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer. Methods We analyzed data from the 2012 Nationwide Emergency Department Sample. Current American Burn Association (ABA) Guidelines were used to identify children burn centers. Burn patient admission volume was used as a proxy for burn expertise. Logistic models were fitted to examine the odds of transfer from low volume hospitals. Results In 2012, there were an estimated 126,742 (95% CI: 116,104–137,380) pediatric burn ED visits in the U.S. Of the 69,003 (54.4%) meeting referral criteria, 83.2% were in low volume hospitals. Only 8.2% of patients meeting criteria were transferred from low volume hospitals. Of the 52,604 (95% CI: 48,433 – 56,775) not transferred, 98.3% were treated and released and 1.7% were admitted without transfer; 54.7% of burns involved hands. Conclusions Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation. PMID:27554628

  5. Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.

    Science.gov (United States)

    Johnson, Sarah A; Shi, Junxin; Groner, Jonathan I; Thakkar, Rajan K; Fabia, Renata; Besner, Gail E; Xiang, Huiyun; Wheeler, Krista K

    2016-11-01

    To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer. We analyzed data from the 2012 Nationwide Emergency Department Sample. Current American Burn Association (ABA) Guidelines were used to identify children burn centers. Burn patient admission volume was used as a proxy for burn expertise. Logistic models were fitted to examine the odds of transfer from low volume hospitals. In 2012, there were an estimated 126,742 (95% CI: 116,104-137,380) pediatric burn ED visits in the U.S. Of the 69,003 (54.4%) meeting referral criteria, 83.2% were in low volume hospitals. Only 8.2% of patients meeting criteria were transferred from low volume hospitals. Of the 52,604 (95% CI: 48,433-56,775) not transferred, 98.3% were treated and released and 1.7% were admitted without transfer; 54.7% of burns involved hands. Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. Oral ketamine for wound care procedures in adult patients with burns

    African Journals Online (AJOL)

    Background: This prospective study was carried out to evaluate the usefulness of oral ketamine for burn wound dressing in adult patients. The aim was to achieve a state-of-conscious sedation in which the patient would be communicative and cooperative, with minimal, or no pain during burn wound care procedures.

  7. Fisiopatología del paciente quemado Burn patient physiopathology

    Directory of Open Access Journals (Sweden)

    Carlos E. Ramírez

    2010-04-01

    Full Text Available Las quemaduras extensas son uno de los traumas más severos al cual puede verse expuesto un individuo, este tipo de trauma tiene efectos locales y sistémicos bien establecidos pero no muy bien comprendidos por la mayoría del personal de salud. Pueden comprometer directa o indirectamente a casi todos los sistemas del organismo. El objetivo de éste artículo es ofrecer una explicación sencilla y sistemática, que permita al lector entender mejor como responde el cuerpo humano ante un trauma extenso por quemadura, se espera que esta lectura mejore la comprensión de la fisiopatología de este tipo de trauma y por lo tanto se manifieste en el actuar diario del personal de salud. Salud UIS 2010; 42: 55-65An extensive burn wound is among the most severe trauma a patient can be exposed to, it has well defined local and systemic effects; however, these effects are little understood by most of the health care personal. This injury can compromise directly or indirectly every system in the body. The objective of this article is to offer a simple and systematic review that allows the reader a better understanding of the response of the human body after an extensive burn injury, it is expected that this paper contributes to the better understanding of the physiology of this type of trauma and therefore be expressed in the daily work of the health care personal. Salud UIS 2010; 42: 55-65.

  8. Successful skin homografting from an identical twin in a severely burned patient.

    Science.gov (United States)

    Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients.

  9. Ultrasonic measurement of high burn-up fuel elastic properties

    International Nuclear Information System (INIS)

    Laux, D.; Despaux, G.; Augereau, F.; Attal, J.; Gatt, J.; Basini, V.

    2006-01-01

    The ultrasonic method developed for the evaluation of high burn-up fuel elastic properties is presented hereafter. The objective of the method is to provide data for fuel thermo-mechanical calculation codes in order to improve industrial nuclear fuel and materials or to design new reactor components. The need for data is especially crucial for high burn-up fuel modelling for which the fuel mechanical properties are essential and for which a wide range of experiments in MTR reactors and high burn-up commercial reactor fuel examinations have been included in programmes worldwide. To contribute to the acquisition of this knowledge the LAIN activity is developing in two directions. First one is development of an ultrasonic focused technique adapted to active materials study. This technique was used few years ago in the EdF laboratory in Chinon to assess the ageing of materials under irradiation. It is now used in a hot cell at ITU Karlsruhe to determine the elastic moduli of high burnup fuels from 0 to 110 GWd/tU. Some of this work is presented here. The second on going programme is related to the qualification of acoustic sensors in nuclear environments, which is of a great interest for all the methods, which work, in a hostile nuclear environment

  10. Gender differences in pediatric burn patients: does it make a difference?

    Science.gov (United States)

    Jeschke, Marc G; Mlcak, Ronald P; Finnerty, Celeste C; Norbury, William B; Przkora, Rene; Kulp, Gabriela A; Gauglitz, Gerd G; Zhang, Xiao-Jun; Herndon, David N

    2008-07-01

    There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. One-hundred eighty-nine children sustaining a >or=40% total body surface area burn were divided into females (n = 76) and males (n = 113). : Patient demographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29+/-3 days whereas the stay in males was 38+/-3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028+/-0.001% vs. males: -0.05+/-0.007%) and an increase in lean body mass (Delta females: 5+/-4% vs. Delta males: -1+/-3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.

  11. Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients

    Science.gov (United States)

    Forero, Carlos García; Caltran, Marina Paes; Alonso, Jordi; Dantas, Rosana A. Spadoti; Piccolo, Monica Sarto; Farina, Jayme Adriano; Lawrence, John W.; Rossi, Lidia A.

    2018-01-01

    Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale—BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach’s alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p self-esteem (-0.57; p

  12. Identification of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from burn patients by multiplex PCR.

    Science.gov (United States)

    Montazeri, Effat Abbasi; Khosravi, Azar Dokht; Jolodar, Abbas; Ghaderpanah, Mozhgan; Azarpira, Samireh

    2015-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCoNS) as important human pathogens are causes of nosocomial infections worldwide. Burn patients are at a higher risk of local and systemic infections with these microorganisms. A screening method for MRSA by using a multiplex polymerase chain reaction (PCR) targeting the 16S ribosomal RNA (rRNA), mecA, and nuc genes was developed. The aim of the present study was to investigate the potential of this PCR assay for the detection of MRSA strains in samples from burn patients. During an 11-month period, 230 isolates (53.11%) of Staphylococcus spp. were collected from burn patients. The isolates were identified as S. aureus by using standard culture and biochemical tests. DNA was extracted from bacterial colonies and multiplex PCR was used to detect MRSA and MRCoNS strains. Of the staphylococci isolates, 149 (64.9%) were identified as S. aureus and 81 (35.21%) were described as CoNS. Among the latter, 51 (62.97%) were reported to be MRCoNS. From the total S. aureus isolates, 132 (88.6%) were detected as MRSA and 17 (11.4%) were methicillin-susceptible S. aureus (MSSA). The presence of the mecA gene in all isolates was confirmed by using multiplex PCR as a gold standard method. This study presented a high MRSA rate in the region under investigation. The 16S rRNA-mecA-nuc multiplex PCR is a good tool for the rapid characterization of MRSA strains. This paper emphasizes the need for preventive measures and choosing effective antimicrobials against MRSA and MRCoNS infections in the burn units. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  13. Fungiform papillae density in patients with burning mouth syndrome and xerostomia

    Science.gov (United States)

    López-Jornet, Pía; Molino-Pagán, Diana

    2012-01-01

    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 BMS showed significantly higher fungiform papillae density than the patients with xerostomia; though no statistically significant differences were recorded versus the control group. In the BMS group, 65% of all cases presented a density of 71-90 papillae (within an area of 19 mm2), while 10% had more than 90 papillae. On the contrary, 70% of the patients with xerostomia had fewer than 70 papillae in the studied area. Conclusions: The digital camera offers a rapid, noninvasive and relatively simple way to study fungiform papillae density. The patients with BMS have higher fungiform papillae density than the patients with xerostomia. Key words:Tongue, fungiform papillae, burning mouth syndrome, xerostomia. PMID:22143737

  14. MTR fuel element burn-up measurements by the reactivity method

    International Nuclear Information System (INIS)

    Zuniga, A.; Cuya, T.R.; Ravnik, M.

    2003-01-01

    Fuel element burn-up was measured by the reactivity method in the 10 MW Peruvian MTR reactor RP-10. The main purpose of the experiment was testing the reactivity method for an MTR reactor as the reactivity method was originally developed for TRIGA reactors. The reactivity worth of each measured fuel element was measured in its original core position in order to measure the burn-up of the fuel elements that were part of the experimental core. The burn-up of each measured fuel element was derived by interpolating its reactivity worth from the reactivity worth of two reference fuel elements of known burn-up, whose reactivity worth was measured in the position of the measured fuel element. The accuracy of the method was improved by separating the reactivity effect of burn-up from the effect of the position in the core. The results of the experiment showed that the modified reactivity method for fuel element burn-up determination could be applied also to MTR reactors. (orig.)

  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. Nutritional management of the burn patient | Prins | South African ...

    African Journals Online (AJOL)

    Burn injury, the most severe type of injury from a metabolic point of view, is characterised by the most profound alterations in basal metabolic rate and urinary nitrogen excretion. In addition, requirements for and/or metabolism of macro- and micronutrients are altered or increased. The major improvement in burn survival can ...

  17. Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care

    Science.gov (United States)

    Talizin, Thalita Bento; Tsuda, Meiry Sayuri; Tanita, Marcos Toshiyuki; Kauss, Ivanil Aparecida Moro; Festti, Josiane; Carrilho, Cláudia Maria Dantas de Maio; Grion, Cintia Magalhães Carvalho; Cardoso, Lucienne Tibery Queiroz

    2018-01-01

    Objective To evaluate the frequency of intra-abdominal hypertension in major burn patients and its association with the occurrence of acute kidney injury. Methods This was a prospective cohort study of a population of burn patients hospitalized in a specialized intensive care unit. A convenience sample was taken of adult patients hospitalized in the period from 1 August 2015 to 31 October 2016. Clinical and burn data were collected, and serial intra-abdominal pressure measurements taken. The significance level used was 5%. Results A total of 46 patients were analyzed. Of these, 38 patients developed intra-abdominal hypertension (82.6%). The median increase in intra-abdominal pressure was 15.0mmHg (interquartile range: 12.0 to 19.0). Thirty-two patients (69.9%) developed acute kidney injury. The median time to development of acute kidney injury was 3 days (interquartile range: 1 - 7). The individual analysis of risk factors for acute kidney injury indicated an association with intra-abdominal hypertension (p = 0.041), use of glycopeptides (p = 0.001), use of vasopressors (p = 0.001) and use of mechanical ventilation (p = 0.006). Acute kidney injury was demonstrated to have an association with increased 30-day mortality (log-rank, p = 0.009). Conclusion Intra-abdominal hypertension occurred in most patients, predominantly in grades I and II. The identified risk factors for the occurrence of acute kidney injury were intra-abdominal hypertension and use of glycopeptides, vasopressors and mechanical ventilation. Acute kidney injury was associated with increased 30-day mortality. PMID:29513889

  18. Determinants of the Lethal Area 50 Index (LA50) in Burn Patients Admitted to a Tertiary Referral Burn Center in Southern Iran

    Science.gov (United States)

    Keshavarzi, Abdolkhalegh; Kardeh, Sina; Pourdavood, Amirhosein; Mohamadpour, Mana; Dehghankhalili, Maryam

    2018-01-01

    Objective: To evaluate the lethal area 50 (LA50) and determinants of mortality in burn patients admitted to a single burn center. Methods: This retrospective cross-sectional study was conducted in a tertiary burn center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, during a 1-year period from 2015 to 2016. To determine prognostic factors in fatal burns, medical records of eligible burn patients were reviewed for demographic and clinical variables, as well as patient outcome. Also, LA50 was calculated using Probit analysis. Results: Overall 559 patients with the mean age of 27.2±23.65 years and including 343 (61.4%) males and 216 (38.6%) females were enrolled in this study. The average burn TBSA% was 31.38±24.41% (1-100%). Duration of hospital stay ranged from 1 to 67 days (15.11±10.64). With 93 expired patients, the mortality rate was calculated to be 16.6%. The total LA50 was 66.55% (58.4-79.3). Fire was the most common cause of burn injury. Conclusion: Compared to developed countries, in our burn center the LA50 and survival rate of burn patients are lower. This indicates an urgent need for prompt attention in order to improve current policies regarding this public health issue to reduce mortality. PMID:29379811

  19. A randomized control trial measuring the effectiveness of a mouth-exercising device for mucosal burning in oral submucous fibrosis.

    Science.gov (United States)

    Patil, Pravinkumar G; Hazarey, Vinay; Chaudhari, Rekha; Nimbalkar-Patil, Smita

    2016-12-01

    To evaluate effect of ice-cream stick exercise regimen with or without a mouth-exercising device (MED) on mucosal burning sensation in oral submucous fibrosis. In total, 282 patients with oral submucous fibrosis were treated with topical corticosteroid and oral antioxidant and the ice-cream stick exercise regimen. Patients in subgroups A1, A2, and A3 were additionally given a new MED. Patients in subgroups A1 and B1 patients with interincisal distance (IID) of 20 to 35 mm were managed without any additional therapy; patients in subgroups A2 and B2 with IID of 20 to 35 mm were additionally managed with intralesional injections; and those in subgroups A3 and B3 with IID less than 20 mm were managed surgically. Subjective evaluation of decrease in the oral mucosal burning was measured on a visual analogue scale (VAS). Analysis of variance and Tukey's multiple post hoc analysis were carried out to present the results. Patients using the MED, that is, subgroups A1, A2, and A3, showed reduction in burning sensation in the range of 64.8% to 71.1% and 27.8% to 30.9%, whereas in subgroups B1, B2, and B3, reduction in burning sensation ranged from 64.7% to 69.9% and from 29.3% to 38.6% after 6 months. The wo-way analysis of variance indicated statistically significant results in changes in initial VAS scores to 6-monthly VAS scores between MED users and non-MED users. The MED helps to enhance the rate of reduction of mucosal burning sensation, in addition to the conventional ice-cream stick regimen, as an adjunct to local and surgical treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Characterization of Burning Mouth Syndrome in Patients with Parkinson's Disease.

    Science.gov (United States)

    Bonenfant, David; Rompré, Pierre H; Rei, Nathalie; Jodoin, Nicolas; Soland, Valerie Lynn; Rey, Veronica; Brefel-Courbon, Christine; Ory-Magne, Fabienne; Rascol, Olivier; Blanchet, Pierre J

    2016-01-01

    To determine the prevalence and characteristics of burning mouth syndrome (BMS) in a Parkinson's disease (PD) population through a self-administered, custom-made survey. A total of 218 surveys were collected during regular outpatient visits at two Movement Disorders Clinics in Montreal (Canada) and Toulouse (France) to gather information about pain experience, PD-related symptoms, and oral and general health. A neurologist confirmed the diagnosis of PD, drug treatment, Hoehn-Yahr stage, and Schwab & England Activity of Daily Living score. Data between groups were compared using the independent samples Mann-Whitney U test and two-sided exact Fisher test. Data from 203 surveys were analyzed. BMS was reported by eight subjects (seven females and one male), resulting in a prevalence of 4.0% (95% confidence interval [CI] = 2.1-7.8). Five participants with chronic nonburning oral pain were excluded. PD severity and levodopa equivalent daily dose did not differ between non-BMS and BMS participants. Mean poor oral health index was higher in BMS compared to non-BMS subjects (49.0 vs 32.2 points, P < .05). BMS manifested after PD onset in seven patients, did not occur on a daily basis in four, and always coexisted with restless legs syndrome. This survey yielded a low prevalence of BMS in PD patients, indicating no strong link between the two conditions. An augmenting effect such as that resulting from drug treatment in restless legs syndrome or sensory neuropathy cannot be excluded.

  1. Validation of the Perceived Stigmatization Questionnaire for Brazilian adult burn patients.

    Science.gov (United States)

    Freitas, Noélle de Oliveira; Forero, Carlos García; Caltran, Marina Paes; Alonso, Jordi; Dantas, Rosana A Spadoti; Piccolo, Monica Sarto; Farina, Jayme Adriano; Lawrence, John W; Rossi, Lidia A

    2018-01-01

    Currently, there is no questionnaire to assess perceived stigmatization among people with visible differences in Brazil. The Perceived Stigmatization Questionnaire (PSQ), developed in the United States, is a valid instrument to assess the perception of stigmatizing behaviours among burn survivors. The objective of this cross-sectional and multicentre study was to assess the factor structure, reliability and validity of the Brazilian Portuguese version of the PSQ in burn patients. A Brazilian version of the 21-item PSQ was answered by 240 adult burn patients, undergoing rehabilitation in two burns units in Brazil. We tested its construct validity by correlating PSQ scores with depression (Beck Depression Index-BDI) and self-esteem (Rosenberg Self-Esteem Scale-RSE), as well as with two domains of the Revised Burn Specific Health Scale-BSHS-R: affect and body image, and interpersonal relationships. We used Confirmatory Item Factor Analysis (CIFA) to test whether the data fit a measurement model involving a three-factor structure (absence of friendly behaviour; confusing/staring behaviour; and hostile behaviour). We conducted Exploratory Factor Analyses (EFA) of the subscale in a 50% random sample of individuals (training split), treating items as ordinal categorical using unweighted least squares estimation. To assess discriminant validity of the Brazilian version of the PSQ we correlated PSQ scores with known groups (sex, total body surface area burned, and visibility of the scars) and assessed its reliability by means of Cronbach's alpha and using test-retest. Goodness-of-fit indices for confirmatory factor analysis were satisfactory for the PSQ, but not for the hostile behaviour subscale, which was modified to improve fit by eliminating 3 items. Cronbach's alphas for the PSQ refined version (PSQ-R) ranged from 0.65 to 0.88, with test-retest reliability 0.87 for the total score. The PSQ-R scores correlated strongly with depression (0.63; p validity comparable to the

  2. A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns.

    Science.gov (United States)

    Mudawarima, Tapfuma; Chiwaridzo, Matthew; Jelsma, Jennifer; Grimmer, Karen; Muchemwa, Faith Chengetayi

    2017-10-23

    Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves). Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement). Settings = any setting in any country. A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention programmes aimed at improving the function of patients with burns

  3. Increased liver weights in severely burned children: comparison of ultrasound and autopsy measurements.

    Science.gov (United States)

    Barrow, R E; Mlcak, R; Barrow, L N; Hawkins, H K

    2004-09-01

    Hepatomegaly is a common finding at autopsy in severely burned children surviving less than 6 months. This study validates a reliable ultrasound method which can be used to identify changes in liver size in severely burned children during acute hospitalization. Thirty-eight children, age 0.5-17 years with burns covering over 40% of their total surface area were studied at autopsy. Liver weight was measured at autopsy and compared to predicted liver weight for age and height. Eighteen had liver size measured by ultrasound within 10 days of death while five had ultrasound liver measures after death just prior to autopsy. All burned children who survived 7 days or more (n = 33) had liver weights at autopsy that were greater than predicted for age and height while all 23 livers measured by ultrasound were greater than predicted. Autopsy weights correlated well with weights estimated by ultrasound, R = 0.824. At autopsy, those who survived 7 days or more had enlarged livers ranging from 142 to 406% of their predicted normal age and height. Common histologic findings include large and small-droplet fat deposits, and cholestasis. The degree of these histologic abnormalities correlated with the increase in liver weight, R = 0.652. Ultrasound is a valid, noninvasive method for measuring liver weight changes in severely burned children during acute hospitalization. Ninety-five percent of the severely burned children from this institute had significant hepatomegaly identified at autopsy.

  4. [Advances in the research of effects of music therapy on pain and anxiety in burn patients].

    Science.gov (United States)

    Jinyi, Li; Yungui, Wang

    2015-06-01

    Pain and anxiety engender major psychic problems during all phases of treatment for burn patients. Analgesic alone does not allay these problems satisfactorily in these patients. Music therapy, as an important complementary and alternative therapy, has been widely used in multiple medical fields. However, its positive effect on alleviation of pain and anxiety in burn patients is undefined. The objective of this review is to summarize the feasibility, application fields, methods, and the effectiveness of music therapy in allaying pain and anxiety of burn patients during the whole course of treatment.

  5. Management of patients in a dedicated burns intensive care unit (BICU) in a developing country.

    Science.gov (United States)

    Hashmi, Madiha; Kamal, Rehana

    2013-05-01

    In Pakistan the practice of managing extensive burns in dedicated intensive care units is not well established. This audit aims to define the characteristics of the victims of major burns and factors that increase mortality and outcome of the protocol-based management in a dedicated burns intensive care unit (BICU). This prospective audit included all patients admitted to the BICU of Suleiman Dawood Burns Unit in Karachi from 1st September 2002 to 31st August 2011. Demographic information, type and place of burn, total body surface area burn (TBSA), type of organ support provided, length of ICU stay, any associated medical diseases, and out outcome were documented. A total of 1597 patients were admitted to the BICU in 9 years. Median age of the patients was 22 (IQR =32-7). 32% victims were children 50 years old. Male to female ratio was 1.4:1. Fire was the leading cause of burns in adults (64%) and scald burns were most common in (64%) in children. 72.4% of the accidents happened at home, where kitchen was the commonest location (597 cases). Mean TBSA burnt was 32.5% (SD ± 22.95%, 95%CI: 31.36-33.61). 27% patients needed ventilatory support, 4% were dialyzed and split skin graftings were performed in 20% patients. Average length of ICU stay was 10.42 days. Epilepsy, psychiatric illness and drug addiction were not common associations with burns. Overall mortality was 41.30% but it decreased over the years from 75% to 27%. Groups of people most vulnerable to sustain burn are young females getting burnt in the kitchen, young males getting burnt at work, and small children falling in pots of hot water stored for drinking or bathing. TBSA >40%, age >50 years, fire burn and female gender were associated with a higher risk of death. Carefully planned, protocol based management of burn patients by burn teams of dedicated healthcare professionals, even with limited resources reduced mortality. Burn hazard awareness, prevention and educational programmes targeted at the

  6. Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

    Directory of Open Access Journals (Sweden)

    Edrisa Sanyang

    2017-07-01

    Full Text Available Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs, where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB, depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51% of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4% were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2% had body area surface burned (BSAB of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62, those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57, or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23 had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively were less likely to have BSAB ≥ 20% than adults. Those burned in a

  7. 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 ...

  8. Prescription pattern of anxiolytic drugs in burn patients: a case study ...

    African Journals Online (AJOL)

    Anxiolytic drugs are essential in the management of cases where anxiety and insomnia are likely to be found. This study was therefore carried out to determine the prescription pattern of these drugs on burn patients and to ascertain their relevance in burn therapy. The study was carried out retrospectively by evaluating ...

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

    Science.gov (United States)

    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 referred to Ghotbeddin Burn Hospital, Shiraz, Iran. Among them, 55 MBL-producing P. aeruginosa strains were isolated from 55 patients hospitalized in burn unit. Minimum inhibitory concentrations (MICs) and MBLs were determined by the E-test method. Results: Of the 55 burn cases, 29 (53%) were females and 26 (47%) males. Injured burn patients’ ages ranged from 16 to 87 years, with maximum number of cases in the age group of 16 to 36 years (n, 40; 72.7%). Overall, 32 cases were accidental (60%), and 22 were suicidal burns (40%). Of the 55 burn patients, 17 cases were expired (30%). All deaths were due to chemical exposures. In antibiotic susceptibility testing by E-test method, ceftazidime was the most effective one and 35 isolates (63.5%) were resistant to all the 11 tested antibiotics. Conclusions: Routine microbiological surveillance and careful in vitro testing of antibiotics prior to prescription and strict adherence to hospital antibiotic policy may help to prevent, treat, and control MDR and pandrug-resistant (PDR) P. aeruginosa strains in burn units. PMID:25147779

  10. Analysis of intra-abdominal hypertension in severe burned patients: the Vall d'Hebron experience.

    Science.gov (United States)

    Ruiz-Castilla, M; Barret, J P; Sanz, D; Aguilera, J; Serracanta, J; García, V; Collado, J M

    2014-06-01

    Although severely burned patients are at a high risk of developing intra-abdominal hypertension (IAH: IAP>12 mmHg) and Abdominal Compartment Syndrome (ACS) (IAP ≥ 20 mmHg), few data about its incidence and prevalence is available. Our aim was to determine the incidence and prevalence of IAH and ACS in patients with severe burns in our geographical setting. A pilot prospective, observational study was performed at the Burns Unit of the Plastic Surgery Department in Vall d'Hebron University Hospital (Barcelona), during a 12-month period. All patients with age ≥ 18 years old and burns >20% of the total body surface area (TBSA) were considered for inclusion. Patients who did not require urinary catheterization via the urethra were excluded. All patients included were followed during the first five days from their admission. Results are expressed as median (interquartile range) or frequency (percentage). During the study period, 303 patients were admitted to the Burns Unit. Twenty-five patients were included in the study (21 [84%] male, 4 [16%] female; age 42 [30-69 years]; TBSA burned 33 [25-58]%; all patients presented deep second-degree and/or third-degree burns). Eighteen (72%) patients met criteria for IAH, but only one (4%) developed ACS. The incidence of IAH and ACS was 0.56 and 0.04 cases/patient-day, respectively. Patients with IAH presented higher number of organs failure (2 [0-2.2] vs 0 [0-0]; p = 0.03). Patients with >20% TBSA burned presented a very high prevalence of IAH. Development of organ failure occurred even at moderately increased values of IAP. In this scenario, monitoring of IAP is the first step for establishing the importance of IAH/ACS in this patient population. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  11. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2016-10-01

    with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1...Texas burn centers to submit data on nutritional provision in the burn ICU that would be analysed for gaps, and control theory algorithms applied to...complications such as high gastric residuals or hypotension . We may also find other unexpected gaps which will be included in further analyses. We then

  12. Propofol clearance and volume of distribution are increased in patients with major burns.

    Science.gov (United States)

    Han, Tae-Hyung; Greenblatt, David J; Martyn, J A Jeevendra

    2009-07-01

    Propofol pharmacokinetics were examined in 17 adults with major burns during the hyperdynamic convalescent phase. Eighteen nonburned surgical patients served as controls. After a 2-mg/kg intravenous dose of propofol, blood samples were collected at multiple time points. Noncompartmental methods were used to calculate the pharmacokinetic parameters. The following indices were higher in burns than controls: propofol clearance (64+/-17 vs 29+/-4 mL/kg/min, Pclearance of propofol in burned patients may imply that these patients require higher doses or infusion rates of propofol to attain a target plasma concentration or pharmacodynamic effect.

  13. 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

    2015-05-01

    Pulmonary abnormalities occur in 30-80% of fatalities after burn. The objective of our study is to investigate lung pathology in autopsy tissues of pediatric burn patients. 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 to 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. 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). 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. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  14. Frequency of burning mouth and subjective xerostomia in patients with diabetes mellitus type 2

    Directory of Open Access Journals (Sweden)

    M. Salehi

    2017-12-01

    Full Text Available Background: Diabetes mellitus is a common chronic metabolic disease which have numerous physical effects for patients. Objective: The aim of this study was to determine the prevalence of subjective xerostomia and burning mouth of patients with type 2 diabetes mellitus in cities of Sari and Qaemshahr. Methods: In this descriptive-analytic study, totally 1455 patients with type 2 diabetes mellitus with complain of xerostomia and/or burning mouth which had referred to diabetes clinic in Sari and Qaemshahr were examined in 2016. For every patient asked about chronic xerostomia and burning mouth and if the answer was positive, the oral examination was done to ensure the absence of mucosal lesions and find signs of xerostomia. Then, xerostomia questionnaire was completed by patients suffering from dry mouth. Finally, the information was statistically analyzed by T test and chi square test. Findings: Prevalence of burning mouth was found 111 (7.6% in diabetic patients that in the women were significantly higher than in men (P<0.0001. Prevalence of xerstomia patients was found 239 (16.4% that was not significant between the male and female. There was a significant correlation between burning mouth and xerostomia with FBS and HbA1c in diabetic patients (P<0.0001. Conclusion: Possibility of burning mouth, and xerostomia will increase in the diabetic patients with low metabolic control which can cause more severe side effects related to oral health.

  15. Neutron spectrometer for DD/DT burning ratio measurement in fusion experimental reactor

    International Nuclear Information System (INIS)

    Asai, Keisuke; Naoi, Norihiro; Iguchi, Tetsuo; Watanabe, Kenichi; Kawarabayashi, Jun; Nishitani, Takeo

    2006-01-01

    The most feasible fuels for a fusion reactor are D (Deuterium) and T (Tritium). DD and/or DT fusion reaction or nuclear burning reaction provides two kinds of neutrons, DD neutron and DT neutron, respectively. DD/DT burning ratio, which can be estimated by DD/DT neutron ratio in the burning plasma, is essential for burn control, alpha particle emission rate monitoring and tritium fuel cycle estimation. Here we propose a new neutron spectrometer for the absolute DD/DT burning ratio measurement. The system consists of a Proton Recoil Telescope (PRT) and a Time-of-Flight (TOF) technique. We have conducted preliminary experiments with a prototype detector and a DT neutron beam (φ20 mm) at the Fusion Neutronics Source, Japan Atomic Energy Agency (JAEA), to assess its basic performance. The detection efficiency obtained by the experiment is consistent with the calculation results in PRT, and sufficient energy resolution for the DD/DT neutron discrimination has been achieved in PRT and TOF. The validity of the Monte Carlo calculation has also been confirmed by comparing the experimental results with the calculation results. The design consideration of this system for use in ITER (International Thermonuclear Experimental Reactor) has shown that this system is capable of monitoring the line-integrated DD/DT burning ratio for the plasma core line of sight with the required measurement accuracy of 20% in the upper 4 decades of the ITER operation (fusion power: 100 kW-700 MW). (author)

  16. [Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].

    Science.gov (United States)

    Cheng, Hua; Li, Xiao-jian; Cao, Wen-juan; Chen, Li-ying; Zhang, Zhi; Liu, Zhi-he; Yi, Xian-feng; Lai, Wen

    2013-04-01

    To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients. Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis. (1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders

  17. Soluble urokinase-type plasminogen activator receptor levels in patients with burn injuries and inhalation trauma requiring mechanical ventilation: an observational cohort study

    OpenAIRE

    Backes, Yara; van der Sluijs, Koenraad F; Tuip de Boer, Anita M; Hofstra, Jorrit Jan; Vlaar, Alexander PJ; Determann, Rogier M; Knape, Paul; Mackie, David P; Schultz, Marcus J

    2011-01-01

    Introduction Soluble urokinase-type plasminogen activator receptor (suPAR) has been proposed as a biologic marker of fibrinolysis and inflammation. The aim of this study was to investigate the diagnostic and prognostic value of systemic and pulmonary levels of suPAR in burn patients with inhalation trauma who need mechanical ventilation. Methods suPAR was measured in plasma and nondirected lung-lavage fluid of mechanically ventilated burn patients with inhalation trauma. The samples were obta...

  18. The Acute Respiratory Distress Syndrome (ARDS) in mechanically ventilated burn patients: An analysis of risk factors, clinical features, and outcomes using the Berlin ARDS definition.

    Science.gov (United States)

    Cartotto, Robert; Li, Zeyu; Hanna, Steven; Spano, Stefania; Wood, Donna; Chung, Karen; Camacho, Fernando

    2016-11-01

    The Berlin definition of Acute Respiratory Distress Syndrome (ARDS) has been applied to military burns resulting from combat-related trauma, but has not been widely studied among civilian burns. This study's purpose was to use the Berlin definition to determine the incidence of ARDS, and its associated respiratory morbidity, and mortality among civilian burn patients. Retrospective study of burn patients mechanically ventilated for ≥48h at an American Burn Association-verified burn center. The Berlin criteria identified patients with mild, moderate, and severe ARDS. Logistic regression was used to identify variables predictive of moderate to severe ARDS, and mortality. The outcome measures of interest were duration of mechanical ventilation and in-hospital mortality. Values are shown as the median (Q1-Q3). We included 162 subjects [24% female, age 48 (35-60), % total body surface area (TBSA) burn 28 (19-40), % body surface area (BSA) full thickness (FT) burn 13 (0-30), and 62% with inhalation injury]. The incidence of ARDS was 43%. Patients with ARDS had larger %TBSA burns [30.5 (23.1-47.0) vs. 24.8 (17.1-35), p=0.007], larger FT burns [20.5(5.4-35.5) vs. 7 (0-22.1), p=0.001], but had no significant difference in the incidence of inhalation injury (p=0.216), compared to those without ARDS. The % FT burn predicted the development of moderate to severe ARDS [OR 1.034, 95%CI (1.013-1.055), p=0.001]. ARDS developed in the 1st week after burn in 86% of cases. Worsening severity of ARDS was associated with increased days of mechanical ventilation in survivors (p=0.001), a reduction in ventilator-free days/1st 30 days in all subjects (p=0.004), and a strong indication of increased mortality (0% in mild ARDS vs. 50% in severe ARDS, unadjusted p=0.02). Neither moderate ARDS nor severe ARDS were significant predictors of death. ARDS is common among mechanically ventilated civilian burn patients, and develops early after burn. The extent of full thickness burn predicted

  19. Neuropsychological outcomes of pediatric burn patients who sustained hypoxic episodes.

    Science.gov (United States)

    Rosenberg, Marta; Robertson, Carrie; Murphy, Kevin D; Rosenberg, Laura; Mlcak, Ronald; Robert, Rhonda S; Herndon, David N; Meyer, Walter J

    2005-11-01

    The neuropsychological outcomes of children who suffered hypoxic episodes following their burns are not completely understood and vary depending on the nature and severity of the episode. A retrospective review of youth that were admitted to this acute burn care facility over the past 20 years was conducted to identify the extent of cognitive and affective difficulties. Thirty-nine children who sustained hypoxic injuries related to their burns were compared with 21 controls that were matched for age, TBSA, and time of injury. Approximately a third of the children who survived from the hypoxia group continued to have long-term cognitive and emotional difficulties. For those who recovered reasonably well, no differences were found from the matched burned controls. These results probably underestimate the true extent of neuropsychological difficulties experienced by these youth given that detailed cognitive testing was not routinely performed. Prospective studies are needed to further characterize the full nature of difficulties and outcomes associated with burn related hypoxic injuries.

  20. Intentional injuries and patient survival of burns: a 10-year retrospective cohort in southern Brazil.

    Science.gov (United States)

    Duarte, Daniele Walter; Neumann, Cristina Rolim; Weber, Elisabete Seganfredo

    2015-03-01

    Patients burned intentionally experience extensive injuries with high rates of morbidity and mortality. Nonetheless, there is no consensus if these patients have worse outcomes than unintentional burns considering injury severity and other preexistent comorbidities. We conducted a ten-year retrospective review on all patients treated at the Burn Unit of Hospital de Pronto Socorro, Porto Alegre, Brazil, between 2003 and 2012. The aim was to compare survival of self-inflicted burns and burns from assaults with unintentional injuries using a Multivariable Cox Regression Analysis. 1734 patients were included in the study, 87.7% non-intentional, 6.6% self-inflicted and 5.8% from aggression. Intentional injuries resulted in more severe injuries and were associated with psychiatric disorders and drug abuse. After controlling for injury severity, previous clinical comorbidities and previous psychiatric disorders, only self-inflicted burns correlated significantly with a higher risk of death (HR=1.59, CI 95% 1.05-2.41, p=0.03). Self-inflicted injuries were independently associated with a higher risk of death. Burns from aggression were not associated with higher mortality in this model. Prevention of these injuries must be priority and treating the main associated factors such as drug abuse and psychiatric disorders may lower its occurrence. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  1. Use of the CONUT index as a predictor of integration of cutaneous grafts in burn patients

    Directory of Open Access Journals (Sweden)

    Jaime Aron Garcia-Espinoza

    2017-01-01

    Full Text Available Objective: To present the initial experience of 12 patients with burns treated with cutaneous grafts and to analyse the variables that influence their integration. Materials and Methods: We analysed data from 12 patients seen in a year in the regional hospital of high speciality of Oaxaca. Quantified variables: Age, sex, burned body surface, depth of burn, airway injury, nutritional status by CONUT index, type of graft, development of local infection and days of hospital stay. Results: We included 10 men (83% and 2 women (17% with median age of 28 years, median burned body surface area of 19%, depth: 75% were mixed burns and 25% were third degree; with median time between injury and application of grafts of 13 days, 1 patient presented airway injury and 50% concomitant trauma. Regarding Nutritional Status: Fifty percent had severe malnutrition, 33% moderate and 16% mild. About 67% of the grafts were meshed and 33% intact, the mean integration percentage was 80%, 25% developed local infection and the average length of hospital stay was 21 days. Conclusions: Cutaneous grafts are the definitive treatment of burns, in their integration process influence different factors, including nutritional status. The CONUT index seems to be a useful, safe and widely available tooling in the nutritional assessment of the burned patient and can be related to the percentage of integration of the grafts and the days of hospital stay.

  2. Medical treatment for burn patients with eating disorders: a case report.

    Science.gov (United States)

    Akimoto, Minekatsu; Takeda, Akira; Nagashima, Kazutaka; Uehara, Rie; Nemoto, Mitsuru; Uchinuma, Eiju

    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 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.

  3. 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.

  4. 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.

  5. Tratamento da dor em queimados Tratamiento del dolor en quemados Pain management in burn patients

    Directory of Open Access Journals (Sweden)

    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.

  6. Images of God used by self-injurious burn patients.

    Science.gov (United States)

    Grossoehme, D H; Springer, L S

    1999-08-01

    Suicide by burning and other forms of self-injurious behaviors which involve burning are sometimes considered to have religious overtones. The ritual death of widows upon their husband's funeral pyre is closely associated with Hindu beliefs. Buddhists have used self-immolation as a form of protest. The Judaeo-Christian traditions have imagery of fire as cleansing and purifying; there is also secular imagery associating fire with images of condemnation and evil. Previous studies have described religiosity as a common theme among survivors. The present study describes the ways in which persons who inflicted self-injurious behaviors through burning, including attempted suicide, imagine the Divinity and use religious language to give meaning to their experience.

  7. Development of a Conceptual Framework to Measure the Social Impact of Burns.

    Science.gov (United States)

    Marino, Molly; Soley-Bori, Marina; Jette, Alan M; Slavin, Mary D; Ryan, Colleen M; Schneider, Jeffrey C; Resnik, Linda; Acton, Amy; Amaya, Flor; Rossi, Melinda; Soria-Saucedo, Rene; Kazis, Lewis E

    Measuring community reintegration following burn injury is important to assess the efficacy of therapies designed to optimize recovery. This project aims to develop and validate a conceptual framework for understanding the social impact of burn injuries in adults. The framework is critical for developing the item banks used for a computerized adaptive test. We performed a comprehensive literature review and consulted with clinical experts and burn survivors about social life areas impacted by burn injury. Focus groups with burn survivors and clinicians were conducted to inform and validate the framework. Transcripts were coded using grounded theory methodology. The World Health Organization's International Classification of Functioning, Disability and Health, was chosen to ground the content model. The primary construct identified was social participation, which contains two concepts: societal role and personal relationships. The subdomains chosen for item development were work, recreation and leisure, relating with strangers, and romantic, sexual, family, and informal relationships. Qualitative results strongly suggest that the conceptual model fits the constructs for societal role and personal relationships with the respective subdomains. This conceptual framework has guided the implementation of a large-scale calibration study currently underway which will lead to a computerized adaptive test for monitoring the social impacts of burn injuries during recovery.

  8. Measurement of volatiles, semi-volatiles and heavy metals in an oil burn test

    International Nuclear Information System (INIS)

    Li, K.; Caron, T.; Landriault, M.; Pare, J.R.J.; Fingas, M.

    1992-01-01

    Tests involving meso-scale burning of Louisiana crude oil were conducted, and during each burn, extensive samples were taken from the oil, residue, and the smoke plume. The detailed analytical work employed to obtain and analyze the burn samples is outlined and discussed. The analytical parameters included volatiles and semi-volatiles of environmental interests as well as heavy metals typically contained in the starting crude oil. Because the smoke plume did not always impinge on the samplers, the ground samplers did not collect sufficient samples for a definitive analysis. Crude/residue analyses showed the burn resulted in a significant reduction of polycyclic aromatic hydrocarbons (PAH) in the original oil. Most of the reduction was thought to be simply evaporation or destruction from combustion. The residue did not have the degree of enrichment of the higher molecular weight PAHs as was the case in bench-scale burn experiments. Volatile organic compound and dioxin/furan measurements likewise did not show high levels of contamination from the burn itself. Most of the elevated levels of contaminants could probably be due to evaporation of the oil itself. Insufficient sampling was conducted to investigate the background levels from the weathering process. A novel means of sampling using a small remote controlled helicopter was attempted and sufficiently interesting results were obtained to indicate the potential of this passive sampling device for future work. 5 refs., 4 figs

  9. Measurements of the laminar burning velocity of hydrogen-air premixed flames

    Energy Technology Data Exchange (ETDEWEB)

    Pareja, Jhon; Burbano, Hugo J. [Science and Technology of Gases and Rational Use of Energy Group, Faculty of Engineering, University of Antioquia, Calle 67 N 53, 108 Bloque 20, 447 Medellin (Colombia); Ogami, Yasuhiro [Institute of Fluid Science, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi 980-8577 (Japan)

    2010-02-15

    Experimental and numerical studies on laminar burning velocities of hydrogen-air mixtures were performed at standard pressure and room temperature varying the equivalence ratio from 0.8 to 3.0. The flames were generated using a contoured slot-type nozzle burner (4 mm x 10 mm). Measurements of laminar burning velocity were conducted using particle tracking velocimetry (PTV) combined with Schlieren photography. This technique provides the information of instantaneous local burning velocities in the whole region of the flame front, and laminar burning velocities were determined using the mean value of local burning velocities in the region of non-stretch. Additionally, average laminar burning velocities were determined using the angle method and compared with the data obtained with the PTV method. Numerical calculations were also conducted using detailed reaction mechanisms and transport properties. The experimental results from the PTV method are in good agreement with the numerical results at every equivalence ratio of the range of study. Differences between the results obtained with the angle method and those with the PTV method are reasonably small when the effects of flame stretch and curvature are reduced by using a contoured slot-type nozzle. (author)

  10. Eccrine syringofibroadenoma in a patient with a burn scar ulcer.

    Science.gov (United States)

    Ichikawa, E; Fujisawa, Y; Tateishi, Y; Imakado, S; Otsuka, F

    2000-09-01

    A 72-year-old woman with a burn scar on the calves of both legs developed an ulcer on her right heel, surrounded by multiple verrucous nodules and plaques. She had experienced similar verrucous lesions on both legs in the burn scar areas. Although the clinical diagnosis was Marjolin's ulcer, histologically the ulcer region showed thick fibrous tissue without any atypical epithelial cells. The verrucous lesions were consistent with the diagnosis of eccrine syringofibroadenoma (ESFA). Moreover, an ESFA-like growth pattern was seen in the elevated margin of the ulcer. Our findings suggest that these lesions developed as a result of reactive eccrine duct hyperplasia followed by skin tissue remodelling.

  11. 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...

  12. Gap analysis of pharmacokinetics and pharmacodynamics in burn patients: a review.

    Science.gov (United States)

    Steele, Amanda N; Grimsrud, Kristin N; Sen, Soman; Palmieri, Tina L; Greenhalgh, David G; Tran, Nam K

    2015-01-01

    Severe burn injury results in a multifaceted physiological response that significantly alters drug pharmacokinetics and pharmacodynamics (PK/PD). This response includes hypovolemia, increased vascular permeability, increased interstitial hydrostatic pressure, vasodilation, and hypermetabolism. These physiologic alterations impact drug distribution and excretion-thus varying the drug therapeutic effect on the body or microorganism. To this end, in order to optimize critical care for the burn population it is essential to understand how burn injury alters PK/PD parameters. The purpose of this article is to describe the relationship between burn injury and drug PK/PD. We conducted a literature review via PubMed and Google to identify burn-related PK/PD studies. Search parameters included "pharmacokinetics," "pharmacodynamics," and "burns." Based on our search parameters, we located 38 articles that studied PK/PD parameters specifically in burns. Twenty-seven articles investigated PK/PD of antibiotics, 10 assessed analgesics and sedatives, and one article researched an antacid. Out of the 37 articles, there were 19 different software programs used and eight different control groups. The mechanisms behind alterations in PK/PD in burns remain poorly understood. Dosing techniques must be adapted based on burn injury-related changes in PK/PD parameters in order to ensure drug efficacy. Although several PK/PD studies have been undertaken in the burn population, there is wide variation in the analytical techniques, software, and study sample sizes used. In order to refine dosing techniques in burns and consequently improve patient outcomes, there must be harmonization among PK/PD analyses.

  13. Whole body protein kinetics measured with a non-invasive method in severely burned children.

    Science.gov (United States)

    Børsheim, Elisabet; Chinkes, David L; McEntire, Serina J; Rodriguez, Nancy R; Herndon, David N; Suman, Oscar E

    2010-11-01

    Persistent and extensive skeletal muscle catabolism is characteristic of severe burns. Whole body protein metabolism, an important component of this process, has not been measured in burned children during the long-term convalescent period. The aim of this study was to measure whole body protein turnover in burned children at discharge (95% healed) and in healthy controls by a non-invasive stable isotope method. Nine burned children (7 boys, 2 girls; 54±14 (S.D.)% total body area burned; 13±4 years; 45±20 kg; 154±14 cm) and 12 healthy children (8 boys, 4 girls; 12±3 years; 54±16 kg; 150±22 cm) were studied. A single oral dose of (15)N-alanine (16 mg/kg) was given, and thereafter urine was collected for 34 h. Whole body protein flux was calculated from labeling of urinary urea nitrogen. Then, protein synthesis was calculated as protein flux minus excretion, and protein breakdown as flux minus intake. At discharge, total protein turnover was 4.53±0.65 (S.E.)g kg body weight(-1) day(-1) in the burned children compared to 3.20±0.22 g kg(-1) day(-1) in controls (P=0.02). Expressed relative to lean body mass (LBM), the rates were 6.12±0.94 vs. 4.60±0.36 g kg LBM(-1) day(-1) in burn vs. healthy (P=0.06). Total protein synthesis was also elevated in burned vs. healthy children, and a tendency for elevated protein breakdown was observed. Total protein turnover is elevated in burned children at discharge compared to age-matched controls, possibly reflecting the continued stress response to severe burn. The oral (15)N-alanine bolus method is a convenient, non-invasive, and no-risk method for measurement of total body protein turnover. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  14. [Nosocomial infection due to Trichosporon asahii in a critical burned patient].

    Science.gov (United States)

    Tamayo Lomas, Luis; Domínguez-Gil González, Marta; Martín Luengo, Ana Isabel; Eiros Bouza, José María; Piqueras Pérez, José María

    2015-01-01

    Invasive fungal infection is an important cause of morbimortality in patients with severe burns. The advances in burn care therapy have considerably extended the survival of seriously burned patients, exposing them to infectious complications, notably fungal infections, with increased recognition of invasive infections caused by Candida species. However, some opportunistic fungi, like Trichosporon asahii, have emerged as important causes of nosocomial infection. A case of nosocomial infection due to T. asahii in a severely ill burned patient successfully treated with voriconazole is presented. The management of invasive fungal infections in burned patients, from diagnosis to selection of the therapeutic protocol, is often a challenge. Early diagnosis and treatment are associated with a better prognosis. In this case report, current treatment options are discussed, and a review of previously published cases is presented. Due to the difficulty in the diagnosis of invasive mycoses and their high associated mortality rates, it is advisable to keep a high degree of clinical suspicion of trichosporonosis in susceptible patients, including burned patients. The isolation of T. asahii in clinical specimens of this type of host must raise clinical alert, since it may precede an invasive infection. Copyright © 2014 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  15. An appraisal of antibiotic sensitivity pattern and drug utilization in burn patients

    Directory of Open Access Journals (Sweden)

    Janki Raj Chauhan

    2016-01-01

    Full Text Available Aim: To analyze the antibiotic sensitivity and resistance pattern and antibiotic consumption in defined daily dose (DDD/100 bed days (BD. Materials and Methods: Burns patients admitted from January 2013 to December 2013 were identified retrospectively from medical record department registry using the International Classification of Diseases-(ICD Codes T 30.1-39.9. Patient demographics, total body surface area (TBSA of burn, treatment chart, hospitalization days, and antibiotic sensitivity/resistance profile were recorded. Cumulative sensitivity/resistance pattern of isolated microorganisms against various antibiotics was calculated (in percentage from culture sensitivity reports. Total use of antibiotics in burn patients was calculated as DDD/100 BD using antibiotic consumption calculator-WHO ABC Calc version 3.1. Results: Of total 159 burn patients, the main cause of burns in these patients was thermal (81.8%. Cefoperazone-sulbactam (54.7% was the most frequently prescribed antibiotic followed by amoxicillin-clavulanic acid (34%. Totally, 82 bacterial isolates were obtained, among which Pseudomonas aeruginosa (31.6% was the most common organism. P. aeruginosa was sensitive to rifampicin and erythromycin but resistant to clindamycin. The DDD/100 BD was highest for parenteral cefoperazone (40.21. Conclusion: Proper antibiogram and DDD will facilitate conceptualizing and developing drug policies for improved patient outcomes in burns.

  16. Measurements and correlations of turbulent burning velocities over wide ranges of fuels and elevated pressures

    KAUST Repository

    Bradley, Derek

    2013-01-01

    The implosion technique has been used to extend measurements of turbulent burning velocities over greater ranges of fuels and pressures. Measurements have been made up to 3.5 MPa and at strain rate Markstein numbers as low as 23. The implosion technique, with spark ignition at two opposite wall positions within a fan-stirred spherical bomb is capable of measuring turbulent burning velocities, at higher pressures than is possible with central ignition. Pressure records and schlieren high speed photography define the rate of burning and the smoothed area of the flame front. The first aim of the study was to extend the previous measurements with ethanol and propane-air, with further measurements over wider ranges of fuels and equivalence ratios with mixtures of hydrogen, methane, 10% hydrogen-90% methane, toluene, and i-octane, with air. The second aim was to study further the low turbulence regime in which turbulent burning co-exists with laminar flame instabilities. Correlations are presented of turbulent burning velocity normalised by the effective rms turbulent velocity acting on the flame front, ut=u0k , with the Karlovitz stretch factor, K, for different strain rate Markstein numbers, a decrease in which increases ut=u0k . Experimental correlations are presented for the present measurements, combined with previous ones. Different burning regimes are also identified, extending from that of mixed turbulence/laminar instability at low values of K to that at high values of K, in which ut=u0k is gradually reduced due to increasing localised flame extinctions. © 2012 The Combustion Institute.

  17. Comparison of two-dimensional methods versus three-dimensional scanning systems in the assessment of total body surface area estimation in burn patients.

    Science.gov (United States)

    Retrouvey, Helene; Chan, Justin; Shahrokhi, Shahriar

    2018-02-01

    Accurate measurement of percent total body surface area (%TBSA) burn is crucial in the management of burn patients for calculating the estimated fluid resuscitation, determining the need to transfer to a specialized burn unit and probability of mortality. %TBSA can be estimated using many methods, all of which are relatively inaccurate. Three-dimensional (3D) systems have been developed to improve %TBSA calculation and consequently optimize clinical decision-making. The objective of this study was to compare the accuracy of percent total burn surface area calculation by conventional methods against novel 3D methods. This prospective cohort study included all acute burn patients admitted in 2016 who consented to participate. The staff burn surgeon determined the %TBSA using conventional methods. In parallel, a researcher determined 3D %TBSA using the BurnCase 3D program (RISC Software GmbH, Hagenberg, Austria). Demographic data and injury characteristics were also collected. Wilcoxon Signed Rank test was used to determine differences between each measure of %TBSA, with assessment of the influence of body mass index (BMI) and gender on accuracy. Thirty-five patients were included in the study (6 female and 29 male). Average age was 47.5 years, with a median BMI of 26.6kg/m 2 . %TBSA determined by BurnCase 3D program was statistically significantly different from conventional %TBSA assessment (p=0.007), with the %TBSA measured using Burn Case 3D being lower than the %TBSA determined using conventional means (Lund and Browder Diagram) by 1.3% (inter-quartile range -0.6% to 5.6%). BMI and gender did not have an impact on the estimation of the %TBSA. The BurnCase 3D program underestimated %TBSA by 1.3%, as compared to conventional methods. Although statistically significant, this difference is not clinically significant as it has minimal impact on fluid resuscitation and on the decision to transfer a patient to a burn unit. 3D %TBSA evaluation systems are valid tools to

  18. Scald burns in young children--a review of Arizona burn center pediatric patients and a proposal for prevention in the Hispanic community.

    Science.gov (United States)

    Rimmer, Ruth B; Weigand, Shannon; Foster, Kevin N; Wadsworth, Michelle M; Jacober, Katie; Matthews, Marc R; Drachman, David; Caruso, Daniel M

    2008-01-01

    Arizona Burn Center staff observed an increasing number of pediatric scald burn admissions. Therefore, a retrospective study was conducted to identify scald demographics and etiologies. Focus groups were subsequently conducted to determine burn prevention knowledge in the target community. Arizona Burn Center scald admission variables (ages 0-5 years) reviewed included age, sex, ethnicity, TBSA, body parts burned, occurrence month and location, caregiver present, child and caregiver activities when injured, payor source, length of stay, parental language, and zip code. High-risk zip code area focus groups were then conducted. There were a total of 170 pediatric patients, aged 0 to 5 years, admitted to the burn center during 2005 to 2006. Of this total, 124 of the patients were admitted for scald burns, accounting for 59% of all pediatric burn admissions. Scald burn patient's demographics included male (52%), female (48%) with a mean age of 1.7 years. Majority ethnicity was Hispanic (63%). The mean TBSA was 8% with mean length of stay of 8 days. The remaining pediatric admissions for children aged 0 to 5 were for burns caused by fire or flame 15%, contact with a hot object 13%, friction burns 7%, chemical burns 3%, and electrical burns 3%. Demographics for the combined etiologies included an identical sex breakdown with male (52%) and female (48%). The majority ethnicity in the nonscald group was also Hispanic at 59% with a mean length of stay of 7 days and an average TBSA of 9.5%. Main etiologies of scald burns included hot water (25%), soup (24%), and coffee or tea (21%). Most common child behaviors were pulling hot substance from stove (24%), from countertop (13%), and having liquid spilled on them (13%) typically while caregiver was cooking. Mean TBSA was 8% with mean length of stay (8 days). Scalds occurred in the kitchen (83%) and mainly in child's home (94%). Mother was primary caregiver (78%). Payor source was Medicaid (86%) and the average admission cost

  19. Persistent lactic acidosis after chronic topical application of silver sulfadiazine in a pediatric burn patient: a review of the literature.

    Science.gov (United States)

    Willis, Monte S; Cairns, Bruce A; Purdy, Ashley; Bortsov, Andrey V; Jones, Samuel W; Ortiz-Pujols, Shiara M; Willis, Tina M Schade; Joyner, Benny L

    2013-01-01

    A 3-year old male who sustained 2(nd) and 3(rd) 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-propylene glycol. Previous studies have implicated the propylene glycol emulsifier in the silver sulfadiazine that was being applied to his skin as a rare cause of lactic acidosis in severely burned patients. Within 24 hours of stopping the silver sulfadiazine therapy, his lactic acidosis and osmol gap resolved; within 72 hours his metabolic acidosis resolved. Silver sulfadiazine is commonly used adjunct therapy in the treatment of 2(nd) and 3(rd) degree burns and generally has few adverse reactions. The absorption of propylene glycol systemically can rarely occur when applied to extensive burns, presumably due to the disruption of the skin barrier; the half-life of PG is 10 hours and can be prolonged with renal disease because ~50% of the sulfadiazine is excreted in the urine unchanged. When propylene glycol is present systemically, it is metabolized to lactic acid in the liver, which can cause a lactic acidosis. Several commonly used drugs also use propylene glycol as an emulsifier, including IV preparations of lorazepam, pentobarbital, phenobarbital, and phenytoin. In all of these clinical scenarios, including severe burn patients that are being treated with silver sulfadiazine, both lactic acid and propylene glycol levels should be measured to monitor for this rare, potentially serious co-morbidity.

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

    International Nuclear Information System (INIS)

    Sabry, Alaa; Wafa Ihab; Eldin Ahmed Bahaa; ElHadidy AlModdather; Hassan, Mohammed

    2009-01-01

    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)

  1. A Retrospective Analysis of Clinical Laboratory Interferences Caused by Frequently Administered Medications in Burn Patients.

    Science.gov (United States)

    Godwin, Zachary; Lima, Kelly; Greenhalgh, David; Palmieri, Tina; Sen, Soman; Tran, Nam K

    2016-01-01

    The goal of this study is to quantify the number of medications administered to burn patients and identify potential drugs interfering with laboratory testing. The authors reviewed the medical records of 12 adult (age ≥ 18 years) burn patients with more than 20% TBSA burns from an existing glucose control database at our institution. Dose, interval, and route of medications administered from admission to discontinuation of intensive insulin therapy were recorded. Interfering drugs were identified based on established clinical chemistry literature. The retrospective cohort of adult burn patients exhibited a mean (SD) age of 37.9 (3.0) years. Mean TBSA burn was 51.3 (9.3)%. Disease severity determined by the average multiple organ dysfunction score was 5.4 (0.2). Mean and median medications administered per day were 42.1 (9.5) and 49 (with a daily range of 0-65), respectively. A total of 666 potential laboratory test interferences caused by medications were identified. There were 261 different effects (eg, increased glucose, decreased potassium). Multiple interferences, 71.0% (475/666), were caused by more than one medication. Investigation of the number of medications administered to a burn patient and delineation of potential laboratory test interferences has not been conducted in burn patients. Given the substantial number of medications administered to burn patients, physicians and laboratory personnel should work together to identify potential interferences and define appropriate countermeasures while enhancing the laboratorians understanding of this unique population. This synergistic partnership can lead to intelligent support tools and potentially autocorrecting instruments.

  2. [A practical method for the calculation of wound water loss in burn patients].

    Science.gov (United States)

    Zhang, Ming-Liang; Wang, Hao; Chen, Hui; Chen, Xu; Zhou, Guang-Feng

    2005-02-01

    To evaluate a calculating method of wound water loss (WWL) in hospitalized burn patients. Eighty-five adult burn patients with total burn area over 50% were enrolled in the study. The WWL formula after shock stage (after 3rd postburn day) was given as: WWL (ml/%/kg/24 h) = [input (ml/24 h)-urine output (ml/24 h)-500 ml] / actual burn wound area(%) / body weight (kg). The result was compared with that determined by other formulas such as Davies, S.M.S.P and Lamke and palm rule. The calculated daily WWL in burn patients after shock stage was found out to be 0.9 +/- 0.1 ml/%/kg/24 h by this method. This figure is comparable with that calculated by several different methods. Palm rule could be simply applied in the patients with body weight around 60 kg. This method and palm rule were proved to be simple and practical for the calculation of WWL in burn patients, which could be applied in clinical work.

  3. Pulmonary failure in geriatric patients with burns: the need for a diagnosis-related group modifier.

    Science.gov (United States)

    Clayton, M C; Solem, L D; Ahrenholz, D H

    1995-01-01

    One hundred eleven patients with burns who were age 60 years or older were treated from January 1984 through December 1992. Twenty-nine patients had pulmonary failure defined as 7 or more days of ventilatory support from the day of burn. The mortality rate for these patients was 41%; only four were discharged to home. The mortality rate for patients without pulmonary failure was 11%. Billing information was analyzed for 102 of the 111 patients. Charges for patients without pulmonary failure were two to three times greater than reimbursement. Charges for patients with pulmonary failure were 4 to 14 times greater than reimbursement. Reimbursement for elderly patients with burns is inadequate. Altering the Diagnosis-Related Group (DRG) definition of extensive burn to reflect the severity of injury in the geriatric population is one step toward reimbursement reform. Patients who require 7 or more days of ventilatory support after burn injury should be reimbursed under a separate DRG category or should have a DRG modifier.

  4. Pulmonary complications in major burn patients: differences in radiologic and clinical findings between inhaled and non-inhaled burn

    International Nuclear Information System (INIS)

    Kim, Jung Sook; Lee, Eil Seong

    2003-01-01

    To analyze differences in the radiologic and clinical findings of pulmonary complications between an inhalation and non-inhalation group of major burn patients, and to apply the findings to the specific diagnosis of pulmonary complications. This study involved 45 major burn patients (18 with inhalation injury, and 27 without) in whom pulmonary complications ensued. Follow-up studies were based on chest radiographs obtained between initial burn day and postburn (PB) 57 (mean, day 27). Types, times of onset, underlying causes, and changes at follow-up study of pulmonary complications between the inhalation and the non-inhalation group were assessed. In the inhalation group, the most frequent complication was air-borne pneumonia (n=7, 395); others were hydrostatic pulmonary edema (n=5, 28%), ARDS (n=5, 28%), atelectasis (n=5, 28%), inhalation pneumonitis (n=3, 17%), pleural effusion (n=3, 17%), and hematogenous pneumonia (n=1, 6%). In the non-inhalation group, airborne pneumonia (n=8, 30%) was also the most common complication; other were hydrostatic edema (n=6, 22%), ARDS (n=5, 19%), atelectasis (n=5, 19%), pleural effusion (n=5, 19%) and hematogenous pneumonia (n=2, 7%). The average times of onset were as follow: for airborne pneumonia, PB day 13.1 (range, 5-27) in the inhalation group, and PB day 21.7 (10-49) in the non-inhalation group; for hematogenous pneumonia, more than one month, regardless of inhalation; for ARDS, PB day 4.9 (2-15) and PB day 13 (7-20) in the inhalation and non-inhalation group, respectively; and for inhalation pneumonitis, PB day 1.7 (1-3). The most common probable cause of ARDS in the inhalation group was inhalation injury (3/5), and in the non-inhalation group, sepsis (4/5). In major burn patients, pulnonary complications differed in terms of their onset time and causes between the inhalation group and the non-inhalation group. In such cases, awareness of the presence or absence of inhalation injury and the onset time of pulmonary

  5. Pulmonary complications in major burn patients: differences in radiologic and clinical findings between inhaled and non-inhaled burn

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Sook; Lee, Eil Seong [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-05-01

    To analyze differences in the radiologic and clinical findings of pulmonary complications between an inhalation and non-inhalation group of major burn patients, and to apply the findings to the specific diagnosis of pulmonary complications. This study involved 45 major burn patients (18 with inhalation injury, and 27 without) in whom pulmonary complications ensued. Follow-up studies were based on chest radiographs obtained between initial burn day and postburn (PB) 57 (mean, day 27). Types, times of onset, underlying causes, and changes at follow-up study of pulmonary complications between the inhalation and the non-inhalation group were assessed. In the inhalation group, the most frequent complication was air-borne pneumonia (n=7, 395); others were hydrostatic pulmonary edema (n=5, 28%), ARDS (n=5, 28%), atelectasis (n=5, 28%), inhalation pneumonitis (n=3, 17%), pleural effusion (n=3, 17%), and hematogenous pneumonia (n=1, 6%). In the non-inhalation group, airborne pneumonia (n=8, 30%) was also the most common complication; other were hydrostatic edema (n=6, 22%), ARDS (n=5, 19%), atelectasis (n=5, 19%), pleural effusion (n=5, 19%) and hematogenous pneumonia (n=2, 7%). The average times of onset were as follow: for airborne pneumonia, PB day 13.1 (range, 5-27) in the inhalation group, and PB day 21.7 (10-49) in the non-inhalation group; for hematogenous pneumonia, more than one month, regardless of inhalation; for ARDS, PB day 4.9 (2-15) and PB day 13 (7-20) in the inhalation and non-inhalation group, respectively; and for inhalation pneumonitis, PB day 1.7 (1-3). The most common probable cause of ARDS in the inhalation group was inhalation injury (3/5), and in the non-inhalation group, sepsis (4/5). In major burn patients, pulnonary complications differed in terms of their onset time and causes between the inhalation group and the non-inhalation group. In such cases, awareness of the presence or absence of inhalation injury and the onset time of pulmonary

  6. Determinants and time to blood transfusion among thermal burn patients admitted to Mulago Hospital.

    Science.gov (United States)

    Kilyewala, C; Alenyo, R; Ssentongo, R

    2017-07-06

    Blood transfusion, a practice under re-evaluation in general, remains common among thermal burn patients due to the hematological alterations associated with burns that manifest as anemia. Today advocacy is for restrictive blood transfusion taking into account individual patient characteristics. We went out to identify the parameters that may determine transfusion requirement and the time to blood transfusion for thermal burn patients in Mulago Hospital in order to build statistics and a basis to standardize future practice and Hospital protocol. 112 patients with thermal burns were enrolled into a prospective cohort study conducted in the Surgical Unit of the Accidents and Emergency Department and Burns Unit of Mulago Hospital. Relevant data on pre-injury, injury and post-injury factors was collected including relevant laboratory investigations and treatment modalities like surgical intervention. Patients were clinically followed up for a maximum period of 28 days and we identified those that were transfused. 22.3% of patients were transfused. The median time to transfusion was 17 days from time of injury and varied with different patient characteristics. The median pre-transfusion hemoglobin (Hb) level was 8.2 g/dL. Transfusion was significantly related to; admission to the intensive care unit (p = 0.001), a body mass index (BMI) 20 (p = 0.049), pre-existing illness (p = 0.046), and white blood cell (WBC) count 12,000/μL (p = 0.05). Pre-existing illnesses, a low BMI, TBSA of >20%, admission to the intensive care unit and abnormalities in the WBC count are useful predictors of blood transfusion among thermal burns patients admitted to Mulago Hospital. The precise time to transfusion from time of burns injury cannot be generalized. With close monitoring of each individual patient lies the appropriateness and timeliness of their management.

  7. The relationship of field burn severity measures to satellite-derived Burned Area Reflectance Classification (BARC) maps

    Science.gov (United States)

    Andrew Hudak; Penelope Morgan; Carter Stone; Pete Robichaud; Terrie Jain; Jess Clark

    2004-01-01

    Preliminary results are presented from ongoing research on spatial variability of fire effects on soils and vegetation from the Black Mountain Two and Cooney Ridge wildfires, which burned in western Montana during the 2003 fire season. Extensive field fractional cover data were sampled to assess the efficacy of quantitative satellite image-derived indicators of burn...

  8. Backyard burning.

    Science.gov (United States)

    Murphy, S M; Davidson, C; Kennedy, A M; Eadie, P A; Lawlor, C

    2008-01-01

    This study was undertaken to determine whether changes had occurred in the numbers of burns that could be related to backyard burning subsequent to the introduction of the council tax throughout Eire for the collection of household refuse. Numbers of patients admitted to our unit who had sustained burns by burning rubbish were recorded prospectively over a period of 12 months. A random control group was taken as three years prior to this and results found by retrospective chart review. Between January and November 2005, 168 patients were admitted to the National Burns Unit, St James's Hospital Dublin, Ireland. Nineteen of these patients sustained flame burns from backyard burning. One hundred and seventy patients were admitted in the comparative period of 2002; Seven of these from backyard burning. The total number of inpatient days for these patients in 2005 (255) was significantly more than in 2002 (68) (p=0.024). The numbers in our study show a marked increase in the number of patients sustaining burns in this manner, and appear to correlate with the introduction of bin charges by a number of county councils around the country last year. This study demonstrates that the introduction of legislation can have an unforeseen adverse affect on the population if not introduced in correlation with appropriate public education. While the introduction of waste charges represents a very necessary move forward in waste disposal in Ireland, public awareness campaigns should be implemented to prevent further such injuries from occurring.

  9. The management of pain associated with wound care in severe burn patients in Spain

    OpenAIRE

    Mendoza, Antonio; Santoyo, Fernando L; Agulló, Alberto; Fenández-Cañamaque, José L; Vivó, Carmen

    2016-01-01

    Objective: To describe the management of pain prevention associated with burn care. Methods: Multi-centre, observational, cross-sectional, descriptive study performed in 4 burn units in Spain. Results: A total of 55 patients undergoing 64 procedures were analysed. Burns were classified as severe (90.4%), third-degree (78.2%) and caused by thermal agents (81.8%). Background analgesia consisted of non-opioid drugs (87.5%) and opioids (54.7%) [morphine (20.3%), morphine and fentanyl (14.1%) or f...

  10. Transepidermal water loss measured with the Tewameter TM300 in burn scars.

    Science.gov (United States)

    Gardien, Kim L M; Baas, Dominique C; de Vet, Henrica C W; Middelkoop, Esther

    2016-11-01

    Transepidermal water loss (TEWL) is a physiological characteristic to measure the efficiency of the skin barrier. The aim was to investigate the reliability of the Tewameter TM300 for the assessment of TEWL (g/m 2 /h) in burn scars. Also the relation between TEWL scar values and scar quality parameters was investigated. Three different study areas (scar, healthy adjacent and contralateral skin) were assessed in 55 adult patients. The intra- and inter-observer reliability were tested using the intra-class correlation coefficient (ICC) and the standard error of measurement (SEM). The inter-observer reliability for the three areas was excellent with ICC values between 0.85 and 0.94. SEM values were between 1.76 and 3.97g/m 2 /h. Bland-Altman plots showed relatively wide LoA values for scar and healthy skin. Mean TEWL scar values were significantly higher than healthy skin (pTewameter TM300 measurements have to be performed according to strict and standardized protocols. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. Assessment of biochemical markers in the early post-burn period for predicting acute kidney injury and mortality in patients with major burn injury: comparison of serum creatinine, serum cystatin-C, plasma and urine neutrophil gelatinase-associated lipocalin.

    Science.gov (United States)

    Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kym, Dohern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Kim, Hyun Soo

    2014-07-14

    The reported mortality rates range from 28% to 100% in burn patients who develop acute kidney injury (AKI) and from 50% to 100% among such patients treated with renal replacement therapy. Recently, the serum cystatin C and plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) levels have been introduced as early biomarkers for AKI; the levels of these biomarkers are known to increase 24 to 48 hours before the serum creatinine levels increase. In this study, we aimed to estimate the diagnostic utility of the cystatin C and plasma and urine NGAL levels in the early post-burn period as biomarkers for predicting AKI and mortality in patients with major burn injuries. From May 2011 to July 2012, 90 consecutive patients with a burn wound area comprising ≥ 20% of the total body surface area (TBSA) were enrolled in this study. Whole blood and urine samples were obtained for measuring the serum creatinine, serum cystatin C, and urine and plasma NGAL levels at 0, 3, 6, 12, 24, and 48 hours after admission. Receiver operating characteristic curve, area under the curve, and multivariate logistic regression analyses were performed to assess the predictive values of these biomarkers for AKI and mortality. In the multivariate logistic regression analysis, all variables, including age, percentage TBSA burned, sex, inhalation injury, and serum creatinine levels, serum cystatin C levels, and plasma and urine NGAL levels were independently associated with AKI development. Moreover, age, sex, percentage TBSA burned, and plasma and urine NGAL levels were independently associated with mortality. However, inhalation injury and the serum creatinine and cystatin C levels were not independently associated with mortality. Massively burned patients who maintained high plasma and urine NGAL levels until 12 hours after admission were at the risk of developing early AKI and early mortality with burn shock. However, the plasma and urine NGAL levels in the early post-burn period

  12. Impact of Extended Spectrum Beta-Lactamase Producing Klebsiella pneumoniae Infections in Severely Burned Patients

    Science.gov (United States)

    2010-09-01

    producing K pneu - moniae are associated with higher mortality when com- pared with non-ESBL-producing isolates, but the exact reason for this is unclear...identify patients with burns admitted to the burn intensive care unit and infected with Klebsiella pneu - moniae, between January 1, 2004 and July 1, 2008...The model was controlled for the presence of EBSL-producing K pneu - moniae at any time during the hospital stay. Variables were entered into the

  13. Acute Resuscitation and Transfer Management of Burned and Electrically Injured Patients,

    Science.gov (United States)

    1994-01-01

    resuscitation, significant de- tion of xanthine oxidase , complement creases in intravascular oncotic pres- byproduct activation and oxygen radi- sure...myoglobin and to the terminal cyto- have evidence of smoke inhalation chrome oxidase , further impairing tis- (b) Patients with steam burns of the sue...voltage electric in- to fruit juices, milk , or other electrolyte- jury, burns >20% TBSA, suspected containing fluids should be provided. If smoke

  14. GOES-8 ABBA Biomass Burning Observations and Downwind MOPPIT Carbon Monoxide Measurements

    Science.gov (United States)

    Feltz, J. M.; Warner, J. X.; Prins, E. M.; LaCasse, K. M.

    2002-05-01

    Studies have shown that biomass burning is a major source of aerosols and trace gases such as NO, CO2, CO, O3, NOx, N2O, NH3, SO2, CH3, and other nonmethane hydrocarbons. Preliminary global estimates indicate that biomass burning may be responsible for 38% of ozone in the troposphere, 32% of global carbon monoxide, 39% of the particulate organic carbon, and up to 40% of CO2. Recent advances in satellite technology provide the opportunity to investigate the linkages between fire activity and CO emissions using satellite derived fire products and CO retrievals. The Cooperative Institute for Meteorological Satellite Studies (CIMSS) at the University of Wisconsin - Madison is using the Geostationary Operational Environmental Satellite (GOES) data to detect and monitor smoke and fires in real-time throughout the Western Hemisphere using the Wildfire Automated Biomass Burning Algorithm (WF_ABBA). The Measurements Of Pollution In The Troposphere (MOPITT) science team is retrieving carbon monoxide (CO) distributions from the MOPITT instrument on the Terra platform. Preliminary studies show good agreement between large biomass burning events as detected by GOES and regions of elevated MOPITT derived carbon monoxide values. Examples from several significant biomass burning events will be presented, along with transport analyses and MOPITT carbon monoxide summaries.

  15. SELECTIVE INTESTINAL DECONTAMINATION FOR PREVENTION OF WOUND COLONIZATION IN SEVERELY BURNED PATIENTS - A RETROSPECTIVE ANALYSIS

    NARCIS (Netherlands)

    MANSON, WL; KLASEN, HJ; SAUER, EW; OLIEMAN, A

    In this study the effect of selective intestinal decontamination of the digestive tract (SDD) on wound colonization was investigated. Ninety-one patients with at least 25 per cent total burned surface area (TBSA) were included in this study. All patients received oral polymyxin. In 63 patients oral

  16. Response to topical clonazepam in patients with burning mouth syndrome: a clinical study.

    Science.gov (United States)

    Rodríguez de Rivera Campillo, E; López-López, J; Chimenos-Küstner, E

    2010-05-21

    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 analogical scale from 0 to 10. Among the 33 patients treated with clonazepam, 23 showed at least a 50% reduction in symptoms after 1 month of treatment. On the contrary, only 4 in the placebo group exhibited significant improvement. After 6 months, significant differences were observed again, as 23 of the 33 patients treated with the drug reported at least a 50% reduction in symptoms, whereas only 2 among those treated with the placebo significantly improved. However, when measured in terms of a complete cure (lack of symptoms), the differences were not significant: 5 drug-treated patients and one belonging to the placebo group were asymptomatic after one month of treatment. In summary, it seems that clonazepam applied topically was effective in treating BMS in a large proportion of patients.

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

    Directory of Open Access Journals (Sweden)

    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. Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients : infectious consequences from the Colectiv fire disaster

    NARCIS (Netherlands)

    Pirii, L E; Friedrich, A W; Rossen, J W A; Vogels, W; Beerthuizen, G I J M; Nieuwenhuis, M K; Kooistra-Smid, A M D; Bathoorn, E

    Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop

  19. Biomass burning fuel consumption rates: a field measurement database

    CSIR Research Space (South Africa)

    Van Leeuwen, TT

    2014-01-01

    Full Text Available are generally not susceptible to fire except during extreme drought periods due to their dense canopy cover keeping humidity high and wind speed low,25 and also because the amount of fuel on the surface is low due to rapid decomposition. However, human... by high temperatures, low humidities, and high offshore Santa Ana winds (Moritz et al., 2010) may lead to large and costly wildfires (Keeley et al., 2009).20 We found 2 studies covering 4 different measurement locations in southwestern US (Table 1, Fig. 1g...

  20. Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients.

    Science.gov (United States)

    Peng, Xi; Yan, Hong; You, Zhongyi; Wang, Pei; Wang, Shiliang

    2006-08-01

    Glutamine is an important energy source for immune cells. It is a necessary nutrient for cell proliferation, and serves as specific fuel for lymphocytes, macrophages, and enterocytes when it is present in appropriate concentrations. The purpose of this clinical study was to observe the effects of enteral nutrition supplemented with glutamine granules on immunologic function in severely burned patients. Forty-eight severely burned patients (total burn surface area 30-75%, full thickness burn area 20-58%) who met the requirements of the protocol joined this double-blind randomized controlled clinical trail. Patients were randomly divided into two groups: burn control group (B group, 23 patients) and glutamine treated group (Gln group, 25 patients). There was isonitrogenous and isocaloric intake in both groups, Gln and B group patents were given glutamine granules or placebo (glycine) at 0.5 g/kgd for 14 days with oral feeding or tube feeding, respectively. The plasma level of glutamine and several indices of immunologic function including lymphocyte transformation ratio, neutrophil phagocytosis index (NPI), CD4/CD8 ratio, the content of immunoglobulin, complement C3, C4 and IL-2 levels were determined. Moreover, wound healing rate of burn area was observed and then hospital stay was recorded. The results showed significantly reduced plasma glutamine and damaged immunological function after severe burn Indices of cellular immunity function were remarkably decreased from normal controls. After taking glutamine granules for 14 days, plasma glutamine concentration was significantly higher in Gln group than that in B group (607.86+/-147.25 micromol/L versus 447.63+/-132.38 micromol/L, P0.05). In addition, wound healing was better and hospital stay days were reduced in Gln group (46.59+/-12.98 days versus 55.68+/-17.36 days, Pfeeding or tube feeding abate the degree of immunosuppression, improve immunological function especially cellular immunity function, ameliorate wound

  1. [Advances in the research of zinc deficiency and zinc supplementation treatment in patients with severe burns].

    Science.gov (United States)

    Wang, X X; Zhang, M J; Li, X B

    2018-01-20

    Zinc is one of the essential trace elements in human body, which plays an important role in regulating acute inflammatory response, glucose metabolism, anti-oxidation, immune and gastrointestinal function of patients with severe burns. Patients with severe burns may suffer from zinc deficiency because of insufficient amount of zinc intake from the diet and a large amount of zinc lose through wounds and urine. Zinc deficiency may affect their wound healing process and prognosis. This article reviews the characteristics of zinc metabolism in patients with severe burns through dynamic monitoring the plasma and urinary concentration of zinc. An adequate dosage of zinc supplemented to patients with severe burns by an appropriate method can increase the level of zinc in plasma and skin tissue and improve wound healing, as well as reduce the infection rates and mortality. At the same time, it is important to observe the symptoms and signs of nausea, dizziness, leukopenia and arrhythmia in patients with severe burns after supplementing excessive zinc.

  2. [Clinical and epidemiological aspects of burned patients hospitalized in a teaching hospital].

    Science.gov (United States)

    Montes, Samanta Flor; Barbosa, Maria Helena; de Sousa Neto, Adriana Lemos

    2011-04-01

    The objectives of this study were to characterize burned patients according to epidemiological and clinical variables and identify the treatments, invasive procedures and complications. This is a retrospective, descriptive and quantitative study. The sample consisted of 138 burned patients hospitalized in a teaching hospital from January 2003 to December 2007, in Uberaba-MG. Of the 138 hospitalized patients, 98 (71.0%) were male, and the average age was 26.1 years. The average length of stay was 16.2 days; 93 (67.4%) of the burns were caused by accidents and the main cause (68; 49.3%) was an open flame. The average burned body surface was 20.8% and most (122; 88.4%) had second degree burns. The most common topic treatment (93; 67.4%) was silver sulfadiazine. Forty-seven (34.0%) patients had indwelling catheters; 30 (21.7%) underwent tissue transplantation, and 28 (20.3%) underwent debridement; the lesions in 14 (10.1%) patients became infected.

  3. The Changing Epidemiology of Infection in Burn Patients,

    Science.gov (United States)

    1992-01-01

    opportunist interactions in surgical infection,Arch. Surg. 121:13. 1986 del paciente, en el manejo de la herida, y en el control de Ia 16. McManus, A.T...Jr.. Foley, F.D.: The use of biopsies in burn patientcare. Surgery 73:887, 1973 relacionada con Ia extensi6n de Ia quemadura y la edad del 18. Kim...S.H., Hubbard, G.B., McManus, W.F., Mason, A.D._ Pruitt, paciente han variado en concierto con los cambios en Ia flora de B.A. Jr.: Frozen section

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

    Directory of Open Access Journals (Sweden)

    L.D. Morris

    2010-01-01

    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.

  5. Duration of antibiotic therapy for ventilator-associated pneumonia in burn patients.

    Science.gov (United States)

    Wahl, Wendy L; Taddonio, Michael A; Arbabi, Saman; Hemmila, Mark R

    2009-01-01

    Shorter compared with longer courses of antibiotic therapy for ventilator-associated pneumonia (VAP) in mixed medical-surgical intensive care units (ICUs) have been reported to produce equivalent outcomes. There have been few studies on the duration of antibiotic therapy for VAP in the burn population. We hypothesized that a shorter duration of antibiotic therapy for VAP would produce similar outcomes in our burn ICU. All burn patients from July 2001 to December 2006 admitted to the burn ICU requiring mechanical ventilation were studied. VAP was diagnosed prospectively by our Infection Control Liaison using bronchoalveolar lavage for cultures. Patients were cohorted into two groups: before July 1, 2004, antibiotic therapy duration was directed by the discretion of the attending physician (preprotocol), and after, the goal was 8 days of appropriate therapy or longer based on physician discretion (postprotocol). There were 98 patients treated for VAP with similar rates of inhalation injury, %TBSA burn size, age, and need for mechanical ventilation between the groups. The incidence of recurrent VAP was the same: 17% for the preprotocol and 15% for the postprotocol periods. The overall duration of antibiotic therapy did not change from 11 +/- 4 to 12 +/- 6 days. For patients treated longer than the target of 8 days, 66% had positive respiratory cultures at 4 days after initiation of antibiotic therapy. For the majority of patients with aspiration-type organisms or nonvirulent strains, there were fewer antibiotic days overall at 10 +/- 5 days (P VAP with the same bacteria. Despite a focused effort to decrease antibiotic usage for VAP in burn patients, the overall duration of therapy did not change. The majority of patients with virulent organisms such as methicillin-resistant Staphylococcus aureus or nonfermenting Gram-negative rods still had clinical signs of pneumonia and positive cultures, leading clinicians to continue antibiotics. In patients without virulent

  6. A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns

    Directory of Open Access Journals (Sweden)

    Tapfuma Mudawarima

    2017-10-01

    Full Text Available Abstract Background Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves. Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement. Settings = any setting in any country. Methods/design A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Discussion Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention

  7. 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.

  8. Epidemiology of pediatric burns and future prevention strategies-a study of 475 patients from a high-volume burn center in North India.

    Science.gov (United States)

    Dhopte, Amol; Tiwari, V K; Patel, Pankaj; Bamal, Rahul

    2017-01-01

    Pediatric burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric burns in India and to suggest future preventive strategies. Children up to 18 years old admitted to the Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. There were a total of 475 patients involved in the study, including seven suicidal burns, all of whom were females with a mean age greater than the cohort average. Age, type of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal burns. This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.

  9. 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:

  10. The effectiveness of acupuncture versus clonazepam in patients with burning mouth syndrome.

    Science.gov (United States)

    Jurisic Kvesic, A; Zavoreo, I; Basic Kes, V; Vucicevic Boras, V; Ciliga, D; Gabric, D; Vrdoljak, D V

    2015-08-01

    Burning mouth syndrome (BMS) is a chronic oral condition, characterised by burning symptoms, which mainly affects perimenopausal and postmenopausal women. Neuropathy might be the underlying cause of the condition. There are still insufficient data regarding successful therapy. The aim of this study was to compare the effectiveness of acupuncture and clonazepam. Forty-two patients with BMS (38 women, 4 men) aged 66.7±12.0 years were randomly divided into two groups. Acupuncture was performed on 20 participants over 4 weeks, 3 times per week, on points ST8, GB2, TE21, SI19, SI18 and LI4 bilaterally as well as GV20 in the midline, each session lasting half an hour. Twenty-two patients took clonazepam once a day (0.5 mg in the morning) for 2 weeks and, after 2 weeks, two tablets (0.5 mg in the morning and in the evening) were taken for the next 2 weeks. Prior to and 1 month after either therapy, participants completed questionnaires: visual analogue scale, Beck Depression Inventory, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale, 36-item Short Form Health Survey (SF-36) and Montreal Cognitive Assessment (MoCA). There were significant improvements in the scores of all outcome measures after treatment with both acupuncture and clonazepam, except for MoCA. There were no significant differences between the two therapeutic regimens regarding the scores of the performed tests. Acupuncture and clonazepam are similarly effective for patients with BMS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Management of a patient with small-area burns, severe sepsis and superficial vein thrombosis.

    Science.gov (United States)

    Shao, H; Luo, R; Wang, X; Pan, X; Chen, G

    2015-02-01

    Sepsis is frequently seen in severely burned patients, however it is not common in those with small-area burns. We present a case of a 22-year-old man suffering from a hot crush injury to his left hand dorsum covering 1% of his total body surface area. The patient developed severe sepsis and superficial vein thrombosis, probably due to wound infection. Culture of the wound secretion indicated Corynebacterium striatum. Following intensive topical and systemic treatment the severe sepsis was controlled. The local wound was repaired by the abdominal skin pedicle flap which had taken well by day 27 post admission. A topical superficial vein thrombosis, unintentionally found 42 days after admission, was partially excised. This case demonstrates that when treating severe sepsis in patients with small-area burns, the timely recognition and diagnosis along with active systemic support, play a vital role in successful management. None of the authors have any financial interest to declare.

  12. Assessing burn depth in tattooed burn lesions with LASCA Imaging

    Science.gov (United States)

    Krezdorn, N.; Limbourg, A.; Paprottka, F.J.; Könneker; Ipaktchi, R.; Vogt, P.M

    2016-01-01

    Summary Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours. PMID:28149254

  13. A National Perspective on ECMO Utilization Use in Patients with Burn Injury.

    Science.gov (United States)

    Nosanov, Lauren B; McLawhorn, Melissa M; Vigiola Cruz, Mariana; Chen, Jason H; Shupp, Jeffrey W

    2017-12-27

    Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized used strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization Use and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded. ECMO patients were matched one-to-one to those not requiring ECMO based on age, gender, TBSA, and inhalation injury. Group comparisons were made utilizing using χ2 and Mann-Whitney U tests. Thirty ECMO-treated burn patients were identified. Patients were predominantly male (80.0%) and Caucasian (63.3%) with mean age 38.9 ± 20.3 years. The majority were flame injuries (80.0%) of moderate size (17.0 ± 18.7% TBSA), affecting predominantly upper limbs and trunk. Inhalation injury was reported in 26.7%. Respiratory failure was reported in nine, acute respiratory distress syndrome in three, and pneumonia in nine. Fourteen patients survived to discharge. The ECMO cohort had significantly higher rates of cardiovascular comorbidities, concomitant major thoracic trauma, pneumonia, acute renal failure, and sepsis than non-ECMO patients (P < .05). Ventilator usage, intesive care unit (ICU) length of stay, and mortality were also significantly higher in those treated by ECMO (P < .05). Although burn patients placed on ECMO have significantly higher rates of morbidity and mortality than those not requiring ECMO, the mortality rate is equivalent to patients reported by Extracorporeal Life Support Organization. ECMO is a viable option for supporting critically injured burn patients.

  14. Measuring children’s distress during burns dressing changes: literature search for measures appropriate for indigenous children in South Africa

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    Louw QA

    2011-09-01

    Full Text Available Quinette Louw1,2, Karen Grimmer-Somers2, Angie Schrikk31Department of Physiotherapy, Stellenbosch University, Cape Town, South Africa; 2International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia; 3Red Cross Children’s Hospital, Cape Town, South AfricaBackground: Virtual reality is consistently reported as effective in reducing pain and anxiety in children during burns dressing changes in recent Western studies. Pain scales are a commonly reported outcome measure. Virtual reality is persuasive for all children in distress during medical procedures, because it is a nonaddictive, novel, and inexpensive form of distraction which can be applied repeatedly with good effect. We intend to use virtual reality in South Africa for the many children hospitalized with severe burns from mechanisms rarely seen in the Western world (paraffin/kerosene stoves exploding, electrical fires, shack/township fires, boiling liquid spills. Many severely burnt children are indigenous South Africans who did not speak English, and whose illiteracy levels, cultures, family dynamics, and experiences of pain potentially invalidate the use of conventional pain scales as outcome measures. The purpose of this study was to identify objective measures with sound psychometric properties and strong clinical utility, to assess distress during burns dressing changes in hospitalized indigenous South African children. Choice of measures was constrained by the burns dressing change environment, the ethics of doing no harm whilst measuring distress in vulnerable children, and of capturing valid measures of distress over the entire burns dressing change procedure.Methods: We conducted two targeted systematic reviews of the literature. All major library databases were searched, and measures with strong psychometric properties and sound clinical utility were sought.Results: Seven potentially useful measures were identified, ie

  15. The management of pain associated with wound care in severe burn patients in Spain.

    Science.gov (United States)

    Mendoza, Antonio; Santoyo, Fernando L; Agulló, Alberto; Fenández-Cañamaque, José L; Vivó, Carmen

    2016-01-01

    To describe the management of pain prevention associated with burn care. Multi-centre, observational, cross-sectional, descriptive study performed in 4 burn units in Spain. A total of 55 patients undergoing 64 procedures were analysed. Burns were classified as severe (90.4%), third-degree (78.2%) and caused by thermal agents (81.8%). Background analgesia consisted of non-opioid drugs (87.5%) and opioids (54.7%) [morphine (20.3%), morphine and fentanyl (14.1%) or fentanyl monotherapy (15.6%)]. Burn care was performed by experienced nurses (96.9%); 36.5% followed guidelines. The mean duration of procedures was 44 minutes (Statistical Deviation, SD: 20.2) and the mean duration of pain was 27 minutes (SD: 44.6). Procedural pain was primarily managed with opioid analgesics: fentanyl monotherapy and in combination (84%) and fentanyl monotherapy (48%) administered sublingually (89.1%). Patients described pain as different to usual baseline pain (97%), with a mean maximum intensity score of 4.2 points (SD: 3.3) on the VAS scale and a 34% increase in the intensity of pain. The mean patient and healthcare professional satisfaction score per procedure was 6/10 (SD: 1.9) and 5.5/10 (SD: 1.7), respectively. The results of the study describe the management of pain associated with burn care in clinical practice, helping optimise pain control.

  16. Care for the Critically Injured Burn Patient Modulation of Burn Scars Through Laser Assisted Delivery of Stem Cells

    Science.gov (United States)

    2016-10-01

    hypertrophic third degree burn scars in Red Duroc pigs using ablative fractional CO2 or Erbium:YAG lasers. Epidermal and superficial dermal...Waibel J, Davis S, Badiavas E: Stem Cells to Prevent Contraction and Enhance Healing In A Third Degree Burn Model. Military Health System Research...approach is directed at evaluating the above treatment groups in a third degree burn wound model developed by our laboratory and collaborators involved

  17. Rational Selection and Use of Antimicrobials in Patients with Burn Injuries.

    Science.gov (United States)

    Hill, David M; Sinclair, Scott E; Hickerson, William L

    2017-07-01

    Caring for patients with burn injuries is challenging secondary to the acute disease process, chronic comorbidities, and underrepresentation in evidence-based literature. Much current practice relies on extrapolation of guidance from different patient populations and wide variations in universal practices. Identifying infections or sepsis in this hypermetabolic population is imperfect and often leads to overprescribing of antimicrobials, suboptimal dosing, and multidrug resistance. An understanding of pharmacokinetics and pharmacodynamics may aid optimization of dosing regimens to better attain treatment targets. This article provides an overview of the current status of burn infection and attempts recommendations for consideration to improve universally accepted care. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Wound Healing Trajectories in Burn Patients and Their Impact on Mortality

    Science.gov (United States)

    2014-12-01

    nonsurvivors on OWS as a function of time (P<.001). Patients with a positive healing rate (+2%/day) after postburn day 20 had 100% survival whereas those...Accountability Act, we conducted a retrospective review of existing WoundFlow data for all patients admitted to the burn center ICU from January 2003 through...only the use of continuous renal replacement therapy was significantly different between groups (NH, 12 patients vs H, 8 patients , P = .04). There

  19. The role of resilience in the recovery of the burn-injured patient: an integrative review

    Directory of Open Access Journals (Sweden)

    Kornhaber R

    2016-05-01

    component influencing the recovery from burns trauma, it still remains a broad construct within the burns framework. Regular assessment of resilience in burn-injured patients is recommended in clinical practice in addition to longitudinal and intervention studies to best inform patient care. Keywords: resilience, burn injury, rehabilitation, optimism, tenacity, review

  20. 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.

  1. 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

  2. Laboratory measurements of trace gas emissions from biomass burning of fuel types from the southeastern and southwestern United States

    Science.gov (United States)

    I. R. Burling; R. J. Yokelson; D. W. T. Griffith; T. J. Johnson; P. Veres; J. M. Roberts; C. Warneke; S. P. Urbanski; J. Reardon; D. R. Weise; W. M. Hao; J. de Gouw

    2010-01-01

    Vegetation commonly managed by prescribed burning was collected from five southeastern and southwestern US military bases and burned under controlled conditions at the US Forest Service Fire Sciences Laboratory in Missoula, Montana. The smoke emissions were measured with a large suite of state-of-the-art instrumentation including an open-path Fourier transform infrared...

  3. Intensive insulin therapy in severely burned pediatric patients: a prospective randomized trial.

    Science.gov (United States)

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

    2010-08-01

    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. To determine whether intensive insulin therapy is associated with improved post-burn morbidity. 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). 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). In this prospective randomized clinical trial, we showed that intensive insulin therapy improves post-burn morbidity. Clinical trial registered with www.clinicaltrials.gov (NCT00673309).

  4. Antibacterial susceptibility of bacteria isolated from burns and wounds of cancer patients

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    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.

  5. Cognitive profile of patients with burning mouth syndrome in the Japanese population.

    Science.gov (United States)

    Matsuoka, Hirofumi; Himachi, Mika; Furukawa, Hirokazu; Kobayashi, Shiho; Shoki, Harumi; Motoya, Ryo; Saito, Masato; Abiko, Yoshihiro; Sakano, Yuji

    2010-07-01

    The present study investigated which cognitive characteristics, including cancer phobia, self-efficacy, pain-related catastrophizing, and anxiety sensitivity, affect burning mouth syndrome (BMS) symptoms in the Japanese population. A total of 46 BMS patients (44 women and 2 men; mean age, 59.98 +/- 9.57 years; range, 30-79 years) completed a battery of questionnaires, including measures of pain severity, oral-related quality of life (QOL), stress-response, pain-related catastrophizing, self-efficacy, anxiety sensitivity, and tongue cancer phobia. The Pain Catastrophizing Scale (PCS), General Self-Efficacy Scale (GSES), and Anxiety Sensitivity Index (ASI) scores in the BMS patients were compared with the scores of Japanese healthy participants (PCS, n = 449; GSES, n = 278; ASI, n = 9603) reported in previous studies. Catastrophizing and anxiety sensitivity were significantly higher in the BMS patients than in the healthy subjects (P disability, social disability, and handicap. Cancer phobia was significantly correlated with psychological disability and handicap. Since catastrophizing showed a higher correlation with BMS symptoms than cancer phobia, catastrophizing might be a more significant cognitive factor affecting symptoms than cancer phobia in BMS patients in the Japanese population.

  6. Silver containing hydrofiber dressing promotes wound healing in paediatric patients with partial thickness burns.

    Science.gov (United States)

    Lau, C T; Wong, K K Y; Tam, P

    2016-06-01

    Burn injury is one of the most common reasons for admission in paediatric population. There is currently no international consensus on the best wound dressing material. Aquacel Ag, a new silver containing hydrofiber dressing material has been reported to produce good clinical results. Yet, only a limited number of studies exist in the paediatric population. This study aims to review our experience of burn management over the past 5 years and to evaluate the effectiveness of Aquacel Ag in the management of partial thickness burns. A retrospective review of all patients admitted for burn injury between January 2010 and December 2014 was conducted. Patients' demographics, mechanism of injury, body surface areas involved, treatment applied, and clinical outcomes were analyzed. Patients with superficial injury, full thickness burns that required surgical debridement, burn area less than 2 % or more than 25 % of total body surface area, or incomplete clinical data were excluded from the comparative study. A total of 119 patients were identified. 114 (96 %) was due to domestic injury, of which 108 (91 %) was food-related. The most commonly affected areas were limbs (n = 89, 74.8 %), followed by trunk (n = 62, 74.8). 84 patients fulfilled the inclusion criteria and were recruited into the study. 31 patients received Aquacel Ag dressing and 53 patients received standard paraffin gauze dressing. The two groups showed no statistical difference in age, sex, percentage of total body surface area involved, and infection rate. Outcomes of patients treated with Aquacel Ag were compared with patients treated with standard dressing. The mean hospital stay was significantly shorter for the Aquacel Ag group (14.26 vs 23.45, p = 0.045). Aquacel Ag group required much less frequent dressing change (5.67 vs 20.59, p = 0.002). 5 patients in standard dressing group developed hypertrophic scar and required prolonged pressure garment, whereas only one hypertrophic scar was

  7. Cadaveric bone marrow mesenchymal stem cells: first experience treating a patient with large severe burns.

    Science.gov (United States)

    Mansilla, Eduardo; Marín, Gustavo H; Berges, Mirta; Scafatti, Silvia; Rivas, Jaime; Núñez, Andrea; Menvielle, Martin; Lamonega, Roberto; Gardiner, Cecilia; Drago, Hugo; Sturla, Flavio; Portas, Mercedes; Bossi, Silvia; Castuma, Maria Victoria; Peña Luengas, Sandra; Roque, Gustavo; Martire, Karina; Tau, Jose Maria; Orlandi, Gabriel; Tarditti, Adrian

    2015-01-01

    In January 2005, Rasulov et al. originally published "First experience in the use of bone marrow mesenchymal stem cells (MSCs) for the treatment of a patient with deep skin burns". Here, we present the first ever treated patient with cadaveric bone marrow mesenchymal stem cells (CMSCs) in the history of Medicine. A young man, who severely burned 60 % of his total body surface with 30 % of full-thickness burns while working with a grass trimmer that exploded, was involved in the study. MSCs were obtained from the bone marrow of a cadaver donor in a routine procurement procedure of CUCAIBA, the Province of Buenos Aires, Argentina, Ministry of Health, Transplantation Agency, cultured, expanded, and applied on the burned surfaces using a fibrin spray after early escharotomy. So far, our preliminary experience and our early results have been very impressive showing an outstanding safety data as well as some impressive good results in the use of CMSCs. Based on all this, we think that improvements in the use of stem cells for burns might be possible in the near future and a lot of time as well as many lives could be saved by many other research teams all over the world. CMSCs will probably be a real scientific opportunity in Regenerative Medicine as well as in Transplantation.

  8. Nosocomial Infections in Iranian Pediatric Patients With Burn Injuries: A Review

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    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

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

    International Nuclear Information System (INIS)

    Ibran, E.; Adil, S.E.R.; Rao, M.H.

    2013-01-01

    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)

  10. Molecular Typing of Pseudomonas aeruginosa Strains Isolated from Burn Patients in South of Iran

    Directory of Open Access Journals (Sweden)

    Aziz Japoni

    2016-01-01

    Full Text Available Background: Pseudomonas aeruginosa is one of the main etiological agents in burn infections which could be life threatening for the infected patients. The aim of the present study was to identify and track source of infections using two molecular typing methods. Materials and Methods: Seventy-four strains of P. aeruginosa were isolated from burn patients and hospital environment in Ghotbadden Burn Hospital, Shiraz, Iran. Isolates were typed by arbitrary primed-polymerase chain reaction (AP-PCR and plasmid profiling. Similarity and clustering of the strains was assessed using NTSYS-PC software and photo Capt Mw program. Results: Thirty eight plasmid profiles were obtained and classified them into: 2, 3and 5 clusters, based on 50%, 64.7% and 67.5% similarity on the plotted dendrogram, respectively. Drawn dendrogarm categorized AP-PCR products to 47 different types. Conclusion: Based on these results, a limited number of P. aeruginosa types are predominant in the hospitals which infect the burn patients. To control of the infections in patients with antibiotics, resistant isolates, strong disinfection of patients’ bathroom after scrubbing of patients wounds, should be implemented.

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

    Science.gov (United States)

    Ehmer-al-lbran; Memon, Akhtar Amin; Adil, Syeda Ezz-e-rukhshan; Rao, Masood Hussain; Dawani, Om

    2013-07-01

    To determine the risk of PTSD in patients with acute burn incidents. 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. 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. 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.

  12. Quantitative IR Spectrum and Vibrational Assignments for Glycolaldehyde Vapor: Glycolaldehyde Measurements in Biomass Burning Plumes

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Timothy J.; Sams, Robert L.; Profeta, Luisa T.; Akagi, Sheryl; Burling, Ian R.; Yokelson, Robert J.; Williams, Stephen D.

    2013-04-15

    Glycolaldehyde (GA, 2-hydroxyethanal, C2H4O2) is a semi-volatile molecule of atmospheric importance, recently proposed as a precursor in the formation of aqueous-phase secondary organic aerosol (SOA). There are few methods to measure glycolaldehyde vapor, but infrared spectroscopy has been used successfully. Using vetted protocols we have completed the first assignment of all fundamental vibrational modes and derived quantitative IR absorption band strengths using both neat and pressure-broadened GA vapor. Even though GA is problematic due to its propensity to both dimerize and condense, our intensities agree well with the few previously published values. Using the reference ν10 band Q-branch at 860.51 cm-1, we have also determined GA mixing ratios in biomass burning plumes generated by field and laboratory burns of fuels from the southeastern and southwestern United States, including the first field measurements of glycolaldehyde in smoke. The GA emission factors were anti-correlated with modified combustion efficiency confirming release of GA from smoldering combustion. The GA emission factors (g of GA emitted per kg dry biomass burned on a dry mass basis) had a low dependence on fuel type consistent with the production mechanism being pyrolysis of cellulose. GA was emitted at 0.23 ± 0.13% of CO from field fires and we calculate that it accounts for ~18% of the aqueous-phase SOA precursors that we were able to measure.

  13. Hexachlorophene storage in a burn patient associated with encephalopathy.

    Science.gov (United States)

    Chilcote, R; Curley, A; Loughlin, H H; Jupin, J A

    1977-03-01

    Hexachlorophene (HCP), a chlorinated phenolic hydrocarbon with bacteriostatic properties against Staphylococcus, is used in a number of topical products. Absorption through normal and damaged human skin has been appreciated and neurologic changes have been described in experimental animals, but instances of human toxicity have been reported infrequently. A 10-year-old boy who sustained a 25% burn did well initially but died in the second week of convalescence with hyperthermia, lower-extremity weakness, and cerebral edema. His treatment had included frequent applications of HCP. Analysis of post-mortem tissue revealed the presence of toxic levels of HCP in the blood (2.2 mug/gm) and brain (2.2 mug/gm), with storage in skin (25 mug/gm), liver (4.4 mug/gm), and fat (6.0 mug/gm). This case suggests that topical applications of HCP in man may result in an extensive absorption with fat storage and may cause fatal encephalopathy.

  14. Pediatric oral burns: a ten-year review of patient characteristics, etiologies and treatment outcomes.

    Science.gov (United States)

    Cowan, Douglas; Ho, Brian; Sykes, Kevin J; Wei, Julie L

    2013-08-01

    To summarize etiologies and treatments of pediatric oropharyngeal burns. Retrospective summary of 75 patients treated from January 1999 to January 2009. Tertiary Children's Hospital. Data collected included demographics, etiology of burn, site of injury, medical and/or surgical treatments, need for endoscopy, duration of hospitalization, and complications. 75 patients were treated with 50 being males (66%). Mean age was 4.3 years (median 2.7 years). The five most common causes were chemical (34.6%), electrical (12.3%), hot liquids (12.3%), food (12.3%) and battery ingestion (9.9%). Ingestion of hair products made up nearly 1/3 of the chemical causes (9/28) and alone made up 12% of the burns in our study. Main sites of injury included buccal mucosa (77.3%), lips (56%), tongue (48%), and palate (22.7%). One-third of the patients' required PICU/Burn unit admissions, 1/3 were admitted to floor, and 1/3 were discharged home from the ED. Average duration of hospitalization was 5 days. Of those admitted, 30% received antibiotics and only 8% received systemic steroids. Patients were made NPO on the first day of admission in 33.3% of patients and allowed to resume normal diet after surgical consultation. Only 9/75 (12%) patients required intubation. Otolaryngology consultation was obtained in 10.7% of cases. Only 18% of all patients required surgical intervention with debridement being most common (>60%). In this group, 20% received esophagogastroduodenoscopies due to ingestion of alkali substance. Complications occurred in less than 6% of all cases. Ingestion of chemicals, including hair dye/relaxer products, as well as overheated liquids and foods, are leading causes of oropharyngeal burns treated at our Children's Hospital Emergency Department over the past decade. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Patients with burning mouth sensations. A clinical investigation of causative factors in a group of "compete denture wearers" Jordanian population.

    Science.gov (United States)

    Mukatash-Nimri, Gadeer Elea; Al-Nimri, Marwan A; Al-Jadeed, Omar G; Al-Zobe, Zaid R; Aburumman, Khuzama K; Masarwa, Nader A

    2017-01-01

    To find out the prevalence of "true" burning mouth syndrome and study the association between patients' spontaneous complaints of burning mouth and systemic conditions in a group of middle age and elderly "denture wearers" patients in Jordan. A group of 129 patients (112 female and 17 male) of "complete denture wearers" subjects aged 40 years and over attended prosthetic clinic at King Hussein Medical Hospital complaining from oral burning, with no oral lesion possibly responsible for the burning sensations were selected. Assessment of oral and general status was done based on questioners, detailed history taking, medical records and extra and intraoral examination. The existed complete dentures retention, stability, jaw relationship and the free way space were evaluated. The current blood test and instrumental protocol for examination of patients with burning mouth complains were performed for each patient. Then those studied patients with burning mouth sensations including "true" burning mouth syndrome have been compared to the controls with regard to the presence of local problem, undermined local, systemic or psychological disease. The diagnosis of "true" burning mouth syndrome was established in (2.3%) of the studied population two females and one male. In most patients (58%) more than one site was affected. Significant positive associations were found between local factors (i.e., wearing complete dentures with unsatisfactory retention or jaw relationship, dry mouth or candidasis) and patients suffering from burning mouth sensation. The results also show that some systemic or psychological disorders were significantly more present among patients with burning mouth symptoms when compared to the control group ( p  mouth without mucosal signs should be considered as a manifestation of undermind pathology and/or distress, and the multi-factorial causes of burning mouth syndrome and sensation need to be referred to the suitable specialist for better treatment

  16. Prescribed Grassland Burning Smoke Emission Measurements in the Northern Flint Hills Region

    Science.gov (United States)

    Wilkins, J. L.; Baker, K. R.; Landis, M.; Aurell, J.; Gullett, B.

    2017-12-01

    Historically, frequent wildfires were essential for the maintenance of native prairie fire adapted ecosystems. Today prescribed fires are used to control invasive woody species and potentially improve forage production in these same prairie ecosystems for the beef-cattle industry. The emission of primary particulate matter, secondary aerosol, ozone precursors, and air toxics from prescribed grassland burning operations has been implicated as drivers of downwind air quality problems across a multi-state area. A field study has been planned to quantify prescribed burn smoke emissions using both surface and aerial sampling platforms to better constrain emissions rates for organic and inorganic pollutants. Multiple prescribed burns on tallgrass prairie fields in the northern Flint Hills ecoregion are planned for March 2017 at the Konza Prairie Biological Station in Kansas. An array of measurement systems will be deployed to quantify a suite of continuous and integrated air pollution parameters, combustion conditions, meteorological parameters, and plume dynamics to calculate more accurate and condition-specific emission factors that will be used to better predict primary and secondary pollutants both locally and regionally. These emissions measurements will allow for evaluation and improvement of the U.S. Forest Service's Bluesky modeling framework which includes the Fire Emission Production Simulator (FEPS) and Fuel characterization classification system (FCCS). Elucidating grassland prescribed burning emission factors based on fuel type, loading, and environmental conditions is expected to provide an improved understanding of the impact of this land management practice on air quality in the greater Flint Hills region. It is also expected that measurements will be made to help constrain and develop better routines for fire plume rise, vertical allocation, and smoke optical properties.

  17. Sensitivity and specificity of bronchoalveolar lavage and protected bronchial brush in the diagnosis of pneumonia in pediatric burn patients

    NARCIS (Netherlands)

    Barret, JP; Ramzy, PI; Wolf, SE; Herndon, DN

    1999-01-01

    Background: Infection is still one of the leading causes of death in burn patients. The diagnosis of respiratory tract infection in critically ill burn patients is still difficult. The diagnostic technique of choice remains uncertain, especially because of the lack of a criterion standard by which

  18. 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

    Five patients with extensive deep burns developed septicaemia due to Pseudomonas aeruginosa serogroup O-7.8 and phage type 21 or 21/188 shortly after they had been admitted to hospital. Four other burned patients became colonized with the same strain. The source of infection was contaminated tap ...

  19. 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...

  20. Selective decontamination of the digestive tract in severely burned pediatric patients

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    Infection is still one of the leading causes of morbidity and mortality in severely burned patients. Evidence suggests that many of the responsible organisms are endogenous. Systemic antibiotic prophylaxis is not effective, and produces resistant strains of microorganisms. SDD has been postulated to

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

    OpenAIRE

    Akimoto, Minekatsu; Takeda, Akira; Nagashima, Kazutaka; Uehara, Rie; Nemoto, Mitsuru; Uchinuma, Eiju

    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 ...

  2. Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.

    Directory of Open Access Journals (Sweden)

    Islam Abdelrahman

    Full Text Available Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, p<0.01. The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65. Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean 12 and 17 days (p<0.001, R2 0.51.Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

  3. Management of a patient with thermal burns and para-chloronitrobenzene poisoning

    Directory of Open Access Journals (Sweden)

    Yuanhai Zhang

    2014-10-01

    Full Text Available Para-chloronitrobenzene (p-CNB, a hazardous and toxic substance, is widely used as an intermediary in chemical industries. p-CNB can cause methaemoglobinaemia due to electron-withdrawing properties of the nitro and chlorine groups. We present a case of a 23-year-old man suffering from thermal burns and p-CNB poisoning. In this case, severe methaemoglobinaemia was caused by the absorption of p-CNB through the burn wounds. Despite active treatment, such as the antidote of methylene blue, the patient’s methaemoglobinaemia progressed, with slowly increasing methaemoglobin (MetHb level. This case highlights the complexity and difficulty of managing this type of injury. To our knowledge, this case can be the first case report describing methaemoglobinaemia induced by p-CNB in a patient with thermal burns.

  4. Wide distribution of carbapenem resistant Acinetobacter baumannii in burns patients in Iran.

    Science.gov (United States)

    Farshadzadeh, Zahra; Hashemi, Farhad B; Rahimi, Sara; Pourakbari, Babak; Esmaeili, Davoud; Haghighi, Mohammad A; Majidpour, Ali; Shojaa, Saeed; Rahmani, Maryam; Gharesi, Samira; Aziemzadeh, Masoud; Bahador, Abbas

    2015-01-01

    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 (MLST) 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 bla OXA-23-like (88%) and bla PER-1 (54%) were detected. ISAba1 was detected upstream of bla ADC, bla OXA-23-like and bla OXA51-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 six 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 in Iran is resistant to various antimicrobials, including tigecycline. This study shows wide genetic diversity in CNSAb. Integrating the new Iranian A. baumannii IC variants into the epidemiologic clonal and susceptibility profile databases can help effective global control measures against the XDR-CNSAb pandemic.

  5. Burn Patient Acuity Demographics, Scar Contractures, and Rehabilitation Treatment Time Related to Patient Outcomes (ACT)

    Science.gov (United States)

    2015-12-01

    Age    Definition  Age at the time of  acute  burn admission.  Study inclusion criteria included patients  who were 18 years of age and older...ADMISSION DEMOGRAPHICS  4  Pre‐Existing Medical Conditions (_1‐_4)   Options  None, Diabetes, Lupus, Circulatory Disorder, Hypertension,  Renal ... Insufficiency ,  Hepatitis, HIV/AIDS, Cancer, Seizure History, Pulmonary Diagnosis, Dementia, Other,  Unknown  Note: If ‘Other’ was selected, additional

  6. INTENSIVE THERAPY OF THE ENDOGENOUS INTOXICATION SYNDROME IN PATIENTS WITH SEVERE BURNS

    Directory of Open Access Journals (Sweden)

    N. M. Shulayeva

    2013-01-01

    Full Text Available BACKGROUND. Severe burns are accompanied by the development of endogenous intoxication syndrome. Endogenous intoxication syndrome (EIS is thus specified as a complex of severe clinical aspects with detoxification systems failure — in other words, the syndrome of multi-organ failure (MOFS or inefficiency, depending on severity of EIS (compensation, subcompensation, decompensation [1, 2].PURPOSE. To improve the results of EIS and MOFS treatment in the patients with severe burns by including into medication succinic acid-based anti-oxidants combined with hepatoprotectors of the ademetionine group.MATERIAL AND METHODS. We carried out analysis of complex examination and treatment of 108 patients aged 18–50 with severe thermal injury, total burn area (S ≥40%, and severity index ≥90.RESULTS. The use of succinic acid-based anti-oxidants within the framework of antishock and disintoxication therapy, later combined with hepatoprotectors of the ademetionine group, decreases the intensity of endogenous intoxication and multi-organ failure syndrome.CONCLUSION. To treat endotoxemia and multiple organ dysfunction caused by oxidative stress and hypoxia in patients with severe and extremely severe burns, it is appropriate to prescribe succinic acid-based anti-oxidants. To prevent albumen synthesis and detoxication hepar dysfunctions, decrease the manifestations of endotoxemia, and complement the cytoprotective action of succinic acid-based antioxidants, it is appropriate to prescribe hepatoprotectors. 

  7. 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.

  8. Temperature measurement of burning aluminum powder based on the double line method of atomic emission spectra

    Science.gov (United States)

    Tang, Huijuan; Hao, Xiaojian; Hu, Xiaotao

    2018-01-01

    In the case of conventional contact temperature measurement, there is a delay phenomenon and high temperature resistant materials limitation. By using the faster response speed and theoretically no upper limit of the non-contact temperature method, the measurement system based on the principle of double line atomic emission spectroscopy temperature measurement is put forward, the structure and theory of temperature measuring device are introduced. According to the atomic spectrum database (ASD), Aluminum(Al) I 690.6 nm and Al I 708.5 nm are selected as the two lines in the temperature measurement. The intensity ratio of the two emission lines was measured by a spectrometer to obtain the temperature of Al burning in pure oxygen, and the result compared to the temperature measured by the thermocouple. It turns out that the temperature correlation between the two methods is good, and it proves the feasibility of the method.

  9. Quality of life, body image, and psychiatric complications in patients with a burn trauma: preliminary study of the italian version of the burn specific health scale-brief.

    Science.gov (United States)

    Sideli, L; Prestifilippo, A; Di Benedetto, B; Farrauto, R; Grassìa, R; Mulè, A; Rumeo, M V; Di Pasquale, A; Conte, F; La Barbera, D

    2010-12-31

    Burn patients may suffer both physical and psychopathological consequences and their quality of life and the presence of psychopathological symptoms should be evaluated. The Burn Specific Health Scale - Brief (BHSH-B) is a tried and tested instrument for assessing burn patients' quality of life. The aim of this study is to propose the Italian translation of BSHS-B and presents the preliminary results of an exploratory study. The Italian version of the BSHS-B was administered to a sample group of 50 burn victims. Reliability was verified by Cronbach's alpha, and construct validity was evaluated through correlation with the Short Form 36 Health Survey Questionnaire (SF-36) and the Self-report Symptom Inventory - Revised (SCL-90). The entire scale and two out of three domains showed Cronbach's alpha values higher than 0.8. Significant correlations were identified between BSHS-B subscales and the SF-36 subscales Physical Pain and Social Activities. Several psychopathological SCL-90 subscales correlated with BSHS-B subscales Heat Sensitivity and Body Image. It was concluded that our translation of BSHS-B was reliable and showed good construct validity. The drawbacks of this study are the limited size of the sample and the wide variety of types of burn injuries.

  10. Optical Properties of Biomass Burning Aerosols: Comparison of Experimental Measurements and T-Matrix Calculations

    Directory of Open Access Journals (Sweden)

    Samin Poudel

    2017-11-01

    Full Text Available The refractive index (RI is an important parameter in describing the radiative impacts of aerosols. It is important to constrain the RI of aerosol components, since there is still significant uncertainty regarding the RI of biomass burning aerosols. Experimentally measured extinction cross-sections, scattering cross-sections, and single scattering albedos for white pine biomass burning (BB aerosols under two different burning and sampling conditions were modeled using T-matrix theory. The refractive indices were extracted from these calculations. Experimental measurements were conducted using a cavity ring-down spectrometer to measure the extinction, and a nephelometer to measure the scattering of size-selected aerosols. BB aerosols were obtained by burning white pine using (1 an open fire in a burn drum, where the aerosols were collected in distilled water using an impinger, and then re-aerosolized after several days, and (2 a tube furnace to directly introduce the BB aerosols into an indoor smog chamber, where BB aerosols were then sampled directly. In both cases, filter samples were also collected, and electron microscopy images were used to obtain the morphology and size information used in the T-matrix calculations. The effective radius of the particles collected on filter media from the open fire was approximately 245 nm, whereas it was approximately 76 nm for particles from the tube furnace burns. For samples collected in distilled water, the real part of the RI increased with increasing particle size, and the imaginary part decreased. The imaginary part of the RI was also significantly larger than the reported values for fresh BB aerosol samples. For the particles generated in the tube furnace, the real part of the RI decreased with particle size, and the imaginary part was much smaller and nearly constant. The RI is sensitive to particle size and sampling method, but there was no wavelength dependence over the range considered (500

  11. Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

    Science.gov (United States)

    Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly

    2017-09-01

    Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  12. Characterisation of SCCmec elements in methicillin-resistant Staphylococcus aureus isolated from burn patients.

    Science.gov (United States)

    Namvar, Amirmorteza Ebrahimzadeh; Afshar, Mastaneh; Asghari, Babak; Rastegar Lari, Abdolaziz

    2014-06-01

    Staphylococcus aureus is an important pathogen, especially in burn units all around the world. Because of the emergence of the β-lactam antibiotic-resistant strains since 1961, concern about the prevalence of methicillin-resistant S. aureus (MRSA) has increased in these units. Resistance to methicillin is mediated by penicillin-binding proteins (PBPs) that have enough affinity for binding to the β-lactam ring, but another kind of protein (PBP2α), which is encoded by the mecA gene, has a lower affinity for binding to these antibiotics. The mecA gene is transferred by SCCmec (staphylococcal cassette chromosome mec) as a mobile genetic element, exclusively found in the Staphylococcus genus. Identification of the frequency of the mecA gene, different SCCmec types and also its incidence may have benefit in surveillance prevention and control of MRSA strains in burn units. In this study, 40 S. aureus isolates were collected from patients hospitalised in Motahari burn center of Tehran, during 2012-2013. Conventional microbiological methods were applied and the confirmed isolates were stored at -20°C for molecular polymerase chain reaction (PCR) tests. The antibiotic resistance pattern was performed by disc diffusion method and finally the different SCCmec types were determined by specific primers. During this research, 40 isolates of S. aureus were collected from burn patients, of which (37.5%) of the specimens belonged to female patients and 62.5% to male patients. The aetiology of the burn was classified as follows: open flame (35%), liquid (32.5%), chemical (5%) and other (27.5%). By a disc diffusion method, no resistance pattern was observed to vancomycin and fosfomycin. Based on a multiplex PCR assay, the five different SCCmec types were detected as: 47.5% type III, 25% type IV, 10% type V, 10% type II and 7.5% type I. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  13. Aquacel(®) Ag dressing versus Acticoat™ dressing in partial thickness burns: a prospective, randomized, controlled study in 100 patients. Part 1: burn wound healing.

    Science.gov (United States)

    Verbelen, Jozef; Hoeksema, Henk; Heyneman, Alexander; Pirayesh, Ali; Monstrey, Stan

    2014-05-01

    Studies comparing contemporary silver dressings in burns are scarce. In a prospective, randomized, controlled study, counting 50 patients/research group, we compared two frequently used silver dressings, Acticoat™ and Aquacel(®) Ag, in the management of partial thickness burns with a predicted healing time between 7 and 21 days as assessed by laser Doppler imaging between 48 and 72h after burn. Variables investigated were related to baseline research group characteristics, wound healing, bacteriology, economics, nurse, and patient experience. Both research groups were comparably composed taking into account gender, age and burn characteristics. Similar results were obtained as to healing time and bacterial control with both silver dressings. A statistically significant difference in favor of the Aquacel(®) Ag dressing was found for average ease of use (p<0.001), average ease of application (p=0.001), patient pain (p<0.001), patient comfort with the dressing (p=0.017), silver staining (p<0.001), and cost effectiveness (p<0.001). Both silver dressings resulted in comparable healing times and bacterial control but the Aquacel(®) Ag dressing significantly increased comfort for patients as well as nurses and was significantly more cost-effective than the Acticoat™ dressing for the given indication. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Increasing Blood Glucose Variability Is a Precursor of Sepsis and Mortality in Burned Patients

    OpenAIRE

    Pisarchik, Alexander N.; Pochepen, Olga N.; Pisarchyk, Liudmila A.

    2012-01-01

    High glycemic variability, rather than a mean glucose level, is an important factor associated with sepsis and hospital mortality in critically ill patients. In this retrospective study we analyze the blood glucose data of 172 nondiabetic patients 18-60 yrs old with second and third-degree burns of total body surface area greater than 30% and 5%, respectively, admitted to ICU in 2004-2008. The analysis identified significant association of increasing daily glucose excursion (DELTA) accompanie...

  15. Analysis of the burns profile and the admission rate of severely burned adult patient to the National Burn Center of Chile after the 2010 earthquake.

    Science.gov (United States)

    Albornoz, Claudia; Villegas, Jorge; Sylvester, Marilu; Peña, Veronica; Bravo, Iside

    2011-06-01

    Chile is located in the Ring of Fire, in South America. An earthquake 8.8° affected 80% of the population in February 27th, 2010. This study was conducted to assess any change in burns profile caused by the earthquake. This was an ecologic study. We compared the 4 months following the earthquake in 2009 and 2010. age, TBSA, deep TBSA, agent, specific mortality rate and rate of admissions to the National burn Center of Chile. Mann-Whitney test and a Poisson regression were performed. Age, agent, TBSA and deep TBSA percentages did not show any difference. Mortality rate was lower in 2010 (0.52 versus 1.22 per 1,000,000 habitants) but no meaningful difference was found (Poisson regression p = 0.06). Admission rate was lower in 2010, 4.6 versus 5.6 per 1,000,000 habitants, but no differences were found (p = 0.26). There was not any admissions directly related to the earthquake. As we do not have incidence registries in Chile, we propose to use the rate of admission to the National Burn Reference Center as an incidence estimator. There was not any significant difference in the burn profile, probably because of the time of the earthquake (3 am). We conclude the earthquake did not affect the way the Chilean people get burned. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  16. 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

    Directory of Open Access Journals (Sweden)

    Ali Bikmoradi

    2016-01-01

    Conclusions: Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief.

  17. Relationship between multidisciplinary critical care and burn patients survival: A propensity-matched national cohort analysis.

    Science.gov (United States)

    Win, Thet Su; Nizamoglu, Metin; Maharaj, Ritesh; Smailes, Sarah; El-Muttardi, Naguib; Dziewulski, Peter

    2018-02-01

    The aims of this study are: firstly, to investigate if admission to specialized burn critical care units leads to better clinical outcomes; secondly, to elucidate if the multidisciplinary critical care contributes to this superior outcome. A multi-centre cohort analysis of a prospectively collected national database of 1759 adult burn patients admitted to 13 critical care units in England and Wales between 2005 and 2011. Units were contacted via telephone to establish frequency and constitution of daily ward rounds. Critical care units were categorized into 3 settings: specialized burns critical care units, generalized critical care units and 'visiting' critical care units. Multivariate logistic regression analysis and propensity dose-response analysis were used to calculate risk adjusted mortality. Multivariate logistic regression analysis shows that admission to a specialized burn critical care service is independently associated with significant survival benefit compared to generalized critical care unit (adjusted OR for in-hospital death 1.81, [95% CI, 1.24, 2.66]) and 'visiting' critical care services (adjusted OR for in-hospital death 2.24 [95% CI, 1.49, 3.38]). Further analysis using propensity dose-response analysis demonstrates that risk-adjusted in-hospital mortality rate decreased as the dose of multidisciplinary care increased, with an adjusted odds ratio of 1 (specialized burn critical care units), 1.81 (generalized critical care units) and 2.24 ('visiting' critical care units). Admission to a specialized burn critical care service is independently associated with significant survival benefit. This is, at least in part, due to care being provided by a fully integrated multidisciplinary team. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  18. The treatment of electrical injury compared to burn injury: a review of pathophysiology and comparison of patient management protocols.

    Science.gov (United States)

    Rouse, R G; Dimick, A R

    1978-01-01

    Because of basic differences in pathophysiology, patients with electrical injury require therapeutic measures quite separate and distinct from patients with flame burns. Fluid requirements are much greater for the electrical-injured patient due to the depth of the injury and frequent occurrence of pigment in the urine. Fasciotomy with surgical exploration for determination of tissue viability is usually required in areas of obvious or questionable viability in patients with electrical injury. Sulfamylon is preferred for topical antibacterial therapy in electrical injury, because of its excellent penetration into deeper tissues. With this regimen of conservative surgical debridement of necrotic tissue, in many patients we have been able to salvage limbs and, in particular, preserve function.

  19. Turbulent and Stable/Unstable Laminar Burning Velocity Measurements from Outwardly Propagating Spherical Hydrogen-Air Flames at Elevated Pressures

    Science.gov (United States)

    Smallbone, Andrew; Tsuneyoshi, Kousaku; Kitagawa, Toshiaki

    The laminar burning velocity of pre-mixed hydrogen-air mixtures was measured in a fan stirred combustion bomb. Unstretched laminar burning velocities and Markstein lengths were obtained at 0.10MPa for equivalence ratios of 0.4, 0.6, 0.8 and 1.0 using high speed flame imaging. The difficulties which arose whilst obtaining similar measurements at 0.25MPa and 0.50MPa are outlined. The turbulent burning velocity was measured at equivalence ratios of 0.4 and 0.8 from explosions carried out at 0.10MPa with turbulence intensities of 0.8 and 1.6m/s. Higher turbulent burning velocity ratios were observed for mixtures which yielded lower Markstein lengths in the laminar combustion experiments.

  20. Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes.

    Science.gov (United States)

    van Twillert, Björn; Bremer, Marco; Faber, Albertus W

    2007-01-01

    Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. There was no significant reduction of anxiety ratings.

  1. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2014-10-01

    checklist for the provision of nutritional care which would be supported by decision support technology akin to what we had done previously with...order to encourage Annual Report, Grant W81XWH-12-2-0074 17 eating a regular diet . At this point, only days when the patient received ≥ 90% of

  2. 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.

  3. Measurement of mixed biomass burning and mineral dust aerosol in the thermal infrared

    Science.gov (United States)

    Koehler, C. H.; Trautmann, T.; Lindermeir, E.

    2009-03-01

    From January 19th to February 7th, 2008, we installed a Fourier transform infrared spectrometer (FTIR) at Praia Airport on the island of Santiago, Cape Verde. Our goal was to measure the combined radiative effect of biomass burning aerosol and mineral dust usually observed there during that time of the year, when mineral dust emerging from the Sahara mixes with biomass burning aerosol transported north-westwards from the Sahelian region. Our measurements were part of the Saharan Mineral Dwst Experiment 2 (SAMUM 2) funded by the German Research Foundation (DFG) as continuation of the SAMUM field experiment in Morocco in 2006. SAMUM 2 is a joint venture of several German research institutes and universities and included both ground based as well as airborne measurements with the DLR Falcon research aircraft. The ground based instrumentation included spectrometers for visible and thermal infrared downwelling radiation, sun photometers, LIDAR and particle impactors while the Falcon was equipped with LIDAR and several instruments for aerosol analysis and sample return. A comparison of the FTIR measurements with radiative transfer simulations yields the expected aerosol forcing in the atmospheric window region after application of a suitable calibration method.

  4. Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

    Directory of Open Access Journals (Sweden)

    Lai-Ping Wang

    2016-09-01

    Full Text Available Objective: To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn. Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded. Results: The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05. The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05. Conclusions: The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

  5. Burn patients' return to daily activities and participation as defined by the International Classification of Functioning, Disability and Health: A systematic review.

    Science.gov (United States)

    Osborne, Candice L; Meyer, Walter J; Ottenbacher, Kenneth J; Arcari, Christine M

    2017-06-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a universal classification system of health and health-related domains. The ICF has been successfully applied to a wide range of health conditions and diseases; however, its application in the field of burn recovery has been minimal. This systematic review uses the domains of the ICF component 'activities and participation' to explore: (1) the extent to which return to daily activities and community participation after burn has been examined in the pediatric population, (2) the most common assessments used to determine activity and participation outcomes, and (3) what activity and participation areas are most affected in the pediatric burn population after discharge from acute care. Results determined that it is difficult to draw overarching conclusions in the area of return to 'activities and participation' for children with burn based on the paucity of current evidence. Of the studies conducted, few examined the same subtopics or used similar measurements. This suggests a need for more robust studies in this area in order to inform and improve burn rehabilitation practices to meet the potential needs of burn patients beyond an acute care setting. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. 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.

  7. Persistent candidemia in major burn patients: radiologic findings of the thorax

    International Nuclear Information System (INIS)

    Lee, Eil Seong; Lee, Kwan Seop; Kang, Ik Won

    1997-01-01

    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

  8. A double-blind study on clonazepam in patients with burning mouth syndrome.

    Science.gov (United States)

    Heckmann, Siegfried M; Kirchner, Elena; Grushka, Miriam; Wichmann, Manfred G; Hummel, Thomas

    2012-04-01

    In the treatment of burning mouth syndrome (BMS), various approaches have been tried with equivocal results. The aim of the present randomized clinical trial was to determine the efficacy of clonazepam, a GABA agonist designed as an antiepileptic drug that exerts the typical effects of benzodiazepines. Randomized clinical trial. Twenty patients with idiopathic BMS were carefully selected. Clonazepam (0.5 mg/day, n = 10) or placebo (lactose, n = 10) were randomly assigned to the patients. Patients on clonazepam significantly improved in pain ratings (P Clonazepam appears to have a positive effect on pain in BMS patients. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  9. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics.

    Science.gov (United States)

    Tuvdendorj, Demidmaa; Chinkes, David L; Zhang, Xiao-Jun; Ferrando, Arny A; Elijah, Itoro E; Mlcak, Ronald P; Finnerty, Celeste C; Wolfe, Robert R; Herndon, David N

    2011-08-01

    This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-(2)H(5)]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p 0.05); synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children.

  10. Dissemination of carbapenem-resistant Acinetobacter baumannii in patients with burn injuries.

    Science.gov (United States)

    Shoja, Saeed; Moosavian, Mojtaba; Rostami, Soodabeh; Farahani, Abbas; Peymani, Amir; Ahmadi, Khadijeh; Ebrahimifard, Nasim

    2017-04-01

    Carbapenem-resistant Acinetobacter baumannii has emerged as an important cause of infection in burn patients. This study aimed to characterize the antimicrobial susceptibility pattern, determine the prevalence of oxacillinase and metallo-beta-lactamase (MBL) genes, and type the A. baumannii isolates obtained from burn patients. During a 1-year period, a total of 40 nonduplicated isolates of A. baumannii were obtained from burn patients who were hospitalized in the Taleghani Burn Hospital in Ahvaz, in the southwest of Iran. Testing for antimicrobial susceptibility was carried out by disk diffusion and E-test. To screen MBL production, a double disk synergy and MBL E-test were performed. The presence of bla OXA-23-like , bla OXA-24-like , bla OXA-51-like and bla OXA-58-like , bla VIM , bla IMP and bla SPM , and bla NDM was sought by polymerase chain reaction (PCR). Repetitive extragenic palindromic sequence-based PCR was carried out for determination of isolates clonality. Overall, 92.5% of isolates were carbapenem-resistant. Polymyxin B, colistin, and ampicillin-sulbactam were the most effective agents in vitro, with a susceptibility rate of 100%, 97.5%, and 72.5%, respectively. According to the double disk synergy and E-test, 55.6% and 97.3% of isolates were MBL producers, respectively. Furthermore, 70% of isolates harbored bla OXA-23-like and 20% were positive for bla OXA-24-like. However, no encoding genes were detected for bla VIM , bla IMP and bla SPM , bla NDM , and bla OXA-58-like . Repetitive extragenic palindromic sequence-based PCR revealed that carbapenem-resistant isolates belonged to four clones, including A, B, C, and D; the predominant clones were B and C. The rate of carbapenem resistance was high, and it appeared that bla OXA-23-like and bla OXA-24-like contributed to the carbapenem resistance of A. baumannii isolates. This result suggests that the two predominant clones of A. baumannii were spread among burn patients. In order to prevent future

  11. Reproducibility of repeated measurements with the Kikuhime pressure sensor under pressure garments in burn scar treatment.

    Science.gov (United States)

    Van den Kerckhove, Eric; Fieuws, Steffen; Massagé, Patrick; Hierner, Robert; Boeckx, Willy; Deleuze, Jean-Paul; Laperre, Jan; Anthonissen, Mieke

    2007-08-01

    This study investigated the reproducibility of repeated measurements with the Kikuhime pressure sensor under two different types of pressure garments used in the treatment and prevention of scars after burns. Also efficiency of garments was assessed in clinical circumstances by assessing pressure loss and residual pressure after 1 month. Intra- and inter-observer reproducibility and repeated measurements with 1-month time lapse were examined on 55 sites in 26 subjects by means of intra-class correlation coefficients and standard error of measurements. Results showed good to excellent ICC and low SEMs in the two conditions. There was a significant difference in pressure after 1 month between elastic tricot and weft knit garments, although evolution of pressure loss after 1 month was similar. Concerning different locations, there was a significant difference in pressure loss after 1 month between gloves and sleeves with the largest pressure loss for sleeves. Considering these results we concluded that the Kikuhime pressure sensor provides valid and reliable information and can be used in comparative clinical trials to evaluate pressure garments used in burn scar treatment. Secondly, elastic tricot garments in our study tended to have higher clinical pressures but both types of garments had similar pressure loss over time.

  12. Hypnosis after an adverse response to opioids in an ICU burn patient.

    Science.gov (United States)

    Ohrbach, R; Patterson, D R; Carrougher, G; Gibran, N

    1998-06-01

    Burn injuries produce severe wound care pain that is ideally controlled on intensive burn care units with high-dosage intravenous opioid medications. We report a case illustrating the use of hypnosis for pain management when one opioid medication was ineffective. Intensive burn care unit at a regional trauma center. A 55-year-old man with an extensive burn suffered from significant respiratory depression from a low dosage of opioid during wound care and also experienced uncontrolled pain. Rapid induction hypnotic analgesia. Verbal numeric pain scale, and pain and anxiolytic medication usage. The introduction of hypnosis, supplemented by little or no opioids, resulted in excellent pain control, absence of need for supplemental anxiolytic medication, shortened length of wound care, and a positive staff response over a 14-day period. This case illustrates that hypnosis can not only be used easily and quite appropriately in a busy medical intensive care unit environment, but that sometimes this treatment may be a very useful alternative when opioid pain medication proves to be dangerous and ineffective. This case also illustrates possible clinical implications both pain relief and side-effect profiles for opioid receptor specificity. Although this report does not provide data regarding hypnotic mechanisms, it is clear that with some patients nonopioid inhibitory mechanisms can be activated in a highly effective manner, that clinical context may be important for the activation of those pathways, and that those mechanisms may be accessed more easily than opioid mechanisms.

  13. Field and laboratory measurements of biomass burning and vehicle exhaust using a PTR-MS

    Science.gov (United States)

    VanderSchelden, Graham Samuel

    The Proton Transfer Reaction Mass Spectrometer (PTR-MS) is a powerful tool for analyzing organic compounds in air and has been applied in field and laboratory applications to assess emissions from biomass burning and vehicles. Biomass burning is an important source of air pollution globally in the form of wild fires, burning of crop stubble, and combustion of organic material for home energy. In the United States, residential wood combustion combined with low inversion heights in winter time has caused air quality problems. Through field deployment of the PTR-MS in Xi'an China during August of 2011, it was determined that 27%, 16%, 26%, and 12% of ambient carbon monoxide (CO), acetaldehyde, benzene, and toluene could be attributed to biomass burning. The PTR-MS was also deployed to Yakima, Washington in January of 2013, finding that residential wood combustion was a substantial source of air toxics and PM. Residential wood combustion contributed 100%, 73%, 69%, 55%, 36%, 19%, 19%, and 17% of organic PM1, formaldehyde, acetaldehyde, black carbon, benzene, toluene, C2-alkylbenzenes, and CO respectively. Diesel vehicles are becoming a larger fraction of the vehicle fleet and can be held responsible for a substantial fraction of air pollution emissions from on and off road mobile sources. Diesel engines are a source of low volatility products that are difficult to measure and are thought to be important in the formation of secondary organic aerosol (SOA). This work focuses on measuring important diesel exhaust compounds with the PTR-MS and assessing oxidation processes of these compounds. When the PTR-MS was deployed to the field along with a thermal desorption pre-concentration system, we estimated that diesel vehicles were about 3-15% of the vehicle activity influencing our study site in Yakima, WA using the ratio of m/z 157 to m/z 129. SOA yields of diesel exhaust compounds were assessed and about 48% of the SOA was attributed to compounds measured by the PTR

  14. Burn management.

    Science.gov (United States)

    Endorf, Frederick W; Ahrenholz, David

    2011-12-01

    To update critical care practitioners on the recent advancements in burn care. Particular topics discussed include airway management, acute resuscitation, issues within the intensive care unit, nutrition, and wound management. This is a concise review of the recent burn literature tailored to the critical care practitioner. Criteria for extubation of burn patients are examined, as is the need for cuffed endotracheal tubes in pediatric burn patients. Strategies to avoid over-resuscitation are discussed, including use of colloid, as well as nurse-driven and computer-guided resuscitation protocols. New data regarding common ICU issues such as insulin therapy, delirium, and preferred intravenous access are reviewed. The importance of nutrition in the burn patient is emphasized, particularly early initiation of enteral nutrition, continuation of nutrition during surgical procedures, and use of adjuncts such as immunonutrition and beta blockade. Finally, both short-term and long-term wound issues are addressed via sections on laser Doppler assessment of burns and pressure garment therapy to prevent long-term scarring.

  15. 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

    Five patients with extensive deep burns developed septicaemia due to Pseudomonas aeruginosa serogroup O-7.8 and phage type 21 or 21/188 shortly after they had been admitted to hospital. Four other burned patients became colonized with the same strain. The source of infection was contaminated tap...... 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...

  16. Recent Progress and Emerging Issues in Measuring and Modeling Biomass Burning Emissions

    Science.gov (United States)

    Yokelson, R. J.; Stockwell, C.; Veres, P. R.; Hatch, L. E.; Barsanti, K. C.; Simpson, I. J.; Blake, D. R.; Alvarado, M.; Kreidenweis, S. M.; Robinson, A. L.; Akagi, S. K.; McMeeking, G. R.; Stone, E.; Gilman, J.; Warneke, C.; Sedlacek, A. J.; Kleinman, L. I.

    2013-12-01

    Nine recent multi-PI campaigns (6 airborne, 3 laboratory) have quantified biomass burning emissions and the subsequent smoke evolution in unprecedented detail. Among these projects were the Fourth Fire Lab at Missoula Experiment (FLAME-4) and the DOE airborne campaign BBOP (Biomass Burning Observation Project). Between 2009 and 2013 a large selection of fuels and ecosystems were probed including: (1) 21 US prescribed fires in pine forests, chaparral, and shrublands; (2) numerous wildfires in the Pacific Northwest of the US; (3) 77 lab fires burning fuels collected from the sites of the prescribed fires; and (4) 158 lab fires burning authentic fuels in traditional cooking fires and advanced stoves; peat from Indonesia, Canada, and North Carolina; savanna grasses from Africa; temperate grasses from the US; crop waste from the US; rice straw from Taiwan, China, Malaysia, and California; temperate and boreal forest fuels collected in Montana and Alaska; chaparral fuels from California; trash; and tires. Instrumentation for gases included: FTIR, PTR-TOF-MS, 2D-GC and whole air sampling. Particle measurements included filter sampling (with IC, elemental carbon (EC), organic carbon (OC), and GC-MS) and numerous real-time measurements such as: HR-AMS (high-resolution aerosol MS), SP-AMS (soot particle AMS), SP2 (single particle soot photometer), SP-MS (single particle MS), ice nuclei, CCN (cloud condensation nuclei), water soluble OC, size distribution, and optical properties in the UV-VIS. New data include: emission factors for over 400 gases, black carbon (BC), brown carbon (BrC), organic aerosol (OA), ions, metals, EC, and OC; and details of particle morphology, mixing state, optical properties, size distributions, and cloud nucleating activity. Large concentrations (several ppm) of monoterpenes were present in fresh smoke. About 30-70% of the initially emitted gas-phase non-methane organic compounds were semivolatile and could not be identified with current technology

  17. Update on metabolism and nutrition therapy in critically ill burn patients.

    Science.gov (United States)

    Moreira, E; Burghi, G; Manzanares, W

    2017-09-23

    Major burn injury triggers severe oxidative stress, a systemic inflammatory response, and a persistent hypermetabolic and hypercatabolic state with secondary sarcopenia, multiorgan dysfunction, sepsis and an increased mortality risk. Calorie deficit, negative protein balance and antioxidant micronutrient deficiency after thermal injury have been associated to poor clinical outcomes. In this context, personalized nutrition therapy with early enteral feeding from the start of resuscitation are indicated. Over the last four decades, different nutritional and pharmacological interventions aimed at modulating the immune and metabolic responses have been evaluated. These strategies have been shown to be able to minimize acute malnutrition, as well as modulate the immunoinflammatory response, and improve relevant clinical outcomes in this patient population. The purpose of this updating review is to summarize the most current evidence on metabolic response and nutrition therapy in critically ill burn patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  18. Demonstration of the test-retest reliability and sensitivity of the Lower Limb Functional Index-10 as a measure of functional recovery post burn injury: a cross-sectional repeated measures study design.

    Science.gov (United States)

    Ryland, Margaret E; Grisbrook, Tiffany L; Wood, Fiona M; Phillips, Michael; Edgar, Dale W

    2016-01-01

    Lower limb burns can significantly delay recovery of function. Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools. The aims of this study were to examine the test-retest reliability, sensitivity, and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10 (LLFI-10) questionnaire for measuring functional ability in patients with lower limb burns over time. Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study. In addition, the minimal detectable change (MDC) was calculated for Section 1 and 3 of the LLFI-10. Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties. Section 1 of the LLFI-10 demonstrated excellent test-retest reliability (intra-class correlation coefficient (ICC) 0.98, 95 % CI 0.96-0.99) whilst Section 3 demonstrated high test-retest reliability (ICC 0.88, 95 % CI 0.79-0.94). MDC scores for Sections 1 and 3 were 1.27 points and 30.22 %, respectively. Internal consistency was demonstrated with a significant negative association (r s  = -0.83) between Sections 1 and 3 of the LLFI-10 (p < 0.001). This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months, and furthermore, Section 1 is sensitive to changes in patient function over time.

  19. Cost of nursing most frequent procedures performed on severely burned patients

    Directory of Open Access Journals (Sweden)

    Talita de Oliveira Melo

    Full Text Available ABSTRACT Objective: to identify the mean direct cost (MDC of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. Method: exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. Results: a MDC of US$ 0.65 (SD=0.36 was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23 for "intravenous drug administration"; US$ 5.90 (SD=2.75 for "measurement of diuresis"; US$ 0.93 (SD=0.42 for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55 for "bandaging". Conclusion: the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care.

  20. Fournier's gangrene in a patient after third-degree burns: a case report

    Directory of Open Access Journals (Sweden)

    Iavazzo Christos

    2009-05-01

    Full Text Available Abstract Introduction Fournier's gangrene is characterized by tissue ischemia leading to rapidly progressing necrotizing fasciitis. Case presentation We present the case of a patient with Fournier's gangrene after third-degree burns. Clinical manifestations, laboratory results and treatment options are discussed. Conclusion Fournier's gangrene is a surgical emergency. Although it can be lethal, it is still a challenging situation in the field of surgical infections.

  1. 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

    2014-05-01

    Burns are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complications. 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. 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. 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. 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. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  2. Burn-up measurements of LEU fuel for short cooling times

    International Nuclear Information System (INIS)

    Pereda B, C.; Henriquez A, C.; Klein D, J.; Medel R, J.

    2005-01-01

    The measurements presented in this work were made essentially at in-pool gamma-spectrometric facility, installed inside of the secondary pool of the RECH-1 research reactor, where the measured fuel elements are under 2 meters of water. The main reason for using the in-pool facility was because of its capability to measure the burning of fuel elements without having to wait so long, that is with only 5 cooling days, which are the usual times between reactor operations. Regarding these short cooling times, this work confirms again the possibility of using the 95 Zr as a promising burnup monitor, in spite of the rough approximations used to do it. These results are statistically reasonable within the range calculated using codes. The work corroborates previous results, presented in Santiago de Chile, and it suggests future improvements in that way. (author)

  3. Biomass Burning Aerosol Absorption Measurements with MODIS Using the Critical Reflectance Method

    Science.gov (United States)

    Zhu, Li; Martins, Vanderlei J.; Remer, Lorraine A.

    2010-01-01

    This research uses the critical reflectance technique, a space-based remote sensing method, to measure the spatial distribution of aerosol absorption properties over land. Choosing two regions dominated by biomass burning aerosols, a series of sensitivity studies were undertaken to analyze the potential limitations of this method for the type of aerosol to be encountered in the selected study areas, and to show that the retrieved results are relatively insensitive to uncertainties in the assumptions used in the retrieval of smoke aerosol. The critical reflectance technique is then applied to Moderate Resolution Imaging Spectrometer (MODIS) data to retrieve the spectral aerosol single scattering albedo (SSA) in South African and South American 35 biomass burning events. The retrieved results were validated with collocated Aerosol Robotic Network (AERONET) retrievals. One standard deviation of mean MODIS retrievals match AERONET products to within 0.03, the magnitude of the AERONET uncertainty. The overlap of the two retrievals increases to 88%, allowing for measurement variance in the MODIS retrievals as well. The ensemble average of MODIS-derived SSA for the Amazon forest station is 0.92 at 670 nm, and 0.84-0.89 for the southern African savanna stations. The critical reflectance technique allows evaluation of the spatial variability of SSA, and shows that SSA in South America exhibits higher spatial variation than in South Africa. The accuracy of the retrieved aerosol SSA from MODIS data indicates that this product can help to better understand 44 how aerosols affect the regional and global climate.

  4. Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial.

    Science.gov (United States)

    Seyyed-Rasooli, Alehe; Salehi, Feridoon; Mohammadpoorasl, Asghar; Goljaryan, Sakineh; Seyyedi, Zahra; Thomson, Brian

    2016-12-01

    Anxiety and pain are recognized as major problems of burn patients; because pharmaceutical treatments for controlling anxiety and pain symptoms lead to complications and an increase in health costs, nonpharmacological nursing interventions were considered for this group of patients. This led to the present study aimed at comparing the effect of aromatherapy massage with inhalation aromatherapy for anxiety and pain in burn patients. This single-blind clinical trial was carried out on 90 patients with burns aromatherapy massage, inhalation aromatherapy, and control group. The patients assigned to the aromatherapy massage group received a massage for half an hour using a blend of lavender and almond oils, while a blend of rose and lavender aroma was used for the inhalation aromatherapy group. Spielberger State Anxiety Inventory was used for measuring anxiety and the visual analog scale (VAS) scale was used for measuring pain. The results showed that three groups were equal in terms of demographics, disease characteristics, and scores of anxiety and pain at the baseline. The mean decreases of anxiety scores were -0.04±5.08, 6.33±12.55, and 6.43±10.60 in the control group, aromatherapy massage group, and inhalation group, respectively (p=0.007). The mean decrease of pain scores were -0.10±0.96, 1.70±1.84, and 0.97±1.56 in the control group, aromatherapy massage group, and inhalation group, respectively (paromatherapy massage and inhalation aromatherapy compared with the control group in reducing both anxiety and pain of burn patients. Therefore, both interventions, which are inexpensive, and noninvasive nursing tasks can be proposed for alleviating anxiety and pain of burn patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  5. The impact of socio-economic deprivation on burn injury: A nine-year retrospective study of 6441 patients.

    Science.gov (United States)

    Marsden, N J; Battle, C E; Combellack, E J; Sabra, A; Morris, K; Dickson, W A; Whitaker, I S; Evans, P A

    2016-03-01

    Low socio-economic status is thought to be associated with increased burn risk, however the significance and generalisability across different populations and cultures has been questioned. A nine-year retrospective study of burn presentations to a large teaching hospital (2005-2014) was performed to investigate the association between socio-economic status and burns. Demographic and injury data was collected via the trust 'Information portal'. The Welsh Index of Multiple: Deprivation 2011 was used to score for socio-economic status. Chi-squared test and Odds Ratios were calculated and statistical significance defined as pburns were identified, with 755 (11.7%) admitted. Overall incidence rates were the highest published in the UK (0.35/1000/year) with sub group analysis showing the highest rates in under fives and males. Significant relationships between both age and burn mechanism and gender and burn mechanism (p=0.0005) were identified. Scald (67.1%) was the most common mechanism with the upper limb (48%) most commonly burned. Chi square analysis demonstrated a significant relationship between socio-economic deprivation, age and burn incidence (p≤0.0005), with a disproportionately high number of burns in patients under the age of 16 in the most deprived quintile (OR 1.23; 95% CI 1.06-1.44). This study specifically highlights patients under the age of 16 living in poorer socio-economic areas as the most at risk of suffering burns receiving hospital attention. This study demonstrates burns as a significant public health issue, and the results should aid in designing specific burn prevention strategies to target high-risk groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  6. Bridging burn care education with modern technology, an integration with high fidelity human patient simulation.

    Science.gov (United States)

    Reeves, Patrick T; Borgman, Matthew A; Caldwell, Nicole W; Patel, Leela; Aden, James; Duggan, John P; Serio-Melvin, Maria L; Mann-Salinas, Elizabeth A

    2018-03-10

    The Advanced Burn Life Support (ABLS) program is a burn-education curriculum nearly 30 years in the making, focusing on the unique challenges of the first 24h of care after burn injury. Our team applied high fidelity human patient simulation (HFHPS) to the established ABLS curriculum. Our hypothesis was that HFHPS would be a feasible, easily replicable, and valuable adjunct to the current curriculum that would enhance learner experience. This prospective, evidenced-based practice project was conducted in a single simulation center employing the American Burn Association's ABLS curriculum using HFHPS. Participants managed 7 separate simulated polytrauma and burn scenarios with resultant clinical complications. After training, participants completed written and practical examinations as well as satisfaction surveys. From 2012 to 2013, 71 students participated in this training. Simulation (ABLS-Sim) participants demonstrated a 2.5% increase in written post-test scores compared to traditional ABLS Provider Course (ABLS Live) (p=0.0016). There was no difference in the practical examination when comparing ABLS-Sim versus ABLS Live. Subjectively, 60 (85%) participants completed surveys. The Educational Practice Questionnaire showed best practices rating of 4.5±0.7; with importance of learning rated at 4.4±0.8. The Simulation Design Scale rating for design was 4.6±0.6 with an importance rating of 4.4±0.8. Overall Satisfaction and Self-Confidence with Learning were 4.4±0.7 and 4.5±0.7, respectfully. Integrating HFHPS with the current ABLS curriculum led to higher written exam scores, high levels of confidence, satisfaction, and active learning, and presented an evidenced-based model for education that is easily employable for other facilities nationwide. Copyright © 2018. Published by Elsevier Ltd.

  7. Review of therapeutic agents for burns pruritus and protocols for management in adult and paediatric patients using the GRADE classification

    Directory of Open Access Journals (Sweden)

    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.

  8. A 2000 patient retrospective assessment of a new strategy for burn wound management in view of infection prevention and treatment.

    Science.gov (United States)

    Glik, Justyna; Łabuś, Wojciech; Kitala, Diana; Mikuś-Zagórska, Karolina; Roberts, Christopher D; Nowak, Mariusz; Kasperczyk, Aleksandra; Kawecki, Marek

    2017-12-15

    Infections in burn patients are still the principal cause of complications in burn injuries. The aim of this study is to assess a new strategy for burn wound management in view of infection prevention and treatment in the experience of the Burn Treatment Center in Siemianowice Śląskie. The applied methodology involved the analysis of patient records describing the hospital's epidemiological situation between 2014 and 2016. The analysis also included the use and cost of antibiotics, silver-containing dressings, and other antiseptics relative to the number of sepsis cases, including those caused by Pseudomonas aeruginosa, as well as the mortality ratio. The total costs of prevention and treatment of infections were reduced, while the use of silver-containing dressings and antiseptics increased. The number of patients with sepsis decreased, including cases caused by P. aeruginosa, and the mortality ratio was reduced. Introducing a strategy for burn wound-oriented infection prevention and treatment in burn patients provides a number of benefits. It is also cost-effective. Using locally applied active dressings and antiseptics can be a welcome choice for often-unnecessary antibiotic therapy of a suspected or existing burn wound infection. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  9. [Impact of infection on mortality in burn patients. Multivariate study in 1,773 intensive care unit patients].

    Science.gov (United States)

    Herruzo, Rafael; Banegas, José R; de la Cruz, Juan J; Muñoz-Ratero, Santiago; Garcia-Torres, Vidal

    2009-12-01

    Infections may play an important role in mortality in burn patients, but this impact is not manifested in multivariate analyses that calculate the probability of death on admission. In a cohort of 1,773 ICU patients, logistic regression analysis was used to determine the prognostic factors for death. Subsequently, the cohort was divided into 2 groups according to length of ICU stay: 1-10 days or more than 10 days. The groups contained a similar number of patients and the analysis was repeated in each one. Overall mortality in the 1,773 patients was 12.2%. In the stratified analysis mortality was 8.5% for the 890 patients who were in the ICU for 10 days or less and 15.8% for the 883 who stayed longer. The prognostic factors for death in the 2 groups were very different and had to be studied separately. In the group with a shorter ICU stay, the prognostic factors were similar to those of the entire cohort (eg, age, burned body surface area); in the group with a longer stay, these factors lost power and other factors, such as bacteraemia and pneumonia, gained significance. Estimation of the risk of death in ICU burn patients should be re-evaluated at 10 days after admission.

  10. Use of the low air loss bed system in treatment of burns patients.

    Science.gov (United States)

    Leeder, C J

    1979-01-01

    When a person is confined to bed, whatever the reason, small areas of soft tissues are compressed between the skeleton and the supporting surfaces. Transient circulatory disturbances resulting in epidermis to dermis damage or finally deep penetrating necrosis involving subcutaneous tissues, fascia muscle and bone may result. In the case of the severely burned patient who has already sustained gross trauma, any further destruction of tissues is to be avoided at all costs. The Low Air Loss Bed System offers many advantages in the care and management of the burns patient. There is a definite saving of nursing time by rendering unnecessary constant attention to the patient for preventative skin care, positioning, bed pan etc. The nurse is then able to devote her time positively to the more involved needs of the patient and family. It will also provide for periods of rest that are so often lacking, especially in the initial stages of treatment. The patient does not have to be kept on a rigid regime of Q2H turning. He is turned only for wound care, physio- and general body cleansing. His position may be contoured without having to touch him circumferentially. Any lifting and positioning necessary is easier for staff members due to the design of the unit, and more comfortable for the patient. Over a period of two years, eighteen patients with varying extent and degree of burn injuries were treated on the bed. This paper will describe the mechanical operation of the bed and experiences with nursing management and monitoring of the system.

  11. Decellularized human amniotic membrane: more is needed for an efficient dressing for protection of burns against antibiotic-resistant bacteria isolated from burn patients.

    Science.gov (United States)

    Gholipourmalekabadi, M; Bandehpour, M; Mozafari, M; Hashemi, A; Ghanbarian, H; Sameni, M; Salimi, M; Gholami, M; Samadikuchaksaraei, A

    2015-11-01

    Human amniotic membranes (HAMs) have attracted the attention of burn surgeons for decades due to favorable properties such as their antibacterial activity and promising support of cell proliferation. On the other hand, as a major implication in the health of burn patients, the prevalence of bacteria resistant to multiple antibiotics is increasing due to overuse of antibiotics. The aim of this study was to investigate whether HAMs (both fresh and acellular) are an effective antibacterial agent against antibiotic-resistant bacteria isolated from burn patients. Therefore, a HAM was decellularized and tested for its antibacterial activity. Decellularization of the tissue was confirmed by hematoxylin and eosin (H&E) and 4,6-diamidino-2-phenylindole (DAPI) staining. In addition, the cyto-biocompatibility of the acellular HAM was proven by the cell viability test (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide, MTT) and scanning electron microscopy (SEM). The resistant bacteria were isolated from burns, identified, and tested for their susceptibility to antibiotics using both the antibiogram and polymerase chain reaction (PCR) techniques. Among the isolated bacteria, three blaIMP gene-positive Pseudomonas aeruginosa strains were chosen for their high resistance to the tested antibiotics. The antibacterial activity of the HAM was also tested for Klebsiella pneumoniae (American Type Culture Collection (ATCC) 700603) as a resistant ATCC bacterium; Staphylococcus aureus (mecA positive); and three standard strains of ATCC bacteria including Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27833), and S. aureus (ATCC 25923). Antibacterial assay revealed that only the latter three bacteria were susceptible to the HAM. All the data obtained from this study suggest that an alternative strategy is required to complement HAM grafting in order to fully protect burns from nosocomial infections. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  12. Extracorporeal Blood Purification in Burns: A Review

    Science.gov (United States)

    2014-09-01

    during the first week after the burn injury [18,19]. Enhanced catabolism and metabolism , which have an important impact on prolonged morbidity and...shock and endotoxemia will be examined. The primary outcome measure is 28 day mortality, while secondary outcomes include 90 day, 6 month, and 12...the setting of burn injury [39,40]. Therefore, polymyxin B columns could be a therapeutic option in burn patients with endotoxemia . Peng et al

  13. Frequency and characteristics of battered child syndrome in patients on a paediatric burns unit: A clinical case review

    OpenAIRE

    M. Gil-Vargas; Y. Martínez-Tovilla; E. Martín-Zayago; C. Llanos-Herrera; M.Á. Ramírez-Jacinto; A. Ramírez-Servín

    2017-01-01

    Background: Battered child syndrome is any act of physical, sexual or psychological aggression, negligence or intentional neglect against a minor. Objective: To estimate the frequency and characteristics of battered child syndrome in patients on the Paediatric Burns Unit of the Health Services of the State of Puebla. Materials and methods: In a 1 year and 10 month period, 313 patients under 18 years of age admitted to the Paediatric Burns Unit of the Health Services of the State of Pueb...

  14. Establishing the fuel burn-up measuring system for 106 irradiated assemblies of Dalat reactor by using gamma spectrometer method

    International Nuclear Information System (INIS)

    Nguyen Minh Tuan; Pham Quang Huy; Tran Tri Vien; Trang Cao Su; Tran Quoc Duong; Dang Tran Thai Nguyen

    2013-01-01

    The fuel burn-up is an important parameter needed to be monitored and determined during a reactor operation and fuel management. The fuel burn-up can be calculated using computer codes and experimentally measured. This work presents the theory and experimental method applied to determine the burn-up of the irradiated and 36% enriched VVR-M2 fuel type assemblies of Dalat reactor. The method is based on measurement of Cs-137 absolute specific activity using gamma spectrometer. Designed measuring system consists of a collimator tube, high purity Germanium detector (HPGe) and associated electronics modules and online computer data acquisition system. The obtained results of measurement are comparable with theoretically calculated results. (author)

  15. Long-term effects of physical exercise during rehabilitation in patients with severe burns.

    Science.gov (United States)

    Wurzer, Paul; Voigt, Charles D; Clayton, Robert P; Andersen, Clark R; Mlcak, Ronald P; Kamolz, Lars-P; Herndon, David N; Suman, Oscar E

    2016-09-01

    We have reported that a 12-week exercise program is beneficial for the exercise performance of severely burned children. It is not known, however, whether the beneficial effects remain at 2 years postburn. Severely burned children who received no long-term anabolic drugs were consented to this Institutional Review Board-approved study. Patients chose between a voluntary exercise program (EX-group) and no exercise (NoEX-group) after discharge from the acute burn unit. Peak torque per lean leg mass, maximal oxygen consumption, and percent predicted peak heart rate were assessed. In addition, body mass index percentile and lean body mass index were recorded. Both groups were compared for up to 2 years postburn using mixed multiple analysis of variance. A total of 125 patients with a mean age of 12 ± 4 years were analyzed. Demographics between the EX-group (N = 82) and NoEX-group (N = 43) were comparable. In the EX-group, peak torque per lean leg mass, percent predicted peak heart rate, and maximal oxygen consumption increased significantly with exercise (P < .01). Between discharge and 12-24 months, body mass index percentile increased significantly in the EX-Group (P < .05) but did not change in the NoEX-group. There were no significant differences between groups in body mass index percentile, lean body mass index, peak torque per lean leg mass, and maximal oxygen consumption at 24 months postburn. Exercise significantly improves the physical performance of burned children. The benefits are limited to early time points, however, and greatly narrow with further recovery time. Continued participation in exercise activities or a maintenance exercise program is recommended for exercise-induced adaptations to continue. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. 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

    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 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...... died in group A and 2 in group B; all with a Bull and Fischer index between 1.0 and 2.0. Prestorage leukocyte filtration may reduce transfusion related accumulation of various bioactive substances and the requirement for blood in burn trauma patients....

  17. Subgroup analysis of continuous renal replacement therapy in severely burned patients.

    Directory of Open Access Journals (Sweden)

    Jaechul Yoon

    Full Text Available Continuous renal replacement therapy (CRRT is administered to critically ill patients with renal injuries as renal replacement or renal support. We aimed to identify predictors of mortality among burn patients receiving CRRT, and to investigate clinical differences according to acute kidney injury (AKI status. This retrospective observational study evaluated 216 Korean burn patients who received CRRT at a burn intensive care unit. Patients were categorized by AKI status. Data were collected regarding arterial pH, laboratory results, ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF ratio, and urine production. Among surviving patients, CRRT duration and the sequential organ failure assessment score were 6.5 days and 4.7 in the non-AKI group and 23.4 days and 7.4 in the AKI group, respectively (p = 0.003 and p = 0.008. On logistic regression analyses, mortality was significantly associated with a pH of 5.0 mEg/L (p = 0.045, creatinine levels of >2.0 mg/dL (p = 0.011, lactate levels of >2 mmol/L (p2 mmol/L, and a platelet count of 2 mg/dL. In the non-AKI group, poor outcomes were associated with lactate levels of >1.5 mmol/L, a PF ratio of 1.2 mg/dL. Duration of the CRRT application and the requirement for either renal replacement or renal support at the initiation of CRRT application are important considerations depending on its application.

  18. 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...

  19. Optimization of burn referrals

    DEFF Research Database (Denmark)

    Reiband, Hanna K; Lundin, Kira; Alsbjørn, Bjarne

    2014-01-01

    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), Denmark....

  20. Comparison between burning mouth syndrome patients with and without psychological problems.

    Science.gov (United States)

    Kim, M-J; Kim, J; Kho, H-S

    2018-03-02

    The purpose of this study was to compare clinical and socio-demographic characteristics between burning mouth syndrome (BMS) patients with and without psychological problems. Of 644 patients with symptoms of oral burning, 224 with primary BMS were selected on the basis of laboratory testing, medical history, and psychometric tests: 39 with psychological problems (age 62.5±11.5years) and 185 without psychological problems (age 58.4±11.4years). Comprehensive clinical and socio-demographic characteristics, including psychological profiles and salivary flow rates, were compared between the two groups. No significant difference in sex ratio, duration and diurnal pattern of symptoms, unstimulated whole saliva flow rate, or marital status was found between the groups. The patients with psychological problems had a significantly higher mean age, reduced stimulated whole saliva flow rate, and lower level of education than those without psychological problems. The patients with psychological problems also displayed higher rates and greater severity of various types of BMS-related symptom in most parts of the oral mucosa, higher rates of stress-related symptoms, and greater difficulties in daily activities. The severity of taste disturbance was the factor most significantly correlated with the level of psychometry. In conclusion, psychological problems in BMS patients are associated with an aggravation of BMS symptoms. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. In situ soil temperature and heat flux measurements during controlled surface burns at a southern Colorado forest site

    Science.gov (United States)

    W. J. Massman; J. M. Frank; W. D. Shepperd; M. J. Platten

    2003-01-01

    This study presents in situ soil temperature measurements at 5-6 depths and heat flux measurements at 2-5 depths obtained during the fall/winter of 2001/ 2002 at seven controlled (surface) fires within a ponderosa pine forest site at the Manitou Experimental Forest in central Colorado. Six of these burns included three different (low, medium, and high) fuel loadings...

  2. Measuring forest floor evaporation from interception in prescribed burned forests in Southern Italy.

    Science.gov (United States)

    Giuditta, Elisabetta; Coenders-Gerrits, Miriam; Bogaard, Thom; Wenninger, Jochen; Greco, Roberto; Ialongo, Gianluca; Esposito, Assunta; Rutigliano, Flora Angela

    2016-04-01

    Wildfires are one of the major environmental issue in the Mediterranean area. Prescribed burning (PB) is increasingly used in Europe as a practice to reduce fire risk, through dead fine fuel reduction. Several studies have focused on fire effects on vegetation and soil microbial community, but very few on ecosystem processes involved in water cycle. This study aims to estimate interception by the litter and fermentation layer and the successive evaporation flux in laboratory conditions, using a water balance and 2H and 18O isotopes mass balance calculation, in order to assess PB effects on the hydrology and ecosystem in pine plantations. PB was carried out in spring 2014 in three pine plantations of Southern Italy, dominated by Pinus halepensis (Cilento, Vallo di Diano e Alburni National Park, CVDANP), P. pinaster (Vesuvio National Park, VNP) and P. pinea (Castel Volturno Nature Reserve, CVNR). A dataset concerning the effects of PB on vegetation structure, floristic composition, microbial biomass and activity in the fermentation layer and 5-cm of soil beneath is available for the same stands. In each plantation, two cores of litter and fermentation layer were sampled in a burned area and in a near unburned area (control), respectively, with a collector to extract an "undisturbed" core. Then, each core was transferred in a lysimeter installed in the Water Lab of Delft University of Technology. In total, three lysimeters were set up and each experiment was carried out in duplicate. The laboratory had constant temperature, and both temperature and relative humidity were recorded every 15 minutes. To simulate rainfall, ~1 litre of tap water was sprinkled uniformly on the lysimeter with a plant spray (equivalent to 32 mm of rain). The precipitation was sprinkled every 3 days for a period of two months. Soil moisture and temperature were measured during the experiment every 15 minutes in the top and bottom of the litter and fermentation layer. Interception water was

  3. Comparative Population Plasma and Tissue Pharmacokinetics of Micafungin in Critically Ill Patients with Severe Burn Injuries and Patients with Complicated Intra-Abdominal Infection

    Science.gov (United States)

    García-de-Lorenzo, A.; Grau, S.; Agrifoglio, A.; Cachafeiro, L.; Herrero, E.; Asensio, M. J.; Sánchez, S. M.; Roberts, J. A.

    2016-01-01

    Severely burned patients have altered drug pharmacokinetics (PKs), but it is unclear how different they are from those in other critically ill patient groups. The aim of the present study was to compare the population pharmacokinetics of micafungin in the plasma and burn eschar of severely burned patients with those of micafungin in the plasma and peritoneal fluid of postsurgical critically ill patients with intra-abdominal infection. Fifteen burn patients were compared with 10 patients with intra-abdominal infection; all patients were treated with 100 to 150 mg/day of micafungin. Micafungin concentrations in serial blood, peritoneal fluid, and burn tissue samples were determined and were subjected to a population pharmacokinetic analysis. The probability of target attainment was calculated using area under the concentration-time curve from 0 to 24 h/MIC cutoffs of 285 for Candida parapsilosis and 3,000 for non-parapsilosis Candida spp. by Monte Carlo simulations. Twenty-five patients (18 males; median age, 50 years; age range, 38 to 67 years; median total body surface area burned, 50%; range of total body surface area burned, 35 to 65%) were included. A three-compartment model described the data, and only the rate constant for the drug distribution from the tissue fluid to the central compartment was statistically significantly different between the burn and intra-abdominal infection patients (0.47 ± 0.47 versus 0.15 ± 0.06 h−1, respectively; P burn patients and intra-abdominal infection patients. After the first dose, micafungin at 100 mg/day achieved the PK/PD targets in plasma for MIC values of ≤0.008 mg/liter and ≤0.064 mg/liter for non-parapsilosis Candida spp. and Candida parapsilosis species, respectively. PMID:27458229

  4. [Diagnosis and treatment of respiratory tract burns].

    Science.gov (United States)

    Gerasimova, L I; Loginov, L P; Smol'skii, B G; Pelikh, S T; Skripal', A Iu

    1979-08-01

    The work gives an analysis of clinical signs in 111 patients with burns of the respiratory tract. Two complexes of curative measures are proposed according to anatomical changes found in fibrobronchoscopy. The fibrobronchoscopies are of special importance in the treatment of burns of the tracheobronchial tree.

  5. Measured and modeled humidification factors of fresh smoke particles from biomass burning: role of inorganic constituents

    Directory of Open Access Journals (Sweden)

    J. L. Hand

    2010-07-01

    Full Text Available During the 2006 FLAME study (Fire Laboratory at Missoula Experiment, laboratory burns of biomass fuels were performed to investigate the physico-chemical, optical, and hygroscopic properties of fresh biomass smoke. As part of the experiment, two nephelometers simultaneously measured dry and humidified light scattering coefficients (bsp(dry and bsp(RH, respectively in order to explore the role of relative humidity (RH on the optical properties of biomass smoke aerosols. Results from burns of several biomass fuels from the west and southeast United States showed large variability in the humidification factor (f(RH=bsp(RH/bsp(dry. Values of f(RH at RH=80–85% ranged from 0.99 to 1.81 depending on fuel type. We incorporated measured chemical composition and size distribution data to model the smoke hygroscopic growth to investigate the role of inorganic compounds on water uptake for these aerosols. By assuming only inorganic constituents were hygroscopic, we were able to model the water uptake within experimental uncertainty, suggesting that inorganic species were responsible for most of the hygroscopic growth. In addition, humidification factors at 80–85% RH increased for smoke with increasing inorganic salt to carbon ratios. Particle morphology as observed from scanning electron microscopy revealed that samples of hygroscopic particles contained soot chains either internally or externally mixed with inorganic potassium salts, while samples of weak to non-hygroscopic particles were dominated by soot and organic constituents. This study provides further understanding of the compounds responsible for water uptake by young biomass smoke, and is important for accurately assessing the role of smoke in climate change studies and visibility regulatory efforts.

  6. Satisfaction with life after burn: A Burn Model System National Database Study.

    Science.gov (United States)

    Goverman, J; Mathews, K; Nadler, D; Henderson, E; McMullen, K; Herndon, D; Meyer, W; Fauerbach, J A; Wiechman, S; Carrougher, G; Ryan, C M; Schneider, J C

    2016-08-01

    While mortality rates after burn are low, physical and psychosocial impairments are common. Clinical research is focusing on reducing morbidity and optimizing quality of life. This study examines self-reported Satisfaction With Life Scale scores in a longitudinal, multicenter cohort of survivors of major burns. Risk factors associated with Satisfaction With Life Scale scores are identified. Data from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Model System (BMS) database for burn survivors greater than 9 years of age, from 1994 to 2014, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures were the individual items and total Satisfaction With Life Scale (SWLS) scores at time of hospital discharge (pre-burn recall period) and 6, 12, and 24 months after burn. The SWLS is a validated 5-item instrument with items rated on a 1-7 Likert scale. The differences in scores over time were determined and scores for burn survivors were also compared to a non-burn, healthy population. Step-wise regression analysis was performed to determine predictors of SWLS scores at different time intervals. The SWLS was completed at time of discharge (1129 patients), 6 months after burn (1231 patients), 12 months after burn (1123 patients), and 24 months after burn (959 patients). There were no statistically significant differences between these groups in terms of medical or injury demographics. The majority of the population was Caucasian (62.9%) and male (72.6%), with a mean TBSA burned of 22.3%. Mean total SWLS scores for burn survivors were unchanged and significantly below that of a non-burn population at all examined time points after burn. Although the mean SWLS score was unchanged over time, a large number of subjects demonstrated improvement or decrement of at least one SWLS category. Gender, TBSA burned, LOS, and school status were associated with SWLS scores at 6 months

  7. Measurements of CO in an aircraft experiment and their correlation with biomass burning and air mass origin in South America

    Science.gov (United States)

    Boian, C.; Kirchhoff, V. W. J. H.

    Carbon monoxide (CO) measurements are obtained in an aircraft experiment during 1-7 September 2000, conducted over Central Brazil in a special region of anticyclonic circulation. This is a typical transport regime during the dry season (July-September), when intense biomass burning occurs, and which gives origin to the transport of burning poluents from the source to distant regions. This aircraft experiment included in situ measurements of CO concentrations in three different scenarios: (1) areas of fresh biomass burning air masses, or source areas; (2) areas of aged biomass burning air masses; and (3) areas of clean air or pristine air masses. The largest CO concentrations were of the order of 450 ppbv in the source region near Conceicao do Araguaia (PA), and the smallest value near 100 ppbv, was found in pristine air masses, for example, near the northeast coastline (clean air, or background region). The observed concentrations were compared to the number of fire pixels seen by the AVHRR satellite instrument. Backward isentropic trajectories were used to determine the origin of the air masses at each sampling point. From the association of the observed CO mixing ratios, fire pixels and air mass trajectories, the previous scenarios may be subdivided as follows: (1a) source regions of biomass burning with large CO concentrations; (1b) regions with few local fire pixels and absence of contributions by transport. Areas with these characteristics include the northeast region of Brazil; (1c) regions close to the source region and strongly affected by transport (region of Para and Amazonas); (2) regions that have a consistent convergence of air masses, that have traveled over biomass burning areas during a few days (western part of the Cerrado region); (3a) Pristine air masses with origin from the ocean; (3b) regions with convergent transport that has passed over areas of no biomass burning, such as frontal weather systems in the southern regions.

  8. Epidemiology and outcome analysis of burn patients admitted to an Intensive Care Unit in a University Hospital.

    Science.gov (United States)

    Queiroz, Luiz Fernando Tibery; Anami, Elza H T; Zampar, Elisangela F; Tanita, Marcos T; Cardoso, Lucienne T Q; Grion, Cintia Magalhaes C

    2016-05-01

    To describe the epidemiologic aspects of burn victims who were hospitalized in the Intensive Care Unit (ICU) at the Burn Center in the University Hospital of the State University of Londrina (UEL). A longitudinal retrospective study was conducted, involving patients admitted to the Intensive Care Unit of the Burn Center from January 2010 to December 2012. Demographic and diagnostic data including the diagnosis of the extent and causes of the burns, complications resulting from the burns and the need for specific surgical interventions were collected, together with data for the calculation of the Acute Physiology and Chronic Health Evaluation (APACHE II), Sequential Organ Failure Assessment (SOFA), Therapeutic Intervention Scoring System (TISS-28) and Abbreviated Burn Severity Index (ABSI). Data were collected at admission and daily until discharge from the burn Intensive Care Unit. Risk factors for death and the prognostic performance of scores to predict mortality were analyzed. The level of significance was set at 5%. Two hundred ninety-three patients were analyzed in the study; 68.30% were men, with a median age of 38 years (interquartile range: 28-52). The mean total body surface area burned was 26.60±18.05%. Home incidents were the most frequent cause, occurring in 53.90% of the cases. Fire was the most common cause, found in 77.10% of patients. Liquid alcohol was the most common agent and was associated with 51.50% of the cases. The ABSI presented a median of 7, and the area under the ROC curve was 0.890. In multivariate analysis, age (p<0.001), female gender (p=0.02), total body surface area burned (p<0.001), mechanical ventilation (p<0.001) and acute renal failure (p<0.001) were all associated with mortality. ICU mortality was 32.80%, and hospital mortality was 34.10%. Burns most often occurred in young adult men in our study. The most common cause was a direct flame. Liquid alcohol was the most frequent accelerating agent. Patients were considered to be

  9. The role of the nurse in the rehabilitation of patients with radical changes in body image due to burn injuries.

    Science.gov (United States)

    Aacovou, I

    2005-06-30

    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 body image. The aim of nursing is defined and the nurse's role in cases of severe changes in body image due to burn injuries is discussed.

  10. Skin allograft procurement and transplantation in Mashhad, Iran: Are burn patients' needs being met?

    Science.gov (United States)

    Tavousi, Seyed Hassan; Ahmadabadi, Ali; Sedaghat, Alireza; Khaleghi, Ebrahim; Rashchi, Maryam; Bonakdaran, Zohreh

    2017-09-01

    Only a single donor's tissue may save or improve lives of one hundred patients. Unfortunately, low governmental and media support of tissue procurement and transplantation programs is a worldwide problem. Loss of an effective tissue procurement program in many countries like Iran, may lead to loss of many thousands valuable tissues each year. To evaluate the rate of skin donation in Mashhad in comparison to other organs and tissues, we extracted the data related to tissue and organ procurement in Mashhad from 2001. Then we evaluated the annual skin allograft needs in the Burn Department of Imam Reza Hospital as the only referral burn center in the northeast of Iran. Brain dead potential donation rate per million populations of Mashhad in the years 2007-2014 was about 33. The mean refusal rate was 51%. Of patients who have consent for donation, more than 86% have consent for skin donation. Skin allograft procured from 119 (35.5%) candidates. Average of skin retrieval per cadaveric was 1525 cm 2 with a gradual increase from 1400 cm 2 in the first year to 1800 cm 2 in the last year. The recipient to donor ratio was 1.14. It is estimated that about 1 cm 2 of skin allograft is needed for any cm 2 burnt body surface area. Considering more than 700 acute burn hospitalization in our burn unit, the patients need for skin allograft would be more than 3.5 million cm 2 , annually. The annual amount of skin procurement in Mashhad has been currently about 20,000 cm 2 . It shows that our patients demand is higher than supply. Skin procurement and transplantation is a simple procedure which can be as lifesaving as organ procurement and transplantation. But there isn't any national organization to regulate tissue procurement, banking and transplantation. Governmental support of skin procurement and transplantation programs especially nonprofit programs may improve skin procurement rate and save more lives of severely burnt patients.

  11. EFFECTIVENESS OF EARLY STRETCHING EXERCISES FOR RANGE OF MOTION IN THE SHOULDER JOINT AND QUALITY OF FUNCTIONAL RECOVERY IN PATIENTS WITH BURNS - A RANDOMIZED CONTROL TRIAL

    Directory of Open Access Journals (Sweden)

    Amara D. Perer

    2017-10-01

    Full Text Available Background: This study evaluated the effects of an early stretching exercises programme on the range of motion of the shoulder joint and functional recovery in patients with burns. Methods: A randomized controlled study was conducted. Patients from 15 to 55 years of age with a total burn injury surface area (TBSA of 10% to 45% involving the shoulder joint including axilla were eligible. Participants were randomized into two groups; intervention and a usual care control group, with 110 patients in each group. A standardized protocol was used in the management of intervention group for 14 days. The control group was subjected to usual protocol currently used. The range of Motion (ROM was measured, and Functional recovery (FR was assessed with the Quick DASH questionnaire and the Abduction Ladder. Data were obtained before and after the intervention phase and at 3, 6 and 12 months of post-burn period. Results: The mean (SD age of intervention group and control group were 29.76 [9.81] and 30.31 [9.45] respectively. The mean (SD TBSA% of intervention group and control group was 26.15[9.45] and 24.60[9.56] respectively. There is a significant beneficial difference (p=<0.0001 in ROM and FR between the intervention group and the control group. Conclusion: This study demonstrated that an early sustained stretching exercise regime significantly improved the ROM and functional recovery of the shoulder joint after a severe burn involving the axilla.

  12. 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

    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. 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. 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 significantly greater risk for

  13. Early assessment and identification of posttraumatic stress disorder, satisfaction with appearance and coping in patients with burns.

    Science.gov (United States)

    Dahl, Oili; Wickman, Marie; Björnhagen, Viveca; Friberg, Mona; Wengström, Yvonne

    2016-12-01

    The first year after severe burn is a psychologically challenging period for the patient. Patients may still struggle with burn-related physical and psychological problems such as posttraumatic stress disorder (PTSD) and body image dissatisfaction (BID). This study investigates the presence of PTSD, BID and coping, at three, six and twelve months after discharge for early identification of patients in need of focused support during rehabilitation. Fifty-two adult patients with different degrees of burns were followed at three, six and twelve months after discharge and 36 patients completed all assessment points. A standardized clinical protocol was used for systematic assessment of PTSD (IES-R), BID (SWAP-Swe) and Coping (CBQ). The follow-up included an intervention with a burn nurse as a complement to the existing program. Approximately half of the patients had a risk of developing PTSD three months after discharge from hospital, and body image dissatisfaction was found to potentially predict risk of PTSD during follow-up. The findings suggest that it is important to include patients with less extensive burns in follow-up as this group is at risk of development of PTSD. Using standardized questionnaires in early follow-up along with assessment of body image dissatisfaction may facilitate detection of psychological problems. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Cost of nursing most frequent procedures performed on severely burned patients

    OpenAIRE

    Melo, Talita de Oliveira; Lima, Antônio Fernandes Costa

    2017-01-01

    ABSTRACT Objective: to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. Method: exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. Results: a MDC of US$ 0.65 (SD=0.36) wa...

  15. Burned-out seminom-lymfeknudemetastasepå halsen hos en patient med radikalt behandlet cancer coli

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Rasmussen, Eva Rye

    2017-01-01

    and at the neck. A core needle biopsy from the lymph node at the neck contained malignant cells, but not from colon cancer. The lymph node was extirpated, and pathological analysis proved it to be a metastasis from a testicular seminoma. A burned-out seminoma was subsequently found in the patient's right testicle.......The incidence of metastases to the neck in testicular cancer is 4-15%, and in 5% of these cases the metastasis is the only symptom. We present a 57-year-old asymptomatic male, who had previously been treated for colon cancer. A routine PET-CT showed enlarged lymph nodes in the retroperitoneum...

  16. Treatment of pediatric burn patient having glucose-6-phosphate dehydrogenase deficiency

    Directory of Open Access Journals (Sweden)

    Vijay Y Bhatia

    2016-01-01

    Full Text Available Glucose-6-phosphate dehydrogenase (G6PD deficiency is the most common red cell enzymopathy found in humans. It clearly has an X-linked recessive inheritance with its prevalence varying from 0% to 27% in a different caste, ethnic, and linguistic groups. This deficiency may result in hemolytic anemia during stress, infection, and use of certain drugs. The use of topical silver sulfadiazine can produce hemolysis in patients having G6PD deficiency. Here, we describe one case successfully treated of pediatric burn of 25% of body surface area who was a known case of G6PD deficiency.

  17. Experimental measurements and numerical modeling of marginal burning in live chaparral fuel beds

    Science.gov (United States)

    X. Zhou; D.R. Weise; S Mahalingam

    2005-01-01

    An extensive experimental and numerical study was completed to analyze the marginal burning behavior of live chaparral shrub fuels that grow in the mountains of southern California. Laboratory fire spread experiments were carried out to determine the effects of wind, slope, moisture content, and fuel characteristics on marginal burning in fuel beds of common...

  18. A retrospective study to determine the incidence of pressure ulcers in burn patients using an alternating pressure mattress.

    Science.gov (United States)

    Still, Joseph M; Wilson, Joan; Rinker, Connie; Law, Edward; Craft-Coffman, Beretta

    2003-08-01

    In immobilized patients, unrelieved pressure can create decubitus ulcers over bony prominences. Those burn patients who require prolonged bed rest, are prone to the development of such problems. Various methods of reducing pressure on these areas, including frequent turning and the use of air fluidized and low air loss beds, have been adopted to attempt to prevent the development of this complication. The Pegasus Renaissance alternating pressure mattress is such a device, intended to reduce the incidence of decubitus ulcers. It was introduced at our burn unit and evaluated over a 29-month period. During the study period, 186 (13.4%) of 1390 acutely burned patients, believed to be at high risk for the development of decubiti, were placed on this mattress. Other patients were treated in the standard hospital bed. Care was otherwise the same. No decubitus ulcers developed in any of the patients treated on the Pegasus Renaissance mattress.

  19. Predictive factors of mortality in burn patients Fatores preditivos de mortalidade em queimaduras

    Directory of Open Access Journals (Sweden)

    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

  20. An Experimental Measurement on Laminar Burning Velocities and Markstein Length of Iso-Butane-Air Mixtures at Ambient Conditions

    Directory of Open Access Journals (Sweden)

    Yousif Alaeldeen Altag

    2016-01-01

    Full Text Available In the present work, experimental investigation on laminar combustion of iso-butane-air mixtures was conducted in constant volume explosion vessel. The experiments were conducted at wide range of equivalence ratios ranging between Ф = 0.6 and 1.4 and atmospheric pressure of 0.1 MPa and ambient temperature of 303K. Using spherically expanding flame method, flame parameters including stretched, unstretched flame propagation speeds, laminar burning velocities and Markstein length were calculated. For laminar burning velocities the method of error bars of 95% confidence level was applied. In addition, values of Markstein lengths were measured in wide range of equivalence ratios to study the influence of stretch rate on flame instability and burning velocity. It was found that the stretched flame speed and laminar burning velocities increased with equivalence ratios and the peak value was obtained at equivalence ratio of Ф = 1.1. The Markstein length decreased with the increases in equivalence ratios, which indicates that the diffusion thermal flame instability increased at high equivalence ratios in richer mixture side. However, the total deviations in the laminar burning velocities have discrepancies of 1.2-2.9% for all investigated mixtures.

  1. Inferring brown carbon content from UV aerosol absorption measurements during biomass burning season

    Science.gov (United States)

    Mok, J.; Krotkov, N. A.; Arola, A. T.; Torres, O.; Jethva, H. T.; Andrade, M.; Labow, G. J.; Eck, T. F.; Li, Z.; Dickerson, R. R.; Stenchikov, G. L.; Osipov, S.

    2015-12-01

    Measuring spectral dependence of light absorption by colored organic or "brown" carbon (BrC) is important, because of its effects on photolysis rates of ozone and surface ultraviolet (UV) radiation. Enhanced UV spectral absorption by BrC can in turn be exploited for simultaneous retrievals of BrC and black carbon (BC) column amounts in field campaigns. We present an innovative ground-based retrieval of BC and BrC volume fractions and their mass absorption efficiencies during the biomass burning season in Santa Cruz, Bolivia in September-October 2007. Our method combines retrieval of BC volume fraction using AERONET inversion in visible wavelengths with the inversion of total BC+BrC absorption (i.e., column effective imaginary refractive index, kmeas) using Diffuse/Direct irradiance measurements in UV wavelengths. First, we retrieve BrC volume fraction by fitting kmeas at 368nm using Maxwell-Garnett (MG) mixing rules assuming: (1) flat spectral dependence of kBC, (2) known value of kBrC at 368nm from laboratory absorption measurements or smoke chamber experiments, and (3) known BC volume fraction from AERONET inversion. Next, we derive kBrC in short UVB wavelengths by fitting kmeas at 305nm, 311nm, 317nm, 325nm, and 332nm using MG mixing rules and fixed volume fractions of BC and BrC. Our retrievals show larger than expected spectral dependence of kBrC in UVB wavelengths, implying reduced surface UVB irradiance and inhibited photolysis rates of surface ozone destruction. We use a one-dimensional chemical box model to show that the observed strong wavelength dependence of BrC absorption leads to inhibited photolysis of ozone to O(1D), a loss mechanism, while having little impact or even accelerating photolysis of NO2, an ozone production mechanism. Although BC only absorption in biomass burning aerosols is important for climate radiative forcing in the visible wavelengths, additional absorption by BrC is important because of its impact on surface UVB radiation

  2. Final Report for SERDP Project RC-1649: Advanced Chemical Measurements of Smoke from DoD-prescribed Burns

    Science.gov (United States)

    T.J. Johnson; R.J. Yokelson; S.K. Akagi; I.R. Burling; D.R. Weise; S.P. Urbanski; C.E. Stockwell; J. Reardon; E.N. Lincoln; L.T.M. Profeta; A. Mendoza; M.D.W. Schneider; R.L. Sams; S.D. Williams; C.E. Wold; D.W.T. Griffith; M. Cameron; J.B. Gilman; C. Warneke; J.M. Roberts; P. Veres; W.C. Kuster; J de Gouw

    2014-01-01

    Project RC-1649, "Advanced Chemical Measurement of Smoke from DoD-prescribed Burns" was undertaken to use advanced instrumental techniques to study in detail the particulate and vapor-phase chemical composition of the smoke that results from prescribed fires used as a land management tool on DoD bases, particularly bases in the southeastern U.S. The statement...

  3. Development of a tool to manage patient health records in support of burn injury research.

    Science.gov (United States)

    Price, Ron; Hicks, Chindo; Zelisko, Susan; Halerz, Marcia; Conrad, Peggie; Halerz, John; Gamelli, Richard L

    2011-01-01

    Data captured in electronic medical records (EMRs) and paper charts have enormous potential for clinical research and to improve the quality of health care; however, accessing, organizing, and analyzing these data pose significant challenges. To address these challenges, this article reports development of a web-based application that provides for local clinical data capture as well as integration of patient data directly from an institutional EMR. A web-based system was created using an existing institutional application development framework. The application consists of a local clinical data repository, processes that integrate data from an EMR, and programs that enable end-user access, manual data capture, and analysis. Data are maintained in a relational database at the patient level in a time- oriented manner and by clinical data type. The application and data repository have been used to integrate and analyze a broad range of clinical data of 637 patients with burn injury. Research findings have shown that in addition to tracking clinical outcomes, laboratory data provide the ability to risk stratify patient populations to target high-risk individuals for case management and interventions. This effort validates the utility of web-based applications to collect local clinical data and integrate clinical data directly from an institutional EMR. This approach leverages institutionally collected clinical information and provides the flexibility to incorporate disparate data and accommodate system modifications as needed. Although the current efforts have focused on a cohort of patients with burn injury, the approach and system design are extendable to other patient types.

  4. The Use of Procalcitonin (PCT) for Diagnosis of Sepsis in Burn Patients: A Meta-Analysis.

    Science.gov (United States)

    Cabral, Luís; Afreixo, Vera; Almeida, Luís; Paiva, José Artur

    2016-01-01

    The continuous development of resuscitation techniques and intensive care reduced the mortality rate induced by the initial shock in burn patients and, currently, infections (especially sepsis) are the main causes of mortality of these patients. The misuse of antimicrobial agents is strongly related to antimicrobial and adverse patient outcomes, development of microbial resistance and increased healthcare-related costs. To overcome these risks, antimicrobial stewardship is mandatory and biomarkers are useful to avoid unnecessary medical prescription, to monitor antimicrobial therapy and to support the decision of its stop. Among a large array of laboratory tests, procalcitonin (PCT) emerged as the leading biomarker to accurately and time-effectively indicate the presence of systemic infection. In the presence of systemic infection, PCT blood levels undergo a sudden and dramatic increase, following the course of the infection, and quickly subside after the control of the septic process. This work is a meta-analysis on PCT performance as a biomarker for sepsis. This meta-analysis showed that overall pooled area under the curve (AUC) is 0.83 (95% CI = 0.76 to 0.90); the estimated cut-off is 1.47 ng/mL. The overall sepsis effect in PCT levels is significant and strong (Cohen's d is 2.1 and 95% CI = 1.1 to 3.2). This meta-analysis showed PCT may be considered as a biomarker with a strong diagnostic ability to discriminate between the septic from the non-septic burn patients. Thus, this work encourages the determination of PCT levels in clinical practice for the management of these patients, in order to timely identify the susceptibility to sepsis and to initiate the antimicrobial therapy, improving the patients' outcomes.

  5. MRI induced second-degree burn in a patient with extremely large uterine leiomyomas: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Kang, Bo Kyeong; Song, Soon Young; Koh, Byung Hee; Choi, Joong Sub; Lee, Won Moo [Hanyang University Medical Center, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Burns and thermal injuries related with magnetic resonance imaging (MRI) are rare. Previous literature indicates that medical devices with cable, cosmetics or tattoo are known as risk factors for burns and thermal injuries. However, there is no report of MRI-related burns in Korea. Herein, we reported a case of deep second degree burn after MRI in a 38-year-old female patient with multiple uterine leiomyomas including some that were large and degenerated. The large uterine leiomyoma-induced protruded anterior abdominal wall in direct contact with the body coil during MRI was suspected as the cause of injury, by retrospective analysis. Therefore, awareness of MRI related thermal injury is necessary to prevent this hazard, together with extreme care during MRI.

  6. MRI induced second-degree burn in a patient with extremely large uterine leiomyomas: A case report

    International Nuclear Information System (INIS)

    Lee, Chul Min; Kang, Bo Kyeong; Song, Soon Young; Koh, Byung Hee; Choi, Joong Sub; Lee, Won Moo

    2015-01-01

    Burns and thermal injuries related with magnetic resonance imaging (MRI) are rare. Previous literature indicates that medical devices with cable, cosmetics or tattoo are known as risk factors for burns and thermal injuries. However, there is no report of MRI-related burns in Korea. Herein, we reported a case of deep second degree burn after MRI in a 38-year-old female patient with multiple uterine leiomyomas including some that were large and degenerated. The large uterine leiomyoma-induced protruded anterior abdominal wall in direct contact with the body coil during MRI was suspected as the cause of injury, by retrospective analysis. Therefore, awareness of MRI related thermal injury is necessary to prevent this hazard, together with extreme care during MRI

  7. A multi-decadal history of biomass burning plume heights identified using aerosol index measurements

    Directory of Open Access Journals (Sweden)

    H. Guan

    2010-07-01

    Full Text Available We have quantified the relationship between Aerosol Index (AI measurements and plume height for young biomass burning plumes using coincident Ozone Monitoring Instrument (OMI and Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO measurements. This linear relationship allows the determination of high-altitude plumes wherever AI data are available, and it provides a data set for validating global fire plume heights in chemistry transport models. We find that all plumes detected from June 2006 to February 2009 with an AI value ≥9 are located at altitudes higher than 5 km. Older high-altitude plumes have lower AI values than young plumes at similar altitudes. We have examined available AI data from the OMI and TOMS instruments (1978–2009 and find that large AI plumes occur more frequently over North America than over Australia or Russia/Northeast Asia. According to the derived relationship, during this time interval, 181 plumes, in various stages of their evolution, reached altitudes above 8 km.

  8. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

    Science.gov (United States)

    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 to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  9. Airborne hydrogen cyanide measurements using a chemical ionisation mass spectrometer for the plume identification of biomass burning forest fires

    Directory of Open Access Journals (Sweden)

    M. Le Breton

    2013-09-01

    Full Text Available A chemical ionisation mass spectrometer (CIMS was developed for measuring hydrogen cyanide (HCN from biomass burning events in Canada using I− reagent ions on board the FAAM BAe-146 research aircraft during the BORTAS campaign in 2011. The ionisation scheme enabled highly sensitive measurements at 1 Hz frequency through biomass burning plumes in the troposphere. A strong correlation between the HCN, carbon monoxide (CO and acetonitrile (CH3CN was observed, indicating the potential of HCN as a biomass burning (BB marker. A plume was defined as being 6 standard deviations above background for the flights. This method was compared with a number of alternative plume-defining techniques employing CO and CH3CN measurements. The 6-sigma technique produced the highest R2 values for correlations with CO. A normalised excess mixing ratio (NEMR of 3.68 ± 0.149 pptv ppbv−1 was calculated, which is within the range quoted in previous research (Hornbrook et al., 2011. The global tropospheric model STOCHEM-CRI incorporated both the observed ratio and extreme ratios derived from other studies to generate global emission totals of HCN via biomass burning. Using the ratio derived from this work, the emission total for HCN from BB was 0.92 Tg (N yr−1.

  10. [Effects of group psychological counseling on self-confidence and social adaptation of burn patients].

    Science.gov (United States)

    Dang, Rui; Wang, Yishen; Li, Na; He, Ting; Shi, Mengna; Liang, Yanyan; Zhu, Chan; Zhou, Yongbo; Qi, Zongshi; Hu, Dahai

    2014-12-01

    To explore the effects of group psychological counseling on the self-confidence and social adaptation of burn patients during the course of rehabilitation. Sixty-four burn patients conforming to the inclusion criteria and hospitalized from January 2012 to January 2014 in Xijing Hospital were divided into trial group and control group according to the method of rehabilitation, with 32 cases in each group. Patients in the two groups were given ordinary rehabilitation training for 8 weeks, and the patients in trial group were given a course of group psychological counseling in addition. The Rosenberg's Self-Esteem Scale was used to evaluate the changes in self-confidence levels, and the number of patients with inferiority complex, normal feeling, self-confidence, and over self-confidence were counted before and after treatment. The Abbreviated Burn-Specific Health Scale was used to evaluate physical function, psychological function, social relationship, health condition, and general condition before and after treatment to evaluate the social adaptation of patients. Data were processed with t test, chi-square test, Mann-Whitney U test, and Wilcoxon test. (1) After treatment, the self-confidence levels of patients in trial group were significantly higher than those in control group (Z = -2.573, P self-confidence were 8 (25.0%) and 4 (12.5%) before treatment, which were respectively increased to 13 (40.6%) and 10 (31.3%) after treatment. The overall difference in trial group was obvious between before and after treatment (Z = -4.123, P self-confidence level of patients in control group between before and after treatment (Z = -1.000, P > 0.05). (2) After treatment, the scores of psychological function, social relationship, health condition, and general condition were (87 ± 3), (47.8 ± 3.6), (49 ± 3), and (239 ± 10) points in trial group, which were significantly higher than those in control group [(79 ± 4), (38.3 ± 5.6), (46 ± 4), and (231 ± 9) points, with t

  11. Prevalence of extended spectrum beta lactamases among strains of Pseudomonas aeruginosa isolated from burn patients

    Directory of Open Access Journals (Sweden)

    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.

  12. Clinical outcomes of isolated lower extremity or foot burns in diabetic versus non-diabetic patients: a 10-year retrospective analysis.

    Science.gov (United States)

    Kimball, Zachary; Patil, Sachin; Mansour, Hani; Marano, Michael A; Petrone, Sylvia J; Chamberlain, Ronald S

    2013-03-01

    The incidence of diabetes mellitus (DM) in the United States is expected to increase from 8 per 1000 in 2008 to 15 per 1000 by 2050 [20]. As a result, DM patients will constitute a large proportion of Burn Center admissions, with burns typically due to contact burn or scalding. Peripheral vascular disease (PVD) and peripheral neuropathy (PN) are far more common in DM patients, particularly in those with poorly controlled disease, and are often associated with worse outcomes than non-diabetic (nDM) burn patients. This study sought to analyze whether the outcome of isolated leg and foot burns among DM and nDM individuals differed significantly. Retrospective data on 207 consecutive patients (>18 years old) admitted to a Burn Center with isolated leg or foot burns between 1999 and 2009 was collected and analyzed for this study. Age, gender, ethnicity, total body surface area (TBSA), degree of burn, etiology, hospital and burn intensive care unit (ICU), length of stay (LOS), and status at discharge were reviewed. Patients were grouped as diabetic (DM) or non-diabetic (nDM). Differences were analyzed using either the Student's t-test or Chi-square. 43 DM and 164 nDM patients with isolated lower extremity or foot burns were treated during the study period (1999-2009). The mean age of DM and nDM patients was 54.6 and 43.7 years, respectively (pburn etiology was scalding, flame, or contact burn. Percentage of total body surface area (TBSA) burn in DM patients averaged±standard deviation 1.8±1.3% compared to 1.8±1.6% in nDM (pthird degree burns and 14% (N=6) of patients had second degree burns compared to 76% (N=125) of patients and 24% (N=39) of patients among nDM patients, respectively (pburn ICU admission rates, 16.3% of patients versus 8.5% of patients (pburns to the feet or lower extremities have poorer clinical outcomes and more complicated and protracted hospital courses when compared to nDM patients with similar burns. Although diabetics in the current study did

  13. Increasing blood glucose variability is a precursor of sepsis and mortality in burned patients.

    Directory of Open Access Journals (Sweden)

    Alexander N Pisarchik

    Full Text Available High glycemic variability, rather than a mean glucose level, is an important factor associated with sepsis and hospital mortality in critically ill patients. In this retrospective study we analyze the blood glucose data of 172 nondiabetic patients 18-60 yrs old with second and third-degree burns of total body surface area greater than 30% and 5%, respectively, admitted to ICU in 2004-2008. The analysis identified significant association of increasing daily glucose excursion (DELTA accompanied by evident episodes of hyperglycemia (>11 mmol/l and hypoglycemia (<2.8 mmol/l, with sepsis and forthcoming death, even when the mean daily glucose was within a range of acceptable glycemia. No association was found in sepsis complication and hospital mortality with doses of intravenous insulin and glucose infusion. A strong increase in DELTA before sepsis and death is treated as fluctuation amplification near the onset of dynamical instability.

  14. Fungal Burn Wound Infection

    Science.gov (United States)

    1991-01-01

    Aspergillus), Blasto- T he use of effective topical chemotherapeutic agents to myces (Candida), and Zygomycetes (Mucor, Rhizopus ).6 reduce...below the infected burn wound . If the infection was controlled by these measures and the patient’s condition permit- ted, the involved area was...species, 18%; Mucor species and Rhizopus species, acetate in the morning and silver sulfadiazine in the evening. Prophy- 9.1%; and Microspora species and

  15. LA50 in burn injuries.

    Science.gov (United States)

    Seyed-Forootan, K; Karimi, H; Motevalian, S A; Momeni, M; Safari, R; Ghadarjani, M

    2016-03-31

    Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.

  16. Techniques for Estimating Emissions Factors from Forest Burning: ARCTAS and SEAC4RS Airborne Measurements Indicate which Fires Produce Ozone

    Science.gov (United States)

    Chatfield, Robert B.; Andreae, Meinrat O.

    2016-01-01

    Previous studies of emission factors from biomass burning are prone to large errors since they ignore the interplay of mixing and varying pre-fire background CO2 levels. Such complications severely affected our studies of 446 forest fire plume samples measured in the Western US by the science teams of NASA's SEAC4RS and ARCTAS airborne missions. Consequently we propose a Mixed Effects Regression Emission Technique (MERET) to check techniques like the Normalized Emission Ratio Method (NERM), where use of sequential observations cannot disentangle emissions and mixing. We also evaluate a simpler "consensus" technique. All techniques relate emissions to fuel burned using C(burn) = delta C(tot) added to the fire plume, where C(tot) approximately equals (CO2 = CO). Mixed-effects regression can estimate pre-fire background values of C(tot) (indexed by observation j) simultaneously with emissions factors indexed by individual species i, delta, epsilon lambda tau alpha-x(sub I)/C(sub burn))I,j. MERET and "consensus" require more than emissions indicators. Our studies excluded samples where exogenous CO or CH4 might have been fed into a fire plume, mimicking emission. We sought to let the data on 13 gases and particulate properties suggest clusters of variables and plume types, using non-negative matrix factorization (NMF). While samples were mixtures, the NMF unmixing suggested purer burn types. Particulate properties (b scant, b abs, SSA, AAE) and gas-phase emissions were interrelated. Finally, we sought a simple categorization useful for modeling ozone production in plumes. Two kinds of fires produced high ozone: those with large fuel nitrogen as evidenced by remnant CH3CN in the plumes, and also those from very intense large burns. Fire types with optimal ratios of delta-NOy/delta- HCHO associate with the highest additional ozone per unit Cburn, Perhaps these plumes exhibit limited NOx binding to reactive organics. Perhaps these plumes exhibit limited NOx binding to

  17. Light absorption by pollution, dust, and biomass burning aerosols: a global model study and evaluation with AERONET measurements

    Directory of Open Access Journals (Sweden)

    Mian Chin

    2009-09-01

    Full Text Available Atmospheric aerosol distributions from 2000 to 2007 are simulated with the Goddard Chemistry Aerosol Radiation and Transport (GOCART model to attribute light absorption by aerosol to its composition and sources from pollution, dust, and biomass burning. The 8-year, global averaged total aerosol optical depth (τ, absorption optical depth (τa, and single scattering albedo (ω at 550 nm are estimated at 0.14, 0.0086, and 0.95, respectively, with sulfate making the largest fraction of τ (37%, followed by dust (30%, sea salt (16%, organic matter (OM (13%, and black carbon (BC (4%. BC and dust account for 43% and 53% of τa, respectively. From a model experiment with "tagged" sources, natural aerosols are estimated to be 58% of τ and 53% of τa, with pollution and biomass burning aerosols to share the rest. Comparing with data from the surface sunphotometer network AERONET, the model tends to reproduce much better the AERONET direct measured data of τ and the Ångström exponent (α than its retrieved quantities of ω and τa. Relatively small in its systematic bias of τ for pollution and dust regions, the model tends to underestimate τ for biomass burning aerosols by 30–40%. The modeled α is 0.2–0.3 too low (particle too large for pollution and dust aerosols but 0.2–0.3 too high (particle too small for the biomass burning aerosols, indicating errors in particle size distributions in the model. Still, the model estimated ω is lower in dust regions and shows a much stronger wavelength dependence for biomass burning aerosols but a weaker one for pollution aerosols than those quantities from AERONET. These comparisons necessitate model improvements on aerosol size distributions, the refractive indices of dust and black carbon aerosols, and biomass burning emissions in order to better quantify the aerosol absorption in the atmosphere.

  18. Noninvasive hemoglobin measurement in pediatric trauma patients.

    Science.gov (United States)

    Ryan, Mark Leo; Maxwell, Angela C; Manning, Lisa; Jacobs, Jonathan D; Bachier-Rodriguez, Marielena; Feliz, Alexander; Williams, Regan F

    2016-12-01

    Hemorrhage is a major cause of preventable death secondary to traumatic injury. Diagnosis often requires multiple blood draws, which are psychologically stressful in pediatric patients. The Pronto device is a pulse co-oximeter that measures the total hemoglobin level using multiple wavelengths of light. The purpose of this study was to evaluate the accuracy of the noninvasive hemoglobin measurements relative to current invasive and point of care testing methods in pediatric trauma patients. We performed a prospective observational trial involving patients younger than 17 years presenting to a Level I pediatric trauma center. Following admission, blood was sampled from each patient for testing using an i-Stat device (point-of-care hemoglobin) and a complete blood count within our core laboratory (invasive hemoglobin). Noninvasive hemoglobin analysis was performed within 15 minutes of phlebotomy. Data were evaluated using Spearman correlation and Bland-Altman analysis. Over 2 years, 114 patients had attempted noninvasive hemoglobin measurements, with a success rate of 89%. Mean ± SD age was 9.2 ± 5.1 years. Ninety percent of admissions were for blunt injury, 3% penetrating, 5% near drowning, and 1% burns. Mean invasive hemoglobin was 12.6 ± 1.9 g/dL, mean point-of-care hemoglobin was 12.2 ± 2.0 g/dL, and mean noninvasive hemoglobin was 12.3 ± 1.6 g/dL. Noninvasive hemoglobin values were strongly correlated with both invasive and point of care measurements (R = 0.672 and R = 0.645, respectively; p venipuncture, noninvasive hemoglobin monitoring may be a valuable adjunct in the initial evaluation and monitoring of pediatric trauma patients. Diagnostic test study, level II.

  19. Improving burn care and preventing burns by establishing a burn database in Ukraine.

    Science.gov (United States)

    Fuzaylov, Gennadiy; Murthy, Sushila; Dunaev, Alexander; Savchyn, Vasyl; Knittel, Justin; Zabolotina, Olga; Dylewski, Maggie L; Driscoll, Daniel N

    2014-08-01

    Burns are a challenge for trauma care and a contribution to the surgical burden. The former Soviet republic of Ukraine has a foundation for burn care; however data concerning burns in Ukraine has historically been scant. The objective of this paper was to compare a new burn database to identify problems and implement improvements in burn care and prevention in this country. Retrospective analyses of demographic and clinical data of burn patients including Tukey's post hoc test, analysis of variance, and chi square analyses, and Fisher's exact test were used. Data were compared to the American Burn Association (ABA) burn repository. This study included 1752 thermally injured patients treated in 20 hospitals including Specialized Burn Unit in Municipal Hospital #8 Lviv, Lviv province in Ukraine. Scald burns were the primary etiology of burns injuries (70%) and burns were more common among children less than five years of age (34%). Length of stay, mechanical ventilation use, infection rates, and morbidity increased with greater burn size. Mortality was significantly related to burn size, inhalation injury, age, and length of stay. Wound infections were associated with burn size and older age. Compared to ABA data, Ukrainian patients had double the length of stay and a higher rate of wound infections (16% vs. 2.4%). We created one of the first burn databases from a region of the former Soviet Union in an effort to bring attention to burn injury and improve burn care. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  20. [Mono- and associated microflora during wound infection in patients with burns].

    Science.gov (United States)

    Men'shikov, D D; Godkov, M A; Chernen'kaia, T V; Kiselevskaia-Babinina, I V; Semenova, A V; Men'shikova, E D; Kurilin, B L

    2009-01-01

    To study etiologic role of microorganisms during wound infection and elucidation of their populations interaction in patientswith burns. 2137 patients with wound infection treated in burn center were studied. 3179 samples of wound exudates and 6501 strains of microorganisms were studied. Assessment of microorganism's etiologic role was carried out using results of calculation of various statistic indexes, including indexes of ecological similarities of microorganisms in the wound (indexes of contamination, prevalence or persistence, incidence). Ecological similarity of wounds' microflora was determined by calculation of the coefficient Kj. It was established that Staphylococcus aureus is the most common cause of mono- and mixed wound infections. It was determined that Kj value for common agents points to antagonism or associative interaction. During particular time periods of the study values of Kj significantly differed and depended from species. Specifically, for Pseudomonas aeruginosa the values of Kj were equal or exceeded 30% during several years. It was the first time when correlation between persistence and ecological similarity indexes was studied in agents of wound infections. In order to reveal factors influencing on microbial etiology of mixed wound infections it is reasonable to consider the nature of interspecies interactions of causative agents.

  1. Cost of nursing most frequent procedures performed on severely burned patients.

    Science.gov (United States)

    Melo, Talita de Oliveira; Lima, Antônio Fernandes Costa

    2017-01-01

    to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. a MDC of US$ 0.65 (SD=0.36) was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23) for "intravenous drug administration"; US$ 5.90 (SD=2.75) for "measurement of diuresis"; US$ 0.93 (SD=0.42) for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55) for "bandaging". the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care. identificar o custo direto médio (CDM) dos procedimentos realizados, com maior frequência, por profissionais de enfermagem, em uma Unidade de Terapia Intensiva, aos pacientes grandes queimados. pesquisa quantitativa, exploratório-descritiva, do tipo estudo de caso único. O CDM foi calculado multiplicando-se o tempo (cronometrado) despendido por profissionais de enfermagem na execução dos procedimentos, objeto de estudo, pelo custo unitário da mão de obra direta, somando-se ao custo dos materiais e soluções/medicamentos. obteve-se o CDM de US$ 0.65 (SD=0.36) para "controle dos sinais vitais"; US$ 10.00 (SD=24.23) para "administração de medicamentos via intravenosa"; US$ 5.90 (SD=2.75) para "mensuração de diurese"; US$ 0.93 (SD=0.42) para "verificação de glicemia capilar"; e US$ 99.75 (SD=129.55) para "curativo". o conhecimento desenvolvido pode fundamentar as tomadas de decisão gerenciais subsidiando a eficiência alocativa dos recursos envolvidos e, quando possível, indicar estratégias de conten

  2. [Burn rehabilitation and community reintegration-new challenge to burn surgery in China].

    Science.gov (United States)

    Xie, Wei-Guo

    2010-12-01

    recent years that rehabilitation measurements should be carried out through the whole process of burn treatment. Organizations of burn survivors and summer camps for burnt children proved to be helpful for the patients' self-confidence and community integration have hardly been established in China. Lack of funding is one of the main reasons for the lagging behind in burn rehabilitation in China. According the experiences of other countries, raising money from donation through burn foundation may be a useful way to support burn rehabilitation. Solving the above problems and improving the burn rehabilitation will be a new challenge to burn surgery in China.

  3. [Incidence and risk factors for bacteremia on pediatric patients with burns in a specialized care center in Mexico].

    Science.gov (United States)

    Chávez-Velarde, Teresa de J; Lona-Reyes, Juan C; Riebeling-Dueñas, Alejandra; Orozco-Alatorre, Luis G

    2017-06-01

    Bacteremia events are frequent cause of mortality in burn patients and may originate from infected wounds, by bacterial translocation of endogenous microorganisms, from invasive devices or contaminated intravenous solutions. To quantify the incidence of bacteremia in pediatric patients with burns and to identify risk factors. A prospective cohort study was performed in pediatric patients with burns of Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Bacteremia was diagnosed by blood cultures in patients with clinical manifestations of sepsis. Risk factors were investigated by multivariate analysis with Cox regression. Were included in the cohort 260 patients, median age 3 years. The incidence of bacteremia was 9.6 events per 1,000 days patient. The most frequently isolated bacteria were Enterobacteriaceae (41.9%), Staphylococcus aureus (22.6%) and Pseudomonas aeruginosa (22.6%). Factors associated with bacteremia were: bums ≥ 20% TBSA (HR 11.06; 95% CI 4.8-25.4), deep second degree bums or higher (HR 6.9; 95% CI 2.0-23.3) and have had two or less debridement (HR 26.4; 95% CI 8.0-87.7). Patients with more extensive and deep burns with fewer debridement are at increased risk of bacteremia.

  4. Design and implementation considerations for a personalized patient education system in burn care.

    Science.gov (United States)

    Doupi, Persephone; van der Lei, Johan

    2005-03-01

    Patient education is a significant factor in the provision of health care services, contributing to improved disease management and health care outcomes. Personalization has been suggested as a means for increasing patient education effectiveness and computer-based approaches have been explored as a possible means of achieving this goal. The success and capabilities of the resulting applications have been restricted by the absence of a direct link to patient data and the reliance on locally produced written material, which is expensive to produce, update and tailor. In our research project STructured Evaluated Personalized Patient Support (STEPPS), we are investigating the potential of a novel strategy for personalized or tailored patient education, based on the integration of electronic patient record data and material derived from online health information resources. In this paper we present an overview of the pertinent technical issues and the way we have addressed them in the context of our development work in the domain of burn care. Further, we discuss how the choices made in the design of the system interrelate with the considerations for its implementation in health care practice settings.

  5. The utility of a video game system in rehabilitation of burn and nonburn patients: a survey among occupational therapy and physiotherapy practitioners.

    Science.gov (United States)

    Fung, Vera; So, Ken; Park, Esther; Ho, Aileen; Shaffer, Jennifer; Chan, Elaine; Gomez, Manuel

    2010-01-01

    The objective of this study was to investigate perceptions of occupational therapists and physiotherapists on the use of Nintendo Wii™ (Nintendo of America Inc., Redmond, WA) in rehabilitation. Occupational therapists and physiotherapists in a rehabilitation hospital trialed four Wii games that addressed physical movement, balance, coordination, and cognitive performance. Then, they completed an opinion survey on the utility of Wii in rehabilitation. The results were compared between burn care therapists (BTs) and nonburn care therapists, using chi(2) with a P Wii was easy to set up (71%), operate (68%), and safe to use (76%). Participants agreed that Wii would be beneficial in outpatient (76%) and inpatient (65%) settings and that it could improve treatment compliance (73%). Participants recommended 15 to 30-minute Wii intervention (59%) daily (81%) and twice per week (43%). Participants believed that neurologic (71%), trauma (68%), burn (59%), and musculoskeletal (49%) patients would benefit from Wii intervention but not cardiac (43%) or organ transplant patients (18%). Participants believed that outcomes using Wii could be measured reliably (49%), and skills learned while playing could be transferable to daily function (60%). The significant differences between BTs and nonburn care therapists' perceptions are that BT-treated younger patients (21-40 years vs >60 years, P Wii in rehabilitation (93% vs 58%, P = .02), specifically in burn rehabilitation (85% vs 39%, P = .001). Occupational therapists and physiotherapists favored the use of Wii in rehabilitation as an adjunct to traditional therapy because it is therapeutic, engaging, and may increase patient participation in rehabilitation.

  6. Under Pressure: Applying Practice-Based Learning and Improvement to the Treatment of Chronic Neuropathic Pain in Patients with Burns.

    Science.gov (United States)

    Rapolti, Mihaela; Wu, Cindy; Schuth, Olga A; Hultman, Charles Scott

    2017-10-01

    Chronic neuropathic pain after burn injury may have multiple causes, such as direct nerve injury, nerve compression, or neuroma formation, and can significantly impair quality of life and limit functional recovery. Management includes a team-based approach that involves close collaboration between occupational and physical therapists, plastic surgeons, and experts in chronic pain, from neurology, anesthesia, psychiatry, and physiatry. Carefully selected patients with an anatomic cause of chronic neuropathic pain unequivocally benefit from surgical intervention. Self-reflection and analysis yield improvement in both efficiency and effectiveness when managing patients with burns with chronic neuropathic pain. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Direct measurement of burn up monitor by Pulsed Laser Deposition (PLD) followed by Isotopic Dilution Mass Spectrometry

    International Nuclear Information System (INIS)

    Sajimol, R.; Manoravi, P.; NaIini, S.; Balasubramanian, R.; Joseph, M.

    2012-01-01

    Burn-up measurement is an important aspect in the assessment of fuel performance especially for experimental nuclear fuels. Conventional mass spectrometric technique offer the best accuracy for determination of burn-up but they suffer from the labour intensive and time consuming chemical separation procedures followed by mass spectrometric analysis. Our laboratory has reported a potential laser mass spectrometric technique with advantages of (i) direct and fast measurement of ion intensities of selected rare earth element and residual heavy element atoms to deduce burn up and (ii) adaptability to remote handling of radioactive samples. Direct quantification of burn up monitor element in fuel in the form of pellet as well as liquid was probed by pulsed laser deposition followed by Isotopic Dilution Mass Spectrometric technique (IDMS). The procedure involving laser ablation of heavy element (namely U and Pu) and fission product (Nd, La etc) from a simulated spent fuel matrix followed by isotopic dilution mass spectrometry using thermal ionization mass spectrometry (TIMS) has been presently attempted to arrive at the rare earth element to heavy element ratio to deduce burn up using the methodology described in our earlier work. The details of IDMS technique has been reviewed by Heumann et al. Accurately weighed amounts of major rare earth fission products such as Nd, La, Ce and Sm in solution form were mixed with known quantity of uranium solution (all the weights are corresponding to their fission yields and the residual heavy element atoms after a given burn up) and mixed together to attain uniformity. The solution is then dried and resulting powder was pelletized and sintered. Subsequently, the pellet was ablated with pulsed laser (8 ns, 532 nm, Nd-YAG) and the plume was deposited on a glass plate. This deposit was dissolved in minimum amount of nitric acid. A known volume of the solution was mixed with spike (for e.g., 150 Nd/ 142 Nd, 233 U/ 238 U in this study

  8. [Effects of Meek skin grafting on patients with extensive deep burn at different age groups].

    Science.gov (United States)

    Di, H P; Niu, X H; Li, Q; Li, X L; Xue, J D; Cao, D Y; Han, D W; Xia, C D

    2017-03-20

    Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ (2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the

  9. Suplementação de antioxidantes: enfoque em queimados Antioxidant supplementation: focusing on burned patients

    Directory of Open Access Journals (Sweden)

    Eliana Barbosa

    2007-12-01

    increases the production of free radicals but it is also capable of impairing the antioxidant defense mechanism, subjecting the burned patient to oxidative stress, which can be a perpetuating factor of the inflammatory response and lead to progressive metabolic deterioration. Therefore, the purpose of this work is to provide updated information on antioxidant supplementation in burned patients and describe the benefits of this intervention.

  10. The effects of massage and music on pain, anxiety and relaxation in burn patients: Randomized controlled clinical trial.

    Science.gov (United States)

    Najafi Ghezeljeh, T; Mohades Ardebili, F; Rafii, F

    2017-08-01

    The aim of this study was to evaluate the effects of massage and music on pain intensity, anxiety intensity and relaxation level in burn patients. Pain and anxiety are common among burn patients, but there are many physical and psychological consequences. This randomized controlled clinical trial with factorial design 2×2 included 240 burn patients admitted at Shahid Motahari Burns Hospital, Tehran, Iran, between September 2013 and May 2015. The patients were allocated into the following groups: (i) control (n=60) receiving the conventional primary care, (ii) music group (n=60) receiving their favorite songs, (iii) massage group (n=60) receiving Swedish massage, and (iv) music-plus-massage group (n=60) receiving a combination of their favorite songs and Swedish massage, for 20min once a day for 3 consecutive days, using random permuted blocks of sizes 4 with a 1:1 ratio. To collect the data before and after the intervention, a specific Visual Analogue Scale (VAS) was applied for pain intensity, anxiety intensity, and relaxation level. The data were analyzed using SPSS, version 21. Our findings showed a decrease in pain and anxiety intensity and an increase in relaxation level in all three intervention groups as compared to the control group, indicating there was no significant difference among the interventions applied. Furthermore, following application of each intervention, pain and anxiety intensity decreased and relaxation level increased in the intervention groups as compared to before intervention. Our results revealed that music, massage and a combination of both interventions were effective on reducing pain and anxiety intensity and increasing relaxation level. Due to easy, low-cost and availability of the interventions applied, these complementary therapies are suggested for the burn patients. Although application of a single complementary therapy is cost-effective, further studies are required to determine the most effective and cost-effective method to

  11. Helium burning: a further measurement of the beta-delayed alpha-particle emission of 16 Na

    International Nuclear Information System (INIS)

    Gai, Moshe

    1997-01-01

    The 12 C (α,γ) 16 O is a key (but still unknown) reaction in helium burning. Several attempts to constrain the p-wave S-factor at Helium burning temperatures (200 M K) using the beta-delayed alpha-particle emission of 16 N have been made. However, some discrepancy exists between the spectra measured at Settle and that of TRIUMF. We have improved our previous study of the beta-delayed alpha-particle emission of 16 N by improving our statistical sample (by more than a factor of 5), improving the energy resolution of the experiment (by 20%), and in understanding our line shape, deduced from measured quantities. Our newly measured spectrum of the beta-delayed alpha-particle emission of 16 N is consistent with the Seattle ('95) data, as well as an earlier experiment performed at Mains ('71) and is not consistent with the TRIUMF ('94) data. (author)

  12. Demographic features of pediatric patients with burn injuries referred to the emergency department of Sina hospital in Tabriz, Iran, in 2014

    Directory of Open Access Journals (Sweden)

    Farzad Rahmani

    2017-03-01

    Full Text Available Introduction: The aim of this study was to evaluate the demographic status of children with burn injuries who were referred to the emergency department of the Sina hospital in Tabriz, Iran, in 2014. Methods: Total of 220 pediatric patients with burn injuries, who referred to the emergency department of Sina hospital, were enrolled in this prospective descriptive study. Data such as age, gender, type of injury, location of injury, and severity of burns was collected, and analyzed using SPSS statistical software. Results: Most patients were the first children of their families (61.8%. Two-year-old children had a higher incidence of burn injuries (33.2%. Most of the burns (94.5% occurred at home. The most common cause of injury was hot liquids (74.5%. The position of the burn injuries in most patients was the upper extremities (47.3% and second-degree burn severity was more frequent (70.5%. There were no significant statistical differences between the two genders regarding cause, severity, percentage, and anatomical area of the burn.Conclusion: It is necessary to design effective strategies to reduce the incidence of burn injuries in pediatric patients, so that steps can be taken to reduce burn injuries and their complications.

  13. 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.

  14. Burning Velocity Measurements in Aluminum-Air Suspensions using Bunsen Type Dust Flames

    Science.gov (United States)

    Lee, John; Goroshin, Samuel; Kolbe, Massimiliano

    2001-01-01

    Laminar burning velocity (sometimes also referred in literature as fundamental or normal flame propagation speed) is probably the most important combustion characteristic of the premixed combustible mixture. The majority of experimental data on burning velocities in gaseous mixtures was obtained with the help of the Bunsen conical flame. The Bunsen cone method was found to be sufficiently accurate for gaseous mixtures with burning velocities higher than 10-15 cm/s at normal pressure. Hans Cassel was the first to demonstrate that suspensions of micron-size solid fuel particles in a gaseous oxidizer can also form self-sustained Bunsen flames. He was able to stabilize Bunsen flames in a number of suspensions of different nonvolatile solid fuels (aluminum, carbon, and boron). Using the Bunsen cone method he estimated burning velocities in the premixed aluminum-air mixtures (particle size less than 10 microns) to be in the range of 30-40 cm/s. Cassel also found, that the burning velocity in dust clouds is a function of the burner diameter. In our recent work, we have used the Bunsen cone method to investigate dependence of burning velocity on dust concentration in fuel-rich aluminum dust clouds. Burning velocities in stoichiometric and fuel-rich aluminum dust suspensions with average particle sizes of about 5 microns were found to be in the range of 20-25 cm/s and largely independent on dust concentration. These results raise the question to what degree burning velocities derived from Bunsen flame specifically and other dust flame configurations in general, are indeed fundamental characteristics of the mixture and to what degree are they apparatus dependent. Dust flames in comparison to gas combustion, are thicker, may be influenced by radiation heat transfer in the flame front, respond differently to heat losses, and are fundamentally influenced by the particular flow configuration due to the particles inertia. Since characteristic spatial scales of dust flames are

  15. Management of pediatric hand burns.

    Science.gov (United States)

    Liodaki, Eirini; Kisch, Tobias; Mauss, Karl L; Senyaman, Oezge; Kraemer, Robert; Mailänder, Peter; Wünsch, Lutz; Stang, Felix

    2015-04-01

    Hand burns are common in the pediatric population. Optimal hand function is a crucial component of a high-quality survival after burn injury. This can only be achieved with a coordinated approach to the injuries. The aim of this study was to review the management algorithm and outcomes of pediatric hand burns at our institution. In total, 70 children fulfilling our study criteria were treated for a burn hand injury in our Burn Care Center between January 2008 and May 2013. 14 of the 70 pediatric patients underwent surgery because of the depth of the hand burns. The management algorithm depending on the depth of the burn is described. Two patients underwent correction surgery due to burn contractures later. For a successful outcome of the burned hand, the interdisciplinary involvement and cooperation of the plastic and pediatric surgeon, hand therapist, burn team, patient and their parents are crucial.

  16. Global Characterization of Biomass-Burning Patterns using Satellite Measurements of Fire Radiative Energy

    Science.gov (United States)

    Ichoku, Charles; Giglio, Louis; Wooster, Martin J.; Remer, Lorraine A.

    2008-01-01

    Remote sensing is the most practical means of measuring energy release from large open-air biomass burning. Satellite measurement of fire radiative energy (FRE) release rate or power (FRP) enables distinction between fires of different strengths. Based on a 1-km resolution fire data acquired globally by the MODerate-resolution Imaging Spectro-radiometer (MODIS) sensor aboard the Terra and Aqua satellites from 2000 to 2006, instanteaneous FRP values ranged between 0.02 MW and 1866 MW, with global daily means ranging between 20 and 40 MW. Regionally, at the Aqua-MODIS afternoon overpass, the mean FRP values for Alaska, Western US, Western Australia, Quebec and the rest of Canada are significantly higher than these global means, with Quebec having the overall highest value of 85 MW. Analysis of regional mean FRP per unit area of land (FRP flux) shows that a peak fire season in certain regions, fires can be responsible for up to 0.2 W/m(sup 2) at peak time of day. Zambia has the highest regional monthly mean FRP flux of approximately 0.045 W/m(sup 2) at peak time of day and season, while the Middle East has the lowest value of approximately 0.0005 W/m(sup 2). A simple scheme based on FRP has been devised to classify fires into five categories, to facilitate fire rating by strength, similar to earthquakes and hurricanes. The scheme uses MODIS measurements of FRP at 1-km resolution as follows: catagory 1 (less than 100 MW), category 2 (100 to less than 500 MW), category 3 (500 to less than 1000 MW), category 4 (1000 to less than 1500 MW), catagory 5 (greater than or equal to 1500 MW). In most regions of the world, over 90% of fires fall into category 1, while only less than 1% fall into each of categories 3 to 5, although these proportions may differ significantly from day to day and by season. The frequency of occurence of the larger fires is region specific, and could not be explained by ecosystem type alone. Time-series analysis of the propertions of higher category

  17. Laboratory measurements of emissions of nonmethane volatile organic compounds from biomass burning in Chinese crop residues

    Science.gov (United States)

    Inomata, S.; Tanimoto, H.; PAN, X.; Taketani, F.; Komazaki, Y.; Miyakawa, T.; Kanaya, Y.; Wang, Z.

    2014-12-01

    The emission factors (EFs) of volatile organic compounds (VOCs) from the burning of Chinese crop residue were investigated as a function of modified combustion efficiency by the laboratory experiments. The VOCs including acetonitrile, aldehydes/ketones, furan, and aromatic hydrocarbons were monitored by proton-transfer-reaction mass spectrometry. Two samples, wheat straw and rape plant, were burned in dry conditions and for some experiments wheat straw was burned under wet conditions. We compared the present data to the field data reported by Kudo et al. [2014]. The agreement between the field and laboratory data was obtained for aromatics for relatively more smoldering data of dry samples but the field data were slightly underestimated compared with the laboratory data for oxygenated VOCs (OVOCs) and acetonitrile. When the EFs from the burning of wet samples were investigated, the underestimations for OVOCs and acetonitrile were improved compared with the data of dry samples. It may be a property of the burning of crop residue in the region of high temperature and high humidity that some inside parts of piled crop residue and/or the crop residue facing on the ground are still wet. But the ratios for acetic acid/glycolaldehyde was still lower than 1. This may suggest that strong loss processes of acetic acid/glycolaldehyde are present in the fresh plume.Kudo S., H. Tanimoto, S. Inomata, S. Saito, X. L. Pan, Y. Kanaya, F. Taketani, Z. F. Wang, H. Chen, H. Dong, M. Zhang, and K. Yamaji (2014), Emissions of nonmethane volatile organic compounds from open crop residue burning in Yangtze River Delta region, China, J. Geophys. Res. Atmos., 119, 7684-7698, doi: 10.1002/2013JD021044.

  18. 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.

  19. Simple method of determining induced 32P activity following burning of sulfur tablets by measuring Cherenkov radiation

    International Nuclear Information System (INIS)

    Kubicek, I.

    1986-01-01

    A method is described allowing the detemination of induced beta activity of phosphorus-32 using Cherenkov radiation, following the burning of sulfur tablets in the measuring vesels. A mixture of phosphoric acid and sodium phosphate solutions was used as the medium for the production of Cherenkov radiation. The losses of activity during sulfur tablet burning, the detection efficiency and the minimum detectable activity for which the minimum determinable dose was estimated, were determined. The results obtained by measurement with Cherenkov radiation are compared with other techniques of phosphorus-32 detection. The method was tested at VUPL Bratislava on detectors irradited using a 252 Cf fast neutron source. From Caswell's data, the fluence-to-kerma conversin factor was determined for a neutron spectrum calculated by the Monte Carlo method. Tissue kerma was estimated from the neutron fluence corresponding to the appropriate values of saturated activity per 1 sulfur-32 nucleus. (author)

  20. [Assessing factors that influence patients' perception in returning to work using the brief version of Burns Specific Health Scale].

    Science.gov (United States)

    Dowda, Deborah J; Li, Frank

    2010-12-01

    To assess the factors that influence burn patients' perception in returning to work after discharge. Twenty-four patients hospitalized from March 1, 2007 to February 28, 2009, older than 18 years, and with total burn surface area equal to or more than 10% TBSA were enrolled in the study. Data of physical and psychological health status (PPH) of in-patients including hand function, simple function abilities, heat sensitivity, treatment antipathy, body image, sexuality, interpersonal relationships, affect, and perception in returning to work at discharge and 3 and 6 months after discharge were collected using the brief version of Burns Specific Health Scale in the form of questionnaire, which were analyzed coordinately. The correlation between returning to work and demographic data of patients were analyzed too. Data were processed with t test or Pearson correlation test. Respectively 19 and 16 valid questionnaires were sent back 3 and 6 months after discharge. No statistical difference was found between at discharge and 3 months after discharge in each item concerning PPH of patients (with t values from -4.87 to -2.16, P values all above 0.05). The perception of returning to work scored significantly higher 6 months after discharge than at discharge [(9 ± 5) score vs. (6 ± 3) score, t = -4.87, P antipathy, body image, and heat sensitivity (with r value respectively 0.9256, 0.8891, 0.7502, 0.6022, P values all below 0.05), and negatively correlated with length of stay, total burn surface area, and amount of workers compensation (with r value respectively -0.7000, -0.6844, -0.8003, P values all below 0.05). Patients' perception in returning to work is correlated with heat sensitivity, treatment antipathy, body image, affect, length of stay, total burn surface area, and amount workers compensation. Health professionals need to provide patients with ongoing education and necessary information to help them return to work.

  1. Atitudes de profissionais de enfermagem em relação ao paciente queimado: elaboração e teste de fidedignidade de um instrumento Actitudes de profesionales de enfermería en relación al paciente quemado: elaboración y teste de fidedignidad de un instrumento de medida Attitudes of nursing professionals towards burn patients: elaboration and reliability tests of a measurement instrument

    Directory of Open Access Journals (Sweden)

    Fatima Aparecida Emm Faleiros Souza

    1994-01-01

    Full Text Available Desenvolveu-se um instrumento de Medida de Atitudes dos Profissionais de enfermagem em relação ao Paciente Queimado. Cento e noventa e quatro (194 itens agrupados em subescalas, declarativos de atitudes favoráveis e desfavoráveis frente ao paciente queimado foram analisados quanto à validade aparente e de conteúdo. Após essa análise psicométrica, cento e setenta (170 itens compuseram a escala definitiva. O coeficiente de fidedignidade calculado pelo método da divisão por metades, variou de 0,61 a 0,82 para as diferentes subescalas. A fidedignidade da escala total foi de 0,92.En este trabajo fue desarrollado un instrumento de medida de Actitudes de los Profesionales de Enfermería con Ocupación frente al Paciente Quemado. Ciento y noventa y cuatro (194 itens, agrupados en subescalas, declarativos de actitudes favorables y desfavorables hacia al paciente quemado fueron analisados cuanto a la validad aparente y de contenido. Después de esse análisis psicométrica, ciento y setenta (170 itens formaron la escala definitiva. El enfoque de fidedignidad calculado por el metodo de división por mitades ha variado de 0,61 a 0,82 para las diferentes subescalas. La fidedignidade de la escala total fué de 0,92.In this study it was developed an instrument for Measuring the Attitudes of Nursing Professionals toward patients with Burns. 194 items into subscales, expressing favorable and unfavorable attitudes toward patients with burns, were analyzed their apparent and context validity. Following this psychometric analysis 170 items were selected to compose the definitive scale. The coefficient estimated by the split - half method for the different subscales ranged from 0,61 to 0,81. The confiability coefficient of the total scale was equal to 0,92.

  2. Long-term measurements of carbonaceous aerosols in the Eastern Mediterranean: evidence of long-range transport of biomass burning

    Directory of Open Access Journals (Sweden)

    J. Sciare

    2008-09-01

    Full Text Available Long-term (5-year measurements of Elemental Carbon (EC and Organic Carbon (OC in bulk aerosols are presented here for the first time in the Mediterranean Basin (Crete Island. A multi-analytical approach (including thermal, optical, and thermo-optical techniques was applied for these EC and OC measurements. Light absorbing dust aerosols were shown to poorly contribute (+12% on a yearly average to light absorption coefficient (babs measurements performed by an optical method (aethalometer. Long-range transport of agricultural waste burning from European countries surrounding the Black Sea was shown for each year during two periods (March–April and July–September. The contribution of biomass burning to the concentrations of EC and OC was shown to be rather small (20 and 14%, respectively, on a yearly basis, although this contribution could be much higher on a monthly basis and showed important seasonal and interannual variability. By removing the biomass burning influence, our data revealed an important seasonal variation of OC, with an increase by almost a factor of two for the spring months of May and June, whereas BC was found to be quite stable throughout the year. Preliminary measurements of Water Soluble Organic Carbon (WSOC have shown that the monthly mean WSOC/OC ratio remains stable throughout the year (0.45±0.12, suggesting that the partitioning between water soluble and water insoluble organic matter is not significantly affected by biomass burning and secondary organic aerosol (SOA formation. A chemical mass closure performed in the fine mode (Aerodynamic Diameter, A.D.<1.5μm showed that the mass contribution of organic matter (POM was found to be essentially invariable during the year (monthly average of 26±5%.

  3. OH reactivity and potential SOA yields from volatile organic compounds and other trace gases measured in controlled laboratory biomass burns

    Science.gov (United States)

    J. B. Gilman; C. Warneke; W. C. Kuster; P. D. Goldan; P. R. Veres; J. M. Roberts; J. A. de Gouw; I. R. Burling; R. J. Yokelson

    2010-01-01

    A comprehensive suite of instruments were used to characterize volatile organic compounds (VOCs) and other trace gases (e.g., CO, CH4, NO2, etc.) emitted from controlled burns of various fuel types common to the Southeastern and Southwestern United States. These laboratory-based measurements were conducted in February 2009 at the U.S. Department of Agriculture’s Fire...

  4. The implementation and evaluation of therapeutic touch in burn patients: An instructive experience of conducting a scientific study within a non-academic nursing setting

    NARCIS (Netherlands)

    Busch, Martine; Visser, Adriaan; Eybrechts, Maggie; van Komen, Rob; Oen, Irma; Olff, Miranda; Dokter, Jan; Boxma, Han

    2012-01-01

    Objective: Evaluation of therapeutic touch (TT) in the nursing of burn patients; post hoc evaluation of the research process in a non-academic nursing setting. Methods: 38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on

  5. 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...

  6. 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...

  7. Enhancing the clinical utility of the burn specific health scale-brief: not just for major burns.

    Science.gov (United States)

    Finlay, V; Phillips, M; Wood, F; Hendrie, D; Allison, G T; Edgar, D

    2014-03-01

    Like many other Western burn services, the proportion of major to minor burns managed at Royal Perth Hospital (RPH) is in the order of 1:10. The Burn Specific Health Scale-Brief (BSHS-B) is an established measure of recovery after major burn, however its performance and validity in a population with a high volume of minor burns is uncertain. Utilizing the tool across burns of all sizes would be useful in service wide clinical practice. This study was designed to examine the reliability and validity of the BSHS-B across a sample of mostly minor burn patients. BSHS-B scores of patients, obtained between January 2006 and February 2013 and stored on a secure hospital database were collated and analyzed Cronbach's alpha, factor analysis, logistic regression and longitudinal regression were used to examine reliability and validity of the BSHS-B. Data from 927 burn patients (2031 surveys) with a mean % total burn surface area (TBSA) of 6.7 (SD 10.0) were available for analysis. The BSHS-B demonstrated excellent reliability with a Cronbach's alpha of 0.95. First and second order factor analyses reduced the 40 item scale to four domains: Work; Affect and Relations; Physical Function; Skin Involvement, as per the established construct. TBSA, length of stay and burn surgery all predicted burn specific health in the first three months of injury (pburn (pburn population consisting of 90% minor burns is consistent with that demonstrated in major burns. The BSHS-B can be employed to track and predict recovery after burns of all sizes to assist the provision of targeted burn care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  8. Antibiotic Susceptibility Patterns and Molecular Epidemiology of Metallo-β-Lactamase Producing Pseudomonas Aeruginosa Strains Isolated From Burn Patients

    Science.gov (United States)

    Japoni, Aziz; Anvarinejad, Mojtaba; Farshad, Shohreh; Giammanco, Giovanni M; Rafaatpour, Noroddin; Alipour, Ebrahim

    2014-01-01

    Background: Failure in the treatment of burn patients infected with Pseudomonas aeruginosa could happen as a result of the acquisition of antibiotic resistance, including carbapenems. Objectives: The aim of the present study was to investigate the phenotypic and genotypic characteristics of the Pseudomonas aeruginosa strains, isolated from burn patients. Patients and Methods: During a 12 month period, in this cross-sectional study, two hundred seventy strains of Pseudomonas aeruginosa were isolated from the burn patients in Ghotbeddin Burn Hospital, Shiraz, Iran. Screening for the carbapenem resistance in the isolates was carried out by the E test method. Sensitivity patterns of metallo-β-lactamase (MβLs) producing strains of pseudomonas to eleven antibiotics were determined by the mentioned method. The epidemiological associations of these strains were determined by Pulsed-field gel electrophoresis (PFGE). Results: Of the 270 strains, 60 (22.2%) were resistant to imipenem and meropenem, classified as MβLs producing. MβLs producing strains of pseudomonas were completely resistant to five tested antibiotics while their sensitivities to the three most effective antibiotics including ceftazidime, amikacin and ciprofloxacin were 23.4%, 6.7 % and 1.7%, respectively. In PFGE, 37 patterns from the genome of Pseudomonas aeruginosa were observed. Majority of the strains (43; 71.6%) exhibited more than 80% similarity, based on the drawn dendrogram. Conclusions: According to the results, none of the tested antibiotics is safe to prescribe. As PFGE revealed, a limited number of Pseudomonas aeruginosa types are predominant in the hospitals which infect the burn patients. PMID:25031843

  9. Quantitative long term measurements of burns in a rat model using spatial frequency domain imaging and laser speckle imaging (Conference Presentation)

    Science.gov (United States)

    Ponticorvo, Adrien; Rowland, Rebecca A.; Baldado, Melissa L.; Kennedy, Gordon T.; Saager, Rolf B.; Choi, Bernard; Durkin, Anthony J.

    2016-04-01

    The ability to accurately assess burn wound severity in a timely manner is a critical component of wound management as it dictates the course of treatment. While full thickness and superficial burns can be easily diagnosed through visual inspection, burns that fall in between these categories are difficult to classify. Additionally, the ability to better quantify different stages of wound healing from a burn of any severity would be important for evaluating the efficacy of different treatment options. Here we present a longitudinal (28 day) study that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn wounds and healing in a murine model. Burn wounds were created using an established technique of a brass comb heated to a given temperature and applied for a set amount of time. They were imaged immediately after the initial injury and then at 2, 4, 7, 14, 21, and 28 days following the injury. Biopsies were taken on the day of the injury in order to verify the extent of the burn damage as well as at different time points after the injury in order to visualize different stages of inflammation and healing. The results of this study suggest that the reduced scattering coefficient measured using SFDI and blood flow as measured using LSI have the potential to provide useful metrics for quantifying the severity of burn injuries as well as track the different stages associated with wound healing progression.

  10. Fibrinogen function after severe burn injury.

    Science.gov (United States)

    Schaden, Eva; Hoerburger, David; Hacker, Stefan; Kraincuk, Paul; Baron, David M; Kozek-Langenecker, Sibylle

    2012-02-01

    Evidence regarding hypercoagulability in the first week after burn trauma is growing. This hypercoagulable state may partly be caused by increased fibrinogen levels. Rotational thrombelastometry offers a test which measures functional fibrinogen (FIBTEM(®)). To test the hypothesis that in patients with severe burn injury fibrinogen function changes over time, we simultaneously measured FIBTEM(®) and fibrinogen concentration early after burn trauma. After Ethics Committee approval consecutive patients with severe burn trauma admitted to the burn intensive care unit of the General Hospital of Vienna were included in the study. Blood examinations were done immediately and 12, 24 and 48 h after admission. At each time point fibrinogen level (Clauss) and 4 commercially available ROTEM(®) tests were performed. 20 consecutive patients were included in the study. Fibrinogen level and FIBTEM(®) MCF were within the reference range until 24 h after burn trauma but increased significantly 48 h after trauma. There was a significant correlation between FIBTEM(®) MCF and fibrinogen level (R=0.714, p<0.001). The results of this prospective observational clinical study show that fibrinogen function changes early after burn trauma and can be visualized by ROTEM(®) with the fibrinogen-sensitive FIBTEM(®) test. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  11. Reanimación del paciente quemado Resuscitation of burned patients

    Directory of Open Access Journals (Sweden)

    Marco Antonio Hoyos Franco

    2008-06-01

    -pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}

    Extensive burns can cause significant morbidity and high mortality, determined by both the injuries themselves and the quality of the initial resuscitation measures applied to the patient. If adequate, such measures can prevent the worsening of the burn and, consequently, they can improve the prognosis for the patient. The objective of this review was to compile information that may help resuscitation teams to improve the care of burned patients, looking for lower mortality and less frequent sequels and complications. The Pubmed database was reviewed searching for studies made on the subject from 2000 to 2007, using the key words “Resuscitation” and “Burn”. Some articles published before 2000 were also included because they were considered relevant for understanding this subject.

  12. Persistence of muscle catabolism after severe burn.

    Science.gov (United States)

    Hart, D W; Wolf, S E; Mlcak, R; Chinkes, D L; Ramzy, P I; Obeng, M K; Ferrando, A A; Wolfe, R R; Herndon, D N

    2000-08-01

    The hypermetabolic response to severe burn is characterized by muscle protein catabolism. Current opinion states that the hypermetabolic state resolves soon after complete wound closure. Clinically, we have witnessed that burned children appear to be hypermetabolic and catabolic long after full healing of their wounds. Our goal in this study was to determine scientifically if burn-associated hypermetabolism persists after full wound healing. To determine the duration of muscle catabolism and systemic hypermetabolism after severe burn in children, patients with > 40% total body surface area burns were enrolled in a prospective, longitudinal study; resting energy expenditure was measured by indirect calorimetry, muscle protein kinetics were determined by using stable isotopic methodology, and body composition was measured by dual-energy x-ray absorptiometry imaging. Data were collected at 6, 9, and 12 months after injury. The mean total body surface area burned was 65% +/- 13%, and the mean age was 7.6 +/- 1. 5 years. Resting energy expenditure was elevated above the predicted age-matched levels from the Harris-Benedict equation and incrementally declined throughout the 12-month study. The net protein balance and lean mass reflected catabolic persistence at 6 and 9 months after severe burn. Between 9 and 12 months, protein breakdown decreased, net protein balance improved, and lean body mass increased. In severely burned children, hypermetabolism and catabolism remain exaggerated for at least 9 months after injury. This suggests that therapeutic attempts to manipulate the catabolic and hypermetabolic response to severe injury should be continued long after injury.

  13. Understanding Air Quality in East Africa: Estimating Biomass Burning and Anthropogenic Influence with Long-Term Measurements

    Science.gov (United States)

    DeWitt, L.; Gasore, J.; Rupakheti, M.; Potter, K. E.; Prinn, R. G.

    2017-12-01

    Air pollution is largely unstudied in sub-Saharan Africa, resulting in a large gap in scientific understanding of emissions, atmospheric processes and impacts of air pollutants in this region. The Rwanda Climate Observatory, a joint partnership between MIT and the government of Rwanda, has been measuring ambient concentrations of key long-lived greenhouse gases and short-lived climate-forcing pollutants (CO2, CO, CH4, BC, O3) on the summit of Mt. Mugogo (1.586°S, 29.566°E, 2500 m above sea level) since May 2015. Rwanda is a small, mountainous, and densely populated country in equatorial East Africa currently undergoing rapid development. The location and meteorology of Rwanda is such that emissions transported from both the northern and southern African biomass burning seasons affect BC, CO, and O3 concentrations in Rwanda. Black carbon concentrations during Rwanda's two dry seasons are higher at Mt. Mugogo, a rural site, than in major European cities. Higher BC baseline concentrations at Mugogo are correlated with fire radiative power data for the region acquired with MODIS satellite instrument. Spectral absorption of aerosol measured with a dual-spot aethalometer also varies seasonally, likely due to change in fuel burned and direction of pollution transport to the site. Ozone concentration was found to be higher in air masses from southern Africa than from northern Africa during their respective biomass burning seasons. The higher ozone concentration in air masses from the south could be indicative of more anthropogenic influence as Rwanda is downwind of major East African capitals in this season. During the rainy seasons, local emitting activities (e.g., cooking, driving, trash burning) remain steady, regional biomass burning is low, and transport distances are shorter as rainout of pollution occurs regularly, which allows estimation of local pollution during this time period. Urban PM2.5 measurements in the capital city of Kigali and from the neighboring

  14. Light absorption by pollution, dust, and biomass burning aerosols: a global model study and evaluation with AERONET measurements

    Directory of Open Access Journals (Sweden)

    Mian Chin

    2009-09-01

    Full Text Available Atmospheric aerosol distributions from 2000 to 2007 are simulated with the Goddard Chemistry Aerosol Radiation and Transport (GOCART model to attribute light absorption by aerosol to its composition and sources from pollution, dust, and biomass burning. The 8-year, global averaged total aerosol optical depth (τ, absorption optical depth (τa, and single scattering albedo (ω at 550 nm are estimated at 0.14, 0.0086, and 0.95, respectively, with sulfate making the largest fraction of τ (37%, followed by dust (30%, sea salt (16%, organic matter (OM (13%, and black carbon (BC (4%. BC and dust account for 43% and 53% of τa, respectively. From a model experiment with "tagged" sources, natural aerosols are estimated to be 58% of τ and 53% of τa, with pollution and biomass burning aerosols to share the rest. Comparing with data from the surface sunphotometer network AERONET, the model tends to reproduce much better the AERONET direct measured data of τ and the Ångström exponent (α than its retrieved quantities of ω and τa. Relatively small in its systematic bias of τ for pollution and dust regions, the model tends to underestimate τ for biomass burning aerosols by 30–40%. The modeled α is 0.2–0.3 too low (particle too large for pollution and dust aerosols but 0.2–0.3 too high (particle too small for the biomass burning aerosols, indicating errors in particle size distributions in the model. Still, the model estimated ω is lower in dust regions and shows a much stronger wavelength dependence for biomass burning aerosols but a weaker one for pollution aerosols than those quantities from AERONET. These comparisons necessitate model improvements on aerosol size distributions, the refractive indices of dust and black carbon aerosols, and biomass burning emissions in order to better quantify the aerosol absorption in the atmosphere.

  15. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G.; Bistricky, Steven L.; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V.; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J.; Linehan, Marsha M.

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  16. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® "Observing Sounds and Visuals" Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study.

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G; Bistricky, Steven L; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J; Linehan, Marsha M

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  17. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Directory of Open Access Journals (Sweden)

    Jocelyn Gomez

    2017-09-01

    Full Text Available Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT® by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA severe flame burn injury.Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session.Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home.Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in

  18. Developing Item Response Theory-Based Short Forms to Measure the Social Impact of Burn Injuries.

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    Marino, Molly E; Dore, Emily C; Ni, Pengsheng; Ryan, Colleen M; Schneider, Jeffrey C; Acton, Amy; Jette, Alan M; Kazis, Lewis E

    2018-03-01

    To develop self-reported short forms for the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Short forms based on the item parameters of discrimination and average difficulty. A support network for burn survivors, peer support networks, social media, and mailings. Burn survivors (N=601) older than 18 years. Not applicable. The LIBRE Profile. Ten-item short forms were developed to cover the 6 LIBRE Profile scales: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. Ceiling effects were ≤15% for all scales; floor effects were <1% for all scales. The marginal reliability of the short forms ranged from .85 to .89. The LIBRE Profile-Short Forms demonstrated credible psychometric properties. The short form version provides a viable alternative to administering the LIBRE Profile when resources do not allow computer or Internet access. The full item bank, computerized adaptive test, and short forms are all scored along the same metric, and therefore scores are comparable regardless of the mode of administration. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

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    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.

  20. A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients

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    Baghel P

    2009-01-01

    Full Text Available To compare the effect of honey dressing and silver-sulfadiazene (SSD dressing on wound healing in burn patients. Patients (n=78 of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area were included in the study, over a period of 2 years (2006-08. After stabilization, patients were randomly attributed into two groups: ′honey group′ and ′SSD group′. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37 and SSD cream over the wounds of patients in SSD group (n=41, everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group and control (SSD group was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100% who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound

  1. [Influence of WeChat platform on the compliance of continuous treatment of scar in adult burn patients].

    Science.gov (United States)

    Wang, F; Zhang, H L

    2018-03-20

    Objective: To explore influence of the WeChat platform on the compliance of continuous treatment of scar in adult burn patients. Methods: A total of 124 adult burn patients, conforming to the study criteria, admitted in the Department of Burns of our hospital from January 2015 to January 2016 were divided into WeChat group ( n =63) and control group ( n =61) according to the random number table. Patients in control group only received regular discharging rehabilitation guide, while patients in WeChat group received regular discharging rehabilitation guide and joined WeChat platform after being discharged from hospital. Through pushing rehabilitation plan and rehabilitation related knowledge, organizing support discussion of burn patients, answering the patients' questions, members of WeChat platform intervention group conducted continuous treatment for 6 months on patients of WeChat group. The compliance of functional exercise of patients in two groups in one week before discharge and 3 and 6 months after discharge was evaluated by using the self-made functional exercise compliance log sheet. The compliance of using anti-scar drug and appliance of patients in two groups in 3 and 6 months after discharge was evaluated by using self-made anti-scar drug and appliance usage log sheets. Data were processed with chi-square test, independent sample t test, non-parametric rank sum test of independent sample, and Wilcoxon rank sum test. Results: (1) The compliance ratio of functional exercise of patients in WeChat group (95.24%, 60/63) was close to 93.44% (57/61) in control group in one week before discharge ( χ (2)=0.188, P >0.05). The compliance ratios of functional exercise of patients in WeChat group were respectively 93.65% (59/63) and 87.30% (55/63) in 3 and 6 months after discharge, which were higher than 68.85% (42/61) and 65.57% (40/61) in control group ( χ (2)=12.615, 8.166, P WeChat group was significantly better than that in control group in 3 and 6 months

  2. First Transmitted Hyperspectral Light Measurements and Cloud Properties from Recent Field Campaign Sampling Clouds Under Biomass Burning Aerosol

    Science.gov (United States)

    Leblanc, S.; Redemann, Jens; Shinozuka, Yohei; Flynn, Connor J.; Segal Rozenhaimer, Michal; Kacenelenbogen, Meloe Shenandoah; Pistone, Kristina Marie Myers; Schmidt, Sebastian; Cochrane, Sabrina

    2016-01-01

    We present a first view of data collected during a recent field campaign aimed at measuring biomass burning aerosol above clouds from airborne platforms. The NASA ObseRvations of CLouds above Aerosols and their intEractionS (ORACLES) field campaign recently concluded its first deployment sampling clouds and overlying aerosol layer from the airborne platform NASA P3. We present results from the Spectrometer for Sky-Scanning, Sun-Tracking Atmospheric Research (4STAR), in conjunction with the Solar Spectral Flux Radiometers (SSFR). During this deployment, 4STAR sampled transmitted solar light either via direct solar beam measurements and scattered light measurements, enabling the measurement of aerosol optical thickness and the retrieval of information on aerosol particles in addition to overlying cloud properties. We focus on the zenith-viewing scattered light measurements, which are used to retrieve cloud optical thickness, effective radius, and thermodynamic phase of clouds under a biomass burning layer. The biomass burning aerosol layer present above the clouds is the cause of potential bias in retrieved cloud optical depth and effective radius from satellites. We contrast the typical reflection based approach used by satellites to the transmission based approach used by 4STAR during ORACLES for retrieving cloud properties. It is suspected that these differing approaches will yield a change in retrieved properties since light transmitted through clouds is sensitive to a different cloud volume than reflected light at cloud top. We offer a preliminary view of the implications of these differences in sampling volumes to the calculation of cloud radiative effects (CRE).

  3. Mass spectrometry based data of the blister fluid proteome of paediatric burn patients

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    Tuo Zang

    2016-09-01

    Full Text Available The data presented here are associated with the article “The blister fluid proteome of paediatric burns” (Zang et al., 2016 [1]. Burn injury is a highly traumatic event for children. The degree of burn severity (superficial-, deep-, or full-thickness injury often dictates the extent of later scar formation which may require long term surgical operation or skin grafting. The data were obtained by fractionating paediatric burn blister fluid samples, which were pooled according to burn depth and then analysed using data dependent acquisition LC–MS/MS. The data includes a table of all proteins identified, in which burn depth category they were found, the percentage sequence coverage for each protein and the number of high confidence peptide identifications for each protein. Further Gene Ontology enrichment analysis shows the significantly over-represented biological processes, molecular functions, and cellular components of the burn blister fluid proteome. In addition, tables include the proteins associated with the biological processes of “wound healing” and “response to stress” as examples of highly relevant processes that occur in burn wounds.

  4. Use of cyanide antidotes in burn patients with suspected inhalation injuries in North America: a cross-sectional survey.

    Science.gov (United States)

    Dumestre, Danielle; Nickerson, Duncan

    2014-01-01

    This study aimed to assess the use of cyanide antidotes and the determine the opinion on empiric administration of hydroxocobalamin in North American burn patients with suspected smoke inhalation injuries. An online cross-sectional survey was sent to directors of 90 major burn centers in North America, which were listed on the American Burn Association Web site. A multiple-choice format was used to determine the percentage of patients tested for cyanide poisoning on admission, the current administration of a cyanide antidote based solely on clinical suspicion of poisoning, and the antidote used. To ascertain views on immediate administration of hydroxocobalamin before confirmation of cyanide poisoning an option was included to expand the response in written format. Twenty-nine of 90 burn directors (32%) completed the survey. For the population of interest, the majority of burn centers (59%) do not test for cyanide poisoning on admission and do not administer an antidote based solely on clinical suspicion of cyanide poisoning (58%). The most commonly available antidote is hydroxocobalamin (50%), followed by the cyanide antidote kit (29%). The opinion regarding instant administration of hydroxocobalamin when inhalation injury is suspected is mixed: 31% support its empiric use, 17% do not, and the remaining 52% have varying degrees of confidence in its utility. In North America, most patients burnt in closed-space fires with inhalation injuries are neither tested for cyanide poisoning in a timely manner nor empirically treated with a cyanide antidote. Although studies have shown the safety and efficacy of empiric and immediate administration of hydroxocobalamin, most centers are not willing to do so.

  5. Risk factors for burn injuries and fire safety awareness among patients hospitalized at a public hospital in Nairobi, Kenya: A case control study.

    Science.gov (United States)

    Wanjeri, Joseph K; Kinoti, Mary; Olewe, Tom H A M

    2018-01-29

    Burn injuries are some of the most physically and psychologically devastating forms of trauma and most common injuries affecting children, especially in the home environment. They are more prevalent and are a public health problem in developing countries mainly because of poor socio-economic conditions. Effective prevention programs should be guided by the results of well-designed studies aimed at investigating risk factors for burns. To establish the risk factors for burn injuries among patients hospitalized at the Kenyatta National Hospital (KNH). This was an age and gender matched case-control study comprising 202 patients admitted with burns (cases) and 202 non-surgical patients (controls) admitted into the pediatric and medical wards. The study site was KNH, a 1800-bed national referral and teaching hospital in Kenya. SPSS version 17 was used for data analysis, with descriptive statistics used for demographic data, whereas in the analysis for risk factors chi square test and odds ratio (OR) were used to determine the relationship between the predictive (risk factors) and outcome variables (burn injury). Logistic regression was used to determine the strength of association between risk factors and burn injury. The risk factors found to be significant for burn injuries were: low level of education (p=0.043), use of kerosene as fuel for cooking (OR=2.027; 95% CI: 1.361-3.019, p=0.000) and lack of knowledge of burn injury prevention and fire safety (OR=4.009; CI: 2.603-6.172, p=0.000). Low level of education, use of kerosene for cooking and lack of knowledge of burn injury prevention and fire safety were identified as risk factors for burn injury among patients hospitalized at KNH. These risk factors should be addressed in burn injury prevention programs for Kenya. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  6. Prevention and management of outpatient pediatric burns.

    Science.gov (United States)

    O'Brien, Shannon P; Billmire, David A

    2008-07-01

    Burns are common injuries in the pediatric population, with an estimated 250,000 pediatric burn patients seeking medical care annually. A relative few require inpatient management. This article discusses suggestions for burn prevention, as well as acute burn care and long-term management of small burns.

  7. Acute Kidney Injury in Burn Patients: Clinically Significant Over the Initial Hospitalization and 1 Year After Injury: An Original Retrospective Cohort Study.

    Science.gov (United States)

    Thalji, Samih Z; Kothari, Anai N; Kuo, Paul C; Mosier, Michael J

    2017-08-01

    To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventing AKI after burn injury. Expanding our understanding of the burden AKI has on the clinical course of burn patients would highlight the need for standardized protocols. We queried the Healthcare Cost and Utilization Project State Inpatient Databases in the states of Florida and New York during the years 2009 to 2013 for patients over age 18 hospitalized with a primary diagnosis of burn injury using ICD-9 codes. We identified and grouped 18,155 patients, including 1476 with burns >20% total body surface area, by presence of AKI. Outcomes were compared in these cohorts via univariate analysis and multivariate logistic regression models. During initial hospitalization, AKI was associated with increased pulmonary failure, mechanical ventilation, pneumonia, myocardial infarction, length of stay, cost, and mortality, and also a lower likelihood of being discharged home. One year after injury, AKI was associated with development of chronic kidney disease, conversion to chronic dialysis, hospital readmission, and long-term mortality. AKI is associated with a profound and severe increase in morbidity and mortality in burn patients during initial hospitalization and up to 1 year after injury. Consensus protocols for initial burn resuscitation and early sepsis recognition and treatment are crucial to avoid the consequences of AKI after burn injury.

  8. Airborne measurements of western U.S. wildfire emissions: Comparison with prescribed burning and air quality implications

    Science.gov (United States)

    Liu, Xiaoxi; Huey, L. Gregory; Yokelson, Robert J.; Selimovic, Vanessa; Simpson, Isobel J.; Müller, Markus; Jimenez, Jose L.; Campuzano-Jost, Pedro; Beyersdorf, Andreas J.; Blake, Donald R.; Butterfield, Zachary; Choi, Yonghoon; Crounse, John D.; Day, Douglas A.; Diskin, Glenn S.; Dubey, Manvendra K.; Fortner, Edward; Hanisco, Thomas F.; Hu, Weiwei; King, Laura E.; Kleinman, Lawrence; Meinardi, Simone; Mikoviny, Tomas; Onasch, Timothy B.; Palm, Brett B.; Peischl, Jeff; Pollack, Ilana B.; Ryerson, Thomas B.; Sachse, Glen W.; Sedlacek, Arthur J.; Shilling, John E.; Springston, Stephen; St. Clair, Jason M.; Tanner, David J.; Teng, Alexander P.; Wennberg, Paul O.; Wisthaler, Armin; Wolfe, Glenn M.

    2017-06-01

    Wildfires emit significant amounts of pollutants that degrade air quality. Plumes from three wildfires in the western U.S. were measured from aircraft during the Studies of Emissions and Atmospheric Composition, Clouds and Climate Coupling by Regional Surveys (SEAC4RS) and the Biomass Burning Observation Project (BBOP), both in summer 2013. This study reports an extensive set of emission factors (EFs) for over 80 gases and 5 components of submicron particulate matter (PM1) from these temperate wildfires. These include rarely, or never before, measured oxygenated volatile organic compounds and multifunctional organic nitrates. The observed EFs are compared with previous measurements of temperate wildfires, boreal forest fires, and temperate prescribed fires. The wildfires emitted high amounts of PM1 (with organic aerosol (OA) dominating the mass) with an average EF that is more than 2 times the EFs for prescribed fires. The measured EFs were used to estimate the annual wildfire emissions of carbon monoxide, nitrogen oxides, total nonmethane organic compounds, and PM1 from 11 western U.S. states. The estimated gas emissions are generally comparable with the 2011 National Emissions Inventory (NEI). However, our PM1 emission estimate (1530 ± 570 Gg yr-1) is over 3 times that of the NEI PM2.5 estimate and is also higher than the PM2.5 emitted from all other sources in these states in the NEI. This study indicates that the source of OA from biomass burning in the western states is significantly underestimated. In addition, our results indicate that prescribed burning may be an effective method to reduce fine particle emissions.

  9. A long term source apportionment study of wood burning and traffic aerosols for three measurement sites in Switzerland

    Science.gov (United States)

    Herich, Hanna; Hüglin, Christoph; Buchmann, Brigitte

    2010-05-01

    Besides their effects on radiative forcing soot aerosols have been found to cause health effects as they are carcinogenic. Diesel engines and incomplete biomass burning are the major emission sources of soot particles. Especially during winter, the wood burning (WB) emissions from residential heating have been found to contribute significantly to the total carbonaceous material (CM). To investigate the contribution of fossil fuel (FF) and WB emissions seven-wavelength aethalometers have been deployed in previous studies (Sandradewi et al. 2008, Favez et al. 2009). In these studies, the stronger light absorption of WB aerosols in the blue and ultraviolet compared to the light absorption of aerosols from FF combustion was used. Linear regression modelling of CM against the light absorption coefficient of FF combustion aerosols in the infrared (950 nm) and the light absorption coefficient of WB aerosols in the blue (470 nm) was proposed for source apportionment. In this study we present long term aethalometer measurements at two rural and one urban background measurement stations in Switzerland from 2008 - 2010. At these stations organic (OC) and elemental carbon (EC) were also measured by thermochemical analysis providing estimates for total CM. Above described linear regession modelling was applied for determination of the contribution of FF and WB emissions to total CM. Sensitivity tests for different regression models and for varying light absorption exponents were performed. It was found that the regression modelling approach is only limited suitable for long term datasets because of significant fractions of CM resulting from sources and processes other than FF and WB. Thus in a different approach we focused on black carbon (BC). The contribution of WB and FF to BC was directly determined from the absorption coefficients of FF and WB aerosols which were calculated with the use of absorption exponents taken from literature. First results show that in winter the

  10. Predominance of CD14+ Cells in Burn Blister Fluids.

    Science.gov (United States)

    Chen, Szu-Han; Wong, Tak-Wah; Lee, Chou-Hwei; Chen, Chung-Lin; Wu, Li-Wha; Pan, Shin-Chen

    2018-02-01

    Burn blister fluid contains several angiogenic factors to promote wound neovascularization. In our previous study, we found that deep partial-thickness burn (DPTB) wounds showed higher expression levels of angiogenin to enhance vascularization compared with superficial partial-thickness burn wounds. Neovascularization is a complex process that involves an interaction between circulating angiogenic cells and mediators. We hypothesized that in addition to angiogenic factors burn blisters may contain specific cell types. The aim of the present study was to characterize the specific cells present in burn blisters. Twenty-four burn blister fluid samples were obtained with informed consent from patients with superficial partial-thickness burn (n = 16) or DPTB (n = 8) wounds. Blister cells were isolated from individual intact blisters and characterized with flow cytometry analysis using CD14, CD34, vascular endothelial growth factor receptor 2, and CD133 markers. CD14 and CD34 blister cells were also isolated using a magnetic-activated cell sorting system to examine their potential for endothelial differentiation. Angiogenin levels in the burn blister fluids were evaluated with enzyme-linked immunosorbent assay. CD14 cells were the most highly represented cell type in the burn fluids of both groups, although a significantly greater percentage of CD14 cells were observed in DPTB fluids. CD14 blister cells had a higher potency to differentiate into functional endothelial cells as compared with CD34 cells. The proportion of CD14 cells gradually increased after burn injury. In contrast to CD14 cells, angiogenin showed the highest expression levels at day 1 postburn. With regard to burn wound neovascularization, angiogenin expression was partially correlated with CD14 blister cells in the burn fluids. We provide the first report on the characterization of blister cells in burn fluids. Our data suggest that CD14 blister cells may play a role in burn wound neovascularization

  11. Comparison of Mortality Associated with Sepsis in the Burn, Trauma, and General Intensive Care Unit Patient: A Systematic Review of the Literature

    Science.gov (United States)

    2012-01-01

    17. Bang RL, Gang RK, Sanyal SC, Mokaddas E, Ebrahim MK: Burn septicaemia: an analysis of 79 patients. Burns 24(4):354 361, 1998. 18. Cumming J...14) Center/location Purpose Subjects Sepsis subjects Bang et al. 1998 (17) 1992 1996 Retro review/level IV/grade A Single center; Kuwait...Retrospective review of septicemic burn patients (data included in Bang 2004) 943 admits, 280 (30%) ICU admits, 79/280 (28.2%) septic 79/280 (28.2%) ICU patients

  12. Bacillus cereus infection in burns.

    Science.gov (United States)

    Attwood, A I; Evans, D M

    1983-05-01

    Two patients are reported in whom severe toxicity developed about 4 days after relatively minor burn injuries and in whom the burn areas then appeared to enlarge. In both patients, B. cereus and Staph. aureus were isolated and the affected burn areas had subcutaneous thrombosis and necrosis. The management is outlined and the dramatic rapidity of onset of toxicity emphasized, with special reference to increasing pain, lividity and extension of the burns.

  13. Pediatric facial burns.

    Science.gov (United States)

    Kung, Theodore A; Gosain, Arun K

    2008-07-01

    Despite major advances in the area of burn management, burn injury continues to be a leading cause of pediatric mortality and morbidity. Facial burns in particular are devastating to the affected child and result in numerous physical and psychosocial sequelae. Although many of the principles of adult burn management can be applied to a pediatric patient with facial burns, the surgeon must be cognizant of several important differences. Facial burns and subsequent scar formation can drastically affect the growth potential of a child's face. Structures such as the nose and teeth may become deformed due to abnormal external forces caused by contractures. Serious complications such as occlusion amblyopia and microstomia must be anticipated and urgently addressed to avert permanent consequences, whereas other reconstructive procedures can be delayed until scar maturation occurs. Furthermore, because young children are actively developing the concept of self, severe facial burns can alter a child's sense of identity and place the child at high risk for future emotional and psychologic disturbances. Surgical reconstruction of burn wounds should proceed only after thorough planning and may involve a variety of skin graft, flap, and tissue expansion techniques. The most favorable outcome is achieved when facial resurfacing is performed with respect to the aesthetic units of the face. Children with facial burns remain a considerable challenge to their caregivers, and these patients require long-term care by a multidisciplinary team of physicians and therapists to optimize functional, cosmetic, and psychosocial outcomes.

  14. CLINICAL STUDY OF ELECTRICAL BURNS AMONG ALL BURNS CASES- 3 YEARS’ EXPERIENCE

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    Nagabathula Durga Prasad

    2017-08-01

    Full Text Available BACKGROUND With the advances in technology, electrical injuries are becoming more common and are the leading cause of work-related traumatic death. One third of all electrical traumas and most high-voltage injuries are job related and more than 50% of these injuries result from power line contact. The management of the major burn injury represents a significant challenge to every member of the burns team. Most of electrical burns present with gangrene of toes and limbs with eschar over body parts. Their presentation is mostly due to contact with high-voltage electricity at their work places. MATERIALS AND METHODS A retrospective study was made to study the clinico-social profile of patients suffering electric burns admitted into Department of General Surgery. RESULTS 92 cases were evaluated and studied. Majority of patients developed gangrene of limbs and toes. Amputations and skin grafting was done. Most patients who suffered electric burns were males of age group 21 to 40 years. All cases are accidental and mostly occurred at work places. Most electric burns are high-voltage based and caused deep burns. Major complications like acute renal failure and septicaemia were encountered. Most of them suffered 16 to 30% burns. Most commonly isolated organism from wounds is pseudomonas. Most of them suffered a hospital stay of 1 to 2 months. CONCLUSION Electric burns are a burden to the society. Prevention is the best way to deal with them. Electricity-based employees have to be trained properly regarding safety measures to be taken. General education of public regarding safety measures can prevent electrical burn injuries.

  15. Tourniquet associated chemical burn

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    Jae-Hyuk Yang

    2012-01-01

    Full Text Available Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The two important mechanisms are maceration (friction and wetness underneath the tourniquent. In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

  16. Antimicrobial susceptibility patterns and CTX-M β-lactamase producing clinical isolates from burn patients in Islamabad, Pakistan

    Directory of Open Access Journals (Sweden)

    Mubbashir Hussain

    2017-08-01

    Full Text Available Objective: To evaluate the prevalence of extended spectrum beta-lactamases (ESBL in clinical isolates from burn patients using phenotypic and genotypic analyses. Methods: During 2015–2016, a total of 126 samples were collected at a tertiary care hospital, Islamabad. Antibiotic sensitivity and ESBL prevalence were evaluated according to the Clinical Laboratory and Standards Institute, and molecular analysis of the CTX-M type ESBL gene was performed in 225 bacterial isolates from these samples. Results: The most prevalent bacterial species were Escherichia coli (28.4%, Pseudomonas aeruginosa (22.2%, Staphylococcus aureus (19.6%, Klebsiella pneumoniae (16.4%, and coagulase-negative staphylococci (13.3%. Of the 225 bacterial isolates, 89 (39.5% were found to be ESBL producers. The isolates were highly susceptible to meropenem (88% and imipenem (84%, followed by the aminoglycoside amikacin (81%. Molecular epidemiology of the ESBL isolates indicated 19% prevalence of CTX-M. Resistance to antibiotics was exhibited by 28% isolates. Conclusions: In the present study, bacteria such as P. aeruginosa, K. pneumoniae, S. aureus, and E. coli isolated from burn patients exhibited resistance to one or more antibiotics and produced large amounts of ESBL. Further studies are needed to investigate the virulence and epidemiology of CTX-M type ESBL in clinical isolates from burn patients.

  17. Measuring the impact of a burns school reintegration programme on the time taken to return to school: A multi-disciplinary team intervention for children returning to school after a significant burn injury.

    Science.gov (United States)

    Arshad, Sira N; Gaskell, Sarah L; Baker, Charlotte; Ellis, Nicola; Potts, Jennie; Coucill, Theresa; Ryan, Lynn; Smith, Jan; Nixon, Anna; Greaves, Kate; Monk, Rebecca; Shelmerdine, Teresa; Leach, Alison; Shah, Mamta

    2015-06-01

    Returning to school can be a major step for burn-injured children, their family, and staff and pupils at the receiving school. Previous literature has recognised the difficulties children may face after a significant injury and factors that may influence a successful reintegration. A regional paediatric burns service recognised that some patients were experiencing difficulties in returning to school. A baseline audit confirmed this and suggested factors that hindered or facilitated this process, initiating the development of a school reintegration programme (SRP). Since the programme's development in 2009, it has been audited annually. The aim of this paper was to evaluate the impact of the SRP by presenting data from the 2009 to 2011 audits. For the baseline audit, the burn care team gathered information from clinical records (age, gender, total body surface area burned (TBSA), skin grafting and length of stay) and telephone interviews with parents and teachers of the school returners. For the re-audits, the same information was gathered from clinical records and feedback questionnaires. Since its introduction, the mean length of time from discharge to return to school has dropped annually for those that opted into the programme, when compared to the baseline by 62.3% (53 days to 20 days). Thematic analysis highlights positive responses to the programme from all involved. Increased awareness and feeling supported were amongst the main themes to emerge. Returning to school after a significant burn injury can be challenging for all involved, but we hypothesise that outreach interventions in schools by burns services can have a positive impact on the time it takes children to successfully reintegrate. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  18. Burn Patient Acuity Demographics, Scar Contractures, and Rehabilitation Treatment Time Related to Patient Outcomes (ACT)

    Science.gov (United States)

    2014-10-01

    17 G. Patient Screening and Subject Enrollments.……....…………………....18 H. ACT Consort Diagram.………………..…………………….….…………....19 I. Comparison of...were added to the study population during the over- sampling period. For reporting purposes, the subjects (N = 307) in the consort diagram as

  19. A study of regional nerve blocks and local anesthetic creams (Prilox) for donor sites in burn patients.

    Science.gov (United States)

    Gupta, Amit; Bhandari, P S; Shrivastava, Prabhat

    2007-02-01

    Burn patient requires multiple visits to the operation theatres and undergoing anesthesia with its attendant risks and post anesthesia recovery. It is possible now with the availability of local anesthetic creams like Prilox to conduct these procedures in the minor OT without any discomfort to the patient. Hundred patients of post burn raw areas were selected. These patients had at least one area of healthy skin on anterior, medial or lateral thigh. No patient had a known drug allergy. The age group varied from 5 to 75 years with no bias towards any sex. These patients were then given anesthesia according to the group, and were assessed for the ease of grafting, amount of graft being harvested, subjective pain score, post operative pain relief and any post operative complication. The nerve block technique being used was either femoral and/or LCT block or 3-in-1 block and popliteal fossa block. Both the group of patients had a virtual painless process of skin grafting. It is safe in selected patients to combine the two techniques in order to harvest larger areas. Both techniques of local anesthestic creams and nerve block are safe and convenient to use. Nerve blocks are more useful where larger grafts are required, the creams being more useful in children and where less graft is required.

  20. Aircraft-Measured Indirect Cloud Effects from Biomass Burning Smoke in the Arctic and Subarctic

    Science.gov (United States)

    Zamora, L. M.; Kahn, R. A.; Cubison, M. J.; Diskin, G. S.; Jimenez, J. L.; Kondo, Y.; McFarquhar, G. M.; Nenes, A.; Thornhill, K. L.; Wisthaler, A.; hide

    2016-01-01

    The incidence of wildfires in the Arctic and subarctic is increasing; in boreal North America, for example, the burned area is expected to increase by 200-300% over the next 50-100 years, which previous studies suggest could have a large effect on cloud microphysics, lifetime, albedo, and precipitation. However, the interactions between smoke particles and clouds remain poorly quantified due to confounding meteorological influences and remote sensing limitations. Here, we use data from several aircraft campaigns in the Arctic and subarctic to explore cloud microphysics in liquid-phase clouds influenced by biomass burning. Median cloud droplet radii in smoky clouds were approx. 40- 60% smaller than in background clouds. Based on the relationship between cloud droplet number (N(liq)/ and various biomass burning tracers (BBt/ across the multi-campaign data set, we calculated the magnitude of subarctic and Arctic smoke aerosol-cloud interactions (ACIs, where ACI = (1/3) x dln(N(liq))/dln(BBt)) to be approx. 0.16 out of a maximum possible value of 0.33 that would be obtained if all aerosols were to nucleate cloud droplets. Interestingly, in a separate subarctic case study with low liquid water content (0.02 gm/cu m and very high aerosol concentrations (2000- 3000/ cu cm in the most polluted clouds, the estimated ACI value was only 0.05. In this case, competition for water vapor by the high concentration of cloud condensation nuclei (CCN) strongly limited the formation of droplets and reduced the cloud albedo effect, which highlights the importance of cloud feedbacks across scales. Using our calculated ACI values, we estimate that the smoke-driven cloud albedo effect may decrease local summertime short-wave radiative flux by between 2 and 4 W/sq m or more under some low and homogeneous cloud cover conditions in the subarctic, although the changes should be smaller in high surface albedo regions of the Arctic.We lastly explore evidence suggesting that numerous northern

  1. Aircraft-measured indirect cloud effects from biomass burning smoke in the Arctic and subarctic

    Directory of Open Access Journals (Sweden)

    L. M. Zamora

    2016-01-01

    Full Text Available The incidence of wildfires in the Arctic and subarctic is increasing; in boreal North America, for example, the burned area is expected to increase by 200–300 % over the next 50–100 years, which previous studies suggest could have a large effect on cloud microphysics, lifetime, albedo, and precipitation. However, the interactions between smoke particles and clouds remain poorly quantified due to confounding meteorological influences and remote sensing limitations. Here, we use data from several aircraft campaigns in the Arctic and subarctic to explore cloud microphysics in liquid-phase clouds influenced by biomass burning. Median cloud droplet radii in smoky clouds were  ∼  40–60 % smaller than in background clouds. Based on the relationship between cloud droplet number (Nliq and various biomass burning tracers (BBt across the multi-campaign data set, we calculated the magnitude of subarctic and Arctic smoke aerosol–cloud interactions (ACIs, where ACI  =  (1∕3 × dln(Nliq∕dln(BBt to be  ∼  0.16 out of a maximum possible value of 0.33 that would be obtained if all aerosols were to nucleate cloud droplets. Interestingly, in a separate subarctic case study with low liquid water content ( ∼  0.02 g m−3 and very high aerosol concentrations (2000–3000 cm−3 in the most polluted clouds, the estimated ACI value was only 0.05. In this case, competition for water vapor by the high concentration of cloud condensation nuclei (CCN strongly limited the formation of droplets and reduced the cloud albedo effect, which highlights the importance of cloud feedbacks across scales. Using our calculated ACI values, we estimate that the smoke-driven cloud albedo effect may decrease local summertime short-wave radiative flux by between 2 and 4 W m−2 or more under some low and homogeneous cloud cover conditions in the subarctic, although the changes should be smaller in high surface albedo regions of the

  2. The Potential Association of Later Initiation of Oral/Enteral Nutrition on Euthyroid Sick Syndrome in Burn Patients

    Directory of Open Access Journals (Sweden)

    Joaquín Pérez-Guisado

    2013-01-01

    Full Text Available Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS, and shortens the length of hospital stay (LHS. Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd–5th day and second sample collection (9th–12th day after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: 48 h after the injury (Group 3. Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days was, respectively, in each group, 16.77±4.56, 21.98±4.86, and 26.06±5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61±0.92 days in Group 3, but there was no group with ESS at the second sample collection (9.89±1.01 days. Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients.

  3. The Potential Association of Later Initiation of Oral/Enteral Nutrition on Euthyroid Sick Syndrome in Burn Patients

    Science.gov (United States)

    Pérez-Guisado, Joaquín; de Haro-Padilla, Jesús M.; Rioja, Luis F.; DeRosier, Leo C.; de la Torre, Jorge I.

    2013-01-01

    Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS), and shortens the length of hospital stay (LHS). Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd–5th day) and second sample collection (9th–12th day) after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: 48 h after the injury (Group 3). Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days) was, respectively, in each group, 16.77 ± 4.56, 21.98 ± 4.86, and 26.06 ± 5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61 ± 0.92 days) in Group 3, but there was no group with ESS at the second sample collection (9.89 ± 1.01 days). Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients. PMID:23401683

  4. Burn Wise

    Science.gov (United States)

    Burn Wise is a partnership program of the U.S. Environmental Protection Agency that emphasizes the importance of burning the right wood, the right way, in the right appliance to protect your home, health, and the air we breathe.

  5. Long-term monitoring of arterial pO2 in burned patients.

    Science.gov (United States)

    Nilsson, E; Arnander, C

    1984-02-01

    Five patients, who were treated in a special ward for burns were followed by continuous intra-arterial pO2 monitoring for a total of 1612 h (range 13-604 h). The pao2 catheter electrodes used were surface-heparinized, and inserted either in the radial or the femoral artery. Some electrodes were accidentally withdrawn. Recalibration was performed for two of the 10 electrodes used. These electrodes presented a changed sensitivity after heavy stretching of the sensor during the nursing. The sensitivity of one of these electrodes was altered downwards and the other one upwards. After recalibration the pao2 electrodes presented accurate values for the rest of the monitoring period. Without compensation for drift, the pao2 electrode readout was compared to the results of traditional blood-gas analysis, which served as a reference. The regression function found was y = -0.62 + 1.04 chi (r = 0.93, SD = 1.40, n = 60). The blood flow velocity around some of the pao2 electrodes was studied by the pulsed Doppler technique. There was no influence of the surface-heparinized pao2 electrode on the femoral artery blood flow velocity as compared to the contralateral, non-catheterized femoral artery. The blood flow velocity proximal to a traditional radial artery catheter was compared to the flow velocity in the contralateral radial artery containing a surface-heparinized pao2 electrode. The surface-heparinized electrode did not decrease the mean flow velocity in contrast with the traditional radial artery catheter, which had to be withdrawn after 8 days because of clotting. The surface-heparinized catheter electrode was still monitoring pao2 accurately after 25 days in the artery, which was the longest period studied for a particular sensor.

  6. Distribution of Class I Integron among Isolates of Acinetobacter baumannii Recoverd from Burn Patients

    Directory of Open Access Journals (Sweden)

    Abdolaziz Rastegar-Lari

    2015-10-01

    Full Text Available Background: Acinetobacter baumannii, is an important opportunistic pathogens   responsible   for   nosocomial   infections.   The   aim   of   this experiment  was  to  determine  prevalence  of  Class  I  Integron  in  A. baumannii strains isolated from burn patients in Mottahari Hospital and the drug susceptibility pattern.Methods: There were 69 Acinetobacter isolates, 68 (98.5% were identified as A. baumannii. Antimicrobial susceptibility of these isolates were determined by a disk diffusion method. PCR assay for detection of blaOXA-51 like gene (for identity confirmation and intI was performed.Results:  The  most  effective  antibiotic  for  treating  A.  baumannii  was colistin, followed by tetracyclin and tobramycin. The presence of Integron class  I  was  detected  in  14.49%  of  isolates.  ESBL  and  carbapenemase production were observed in 10% and 24.6% of isolates, respectively. Conclusion: Due to the high resistance of strains lacking Integron I, the findings are although class I integrons are disseminated among clinical isolates  of  A.  baumannii,  at  present  research,  they  they  do  not  play important role in dissemination of antibiotic resistance genes in MottahariHospital in Tehran, Iran. 

  7. Pediatric burns in military hospitals of China from 2001 to 2007: a retrospective study.

    Science.gov (United States)

    Xu, Jian-Hong; Qiu, Jun; Zhou, Ji-Hong; Zhang, Liang; Yuan, Dan-Feng; Dai, Wei; Gao, Zhi-Ming

    2014-12-01

    Childhood burns are a global health problem. To date, no epidemiological study with a large sample size of hospitalized pediatric burn patients from the Chinese mainland has been conducted. This study retrospectively analyzed pediatric burn cases to identify the characteristics of pediatric burns and their risk factors in China. Data for pediatric burn inpatients younger than 14 years were retrieved from the Chinese Trauma Databank (CTDB). The epidemiological characteristics of pediatric burns and risk factors for mortality were analyzed. A total of 61,068 cases were included in the study. Children under 3 years old were at the highest risk of injury. Scalds were the commonest burns (87.59%). Flame burns occurred more in winter, and electrical burns occurred mainly in July and August. Age, etiology, depth of injury, total body surface area (TBSA), site of injury, and outcome were correlated with length of hospital stay. Risk factors for pediatric burn mortality included being male, having third degree burns, ≥30% TBSA, and having multi-site burns. The results showed the epidemiological characteristics of pediatric burns in China, which differ from those reported for other countries and regions. These characteristics can be used to develop measures to prevent pediatric burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  8. Evaporative Water Loss in Superficial to Full Thickness Burns.

    Science.gov (United States)

    Busche, Marc Nicolai; Roettger, Anne; Herold, Christian; Vogt, Peter Maria; Rennekampff, Hans-Oliver

    2016-10-01

    Increased evaporative water loss (EWL) in burn patients leads to dehydration and hypothermia. Early clinical studies performed with outdated hygrometers suggested a 17 to 75 times increased EWL in burns with contradicting results for the different burn depths.Our study proposals were: (1) obtain reliable data of the EWL of all burn depths, (2) compare these results with findings from earlier studies, (3) evaluate the usefulness of the EWL in differentiating between superficial and deep partial thickness burns, (4) determine the effect of Biobrane on the EWL of superficial partial thickness burns in vivo, and (5) evaluate the effect of the sterile incision foil Opraflex on the EWL in split skin graft donor sites. We measured the EWL of all burn depths in 28 patients under stable and recorded conditions regarding room temperature and humidity with a modern digital evaporimeter (Tewameter TM 300). For the first time in vivo, we also determined the effect of Biobrane on the EWL of burns and evaluated the EWL in split skin graft donor sites covered with Opraflex. The EWL in all burn depths was significantly increased (P 0.05) in the EWL of superficial compared with deep partial thickness burns, whereas full thickness burns had a significantly lower EWL (P < 0.05) compared with superficial and deep partial thickness burns. Biobrane significantly reduced the EWL (P < 0.05) of superficial partial thickness burns. The EWL of Opraflex covered skin graft donor sites was significantly reduced compared with uncovered donor sites (P < 0.05). Our data suggest that the actual EWL in burns is approximately 3 times higher in full thickness burns and approximately 4 times higher in superficial and deep partial thickness burns compared with normal skin and therefore much lower than suggested previously.Because there was no significant difference in the EWL of superficial compared with deep partial thickness burns, the EWL cannot be used to differentiate between these burn depths

  9. Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

    International Nuclear Information System (INIS)

    Lubis, L E; Badawy, M K

    2016-01-01

    The increasing prevalence and complexity of fluoroscopically guided interventions (FGI) raises concern regarding radiation dose to patients subjected to the procedure. Despite current evidence showing the risk to patients from the deterministic effects of radiation (e.g. skin burns), radiation induced injuries remain commonplace. This review aims to increase the awareness surrounding radiation dose measurement for patients undergoing FGI. A review of the literature was conducted alongside previous researches from the authors’ department. Studies pertaining to patient dose measurement, its formalism along with current advances and present challenges were reviewed. Current patient monitoring techniques (using available radiation dosimeters), as well as the inadequacy of accepting displayed dose as patient radiation dose is discussed. Furthermore, advances in real-time patient radiation dose estimation during FGI are considered. Patient dosimetry in FGI, particularly in real time, remains an ongoing challenge. The increasing occurrence and sophistication of these procedures calls for further advances in the field of patient radiation dose monitoring. Improved measuring techniques will aid clinicians in better predicting and managing radiation induced injury following FGI, thus improving patient care. (paper)

  10. High tidal volume decreases adult respiratory distress syndrome, atelectasis, and ventilator days compared with low tidal volume in pediatric burned patients with inhalation injury.

    Science.gov (United States)

    Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

    2015-04-01

    Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of this study was to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia, and ARDS in pediatric burned patients with inhalation injury within 1 year post burn injury. From 1986 to 2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n = 932). Patients were divided into 3 groups: unventilated (n = 241), high tidal volume (HTV, 15 ± 3 mL/kg, n = 190), and low tidal volume (LTV, 9 ± 3 mL/kg, n = 501). High tidal volume was associated with significantly decreased ventilator days (p tidal volume significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared with low tidal volume in pediatric burned patients with inhalation injury. Therefore, the use of HTV may interrupt sequences leading to lung injury in our patient population. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Olympic torch flap: one-stop option for simultaneous brow, upper and lower lid reconstruction in post burn patients.

    Science.gov (United States)

    Vathulya, M; Chattopadhyay, D; Koyama, K

    2017-06-30

    Facial units reconstruction in a post burn patient poses tough challenges. Simultaneous brow and lid reconstruction is one of them. This article presents a 45-year-old epileptic male with burn of complete face. The task of reconstructing the brow, upper and lower lids was successfully accomplished using a modification of the Guyuron postauricular fasciocutaneous flap, after initial grafting and radial forearm flap reconstruction of forehead and other parts of the face. The article gives a single-stop solution for simultaneous reconstruction of brow and lids using a random pattern extension of the traditional postauricular flap, thus proving the excellent vascularity and hence durability of the flap in spite of a 180 degrees change in the orientation of the flap with respect to the axis.

  12. Postwildfire measurement of soil physical and hydraulic properties at selected sampling sites in the 2011 Las Conchas wildfire burn scar, Jemez Mountains, north-central New Mexico

    Science.gov (United States)

    Romero, Orlando C.; Ebel, Brian A.; Martin, Deborah A.; Buchan, Katie W.; Jornigan, Alanna D.

    2018-04-10

    The generation of runoff and the resultant flash flooding can be substantially larger following wildfire than for similar rainstorms that precede wildfire disturbance. Flash flooding after the 2011 Las Conchas Fire in New Mexico provided the motivation for this investigation to assess postwildfire effects on soil-hydraulic properties (SHPs) and soil-physical properties (SPPs) as a function of remotely sensed burn severity 4 years following the wildfire. A secondary purpose of this report is to illustrate a methodology to determine SHPs that analyzes infiltrometer data by using three different analysis methods. The SPPs and SHPs are measured as a function of remotely sensed burn severity by using the difference in the Normalized Burn Ratio (dNBR) metric for seven sites. The dNBR metric was used to guide field sample collection across a full spectrum of burn severities that covered the range of Monitoring Trends in Burn Severity (MTBS) and Burned Area Reflectance Classification (BARC) thematic classes from low to high severity. The SPPs (initial and saturated soil-water content, bulk density, soil-organic matter, and soil-particle size) and SHPs (field-saturated hydraulic conductivity and sorptivity) were measured under controlled laboratory conditions for soil cores collected in the field. The SHPs were estimated by using tension infiltrometer measurements and three different data analysis methods. These measurements showed large effects of burn severity, focused in the top1 centimeter (cm) of soil, on some SPPs (bulk density, soil organic matter, and particle sizes). The threshold of these bulk density and soil organic matter effects was between 300 and 400 dNBR, which corresponds to a MTBS thematic class between moderate and high burn severity and a BARC4 thematic class of high severity. Gravel content and the content of fines in the top 1 cm of soil had a higher threshold value between 450 and 500 dNBR. Lesser effects on SPPs were observed at depths of 1–3 cm

  13. OH Reactivity and Potential SOA Yields from Volatile Organic Compounds and Other Trace Gases Measured in Controlled Laboratory Biomass Burns

    Science.gov (United States)

    Gilman, J. B.; Warneke, C.; Kuster, W. C.; Goldan, P. D.; Veres, P. R.; Roberts, J. M.; de Gouw, J. A.; Burling, I. R.; Yokelson, R. J.

    2010-12-01

    A comprehensive suite of instruments were used to characterize volatile organic compounds (VOCs) and other trace gases (e.g., CO, CH4, NO2, etc.) emitted from controlled burns of various fuel types common to the Southeastern and Southwestern United States. These laboratory-based measurements were conducted in February 2009 at the U.S. Department of Agriculture’s Fire Sciences Laboratory in Missoula, Montana. An on-line GC-MS provided highly speciated VOC measurements of alkenes, alkanes, oxygenates, aromatics, biogenics, and nitrogen-containing compounds during the flaming or smoldering phases of replicate burns. The speciated GC-MS “grab” samples were integrated with fast-response gas-phase measurements (e.g., PTR-MS, PTR-IT-MS, NI-PT-CIMS, and FTIR) in order to determine VOC emission ratios and the fraction of identified vs. unidentifiable mass detected by PTR-MS. Emission ratios were used to calculate OH reactivity, which is a measure of potential ozone formation, as well as potential secondary organic aerosol (SOA) yields from the various fuel types. Small oxygenated VOCs had the highest emission ratios of the compounds observed. Alkenes dominated the VOC OH reactivity, which occasionally exceeded 1000 s-1. Calculated SOA yields from known precursors were dominated by aromatic VOCs, such as toluene, naphthalene (C10H8), and 1,3-benzenediol (C6H6O2, resorcinol). The contribution of several compounds not typically reported in ambient air measurements, such as substituted furans (C4H4O), pyrroles (C4H5N), and unsaturated C9 aromatics (C9H10), on OH reactivity and SOA yields will be discussed.

  14. [Effects of application of pulse contour cardiac output monitoring technology in early treatment of patients with large area burns].

    Science.gov (United States)

    Wang, D Y; Xie, W G; Xi, M M; Li, Z; Wang, B

    2018-01-20

    Objective: To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Methods: Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample t test and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis. Results: (1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 ( F =7.428, P 0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 ( F =7.863, P 0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 ( F =0.704, P >0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value ( t =-3.112, -3.554, -2.969, -2.450, -2.476, P 0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 ( F =1.859, P 0.05). (5) The fluid infusion

  15. Longitudinal Evaluation of Hospitalized Burn Patients in Sivas City Center for Six Months and Comparison with a Previously Held Community-based Survey

    Directory of Open Access Journals (Sweden)

    Ömer Faruk Erin

    2016-03-01

    Full Text Available Objective: This study was designed to longitudinally demonstrate the rate and epidemiology of hospitalized burn patients in Sivas city center within 6 months. The second aim was to compare the results of the current study with those of a previously held community-based survey in the same region. Material and Methods: Patients who were hospitalized due to burn injuries in Sivas city for six months were longitudinally evaluated. Epidemiological data of these patients were analyzed. Results: During the course of the study, 87 patients (49 males and 38 females were hospitalized. The ratio of burn patients to the total number of hospitalized patients was 0.38%. The most common etiologic factor was scalds (70.1%. Burns generally took place in the kitchen (41.4% and living room (31.4%, and majority of the patients received cold water as first-aid treatment at the time of injury. The vast majority of patients were discharged from the hospital without the need of surgical intervention (83.9%, and the duration of treatment was between 1 and 14 days for 73.6% of the patients. Sixty patients (68.9% had a total burn surface area under 10%. The total cost of the hospitalization period of these patients was 137.225 Turkish Lira (83.308–92.908$, and the average cost per patient was 1.577 Turkish Lira (957–1067$. Conclusion: Our study revealed a considerable inconsistency when compared with the results of the community-based survey, which had been previously conducted in the same region. We concluded that hospital-based studies are far from reflecting the actual burn trauma potential of a given district in the absence of a reliable, standard, nation-wide record system. Population-based surveys should be encouraged to make an accurate assessment of burn rates in countries lacking reliable record systems.

  16. 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

    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...... died in group A and 2 in group B; all with a Bull and Fischer index between 1.0 and 2.0. Prestorage leukocyte filtration may reduce transfusion related accumulation of various bioactive substances and the requirement for blood in burn trauma patients....

  17. [The relationship between rhGH and blood sugar on different ages of severe degree burned patients].

    Science.gov (United States)

    Chen, Jiong; Xia, Shi-chun; Xie, Bing; Tang, Zhi-jian; Su, Guo-liang; Shi, Jian-wu; Lu, Xue-mian

    2009-08-01

    Probe the effects of rhGH on severe degree burned patients' blood sugar in different age of years. Elected 210 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2008, who were burned in 48 h, older than 18 years, ever had no diabetes and tumor history and placidly pull through shock stage. Among the patients there were 132 males and 78 females. The age was from 18 to 65 years old, average (40.7 +/- 7.2) years old. The extent of burn were form TBSA 25% to TBSA 86%, average TBSA (40.4 +/- 12.5)%. The depths of burn were from superficial second degree to third degree. All of the total divided into A (18 - 44 years old) and B (> 45 years old)groups. Each group had 105 patients. Two groups were randomly divided into A(1), A(2), A(0) and B(1), B(2), B(0) groups. Each group had 35 patients. The A(1) and B(1) groups were used 0.15 U/(kg.d) growth hormone (Somatropin, S19990021), A(2) and B(2) groups were used 0.2 U/(kg.d) growth hormone, A(0) and B(0) groups were used NS as control. Observed and analyzed the change of blood sugar and insulin amount used in 210 patients. Of all the patients in 6 groups, there were 190 patients finished the experimentation in four weeks. The insulin amount of A(1), A(2), A(0) groups used were (2123.3 +/- 152.3), (2885.6 +/- 148.5), (724.1 +/- 31.1) U, B(1), B(2), B(0) group were (2715.1 +/- 95.3), (3652.2 +/- 198.1), (801.8 +/- 22.2) U. The consequence showed that the number need insulin to control blood sugar in B group was more than A group, as well as using 0.2 U/(kg.d) does to 0.15 U/(kg.d) does, and using growth hormone to no using(P 0.05). The blood sugar's alteration has positive correlation with the age of years and the does of rhGH. As long as normative using rhGH it doesn't induce diabetes.

  18. Surgical wound debridement sequentially characterized in a porcine burn model with multispectral imaging.

    Science.gov (United States)

    King, Darlene R; Li, Weizhi; Squiers, John J; Mohan, Rachit; Sellke, Eric; Mo, Weirong; Zhang, Xu; Fan, Wensheng; DiMaio, J Michael; Thatcher, Jeffrey E

    2015-11-01

    Multispectral imaging (MSI) is an optical technique that measures specific wavelengths of light reflected from wound site tissue to determine the severity of burn wounds. A rapid MSI device to measure burn depth and guide debridement will improve clinical decision making and diagnoses. We used a porcine burn model to study partial thickness burns of varying severity. We made eight 4 × 4 cm burns on the dorsum of one minipig. Four burns were studied intact, and four burns underwent serial tangential excision. We imaged the burn sites with 400-1000 nm wavelengths. Histology confirmed that we achieved various partial thickness burns. Analysis of spectral images show that MSI detects significant variations in the spectral profiles of healthy tissue, superficial partial thickness burns, and deep partial thickness burns. The absorbance spectra of 515, 542, 629, and 669 nm were the most accurate in distinguishing superficial from deep partial thickness burns, while the absorbance spectra of 972 nm was the most accurate in guiding the debridement process. The ability to distinguish between partial thickness burns of varying severity to assess whether a patient requires surgery could be improved with an MSI device in a clinical setting. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  19. Which factors influence the development of post-traumatic stress disorder in patients with burn injuries? A systematic review of the literature.

    Science.gov (United States)

    Hobbs, Katherine

    2015-05-01

    This article aims to discover which variables influence the development of post-traumatic stress disorder in patients with burn injuries. It will also consider whether it is possible to predict which burns patients will develop PTSD. Post-traumatic stress disorder is an important psychopathology for burned patients as it can affect both physical outcomes and quality of life for those affected. Research states that PTSD may be identified in up to 30% of burns patients, making it relatively common. A systematic review of the literature was carried out using four databases. Eleven articles were identified from these searches, and were then analysed thematically to draw out common ideas. Gender, extraversion and neuroticism, attribution of blame, capacity for forgiveness, the event as a disaster or non-disaster, alcohol consumption and peri-traumatic emotional response were all found to influence burns patients' risk of developing PTSD. While it is possible to identify the factors that put burns patients are greater risk of developing PTSD, it is not possible to accurately predict who will go on to develop PTSD due to the interplay between variables and individual differences. Focus should instead be on screening for PTSD and timely recognition of intrusive symptoms. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  20. [Patient evaluation and outcome measures].

    Science.gov (United States)

    Nieto Pol, Enrique

    2014-01-01

    Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). Copyright © 2014 Elsevier España, S.L. All rights reserved.

  1. Resolution of Unresolved Safety Issue A-48, ''Hydrogen control measures and effects of hydrogen burns on safety equipment''

    International Nuclear Information System (INIS)

    Ferrell, C.M.; Soffer, L.

    1989-09-01

    Unresolved Safety Issue (USI) A-48 arose as a result of the large amount of hydrogen generated and burned within containment during the Three Mile Island accident. This issue covers hydrogen control measures for recoverable degraded-core accidents for all boiling-water reactors (BWRs) and those pressurized-water reactors (PWRs) with ice-condenser containments. The Commission and the nuclear industry have sponsored extensive research in this area, which has led to significant revision of the Commission's hydrogen control regulations, given in Title 10, Code of Federal Regulations, Part 50 (10 CFR 50), Section 50.44. BWRs having Mark I and II containments are presently required to operate with inerted containment atmospheres that effectively prevent hydrogen combustion. BWRs with Mark III containments and PWRs with ice-condenser containments are now required to be equipped with hydrogen control systems to protect containment integrity and safety systems inside containment. Industry has chosen to use hydrogen igniter systems to burn hydrogen produced in a controlled fashion to prevent damage. An independent review by a Committee of the National Research Council concluded that, for most accident scenarios, current regulatory requirements make it highly unlikely that hydrogen detonation would be the cause of containment failure. On the basis of the extensive research effort conducted and current regulatory requirements, including their implementation, the staff concludes that no new regulatory guidance on hydrogen control for recoverable degraded-core accidents for these types of plants is necessary and that USI A-48 is resolved

  2. Time-dependent inversion estimates of global biomass-burning CO emissions using Measurement of Pollution in the Troposphere (MOPITT) measurements

    Science.gov (United States)

    Arellano, Avelino F.; Kasibhatla, Prasad S.; Giglio, Louis; van der Werf, Guido R.; Randerson, James T.; Collatz, G. James

    2006-05-01

    We present an inverse-modeling analysis of CO emissions using column CO retrievals from the Measurement of Pollution in the Troposphere (MOPITT) instrument and a global chemical transport model (GEOS-CHEM). We first focus on the information content of MOPITT CO column retrievals in terms of constraining CO emissions associated with biomass burning and fossil fuel/biofuel use. Our analysis shows that seasonal variation of biomass-burning CO emissions in Africa, South America, and Southeast Asia can be characterized using monthly mean MOPITT CO columns. For the fossil fuel/biofuel source category the derived monthly mean emission estimates are noisy even when the error statistics are accurately known, precluding a characterization of seasonal variations of regional CO emissions for this source category. The derived estimate of CO emissions from biomass burning in southern Africa during the June-July 2000 period is significantly higher than the prior estimate (prior, 34 Tg; posterior, 13 Tg). We also estimate that emissions are higher relative to the prior estimate in northern Africa during December 2000 to January 2001 and lower relative to the prior estimate in Central America and Oceania/Indonesia during April-May and September-October 2000, respectively. While these adjustments provide better agreement of the model with MOPITT CO column fields and with independent measurements of surface CO from National Oceanic and Atmospheric Administration Climate Monitoring and Diagnostics Laboratory at background sites in the Northern Hemisphere, some systematic differences between modeled and measured CO fields persist, including model overestimation of background surface CO in the Southern Hemisphere. Characterizing and accounting for underlying biases in the measurement model system are needed to improve the robustness of the top-down estimates.

  3. Final Report for SERDP Project RC-1649: Advanced Chemical Measurements of Smoke from DoD-prescribed Burns

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Timothy J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weise, David [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lincoln, E. N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sams, Robert L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cameron, Melanie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Veres, Patrick [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Yokelson, Robert J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Urbanski, Shawn [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Profeta, Luisa T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Williams, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gilman, Jessica [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kuster, W. C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Akagi, Sheryl [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stockwell, Chelsea E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mendoza, Albert [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wold, Cyle E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Warneke, Carsten [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); de Gouw, Joost A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Burling, Ian R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Reardon, James [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Schneider, Matthew D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Griffith, David W.T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Roberts, James M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-12-17

    Objectives: Project RC-1649, “Advanced Chemical Measurement of Smoke from DoD-prescribed Burns” was undertaken to use advanced instrumental techniques to study in detail the particulate and vapor-phase chemical composition of the smoke that results from prescribed fires used as a land management tool on DoD bases, particularly bases in the southeastern U.S. The statement of need (SON) called for “(1) improving characterization of fuel consumption” and “(2) improving characterization of air emissions under both flaming and smoldering conditions with respect to volatile organic compounds, heavy metals, and reactive gases.” The measurements and fuels were from several bases throughout the southeast (Camp Lejeune, Ft. Benning, and Ft. Jackson) and were carried out in collaboration and conjunction with projects 1647 (models) and 1648 (particulates, SW bases). Technical Approach: We used an approach that featured developing techniques for measuring biomass burning emission species in both the laboratory and field and developing infrared (IR) spectroscopy in particular. Using IR spectroscopy and other methods, we developed emission factors (EF, g of effluent per kg of fuel burned) for dozens of chemical species for several common southeastern fuel types. The major measurement campaigns were laboratory studies at the Missoula Fire Sciences Laboratory (FSL) as well as field campaigns at Camp Lejeune, NC, Ft. Jackson, SC, and in conjunction with 1648 at Vandenberg AFB, and Ft. Huachuca. Comparisons and fusions of laboratory and field data were also carried out, using laboratory fuels from the same bases. Results: The project enabled new technologies and furthered basic science, mostly in the area of infrared spectroscopy, a broadband method well suited to biomass burn studies. Advances in hardware, software and supporting reference data realized a nearly 20x improvement in sensitivity and now provide quantitative IR spectra for potential detection of ~60 new

  4. Ambient measurements and source apportionment of fossil fuel and biomass burning black carbon in Ontario

    Science.gov (United States)

    Healy, R. M.; Sofowote, U.; Su, Y.; Debosz, J.; Noble, M.; Jeong, C.-H.; Wang, J. M.; Hilker, N.; Evans, G. J.; Doerksen, G.; Jones, K.; Munoz, A.

    2017-07-01

    Black carbon (BC) is of significant interest from a human exposure perspective but also due to its impacts as a short-lived climate pollutant. In this study, sources of BC influencing air quality in Ontario, Canada were investigated using nine concurrent Aethalometer datasets collected between June 2015 and May 2016. The sampling sites represent a mix of background and near-road locations. An optical model was used to estimate the relative contributions of fossil fuel combustion and biomass burning to ambient concentrations of BC at every site. The highest annual mean BC concentration was observed at a Toronto highway site, where vehicular traffic was found to be the dominant source. Fossil fuel combustion was the dominant contributor to ambient BC at all sites in every season, while the highest seasonal biomass burning mass contribution (35%) was observed in the winter at a background site with minimal traffic contributions. The mass absorption cross-section of BC was also investigated at two sites, where concurrent thermal/optical elemental carbon data were available, and was found to be similar at both locations. These results are expected to be useful for comparing the optical properties of BC at other near-road environments globally. A strong seasonal dependence was observed for fossil fuel BC at every Ontario site, with mean summer mass concentrations higher than their respective mean winter mass concentrations by up to a factor of two. An increased influence from transboundary fossil fuel BC emissions originating in Michigan, Ohio, Pennsylvania and New York was identified for the summer months. The findings reported here indicate that BC should not be considered as an exclusively local pollutant in future air quality policy decisions. The highest seasonal difference was observed at the highway site, however, suggesting that changes in fuel composition may also play an important role in the seasonality of BC mass concentrations in the near-road environment

  5. Adequacy of a hospital-wide standard dose of 7mg/kg bodyweight gentamicin sufficient to achieve an adequate prophylactic maximum serum concentration (Cmax) in burn patients undergoing surgical burn wound treatment

    NARCIS (Netherlands)

    Borra, L.C.P.; Bosch, T.M.; Baar, M.E. van; Dokter, J.; Oen, I.M.; Ruijgrok, E.J.

    2016-01-01

    INTRODUCTION: Pharmacokinetics of drugs can be significantly altered in burn patients. The aim of our study was to validate if the current hospital-wide standard dosage of 7mg/kg total bodyweight gentamicin is sufficient to achieve an adequate prophylactic Cmax (Cmax>/=20mg/L). MATERIALS AND

  6. Fatty infiltration of the liver in severely burned pediatric patients : Autopsy findings and clinical implications

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Background. Trauma induces hypermetabolic responses that are characterized by the mobilization of all available substrates. The marked increase of peripheral lipolysis after a burn can lead to the development of fatty liver, which has been associated with immunodepression and increased mortality.

  7. Early ICU Standardized Rehabilitation Therapy for the Critically Injured Burn Patient

    Science.gov (United States)

    2014-10-01

    Patients were excluded if they had a prior history of MV, chest tube or thoracoabdominal surgery. Images were analyzed using Image J for diaphragm...as maximum distance between the pleural and peritoneal 165 margins of the diaphragm muscle. 35 Quadriceps thickness was measured as the maximum 166

  8. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities.

    Science.gov (United States)

    Takenoshita, Miho; Sato, Tomoko; Kato, Yuichi; Katagiri, Ayano; Yoshikawa, Tatsuya; Sato, Yusuke; Matsushima, Eisuke; Sasaki, Yoshiyuki; Toyofuku, Akira

    2010-10-13

    Burning mouth syndrome (BMS) and atypical odontalgia (AO) are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as "somatoform disorder". From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities. To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities. Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients' medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision. The proportion of F4 classification (neurotic, stress-related, and somatoform disorders) in AO patients was significantly higher than in BMS patients. BMS patients were more frequently given a F3 classification (mood/affective disorders). However, 50.8% of BMS patients and 33.3% of AO patients had no specific psychiatric diagnoses. Although BMS and AO are both chronic pain disorders occurring in the absence of any organic cause, the psychiatric diagnoses of patients with BMS and AO differ substantially.

  9. Noninvasive determination of burn depth in children by digital infrared thermal imaging

    Science.gov (United States)

    Medina-Preciado, Jose David; Kolosovas-Machuca, Eleazar Samuel; Velez-Gomez, Ezequiel; Miranda-Altamirano, Ariel; González, Francisco Javier

    2013-06-01

    Digital infrared thermal imaging is used to assess noninvasively the severity of burn wounds in 13 pediatric patients. A delta-T (ΔT) parameter obtained by subtracting the temperature of a healthy contralateral region from the temperature of the burn wound is compared with the burn depth measured histopathologically. Thermal imaging results show that superficial dermal burns (IIa) show increased temperature compared with their contralateral healthy region, while deep dermal burns (IIb) show a lower temperature than their contralateral healthy region. This difference in temperature is statistically significant (pburns. These results show that digital infrared thermal imaging could be used as a noninvasive procedure to assess burn wounds. An additional advantage of using thermal imaging, which can image a large skin surface area, is that it can be used to identify regions with different burn depths and estimate the size of the grafts needed for deep dermal burns.

  10. Measurements of reactive trace gases and variable O3 formation rates in some South Carolina biomass burning plumes

    Science.gov (United States)

    Akagi, S. K.; Yokelson, R. J.; Burling, I. R.; Meinardi, S.; Simpson, I.; Blake, D. R.; McMeeking, G. R.; Sullivan, A.; Lee, T.; Kreidenweis, S.; Urbanski, S.; Reardon, J.; Griffith, D. W. T.; Johnson, T. J.; Weise, D. R.

    2013-02-01

    In October-November 2011 we measured trace gas emission factors from seven prescribed fires in South Carolina (SC), US, using two Fourier transform infrared spectrometer (FTIR) systems and whole air sampling (WAS) into canisters followed by gas-chromatographic analysis. A total of 97 trace gas species were quantified from both airborne and ground-based sampling platforms, making this one of the most detailed field studies of fire emissions to date. The measurements include the first emission factors for a suite of monoterpenes produced by heating vegetative fuels during field fires. The first quantitative FTIR observations of limonene in smoke are reported along with an expanded suite of monoterpenes measured by WAS including α-pinene, β-pinene, limonene, camphene, 4-carene, and myrcene. The known chemistry of the monoterpenes and their measured abundance of 0.4-27.9% of non-methane organic compounds (NMOCs) and ~ 21% of organic aerosol (mass basis) suggests that they impacted secondary formation of ozone (O3), aerosols, and small organic trace gases such as methanol and formaldehyde in the sampled plumes in the first few hours after emission. The variability in the initial terpene emissions in the SC fire plumes was high and, in general, the speciation of the initially emitted gas-phase NMOCs was 13-195% different from that observed in a similar study in nominally similar pine forests in North Carolina ~ 20 months earlier. It is likely that differences in stand structure and environmental conditions contributed to the high variability observed within and between these studies. Similar factors may explain much of the variability in initial emissions in the literature. The ΔHCN/ΔCO emission ratio, however, was found to be fairly consistent with previous airborne fire measurements in other coniferous-dominated ecosystems, with the mean for these studies being 0.90 ± 0.06%, further confirming the value of HCN as a biomass burning tracer. The SC results also

  11. Simultaneously combining AOD and multiple trace gas measurements to identify decadal changes in urban and biomass burning aerosols

    Science.gov (United States)

    Cohen, Jason

    2017-04-01

    This work presents a methodology by which to comprehensively analyze simultaneous tropospheric measurements of AOD and associated trace gasses. It then applies this methodology by focusing over the past 11 years (2006-2016) on one of the most rapidly changing regions of the troposphere: Eastern and Southeastern Asia. The specific work presented incorporates measurements of both aerosol and related gas phase tropospheric measurements across different spectral, spatial, temporal, and passive/active sensors and properties, including: MODIS, MISR, OMI, CALIOP, and others. This new characterization reveals a trio of new information, including a time-invariant urban signal, slowly-time-varying new-urbanization signal, and a rapidly time-varying biomass burning signal. Additionally, due to the different chemical properties of the various species analyzed, analyzing the different spatial domains of the resulting products allows for further information in terms of the amounts of aerosols produced both through primary emissions as well as secondary processing. The end result is a new characterization, in space, time, and magnitude, of both anthropogenic and biomass burning aerosols. These results are then used to drive an advanced modeling system including aerosol chemistry, physics, optics, and transport, and employing an aerosol routine based on multi-modal and both externally mixed and core-shell mixing. The resulting characterization in space, time, and quantity is analyzed and compared against AERONET, NOAA, and other ground networks, with the results comparing consistently to or better than present approaches which set up net emissions separately from urban and biomass burning products. Scientifically, new source regions of emissions are identified, some of which were previously non-urbanized or found to not contain any fire hotspots. This new approach is consistent with the underlying economic and development pathways of expanding urban areas and rapid economic growth

  12. Effects of early excision and grafting on cytokines and insulin resistance in burned rats.

    Science.gov (United States)

    Chen, Xin-Long; Xia, Zhao-Fan; Ben, Dao-Feng; Duo, Wei

    2010-11-01

    Burn wound excision and grafting is a common clinical practice that decreases patient morbidity and mortality. It is not known, however, if the salutary effects of this procedure are related to effects on interleukin 6 (IL-6) and tumor necrosis factor (TNF-) α, and to reducing insulin resistance after burn. Sprague-Dawley rats were randomly divided into three groups: control, burn, burn ± excision groups. Rats in burn group were given a third-degree scald burn covering 30% total body surface area (TBSA) and no wound excision. Rats in burn ± excision group were subjected to a 30% third-degree burn followed by complete excision and allografting of the injury site within 15 min after burn. The rats in control group were treated in the same manner as the burn group, except that they were immersed in a room-temperature water. Glucose tolerance tests (GTT) were observed at 3 days after burn, euglycemic-hyperinsulinemic glucose clamps were performed at 4 days after burn and interleukin 6 (IL-6) and tumor necrosis factor (TNF-) α were determined after euglycemic-hyperinsulinemic glucose clamps. The levels of IL-6 and TNF-α increased after burn. Significant differences in GTT were observed between control and burn groups, and the rate of glucose infused measured in burned rats was significantly decreased compared with that in control at 4 days after burn. Early excision and grafting significantly decreased levels of IL-6 and TNF-α, and further reduced insulin resistance following thermal injury compared with burn group. Early excision and grafting appeared to have an effect on inflammatory mediators and further reduced insulin resistance induced by major burns. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  13. Acute mental disorders and short and long term morbidity in patients with third degree flame burn: A population-based outcome study of 96,451 patients from the Nationwide Inpatient Sample (NIS) database (2001-2011).

    Science.gov (United States)

    Mahendraraj, Krishnaraj; Durgan, Diane M; Chamberlain, Ronald S

    2016-12-01

    Although burn patients with preexisting mood disorders have been shown to have diminished clinical recovery, acute mental disorders (AMD) are often unrecognized despite a link with post-traumatic stress disorder and social maladjustment later on. This study assessed the clinical profile of a large cohort of burn patients who developed AMD compared to those with chronic mental illness (CMI) and those without mental health problems to assess the impact of AMI on burn outcomes. Admission data on 96,451 patients with third degree flame burns was abstracted from the Nationwide Inpatient Sample (NIS) Database from 2001 to 2011. AMD was defined as adjustment disorder (ICD-10 codes F43.2-F43.29) and acute stress disorder (F43.0), while CMI was defined as major depressive disorder (F33.0-F33.9) and bipolar disorder (F31.0-F31.9). Data was compared across three subgroups: AMD, CMI, and patients without any mood disorders. Categorical variables were compared using the Chi-square test, and continuous variables were compared using Student t-test and analysis of variance (ANOVA). Multivariate analysis using the "backward Wald" method was performed to calculate odds ratios (OR) and determine independent factors which increased the risk of developing AMD after burn. 979 (1%) burn patients were diagnosed with AMD, compared to 5971 (6.2%) with CMI and 89,501 (92.8%) without mood disorders at the time of the burn. Patients with AMD were significantly younger, predominantly male and Caucasian. Patients with AMD had a higher frequency of multiple third-degree burn sites. AMD patients had a significantly longer length of hospitalization and shorter actuarial survival. More AMD patients lacked social or family support, suffered from alcoholism or illicit drug abuse, and had a history of psychological trauma or self-inflicted injuries compared to other groups. After burn, 4.9% of AMD patients developed burn wound infections, 5.0% had nutritional deficiencies, 1.7% had skin graft failure

  14. From skin allograft coverage to allograft-micrograft sandwich method: A retrospective review of severe burn patients who received conjunctive application of cultured epithelial autografts.

    Science.gov (United States)

    Chua, Alvin Wen Choong; Khoo, Yik Cheong; Truong, Thi Thu Ha; Woo, Evan; Tan, Bien Keem; Chong, Si Jack

    2018-02-20

    A 12-year retrospective review of severe burn patients who received cultured epithelial autografts (CEA) at the Singapore General Hospital Burns Centre from January 2005 to December 2016 was carried out. During this period, two different surgical modalities were employed to manage these burn injuries. In the earlier period, following early excision of the burn wounds, exposed surfaces were covered with a combination of split thickness skin autografts (STSG) and allografts. Surfaces covered with skin allografts were subsequently debrided of the allo-epidermis in about 3 weeks later, exposing the allodermis with granulating tissues for grafting of CEA; a technique known as the Cuono's method. In the later period, allograft-autologous micrograft sandwich technique was used to graft on the early excised burns with subsequent CEA grafting. The former and latter groups represented by STSG/C (n=10) and M/CEA (n=14) respectively, were compared in terms of clinical profiles, outcomes, allograft/CEA usage and total graft cost. No significant differences were found based on mean age and presence of inhalation burns between the two treatment methods However, percentage total body surface area (TBSA) and Revised Baux Score were significantly higher (pmicrografts which seemed to improve stabilization of the wound bed resulting in less operating procedures and improving CEA take. To conclude, the M/CEA method introduced was able to treat more severe burn patients at lower graft costs without compromising critical clinical outcomes significantly. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

  15. [Chickenpox, burns and grafts].

    Science.gov (United States)

    Rojas Zegers, J; Fidel Avendaño, L

    1979-01-01

    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually t