Sample records for burning imaging studies

  1. Characterization of burns using hyperspectral imaging technique - a preliminary study. (United States)

    Calin, Mihaela Antonina; Parasca, Sorin Viorel; Savastru, Roxana; Manea, Dragos


    Surgical burn treatment depends on accurate estimation of burn depth. Many methods have been used to asses burns, but none has gained wide acceptance. Hyperspectral imaging technique has recently entered the medical research field with encouraging results. In this paper we present a preliminary study (case presentation) that aims to point out the value of this optical method in burn wound characterization and to set up future lines of investigation. A hyperspectral image of a leg and foot with partial thickness burns was obtained in the fifth postburn day. The image was analyzed using linear spectral unmixing model as a tool for mapping the investigated areas. The article gives details on the mathematical bases of the interpretation model and correlations with clinical examination pointing out the advantages of hyperspectral imaging technique. While the results were encouraging, further more extended and better founded studies are being prepared before recognizing hyperspectral imaging technique as an applicable method of burn wound assessment. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  2. Impact of pediatric burn camps on participants' self esteem and body image: an empirical study. (United States)

    Bakker, Anne; Van der Heijden, Peter G M; Van Son, Maarten J M; Van de Schoot, Rens; Van Loey, Nancy E E


    This study focuses on possible effects of specialized summer camps on young burn survivors' self esteem and body image. Quantitative as well as qualitative measures was used. To study possible effects, a pretest-posttest comparison group design with a follow-up was employed. Self-report questionnaires were used to measure self esteem and body image in a burn camp group (n=83, 8-18 years) and in a comparison group of children with burns who did not attend a burn camp during the course of the study (n=90, 8-18 years). Additionally, burn camp participants and parents completed an evaluation form about benefits derived from burn camp. A small positive short-term effect of burn camp participation was found on the 'satisfaction with appearance' component of body image. Overall, participants and parents showed high appreciation of the burn camps and reported several benefits, particularly concerning meeting other young burn survivors. Albeit statistically modest, this is the first quantitative study to document on a significant short-term impact of burn camp on young burn survivors' body image. Implications of this result for future research and burn camp organization were discussed, including the strengths of residential camps for young burn survivors. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  3. Prospective comparative evaluation study of Laser Doppler Imaging and thermal imaging in the assessment of burn depth. (United States)

    Wearn, Christopher; Lee, Kwang Chear; Hardwicke, Joseph; Allouni, Ammar; Bamford, Amy; Nightingale, Peter; Moiemen, Naiem


    The accurate assessment of burn depth is challenging but crucial for surgical excision and tissue preservation. Laser Doppler Imaging (LDI) has gained increasing acceptance as a tool to aid depth assessment but its adoption is hampered by high costs, long scan times and limited portability. Thermal imaging is touted as a suitable alternative however few comparison studies have been done. Sixteen burn patients with 52 regions of interests were analysed. Burn depth was determined using four methods LDI, thermal imaging, photographic and real-time clinical evaluation at day 1 and day 3. LDI flux and Delta T values were used for the prediction of outcomes (wound closure in evaluation of burn depth was performed by 4 blinded burn surgeons. Accuracy of assessment methods were greater on post burn day 3 compared to day 0. Accuracies of LDI on post burn day 0 and 3 were 80.8% and 92.3% compared to 55.8% and 71.2% for thermal imaging and 62.5% and 71.6% for photographic clinical assessment. Real-time clinical examination had an accuracy of 88.5%. Thermal imaging scan times were significantly faster compared to LDI. LDI outperforms thermal imaging in terms of diagnostic accuracy of burn depth likely due to the susceptibility of thermal imaging to environmental factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  4. A thematic study of the role of social support in the body image of burn survivors

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    Kellie Hodder


    Full Text Available There is evidence that social support is important for the development and mainte- nance of body image satisfaction for people who have sustained burn injuries. This qualitative study explored the specific mechanisms by which social support impacts the body image satisfaction of burn survivors, drawing on nine participants’ in depth accounts. Participants were recruited through a burns unit at a public hospital in South Australia. Interviews were conducted with nine female burn survivors aged between 24 and 65 (mean age 44.6. Participants described their perceptions about their appearance post burn and their social support experiences. Four themes were identified: acceptance, social comparison, talking about appearance concerns, and the gaze of others. Results indicate that for these participants, social support was an important factor in coming to terms with changes in appearance, specifically support that helps to minimise feelings of difference. Unhelpful aspects of social support were also identified included feeling that suffering was being dismissed and resenting the perceived expectation from supports to be positive. Social supports are important to consider in relation to body image for those working with people who have survived burn injuries.

  5. Hole Burning Imaging Studies of Cancerous and Analogous Normal Ovarian Tissues Utilizing Organelle Specific Dyes

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    Matsuzaki, Satoshi [Iowa State Univ., Ames, IA (United States)


    Presented in this dissertation is the successful demonstration that nonphotochemical hole burning (NPWB) imaging can be used to study in vitro tissue cellular systems for discerning differences in cellular ultrastructures due to cancer development. This has been accomplished with the surgically removed cancerous ovarian and analogous normal peritoneal tissues from the same patient and the application of a fluorescent mitochondrion specific dye, Molecular Probe MitoFluor Far Red 680 (MF680), commonly known as rhodamine 800, that has been proven to exhibit efficient NPHB. From the results presented in Chapters 4 and 5 , and Appendix B, the following conclusions were made: (1) fluorescence excitation spectra of MF680 and confocal microscopy images of thin sliced tissues incubated with MF680 confirm the site-specificity of the probe molecules in the cellular systems. (2) Tunneling parameters, {lambda}{sub 0} and σΛ, as well as the standard hole burning parameters (namely, γ and S), have been determined for the tissue samples by hole growth kinetics (HGK) analyses. Unlike the preliminary cultured cell studies, these parameters have not shown the ability to distinguish tissue cellular matrices surrounding the chromophores. (3) Effects of an external electric (Stark) field on the nonphotochemical holes have been used to determine the changes in permanent dipole moment (fΔμ) for MF680 in tissue samples when burn laser polarization is parallel to the Stark field. Differences are detected between fΔμs in the two tissue samples, with the cancerous tissue exhibiting a more pronounced change (1.35-fold increase) in permanent dipole moment change relative to the normal analogs. It is speculated that the difference may be related to differences in mitochondrial membrane potentials in these tissue samples. (4) In the HGK mode, hole burning imaging (HBI) of cells adhered to coverslips and cooled to liquid helium temperatures in the complete absence of

  6. Study of flow field of burning particles in a pyrotechnic flame based on particle image and particle velocity (United States)

    Xue, R.; Xu, H. Q.; Li, Y.; Zhu, C. G.


    Studying the burning particles in the pyrotechnic flame is important to acquire the decomposition mechanism and spectral radiance of pyrotechnics. The high speed video (HSV) and particle image velocimetry (PIV) were used in this paper to analyze the flow field and velocity of burning particles in the flame of pyrotechnics. The binary image was obtained through gray scale treatment and adaptive threshold segmentation from HSV and PIV data, by which the coordinate of each particle was marked. On the basis, the movement trajectory of each particle during combustion was pursued by the most recent guidelines algorithm of cancroids matching. Through the method proposed in this study, the velocity variation of each particle was obtained, the approximate distribution of particle quantity at each zone was visualized and the mathematical model of pyrotechnic particle velocity flow field was established.

  7. Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients. (United States)

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


    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.

  8. Classification of burn severity using Moderate Resolution Imaging Spectroradiometer (MODIS): A case study in the jarrah-marri forest of southwest Western Australia (United States)

    Walz, Yvonne; Maier, Stefan W.; Dech, Stefan W.; Conrad, Christopher; Colditz, René R.


    The southwest of Western Australia is a fire-prone landscape. In this Mediterranean region, prescribed fuel reduction burning is applied as a management tool by the state government's Department of Conservation and Land Management (CALM). Remote sensing data from the Moderate Resolution Imaging Spectroradiometer (MODIS) with multiple observations per day are investigated for operational monitoring of prescribed burning activities.The Normalized Burn Ratio (NBR) is sensitive to the amount of biomass, soil exposure and equivalent water content. The differenced Normalized Burn Ratio (ΔNBR) shows the greatest response of landscape change due to fire. The ratios, originally applied to 30-m Landsat 7 ETM+ data, have been transferred to 250-500 m MODIS data. The high temporal resolution and direct broadcast capability of MODIS are considered favorable for monitoring prefire and postfire conditions, in particular in near-real time. This study applies the ΔNBR to classify burn severity using MODIS data with various levels of preprocessing. On the basis of field studies, four burn severity classes are distinguished with best discrimination for high burn severity where the top layer of the vegetation canopy is altered. As expected, the spatial detail of the classifications from MODIS is reduced when compared to results from Landsat 7 ETM+, but the large-scale spatial patterns are similar. NBR time series of daily data showed that classes of burn severity can be separated for each acquisition date. Large temporal variations of the NBR limit class separation with absolute thresholds, in particular for data uncorrected for effects due to varying viewing geometries. However, MODIS top of atmosphere data allow near-real-time assessment of burn severity, important to fire managers for monitoring postfire conditions.

  9. Nonphotochemical Hole-Burning Imaging Studies of In Vitro Carcinoma and Normal Cells Utilizing a Mitochondrial Specific Dye

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    Walsh, Richard Joseph [Iowa State Univ., Ames, IA (United States)


    Low temperature Nonphotochemical Hole Burning (NPHB) Spectroscopy of the dye rhodamine 800 (MF680) was applied for the purpose of discerning differences between cultured normal and carcinoma ovarian surface epithelial (OSE) cells. Both the cell lines were developed and characterized at the Mayo Clinic (Rochester, MN), with the normal cell line having been transfected with a strain of temperature sensitive Simian Virus 40 Large T Antigen (SV40) for the purpose of extending the life of the cell culture without inducing permanent changes in the characteristics of the cell line. The cationic lipophilic fluorophore rhodamine 800 preferentially locates in in situ mitochondria due to the high lipid composition of mitochondria and the generation of a large negative membrane potential (relative to the cellular cytoplasm) for oxidative phosphorylation. Results presented for NPHB of MF680 located in the cells show significant differences between the two cell lines. The results are interpreted on the basis of the NPHB mechanism and characteristic interactions between the host (cellular mitochondrial) and the guest (MF680) in the burning of spectral holes, thus providing an image of the cellular ultrastructure. Hole growth kinetics (HGK) were found to differ markedly between the two cell lines, with the carcinoma cell line burning at a faster average rate for the same exposure fluence. Theoretical fits to the data suggest a lower degree of structural heterogeneity in the carcinoma cell line relative to the normal cell line. Measurement of changes in the permanent dipole moment (fΔμ)were accomplished by measurement of changes in hole width in response to the application of an external electric field (the Stark effect), and found that Δμ values for the carcinoma line were 1.5x greater than those of the SV40 antigen-free normal analogs. These findings are interpreted in terms of effects from the mitochondrial membrane potential. Results for HGK on the scale of single cells is

  10. Nonphotochemical Hole-Burning Imaging Studies of in vitro Carcinoma and Normal Cells Utilizing a Mitochondrial Specific Dye

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    Walsh, Richard Joseph [Iowa State Univ., Ames, IA (United States)


    Low temperature Nonphotochemical Hole Burning (NPHB) Spectroscopy of the dye rhodamine 800 (MF680) was applied for the purpose of discerning differences between cultured normal and carcinoma ovarian surface epithelial (OSE) cells. Both the cell lines were developed and characterized at the Mayo Clinic (Rochester, MN), with the normal cell line having been transfected with a strain of temperature sensitive Simian Virus 40 Large T Antigen (SV40) for the purpose of extending the life of the cell culture without inducing permanent changes in the characteristics of the cell line. The cationic lipophilic fluorophore rhodamine 800 preferentially locates in in situ mitochondria due to the high lipid composition of mitochondria and the generation of a large negative membrane potential (relative to the cellular cytoplasm) for oxidative phosphorylation. Results presented for NPHB of MF680 located in the cells show significant differences between the two cell lines. The results are interpreted on the basis of the NPHB mechanism and characteristic interactions between the host (cellular mitochondrial) and the guest (MF680) in the burning of spectral holes, thus providing an image of the cellular ultrastructure. Hole growth kinetics (HGK) were found to differ markedly between the two cell lines, with the carcinoma cell line burning at a faster average rate for the same exposure fluence. Theoretical fits to the data suggest a lower degree of structural heterogeneity in the carcinoma cell line relative to the normal cell line. Measurement of changes in the permanent dipole moment (fΔμ) were accomplished by measurement of changes in hole width in response to the application of an external electric field (the Stark effect), and found that Δμ values for the carcinoma line were 1.5x greater than those of the SV40 antigen-free normal analogs. These findings are interpreted in terms of effects from the mitochondrial membrane potential. Results for HGK on the scale of single cells is

  11. Can spectral-spatial image segmentation be used to discriminate experimental burn wounds? (United States)

    Paluchowski, Lukasz A.; Nordgaard, Håvard B.; Bjorgan, Asgeir; Hov, Håkon; Berget, Sissel M.; Randeberg, Lise L.


    Hyperspectral imaging (HSI) is a noncontact and noninvasive optical modality emerging the field of medical research. The goal of this study was to determine the ability of HSI and image segmentation to discriminate burn wounds in a preclinical porcine model. A heated brass rod was used to introduce burn wounds of graded severity in a pig model and a sequence of hyperspectral data was recorded up to 8-h postinjury. The hyperspectral images were processed by an unsupervised spectral-spatial segmentation algorithm. Segmentation was validated using results from histology. The proposed algorithm was compared to K-means segmentation and was found superior. The obtained segmentation maps revealed separated zones within the burn sites, indicating a variation in burn severity. The suggested image-processing scheme allowed mapping dynamic changes of spectral properties within the burn wounds over time. The results of this study indicate that unsupervised spectral-spatial segmentation applied on hyperspectral images can discriminate burn injuries of varying severity.

  12. In vivo imaging of human burn injuries with polarization-sensitive optical coherence tomography (United States)

    Kim, Ki Hean; Pierce, Mark C.; Maguluri, Gopi; Park, B. Hyle; Yoon, Sang June; Lydon, Martha; Sheridan, Robert; de Boer, Johannes F.


    The accurate determination of burn depth is critical in the clinical management of burn wounds. Polarization-sensitive optical coherence tomography (PS-OCT) has been proposed as a potentially non-invasive method for determining burn depth by measuring thermally induced changes in the structure and birefringence of skin, and has been investigated in pre-clinical burn studies with animal models and ex vivo human skin. In this study, we applied PS-OCT to the in-vivo imaging of two pediatric burn patients. Deep and superficial burned skins along with contralateral controls were imaged in 3D. The imaging size was 8 mm×6 mm×2 mm in width, length, and depth in the air respectively, and the imaging time was approximately 6 s per volume. Superficially burned skins exhibited the same layered structure as the contralateral controls, but more visible vasculature and reduced birefringence compared to the contralateral controls. In contrast, a deeply burned skin showed loss of the layered structure, almost absent vasculature, and smaller birefringence compared to superficial burns. This study suggested the vasculature and birefringence as parameters for characterizing burn wounds.

  13. Intentional burns in Nepal: a comparative study. (United States)

    Lama, Bir Bahadur; Duke, Janine M; Sharma, Narayan Prasad; Thapa, Buland; Dahal, Peeyush; Bariya, Nara Devi; Marston, Wendy; Wallace, Hilary J


    Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002-2013. A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying

  14. Friction burns in children: does laser Doppler imaging have a role? (United States)

    Menon, Seema; Ward, Diane; Harvey, John G; Hei, Erik La; Holland, Andrew J A


    Laser Doppler imaging (LDI) has been increasingly used to predict pediatric burn wound outcome. A majority of these wounds are scald, contact, or flame burns. No study has specifically evaluated the use of LDI in pediatric friction burns. Our objective was to critically evaluate LDI assessment of pediatric friction burns to determine its predictive value with this mechanism of injury. We conducted a retrospective review of all LDI scans performed on pediatric friction burns during a 2-year period. We identified 36 patients with a mean age of 3.6 years (range, 19 months to 15 years). LDI accurately predicted burn wound outcome in 23 (64%) cases. In 13 cases, LDI did not correctly predict burn wound outcome. Eight were expected to heal within 14 days, but six of those eight took an average of 20.3 days to heal (range, 18-29 days), and the other two required skin grafting. Of the remaining five incorrect predictions, four were caused by an inability to correlate the flux scan with the clinical appearance of the burn, and one was thought to take more than 21 days to heal but healed within this period. Our data suggest that LDI appears to be a less reliable tool in predicting the outcome of friction burns when compared to other mechanisms of burn injury in children. This may reflect the physical differences in the mechanism of friction burns as opposed to other forms of thermal injury.

  15. Burned Area Detection and Burn Severity Assessment of a Heathland Fire in Belgium Using Airborne Imaging Spectroscopy (APEX

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    Lennert Schepers


    Full Text Available Uncontrolled, large fires are a major threat to the biodiversity of protected heath landscapes. The severity of the fire is an important factor influencing vegetation recovery. We used airborne imaging spectroscopy data from the Airborne Prism Experiment (APEX sensor to: (1 investigate which spectral regions and spectral indices perform best in discriminating burned from unburned areas; and (2 assess the burn severity of a recent fire in the Kalmthoutse Heide, a heathland area in Belgium. A separability index was used to estimate the effectiveness of individual bands and spectral indices to discriminate between burned and unburned land. For the burn severity analysis, a modified version of the Geometrically structured Composite Burn Index (GeoCBI was developed for the field data collection. The field data were collected in four different vegetation types: Calluna vulgaris-dominated heath (dry heath, Erica tetralix-dominated heath (wet heath, Molinia caerulea (grass-encroached heath, and coniferous woodland. Discrimination between burned and unburned areas differed among vegetation types. For the pooled dataset, bands in the near infrared (NIR spectral region demonstrated the highest discriminatory power, followed by short wave infrared (SWIR bands. Visible wavelengths performed considerably poorer. The Normalized Burn Ratio (NBR outperformed the other spectral indices and the individual spectral bands in discriminating between burned and unburned areas. For the burn severity assessment, all spectral bands and indices showed low correlations with the field data GeoCBI, when data of all pre-fire vegetation types were pooled (R2 maximum 0.41. Analysis per vegetation type, however, revealed considerably higher correlations (R2 up to 0.78. The Mid Infrared Burn Index (MIRBI had the highest correlations for Molinia and Erica (R2 = 0.78 and 0.42, respectively. In Calluna stands, the Char Soil Index (CSI achieved the highest correlations, with R2 = 0

  16. Functional Alterations of Postcentral Gyrus Modulated by Angry Facial Expressions during Intraoral Tactile Stimuli in Patients with Burning Mouth Syndrome: A Functional Magnetic Resonance Imaging Study

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    Atsuo Yoshino


    Full Text Available Previous findings suggest that negative emotions could influence abnormal sensory perception in burning mouth syndrome (BMS. However, few studies have investigated the underlying neural mechanisms associated with BMS. We examined activation of brain regions in response to intraoral tactile stimuli when modulated by angry facial expressions. We performed functional magnetic resonance imaging on a group of 27 BMS patients and 21 age-matched healthy controls. Tactile stimuli were presented during different emotional contexts, which were induced via the continuous presentation of angry or neutral pictures of human faces. BMS patients exhibited higher tactile ratings and greater activation in the postcentral gyrus during the presentation of tactile stimuli involving angry faces relative to controls. Significant positive correlations between changes in brain activation elicited by angry facial images in the postcentral gyrus and changes in tactile rating scores by angry facial images were found for both groups. For BMS patients, there was a significant positive correlation between changes in tactile-related activation of the postcentral gyrus elicited by angry facial expressions and pain intensity in daily life. Findings suggest that neural responses in the postcentral gyrus are more strongly affected by angry facial expressions in BMS patients, which may reflect one possible mechanism underlying impaired somatosensory system function in this disorder.

  17. Burns (United States)

    ... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, call 911 or ... the power source has been turned off. For chemical burns: Dry chemicals should be brushed off the skin ...

  18. Impact of obesity on body image dissatisfaction and social integration difficulty in adolescent and young adult burn injury survivors. (United States)

    Chondronikola, Maria; Sidossis, Labros S; Richardson, Lisa M; Temple, Jeff R; van den Berg, Patricia A; Herndon, David N; Meyer, Walter J


    Burn injury deformities and obesity have been associated with social integration difficulty and body image dissatisfaction. However, the combined effects of obesity and burn injury on social integration difficulty and body image dissatisfaction are unknown. Adolescent and young adult burn injury survivors were categorized as normal weight (n = 47) or overweight and obese (n = 21). Burn-related and anthropometric information were obtained from patients' medical records, and validated questionnaires were used to assess the main outcomes and possible confounders. Analysis of covariance and multiple linear regressions were performed to evaluate the objectives of this study. Obese and overweight burn injury survivors did not experience increased body image dissatisfaction (12 ± 4.3 vs 13.1 ± 4.4; P = .57) or social integration difficulty (17.5 ± 6.9 vs 15.5 ± 5.7; P = .16) compared with normal weight burn injury survivors. Weight status was not a significant predictor of social integration difficulty or body image dissatisfaction (P = .19 and P = .24, respectively). However, mobility limitations predicted greater social integration difficulty (P = .005) and body image dissatisfaction (P body image dissatisfaction (P = .05). Obese and overweight adolescents and young adults, who sustained major burn injury as children, do not experience greater social integration difficulty and body image dissatisfaction compared with normal weight burn injury survivors. Mobility limitations and higher weight status at burn are likely more important factors affecting the long-term social integration difficulty and body image dissatisfaction of these young people.

  19. THz Imaging of Skin Burn: Seeing the Unseen—An Overview (United States)

    Dutta, Moumita; Bhalla, Amar S.; Guo, Ruyan


    Significance: This review article puts together all the studies performed so far in realizing terahertz (THz) spectra as a probing mechanism for burn evaluation, summarizing their experimental conditions, observations, outcomes, merits, and demerits, along with a comparative discussion of other currently used technologies to present the state of art in a condensed manner. The key features of this noncontact investigation technique like its precise burn depth analysis and the approaches it follows to convert the probed data into a quantitative measure have also been discussed in this article. Recent Advances: The current research developments in THz regime observed in device design technologies (like THz time domain spectrometer, quantum cascade THz lasers, THz single-photon detectors, etc.) and in understanding its unique properties (like nonionizing nature, penetrability through dry dielectrics, etc.) have motivated the research world to realize THz window as a potential candidate for burn detection. Critical Issues: Application of appropriate medical measure for burn injury is primarily subjective to proper estimation of burn depth. Tool modality distinguishing between partial and full-thickness burn contributing toward correct medical care is indeed awaited. Future Directions: The overview of THz imaging as a burn assessment tool as provided in this article will certainly help in further nurturing of this emerging diagnostic technique particularly in improving its detection and accompanied image processing methods so that the minute nuances captured by the THz beam can be correlated with the physiological–anatomical changes in skin structures, caused by burn, for better sensitivity, resolution, and quantitative analysis. PMID:27602253

  20. Monochromatic imaging studies of a low pressure arc burning on molten Inconel 718 alloy electrodes during vacuum arc remelting

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    Williamson, R.L.; Zanner, F.J.; Hareland, W.A.


    Vacuum arc remelting (VAR) is a melting and solidification process used to produce high quality ingots of chemically reactive or segregation sensitive alloys. Melting is accomplished through the use of a sustained high current (several kiloamperes) dc arc. Energy from the arc is used to melt a consumable electrode (cathode) which is cast from the alloy to be remelted. The molten material drips down into a water-cooled copper crucible (anode) where it solidifies as a larger diameter, homogeneous, porosity-free, cylindrical ingot. Solidification is driven mainly by radial heat extraction from the molten pool atop the ingot and is influenced by magnetically and buoyancy driven fluid flows that are coupled to the arc behavior. The paper reports the initial results of efforts to characterize the VAR furnace arc during remelting of Inconel 718 alloy using monochromatic imaging. This technique allows one to examine how individual atomic species are distributed throughout the arc plasma in the electrode gap. Because only species existing in excited electronic states are able to emit light, the images also give insight into the energy distribution in the gap. Chromium and manganese distributions were investigated. Chromium was chosen to represent one of the major alloy constituents, while manganese represents a highly volatile trace component. 13 refs., 7 figs.

  1. Venous malformations: MR imaging features that predict skin burns after percutaneous alcohol embolization procedures. (United States)

    Fayad, Laura M; Hazirolan, Tuncay; Carrino, John A; Bluemke, David A; Mitchell, Sally


    To examine the value of magnetic resonance (MR) imaging for predicting the occurrence of skin burns in patients with venous malformations who undergo percutaneous alcohol embolization was the objective of the study. Pre-procedural MR imaging at 1.5 T from 40 patients with venous malformations who had undergone percutaneous alcohol embolization was retrospectively reviewed by two observers for these features: anatomic location, definition (well-defined or ill-defined), and the presence of skin, subcutaneous tissue, muscle, tendon, bone, joint, and deep venous system involvement. One observer recorded the length of skin involvement and volume of the malformation. Univariate and multivariate analysis tests were used to determine whether an association between the occurrence of skin burns and MR imaging features existed. The anatomic locations of the venous malformations were the lower extremity (20 out of 40), upper extremity (11 out of 40), trunk (four out of 40), head/neck (three out of 40) and pelvis (two out of 40). Of the 40 subjects, 15% (six out of 40) experienced skin burns. There was a significant association between the absence of muscle involvement (p = 0.0198) as well as the length of skin involvement (p = 0.027), with the occurrence of skin burns. Malformation size and all other features were not significantly associated with skin burns. Skin burns in patients with venous malformations treated with alcohol embolization are associated with the length of skin involvement and with the absence of deeper tissue involvement, as depicted on MR imaging.

  2. Near-infrared hyperspectral imaging: the road traveled to a clinical burn application (United States)

    Levasseur, Michelle; Leonardi, Lorenzo; Payette, Jeri; Kohlenberg, Elicia; Sowa, Michael; Fish, Joel S.; Cross, Karen; Gomez, Manuel


    The process of taking a concept to a clinical device begins with the idea for a technological solution to an unmet clinical challenge. Burns are one of the most destructive insults to the skin causing damage, scarring, and in some cases death. The approach most commonly used to evaluate burns is based on the appearance of the wound. This technique is somewhat subjective and unreliable, relying on clinical experience to assess the burn. Instrument based diagnostic techniques as an adjunct to current practices has the potential to enhance the quality and timeliness of decisions concerning wound assessment and treatment. Near Infrared Spectroscopy is a promising technique that can track changes within the tissue, and can therefore provide insight as to how deep the burn actually penetrates before visual signs become apparent. Preliminary bench and animal studies were used to prove the concept of a near infrared based method of burn assessment. This study demonstrated the ability of near infrared imaging to detect and monitor the hemodynamics of burn injuries in the early post-burn period. Based on this study, a pre-prototype near infrared spectroscopic system was built with the goal of developing a reliable yet simple system that could be used in a clinical setting. A pilot clinical study was designed and implemented at the Ross Tilley Burn Center (Toronto, Canada) in order to assess the feasibility of our strategy in the clinical realm. The goal of this preliminary clinical study was to determine if the pre-prototype could be integrated into the strict regiment of an active burn centre. Both the instrument performance in a clinical setting and the injury assessment based on the analysis of near infrared reflectance measurements were a success.

  3. Interactive home telehealth and burns: A pilot study. (United States)

    Hickey, Sean; Gomez, Jason; Meller, Benjamin; Schneider, Jeffery C; Cheney, Meredith; Nejad, Shamim; Schulz, John; Goverman, Jeremy


    The objective of this study is to review our experience incorporating Interactive Home Telehealth (IHT) visits into follow-up burn care. A retrospective review of all burn patients participating in IHT encounters over the course of 15 months was performed. Connections were established through secure video conferencing and call-routing software. Patients connected with a personal computer or tablet and providers connected with a desktop computer with a high-definition web camera. In some cases, high-definition digital images were emailed to the provider prior to the virtual consultation. For each patient, the following was collected: (1) patient and injury demographics (diagnosis, prognosis, and clinical management), (2) total number of encounters, (3) service for each encounter (burn, psychiatry, and rehabilitation), (4) length of visit, including travel distance and time saved and, (5) complications, including re-admissions and connectivity issues. 52 virtual encounters were performed with 31 patients during the first year of the pilot project from March 2015 to June 2016. Mean age of the participant was 44 years (range 18-83 years). Mean total burn surface area of the participant was 12% (range 1-80%). Average roundtrip travel distance saved was 188 miles (range 4-822 miles). Average round trip travel time saved was 201min (range 20-564min). There were no unplanned re-admissions and no complications. Five connectivity issues were reported, none of which prevented completion of the visit. Interactive Home Telehealth is a safe and feasible modality for delivering follow-up care to burn patients. Burn care providers benefit from the potential to improve outpatient clinic utilization. Patients benefit from improved access to multiple members of their specialized burn care team, as well as cost-reductions for patient travel expenses. Future studies are needed to ensure patient and provider satisfaction and to further validate the significance, cost-effectiveness and

  4. Perfusion of burn wounds assessed by Laser Doppler Imaging is related to burn depth and healing time

    NARCIS (Netherlands)

    Kloppenberg, FWH; Beerthuizen, GIJM; ten Duis, H. J.

    Average perfusion in various burn wounds was assessed using Laser Doppler Imaging (LDI). The time necessary for a complete healing of the wound was compared to the results of the LDI measurements. A certain depth of burn was associated with a typical pattern of perfusion in the course of time. There

  5. Noninvasive determination of burn depth in children by digital infrared thermal imaging (United States)

    Medina-Preciado, Jose David; Kolosovas-Machuca, Eleazar Samuel; Velez-Gomez, Ezequiel; Miranda-Altamirano, Ariel; González, Francisco Javier


    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.

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


    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. Laser doppler line scan burn imager (LDLS-BI): sideways move or a step ahead? (United States)

    Holland, A J A; Ward, D; La Hei, E R; Harvey, J G


    To assess the accuracy of a Laser Doppler Line Scanner (LDLS) in predicting burn wound healing in children compared to conventional Laser Doppler Imaging (LDI). A prospective study comparing a LDLS with a conventional LDI to assess burn wound Healing Potential (HP) was performed in 50 paediatric patients presenting to our institution between February 2010 and March 2011, as part of a multi-centre, international trial. Inclusion criteria were superficial to deep dermal burns that were able to be scanned between 42 h and 5 days of the burn. Of the 50 patients enrolled, one was excluded from subsequent analysis as they were unable to present for wound reviews at 14 and 21 days. Ninety scans were performed of 59 burn wounds in the remaining 49 patients. The mean age was 4 years and 9 months (range 8 months to 16 years) and the mean Total Body Surface Area burnt was 8.3% (range 0.1-15%). The most common mechanism of injury was a scald, followed by contact and flame burns. A limb was the most common site of injury. Overall accuracy of the scanners was 94.5% (LDI) and 95% (LDLS), with accuracy lowest for indeterminate burns that healed within 14-21 days. The LDLS was found to be as accurate as the LDI in predicting burn wound HP in children. Whilst the LDLS scan resolution was lower, with more scans of larger burns required, its smaller size and greater scan speed proved valuable in children. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  8. The impact of laser Doppler imaging on time to grafting decisions in pediatric burns. (United States)

    Kim, Lawrence H C; Ward, Diane; Lam, Lawrence; Holland, Andrew J A


    Early definitive treatment of burns facilitates optimal results by reducing the risk of subsequent hypertrophic scarring. Laser Doppler imaging (LDI) has been shown to assist in predicting burn wound healing potential. This study sought to determine whether use of LDI in pediatric burn patients has led to earlier decision making for grafting. The study cohort were patients who underwent a skin grafting procedure for a burn wound at a single institution, a state referral center for all major pediatric burns, between June 2006 and December 2007. Patients were divided into two groups: those who underwent LDI scanning and those who were only assessed clinically. Time of burn injury to time of decision making for the grafting procedure was calculated in days. Forty-nine percent of 196 patients underwent LDI. The mean time from the date of injury to decision making for graft procedure was 8.9 days in those patients who had an LDI scan vs 11.6 days in the group assessed by clinical observation alone. This trend for earlier decision for grafting procedure in the LDI group was statistically significant (P = .01). There was no significant difference between those patients who were scanned and those only assessed clinically in relation to gender, age, mechanism of injury, percentage BSA burnt, and wound culture results. There was a significant reduction in time to grafting decision in the LDI group. This would potentially lead to reduced length of stay, reduced number of hospital visits, and streamlined care for the patient and their family.

  9. The Bradford Burn Study: the epidemiology of burns presenting to an inner city emergency department (United States)

    Khan, A A; Rawlins, J; Shenton, A F; Sharpe, D T


    Objective The Bradford Burn Study prospectively reviewed all burn attendances at a single emergency department in the UK over a 1 year period. The study reviewed the epidemiology, demographics and outcomes of all patients entered into the study. Design and setting A 12 month prospective study of burn injuries attending an inner city emergency department serving a population of 1 million people. Results 460 patients were enrolled into the study. Average patient age was 22.7 years, male: female ratio was 1:1.4, and children burn units. Conclusions Emergency departments manage patients with burns well, and referrals to plastic surgery departments are appropriate. The majority of burns can be prevented by addressing educational issues and vulnerable sections of the population. PMID:17652679

  10. Acute burn during pregnancy: A retrospective study

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    Ezzatollah Rezaei


    Full Text Available Background & aim: The incidence of acute burn injuries in pregnant women is very low. Burn injuries during pregnancy are often associated with a high rate of fetal and maternal mortality and morbidity. In this study, we aimed to review the cases of acute burn during pregnancy and evaluate the outcome of these patients in Mashhad, Iran. Methods:This retrospective study was performed using the medical records of 48 pregnant women with thermal injuries over a 13-year period. Results: The results showed that 8 (16.7%, 27 (56.3%, and 13 (27.1% patients were in the first, second, and third trimesters of pregnancy. Moreover, 14 mothers (29.2% died, 24 (50.0% were discharged without any fetal problems, eight (16.7% had fetal death, 13 (27.1% had abortion, two (4.2% had normal vaginal delivery, and one (2.1% underwent normal caesarean section. Conclusion: The rate ofmaternal survival in the first and second trimesters was higher than the third one. In the third trimester, pregnancy termination is indicated only after fetal maturation.

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

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    Michael A. Dubick


    Full Text Available Objective: Normal iron handling appears to be disrupted in critically ill patients leading to hypoferremia that may contribute to systemic inflammation. Ceruloplasmin (Cp, an acute phase reactant protein that can convert ferrous iron to its less reactive ferric form facilitating binding to ferritin, has ferroxidase activity that is important to iron handling. Genetic absence of Cp decreases iron export resulting in iron accumulation in many organs. The objective of this study was to characterize iron metabolism and Cp activity in burn and non-burn trauma patients to determine if changes in Cp activity are a potential contributor to the observed hypoferremia. Material and Methods: Under Brooke Army Medical Center Institutional Review Board approved protocols, serum or plasma was collected from burn and non-burn trauma patients on admission to the ICU and at times up to 14 days and measured for indices of iron status, Cp protein and oxidase activity and cytokines. Results: Burn patients showed evidence of anemia and normal or elevated ferritin levels. Plasma Cp oxidase activity in burn and trauma patients were markedly lower than controls on admission and increased to control levels by day 3, particularly in burn patients. Plasma cytokines were elevated throughout the 14 days study along with evidence of an oxidative stress. No significant differences in soluble transferrin receptor were noted among groups on admission, but levels in burn patients were lower than controls for the first 5 days after injury. Conclusion: This study further established the hypoferremia and inflammation associated with burns and trauma. To our knowledge, this is the first study to show an early decrease in Cp oxidase activity in burn and non-burn trauma patients. The results support the hypothesis that transient loss of Cp activity contributes to hypoferremia and inflammation. Further studies are warranted to determine if decreased Cp activity increases the risk of

  12. Raman Spectroscopy Studies of Normal and Burned Biological Tissue (United States)

    Zarnani, Faranak; Maass, David; Idris, Ahamed; Glosser, Robert


    Burn injuries are a significant medical problem, and need to be treated quickly and precisely. Burned skin needs to be removed early, within hours (less than 24 hrs) of injury, when the margins of the burn are still hard to define. Studies show that treating and excising burn wounds soon after the injury prevents the wound from becoming deeper, reduces the release of proinflammatory mediators, and reduces or prevents the systemic inflammatory reaction syndrome. Also, removing burned skin prepares the affected region for skin grafting. Raman spectroscopy could be used as an objective diagnostic method that will assist burn surgeons in removing burned skin precisely. As a first step in developing a diagnostic tool, we present Raman spectroscopy information from normal and burned ex vivo rat skin, and a comparison of our findings. Raman spectroscopy is explored for its specificity and sensitivity.

  13. Quantitative long term measurements of burns in a rat model using spatial frequency domain imaging and laser speckle imaging (Conference Presentation) (United States)

    Ponticorvo, Adrien; Rowland, Rebecca A.; Baldado, Melissa L.; Kennedy, Gordon T.; Saager, Rolf B.; Choi, Bernard; Durkin, Anthony J.


    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.

  14. Body image, mood and quality of life in young burn survivors. (United States)

    Pope, S J; Solomons, W R; Done, D J; Cohn, N; Possamai, A M


    This study looks at the body image, mood and quality of life of a group of 36 young people aged between 11 and 19 years who had burns as children, compared with an age-matched control group of 41 young people who had not had these injuries. Participants completed the Body Esteem Scale (BES), the Satisfaction With Appearance Scale (SWAP), the Beck Depression Inventory-II (BDI-II) and the Youth Quality of Life Questionnaire (YQOL). It was hypothesised that young burn survivors would report more dissatisfaction with their appearance, a lower mood and a lower quality of life compared with non-injured controls. However, young burn survivors reported significantly more positive evaluations of how others view their appearance (p=0.018), more positive weight satisfaction (p=0.001) and a higher quality of life (p=0.005) than the control group. They also reported more positive general feelings about their appearance, although this was just below the level for statistical significance (p=0.067) and a similar mood to the school sample (p=0.824). The data suggest that young burn survivors appear to be coping well in comparison to their peers, and in some areas may be coping better, in spite of living with the physical, psychological and social consequences of burns.

  15. A clinico-epidemiological study of rescuer burns. (United States)

    Basra, Baljeet Kumar; Suri, Manav P; Patil, Nilesh; Atha, Ravish; Patel, Natvar; Sachde, Jayesh P; Shaikh, M F


    Rescuer burn is a relatively newer terminology introduced to define the burns sustained by a person attempting to rescue a primary burn victim. Few studies have been published thus far on this peculiar type of burns. Due to the general neglect of the rescuer burns victim and discontinuation of treatment in most cases, once the primary victim dies, the rescuer often ends up in badly infected wounds and has a delayed return to work. A prospective study was conducted at the B J Medical College and Civil Hospital, Ahmedabad from January 2009 to December 2012 on the rescuer burns patients treated in its burns and plastic surgery department. 3074 patients of burns received treatment during the period of study. Of these, 48 patients gave the history of sustaining burns while trying to rescue a burns victim. Male to female ratio of rescuers was approximately 7:1. It was significantly higher as compared to the ratio of 1:0.8 of females to male burn victims observed at our centre (p≤0.01). Average age of the rescuers was higher in males as compared to females but the difference was not significant (p≥0.05). Of the 45 cases of female primary burns victims, male rescuer was husband of the primary victim in 41/45 cases (91.1%), mother was rescuer in three cases (6.6% cases) and sister was rescuer in one case. Though multiple people came to rescue a burns victim, in all cases, it was seen that it was the first rescuer who sustained burns himself or herself. None of the rescuers had any knowledge of the techniques and precautions to be taken while performing a rescue operation irrespective of their education status, indirectly pointing to the lack of any teaching on burns rescue in the school education curriculum. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.


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    Nagabathula Durga Prasad


    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.

  17. Spectral hole burning studies of photosystem II

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Hai -Chou [Iowa State Univ., Ames, IA (United States)


    Low temperature absorption and hole burning spectroscopies were applied to the D1-D2-cyt b559 and the CP47 and CP43 antenna protein complexes of Photosystem H from higher plants. Low temperature transient and persistent hole-burning data and theoretical calculations on the kinetics and temperature dependence of the P680 hole profile are presented and provide convincing support for the linker model. Implicit in the linker model is that the 684-nm-absorbing Chl a serve to shuttle energy from the proximal antenna complex to reaction center. The stoichiometry of isolated Photosystem H Reaction Center (PSII RC) in several different preparations is also discussed. The additional Chl a are due to 684-nm-absorbing Chl a, some contamination by the CP47 complex, and non-native Chl a absorbing near 670 nm. In the CP47 protein complex, attention is focused on the lower energy chlorophyll a Qy-states. High pressure hole-burning studies of PSII RC revealed for the first time a strong pressure effect on the primary electron transfer dynamics. The 4.2 K lifetime of P680*, the primary donor state, increases from 2.0 ps to 7.0 ps as pressure increases from 0.1 to 267 MPa. Importantly, this effect is irreversible (plastic) while the pressure induced effect on the low temperature absorption and non-line narrowed P680 hole spectra are reversible (elastic). Nonadiabatic rate expressions, which take into account the distribution of energy gap values, are used to estimate the linear pressure shift of the acceptor state energy for both the superexchange and two-step mechanisms for primary charge separation. It was found that the pressure dependence could be explained with a linear pressure shift of ~1 cm-1/MPa in magnitude for the acceptor state. The results point to the marriage of hole burning and high pressures as having considerable potential for the study of primary transport dynamics in reaction centers and antenna complexes.

  18. Epidemiologic study of scald burns in victims in Tehran burn hospital

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    Kamran Aghakhani


    Full Text Available Background: Damages caused by scald burns are common and can cause severe complications and death. The purpose of this study was to define risk groups and then methods of prevention and treatment is designed to fit. Methods: Data for this retrospective study of hospitalized patients in Shahid Motahari Hospital in Tehran from 2007-2011 were compiled. Data including age, sex, cause of burn, and degree of burn and ultimate fate of the victims were collected from scald burns. Burns caused by boiling water and hot food (Scald , in two age groups : 12 and under 12 years ( children and more than 12 years ( adults were compared in terms of statistics . Results: A total of 1150 patients consisting of males (57.9% and females (42.1% were studied. The most common age was 1 year old and 50% of patients were under 3 years of age. 87.9% burned with boiling water and 12.1% had experienced burns with hot food. Incentive to burn was 0.3% cross burning and 99.7% incident. A maximum number of burns in children 12 years and younger males (42.1% and a minimum number in men over 12 years (15.7% were observed. Mean percentage of burns was 11% in over 12 years group and 30.9% in 12 and under 12 years group. The average hospital stay was 11.4 days and the mortality rate was 4.8%. The final status of the patients was as fallows: full recovery 904 cases (78.6%, partial recovery 134 (11.7%, clearance with personal consent 41 (3.6%, death 55 (4.8% and 16 cases (3.1% were among other reasons. Conclusion: In general it can be said, scald burns incidence in individuals aged 12 and younger were more than the older ones and the mean of burns was lower in individuals with over 12 years old. There was a sexual preference for males under 12 years. Mortality rate in the two groups has not any statistically significant difference. There was no statistically significant association between sex and mortality rate. Some of our findings are depending on cultural, social and economic

  19. Descriptive epidemiological study of burn admissions to the Burns Intensive Care Unit of the Komfo

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    Pius Agbenorku


    Full Text Available Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years. Methods: Patients’ data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson’s rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5% with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%. Majority of the patients spent less than 10 days on admission (67.1%. Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.

  20. The epidemiology of geriatric burns in Iran: A national burn registry-based study. (United States)

    Emami, Seyed-Abolhassan; Motevalian, Seyed Abbas; Momeni, Mahnoush; Karimi, Hamid


    Defining the epidemiology and outcome of geriatric burn patients is critical for specialized burn centers, health-care workers, and governments. Better resource use and effective guidelines are some of the advantages of studies focusing on this aspect. The outcome of these patients serves as an objective criterion for quality control, research, and preventive programs. We used data from the burn registry program in our country. For 2 years, >28,700 burn patients were recorded, 1721 of whom were admitted. Among them, 187 patients were ≥55 years old. Sixty-nine percent of patients were male and 31% female, with a male to female ratio of 2.22:1. The mean±standard deviation (SD) of age was 63.4±8.1. The cause of burns was flame (58.2%) and scalds (20.3%). Most of the burns were sustained at home. The mean duration of hospital stay was 19.5 days (range 3-59 days). The mean (SD) of the total body surface area (TBSA) was 20.3% (8.4%). The median hospital stay (length of stay (LOS)) was 11 days (SD=14). The increase in TBSA was related to a longer LOS (pBurn wound infection developed in 44.3% of patients. The presence of inhalation injury was significantly related to mortality (pburn patients. However, being alone or single, ignition of clothing, cause of burn, comorbid illnesses, complications following the burn, TBSA, age, and sepsis were positively correlated with mortality. The mean cost of treatment for each patient was about $7450. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  1. Burns in mobile home fires--descriptive study at a regional burn center. (United States)

    Mullins, Robert F; Alarm, Badrul; Huq Mian, Mohammad Anwarul; Samples, Jancie M; Friedman, Bruce C; Shaver, Joseph R; Brandigi, Claus; Hassan, Zaheed


    Death from fires and burns are the sixth most common cause of unintentional injury death in the United States. More than (3/4) of burn deaths occurring in the United States are in the home. Mobile home fires carry twice the death rate as other dwellings. The aim of the study was to describe the characteristics of deaths and injuries in mobile home fire admitted in a regional Burn Center and to identify possible risk factors. A cross-sectional retrospective study was carried out among all burn patients admitted to a regional Burn Center between January 2002 and December 2004 (3469 patients). The study included patients who suffered a burn injury from a mobile home fire. The demographic characteristics of the patients, location of mobile home, associated inhalation injury, source of fire, comorbidity of the victims, employment status, insurance status, family history of burns, and outcomes of the treatment were incorporated in a data collection record. There were 65 burn patients in mobile home fires admitted to the Burn Center during the studied period. The average age of the patients was 39 years (ranging from 2 to 81 years, SD=16.06), 77% were male, 67% were white, and 79% were the residents in the suburban areas of Georgia, South Carolina, North Carolina, and Florida. The average TBSA of burns was about 21% (ranging from 1 to 63%, SD=17.66), 63% of the patients had associated inhalation, three inhalation injury only, and 69% patients required ventilator support. The average length of stay per TBSA percentage of burn was 1.01 days (P=0.00), controlling for age, preexisting medical comorbidities, and inhalation injury. About 88% of the patients had preexisting medical comorbid conditions, 74% were smokers, 64% reported as alcoholic, and 72% had at least some form of health insurance coverage. In 40% of the cases, the cause of the fire was unknown, 31% were caused by accidental explosions, such as electric, gasoline, or kerosene appliances, and 29% were due to other

  2. The Fenix II study: A longitudinal study of psychopathology among burn patients. (United States)

    Fidel-Kinori, Sara Guila; Eiroa-Orosa, Francisco Jose; Giannoni-Pastor, Anna; Tasqué-Cebrián, Ruth; Arguello, Jose Maria; Casas, Miguel


    Psychological symptoms are common among burn survivors. However, knowledge about epidemiology and predictors of psychopathology has shown great heterogeneity in this population. The Fenix-II Project was the first epidemiological study on the psychopathological consequences of burns developed in Spain, providing a detailed analysis of the progression of psychological symptoms during the first six months after injury. Three hundred and thirty-three patients were screened and 183 were included in this study. Posttraumatic, depression and anxiety symptoms showed a general decreasing tendency across time. At 6 months, 34 patients showed clinically significant Posttraumatic Stress Disorder (PTSD) symptoms (20.5% of 166 patients reached at 6 months) as assessed with the MINI Neuropsychiatric Interview. Within this group of patients, anxiety, depression and hyperarousal increased at 30 days, and avoidance 90 days after injury. The most accurate predictors of PTSD were found to be being burned in a Motor Vehicle Crash, risk of social exclusion, low body-image adjustment, anterior trunk location of the burn and life threat perception during the burn-shock period. Considering these factors, clinicians may identify patients at risk of PTSD development, allowing an adequate follow up and preventive interventions which may minimize the psychological consequences of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  3. Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana. (United States)

    Agbenorku, Pius


    To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. A total of 70 participants consented for the study. Their ages ranged from 8/12 - 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers' time and financial constrains.

  4. Study of Alterations in Lipid Profile After Burn Injury.

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    Dr.Asha Khubchandani


    Full Text Available Introduction: After burn injury, changes in lipid profile occur in body. Dyslipidemia after burn injury is one of the important alterations. Objective: To check alterations in lipid profile after burn injury. Materials and Method: It was cross sectional study which was carried out on 250 burns patients of both sex, with an age group of 18-45 years, and varying burns percentage of 20-80% of total body surface area (TBSA. Serum cholesterol, serum LDL, serum HDL and serum triglyceride level were measured on XL-640 fully-auto biochemical analyser. Serum LDL and HDL were measured by Accelerator Selective Detergent Method. Serum cholesterol and triglyceride were measured by Trindor’s method. Results: Results showed decrease in serum cholesterol, serum LDL and serum HDL, while increase in serum triglyceride level in burns patients compared to normal subjects. Conclusion: This study clearly showed the importance of measuring serum cholesterol, TG, LDL and HDL in burn patients and targeting changes that occur in their levels along the burns course, which may have beneficial effect in protection from organ damage, increasing survival rates and improving burn outcome.

  5. Postfire soil burn severity mapping with hyperspectral image unmixing (United States)

    Peter R. Robichaud; Sarah A. Lewis; Denise Y. M. Laes; Andrew T. Hudak; Raymond F. Kokaly; Joseph A. Zamudio


    Burn severity is mapped after wildfires to evaluate immediate and long-term fire effects on the landscape. Remotely sensed hyperspectral imagery has the potential to provide important information about fine-scale ground cover components that are indicative of burn severity after large wildland fires. Airborne hyperspectral imagery and ground data were collected after...

  6. Quantitative assessment of graded burn wounds using a commercial and research grade laser speckle imaging (LSI) system (United States)

    Ponticorvo, A.; Rowland, R.; Yang, B.; Lertsakdadet, B.; Crouzet, C.; Bernal, N.; Choi, B.; Durkin, A. J.


    Burn wounds are often characterized by injury depth, which then dictates wound management strategy. While most superficial burns and full thickness burns can be diagnosed through visual inspection, clinicians experience difficulty with accurate diagnosis of burns that fall between these extremes. Accurately diagnosing burn severity in a timely manner is critical for starting the appropriate treatment plan at the earliest time points to improve patient outcomes. To address this challenge, research groups have studied the use of commercial laser Doppler imaging (LDI) systems to provide objective characterization of burn-wound severity. Despite initial promising findings, LDI systems are not commonplace in part due to long acquisition times that can suffer from artifacts in moving patients. Commercial LDI systems are being phased out in favor of laser speckle imaging (LSI) systems that can provide similar information with faster acquisition speeds. To better understand the accuracy and usefulness of commercial LSI systems in burn-oriented research, we studied the performance of a commercial LSI system in three different sample systems and compared its results to a research-grade LSI system in the same environments. The first sample system involved laboratory measurements of intralipid (1%) flowing through a tissue simulating phantom, the second preclinical measurements in a controlled burn study in which wounds of graded severity were created on a Yorkshire pig, and the third clinical measurements involving a small sample of clinical patients. In addition to the commercial LSI system, a research grade LSI system that was designed and fabricated in our labs was used to quantitatively compare the performance of both systems and also to better understand the "Perfusion Unit" output of commercial systems.

  7. Burn Patient Expectations from Nurses


    Sibel Yilmaz sahin; Umran Dal; Gulsen Vural


    AIM: Burn is a kind of painful trauma that requires a long period of treatment and also changes patients body image. For this reason, nursing care of burn patients is very important. In this study in order to provide qualified care to the burned patients, patient and #8217;s expectations from nurses were aimed to be established. METHODS: Patients and #8217; expectations were evaluated on 101 patients with burn in Ministry of Health Ankara Numune Education and Research Hospital Burn Servic...

  8. Pediatric Contractures in Burn Injury: A Burn Model System National Database Study. (United States)

    Goverman, Jeremy; Mathews, Katie; Goldstein, Richard; Holavanahalli, Radha; Kowalske, Karen; Esselman, Peter; Gibran, Nicole; Suman, Oscar; Herndon, David; Ryan, Colleen M; Schneider, Jeffrey C

    Joint contractures are a major cause of morbidity and functional deficit. The incidence of postburn contractures and their associated risk factors in the pediatric population has not yet been reported. This study examines the incidence and severity of contractures in a large, multicenter, pediatric burn population. Associated risk factors for the development of contractures are determined. Data from the National Institute on Disability and Rehabilitation Research Burn Model System database, for pediatric (younger than 18 years) burn survivors from 1994 to 2003, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures included the presence of contractures, number of contractures per patient, and severity of contractures at each of nine locations (shoulder, elbow, hip, knee, ankle, wrist, neck, lumbar, and thoracic) at time of hospital discharge. Regression analysis was performed to determine predictors of the presence, severity, and numbers of contractures, with P burned, and TBSA grafted. This is the first study to report the epidemiology of postburn contractures in the pediatric population. Approximately one quarter of children with a major burn injury developed a contracture at hospital discharge, and this could potentially increase as the child grows. Contractures develop despite early therapeutic interventions such as positioning and splinting; therefore, it is essential that we identify novel and more effective prevention strategies.

  9. [Psychiatric co-morbidity, body image problems and psychotherapeutic interventions for burn survivors: a review]. (United States)

    Jasper, Stefanie; Rennekampff, Hans-Oliver; de Zwaan, Martina


    Due to progress in burn treatment, more patients even with severe burn injuries survive. Despite this positive development, however, there are still negative somatic and mental consequences. These include the life-long care of scars and pain. In addition, posttraumatic-stress disorder and depression are common consequences. Also distress due to disfigurement and body image problems have to be considered, since this is likely to result in social withdrawal, low self-esteem, and reduction of quality of life. Overall, the impact of mental strain on burn victims is quite high. Therefore, psychotherapeutic treatment approaches should be integrated into the care of patients with burns. This might be helpful for both coping and compliance with long-term treatment. This paper provides a review of the mental co-morbidity of burn victims and of psychotherapeutic treatment approaches focusing on changes in body image and the respective social consequences. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Determinants of burn first aid knowledge: Cross-sectional study. (United States)

    Wallace, Hilary J; O'Neill, Tomas B; Wood, Fiona M; Edgar, Dale W; Rea, Suzanne M


    This study investigated demographic factors, experience of burn/care and first aid course attendance as factors influencing burn first aid knowledge. A cross-sectional study was undertaken using convenience sampling of members of sporting and recreation clubs. The main outcome measure was the proportion of correct responses to multiple-choice questions relating to four burn scenarios: (1) scald, (2) contact burn, (3) ignited clothing, and (4) chemical burn. A total of 2602 responses were obtained. Large gaps (30-50% incorrect answers) were identified in burn first aid knowledge across all scenarios. 15% more individuals gave correct answers if they had attended a first aid course compared to those who had not (pfirst aid knowledge. Gender and age were significant predictors of first aid course attendance, with males and younger (≤25 years) and older (≥65 years) age-groups less likely to have attended a first aid course. In this sample, first aid training undertaken within the last 5 years with a specific burns component was associated with enhanced burn first aid knowledge. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  11. Burn wound healing time assessed by laser Doppler imaging (LDI). Part 1: Derivation of a dedicated colour code for image interpretation. (United States)

    Pape, S A; Baker, R D; Wilson, D; Hoeksema, H; Jeng, J C; Spence, R J; Monstrey, S


    Laser Doppler imaging produces a colour-coded image of dermal blood flow, which can be used to quantify the inflammatory response in a burn. The original colour palette had arbitrary boundaries, which inexperienced clinicians found difficult to interpret. The aim of this study was to define clinically useful boundaries that would assist in the prediction of burn healing potential. We conducted a prospective, multi-centre study of burns in adults and children. LDI scans were performed between 48 h and 5 days after injury. The burns were assessed clinically and photographed on day of scan, day 14 and day 21 post-injury. Areas healed at day 14, healed between day 14 and 21 and unhealed at day 21 were identified on the LDI scan. The flow values for the pixels in these regions were analysed to calculate boundaries between the three healing categories. We recruited 137 patients (ages 1-88 years, 65% male); 392 LDI scans contained 433 different burn sites; 109 regions of interest were studied. Analysis allowed us to define ranges for the three healing categories: HP14 colour coded red, >600 PU; HP14-21, yellow, 260-440 PU; HP>21, blue, times of a series of burns. Validation of this palette is described separately, in Part 2. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  12. The time factor in the LDI (Laser Doppler Imaging) diagnosis of burns. (United States)

    Štětinský, Jiří; Klosová, Hana; Kolářová, Hana; Šalounová, Dana; Bryjová, Iveta; Hledík, Stanislav


    The not quite rare occurrence of inaccurate clinical diagnoses of burns in early post-burn days leads to an inappropriate conservative treatment strategy, or unnecessary surgery. LDI (Laser Doppler Imaging) objectively evaluates skin blood circulation, which correlates with the depth of the burn and the length of healing. The aim of this work was to suggest cutoff values for detecting burns without healing potential within 3 weeks, which should have undergone surgery. The burned area's average blood perfusion of 148 burns was measured on 115 patients, using the Laser Doppler Imager PIM III. A total of 268 measurements were performed from the one to the ninth post-burn day (PBD). The perfusion values were compared to the healing time or histology in the case of the surgical treatment. Cutoff values indicating surgery were investigated in various post-burn days; the ROC analysis was used. This work suggest statistically significant increasing cutoff values for indication to surgery (P = 0.05). From the third to the fifth day 148.5 perfusion units (PU), from the sixth to the seventh day 186.0 PU, from the eighth to the ninth PBD 269.5 PU. The cutoff value is not possible to establish until the second day. LDI is a useful method for wound healing prediction and an indication of the necessity of surgery. We have demonstrated that the diagnosis of the healing capacity of LDI needs to take into account the factor of time. © 2015 Wiley Periodicals, Inc.

  13. Cutaneous chemical burns in children - a comparative study. (United States)

    Hardwicke, Joseph; Bechar, Janak; Bella, Husam; Moiemen, Naiem


    Exposure to chemicals is an unusual causation of cutaneous burns in children. The aim of this study is to look at childhood chemical burns and compare this to adult chemical burns from the same population. A total of 2054 patients were referred to the pediatric burns unit during the study period. This included 24 cutaneous chemical burns, equating to an incidence of 1.1%. Over half of the injuries occurred in the domestic setting. The mean total body surface area (TBSA) affected was 1.9%. When compared to a cohort of adult patients from the same population with cutaneous chemical burns, the TBSA affected was identical (1.9%) but distribution favored the buttock and perineum in children, rather than the distal lower limb in adults. Children presented earlier, had lower rates of surgical intervention and had a shorter length of stay in hospital (p Chemical burns in children are rare, but are becoming more common in our region. It is important to be aware of the characteristic distribution, etiology and need to identify children at risk of child protection issues. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Five-year epidemiological study of burn patients admitted in burns care unit, Tata Main Hospital, Jamshedpur, Jharkhand, India

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    Prasenjit Goswami


    Full Text Available Introduction: Burn injury remains one of the biggest health concerns in the developing world and is a formidable public health issue in terms of mortality, morbidity, and permanent disability. The incidence of burn injuries is found all over India; detailed epidemiological studies from the eastern part of the country are sparse. Materials and Methods: We present an epidemiological study form the burn care unit (BCU of Tata Main Hospital, Jamshedpur, Jharkhand, India of a period of 5 years from January 2009 to December 2013. Results: A total of 1975 burn patients were admitted in the BCU in this 5-year period. The mean age of all the patients included in the study was 29.16 years. There was a slight female predominance in this 5-year period. The overall male to female ratio was 1:1.05. The mean percentage total body surface area (TBSA burn of all the patients over the period of 5 years was 42.5%. Flame burns were the most common form of burn, accounting for 65.16% of all burns. The overall mortality of the patients over 5 years was 40.8%. If the data are further classified, the overall mortality of patients up to 30% burns was 3.45%, with 30-60% burns was 42.3%, and above 60% burns was 91.8%. Conclusion: Analysis of the 5-year data fairly represents the epidemiological pattern of burns in this region, which has never been studied before and this study can serve as a pilot study for any burn care-related development in this region.

  15. Efficacy of glutathione mesotherapy in burns: an experimental study. (United States)

    Buz, A; Görgülü, T; Olgun, A; Kargi, E


    Thermal burns are the leading cause of trauma worldwide. Currently, no consensus on optimal treatment of deep partial-thickness (second-degree) burns has emerged, as reflected by the wide variability in available wound-care materials. The relative efficacies of products used for treatment of partial-thickness thermal burns remain unclear. Mesotherapy features intradermal administration of various agents, depending on burn location. In the present experimental study, we explored the efficacy of mesotherapy used to treat partial-thickness thermal burns in 50 male Wistar rats divided into five groups of equal number. No procedure was performed after infliction of thermal burns in control group (Group 1). Mesotherapy was applied with physiological saline in sham group (Group 2), glutathione, taurine, and L-carnitine were separately applied in Group 3, Group 4, and Group 5, respectively. Mesotherapeutic agents were injected intradermally into the reticular layer of the dermis using the point technique. The first course of mesotherapy was given within the first 2 h after infliction of thermal burns, and therapy was continued to day 10. On day 22, unhealed thermal burn areas were measured prior to sacrifice, and biopsies covering the total areas of burns were performed to allow of pathological evaluation. Group 3 (the glutathione group) showed the best extent of healing, followed by Group 4 (the taurine group) and Group 5 (the L-carnitine group). The healed thermal burn areas in these groups were significantly greater than those in the control and sham groups (P = 0.001). All of healing, acute and chronic inflammation, the amount of granulation tissue, the level of fibroblast maturation, the amount of collagen, the extent of re-epithelization and neovascularization, and ulcer depth were scored upon pathological examination of tissue cross-sections. The best outcomes were evident in the glutathione group, with statistical significance. Although wound healing in the L

  16. Multispectral imaging burn wound tissue classification system: a comparison of test accuracies between several common machine learning algorithms (United States)

    Squiers, John J.; Li, Weizhi; King, Darlene R.; Mo, Weirong; Zhang, Xu; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.


    The clinical judgment of expert burn surgeons is currently the standard on which diagnostic and therapeutic decisionmaking regarding burn injuries is based. Multispectral imaging (MSI) has the potential to increase the accuracy of burn depth assessment and the intraoperative identification of viable wound bed during surgical debridement of burn injuries. A highly accurate classification model must be developed using machine-learning techniques in order to translate MSI data into clinically-relevant information. An animal burn model was developed to build an MSI training database and to study the burn tissue classification ability of several models trained via common machine-learning algorithms. The algorithms tested, from least to most complex, were: K-nearest neighbors (KNN), decision tree (DT), linear discriminant analysis (LDA), weighted linear discriminant analysis (W-LDA), quadratic discriminant analysis (QDA), ensemble linear discriminant analysis (EN-LDA), ensemble K-nearest neighbors (EN-KNN), and ensemble decision tree (EN-DT). After the ground-truth database of six tissue types (healthy skin, wound bed, blood, hyperemia, partial injury, full injury) was generated by histopathological analysis, we used 10-fold cross validation to compare the algorithms' performances based on their accuracies in classifying data against the ground truth, and each algorithm was tested 100 times. The mean test accuracy of the algorithms were KNN 68.3%, DT 61.5%, LDA 70.5%, W-LDA 68.1%, QDA 68.9%, EN-LDA 56.8%, EN-KNN 49.7%, and EN-DT 36.5%. LDA had the highest test accuracy, reflecting the bias-variance tradeoff over the range of complexities inherent to the algorithms tested. Several algorithms were able to match the current standard in burn tissue classification, the clinical judgment of expert burn surgeons. These results will guide further development of an MSI burn tissue classification system. Given that there are few surgeons and facilities specializing in burn care

  17. [Attaching importance to molecular imaging techniques and promoting precision diagnosis in burns]. (United States)

    Yu, Y M; Peng, X


    The explosive growth and advancement of computer science in recent decades have prompted the rapid development and wide applications of imaging techniques in life science, which have brought about revolutionary changes in modern medicine. Nowadays, it is possible to visualize multiple physiological and disease processes, precisely and non-invasively, in a living human body. Modern medicine has even started"reading the mind", to diagnose psychology, behavior and degenerative disorders of human brain. The border between the organic and inorganic diseases in old dogma is disappearing because imaging techniques have"visualized"the neurological and tissue changes of inorganic disorders. Severe burn injury is associated with very complicated pathological processes, which are always at the borderline between life and death. Complete recovery of patients with severe burn injury, if possible, may take years of time. Hence, a real-time monitoring of the disease process is of pivotal importance in early recognition and prevention of life-threatening complications and in assessing the therapeutic efficacy for a less-eventful recovery. Here we review and introduce some potential applications of modern imaging techniques in burn care and research, which may benefit burn patients. Some techniques are still in their early or pre-clinical stage and some are mature techniques in other fields of medicine, which are potentially applicable in burn diagnosis and treatment through our research. We intend to bring your interest to this field which may eventually lead to new revenues improving our clinical work on burn victims.

  18. Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study. (United States)

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


    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.

  19. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

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    Sadeghi-Bazargani H


    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  20. Health effects of smoke from planned burns: a study protocol

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    David O’Keeffe


    Full Text Available Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest. It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors.

  1. Diabetes mellitus after injury in burn and non-burned patients: A population based retrospective cohort study. (United States)

    Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; Rea, Suzanne; Wood, Fiona M


    To compare hospitalisations for diabetes mellitus (DM) after injury experienced by burn patients, non-burn trauma patients and people with no record of injury admission, adjusting for socio-demographic, health and injury factors. Linked hospital and death data for a burn patient cohort (n=30,997) in Western Australia during the period 1980-2012 and two age and gender frequency matched comparison cohorts: non-burn trauma patients (n=28,647); non-injured people (n=123,399). The number of DM admissions and length of stay were used as outcome measures. Multivariate negative binomial regression was used to derive adjusted incidence rate ratios and 95% confidence intervals (IRR, 95%CI) for overall post-injury DM admission rates. Multivariate Cox regression models and hazard ratios (HR) were used to examine time to first DM admission and incident admission rates after injury discharge. The burn cohort (IRR, 95%: 2.21, 1.80-2.72) and other non-burn trauma cohort (IRR, 95%CI: 1.63, 1.24-2.14) experienced significantly higher post-discharge admission rates for DM than non-injured people. Compared with the non-burn trauma cohort, the burn cohort experienced a higher rate of post-discharge DM admissions (IRR, 95%CI: 1.40, 1.07-1.84). First-time DM admissions were significantly higher during first 5-years after-injury for the burn cohort compared with the non-burn trauma cohort (HR, 95%CI: 2.00, 1.31-3.05) and non-injured cohort (HR, 95%CI: 1.96, 1.46-2.64); no difference was found >5years (burn vs. non-burn trauma: HR, 95%CI: 0.88, 0.70-1.12; burn vs non-injured: 95%CI: 1.08 0.82-1.41). No significant difference was found when comparing the non-burn trauma and non-injured cohorts (0-5 years: HR, 95%CI: 1.03, 0.71-1.48; >5years: HR. 95%CI: 1.11, 0.93-1.33). Burn and non-burn trauma patients experienced elevated rates of DM admissions after injury compared to the non-injured cohort over the duration of the study. While burn patients were at increased risk of incident DM

  2. Insights into the use of thermography to assess burn wound healing potential: a reliable and valid technique when compared to laser Doppler imaging (United States)

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


    Adequate assessment of burn wounds is crucial in the management of burn patients. Thermography, as a noninvasive measurement tool, can be utilized to detect the remaining perfusion over large burn wound areas by measuring temperature, thereby reflecting the healing potential (HP) (i.e., number of days that burns require to heal). The objective of this study was to evaluate the clinimetric properties (i.e., reliability and validity) of thermography for measuring burn wound HP. To evaluate reliability, two independent observers performed a thermography measurement of 50 burns. The intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the limits of agreement (LoA) were calculated. To assess validity, temperature differences between burned and nonburned skin (ΔT) were compared to the HP found by laser Doppler imaging (serving as the reference standard). By applying a visual method, one ΔT cutoff point was identified to differentiate between burns requiring conservative versus surgical treatment. The ICC was 0.99, expressing an excellent correlation between two measurements. The SEM was calculated at 0.22°C, the LoA at -0.58°C and 0.64°C. The ΔT cutoff point was -0.07°C (sensitivity 80% specificity 80%). These results show that thermography is a reliable and valid technique in the assessment of burn wound HP.

  3. The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study. (United States)

    Cukor, Judith; Wyka, Katarzyna; Leahy, Nicole; Yurt, Roger; Difede, JoAnn


    Burn injuries are unique in their medical and psychological impact, yet there has been little exploration of psychiatric treatment for this population. This uncontrolled pilot study assessed feasibility, acceptability, and preliminary efficacy of a treatment protocol designed to address posttraumatic stress disorder, depression, coping with scarring, and community integration among adult burn survivors. A 14-session, manualized treatment protocol was created using cognitive-behavioral interventions including imaginal exposure, behavioral activation, cognitive restructuring, modeling, and in vivo exposure. Responses were measured using the Clinician Administered PTSD Scale, Beck Depression Index, Community Integration Questionnaire, Oswestry Disability Questionnaire, and Burn Specific Health Scale. Nine of 10 enrolled patients (60% women; mean = 42 years old) completed treatment. Burn size was 0.5% to 65%; mechanism of injury included flame (4), scald (5), and contact (1) burns. Mean acute hospitalization was 30.1 days (range = 13-87); mean time from injury to treatment was 3.2 months (range = 1-7). Baseline mean posttraumatic stress score was 68 on the Clinician Administered PTSD Scale (severe); scores decreased by 36% to a mean of 45.3 at posttreatment, with a large effect size. Baseline self-reported depression was 21 (moderate) on the Beck Depression Index, decreasing by 47% to a mean of 12 posttreatment (nonclinical). Change in community reintegration score was significant and large, and body image showed significant improvement. The protocol showed promise in the treatment of posttraumatic stress disorder, depression, self-image, and community reintegration following burn injury. These findings suggest that coping may improve with treatment and symptoms should not be dismissed as unavoidable consequences of burn injury.

  4. A comparison of non-invasive imaging modalities: Infrared thermography, spectrophotometric intracutaneous analysis and laser Doppler imaging for the assessment of adult burns. (United States)

    Burke-Smith, Alexandra; Collier, Jonathan; Jones, Isabel


    Currently, the only evidence-based adjunct to clinical evaluation of burn depth is laser Doppler imaging (LDI), although preliminary studies of alternative imaging modalities with instant image acquisition are promising. This is a study to investigate the accuracy of infrared thermography (IRT) and spectrophotometric intracutaneous analysis (SIA) for burn depth assessment, and compare this to the current gold standard: LDI. We include a comparison of the three modalities in terms of cost, reliability and usability. We recruited 20 patients with burns presenting to the Chelsea and Westminster Adult Burns Service. Between 48h and 5 days afterburn we recorded imaging using moorLDI2-BI-VR (LDI), FLIR E60 (IRT) and Scanoskin™ (SIA). Subsequent clinical management and outcome was as normal, and not affected by the extra images taken. 24 burn regions were grouped according to burn wound healing: group A healed within 14 days, group B within 14-21 days, and group C took more than 21 days or underwent grafting. Both LDI and IRT accurately determined healing potential in groups A and C, but failed to distinguish between groups B and C (p>0.05). Scanoskin™ interpretation of SIA was 100% consistent with clinical outcome. FLIR E60 and Scanoskin™ both present advantages to moorLDI2-BI-VR in terms of cost, ease-of-use and acceptability to patients. IRT is unlikely to challenge LDI as the gold standard as it is subject to the systematic bias of evaporative cooling. At present, the LDI colour-coded palette is the easiest method for image interpretation, whereas Scanoskin™ monochrome colour-palettes are more difficult to interpret. However the additional analyses of pigment available using SIA may help more accurately indicate the depth of burn compared with perfusion alone. We suggest development of Scanoskin™ software to include a simplified colour-palette similar to LDI and additional work to further investigate the potential of SIA as an alternative to the current gold

  5. MR imaging findings of high-voltage electrical burns in the upper extremities: correlation with angiographic findings

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    Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Min, Seon Jung; Han, You Mi (Dept. of Radiology, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of)); Suh, Kyung Jin (Dept. of Radiology, Dongguk Univ. College of Medicine, Gyeongju Hospital, Gyeongju (Korea, Republic of)), email:; Choi, Min Ho (Dept. of Internal Medicine, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of))


    Background: A high-voltage electrical burn is often associated with deep muscle injuries. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, and this can lead to major amputations or sepsis. MRI has excellent soft tissue contrast and it may aid in differentiating the areas of viable deep muscle from the areas of non-viable deep muscle. Purpose: To describe the MR imaging findings of a high-voltage electrical burn in the upper extremity with emphasis on the usefulness of the gadolinium-enhanced MRI and to compare the MR imaging findings with angiography. Material and Methods: We retrospectively reviewed the imaging studies of six patients with high-voltage electrical burns who underwent both MRI and angiography at the burn center of our hospital from January 2005 to December 2009. The imaging features were evaluated for the involved locations, the MR signal intensity of the affected muscles, the MR enhancement pattern, the involved arteries and the angiographic findings (classified as normal, sluggish flow, stenosis or occlusion) of the angiography of the upper extremity. We assessed the relationship between the MR imaging findings and the angiographic findings. Results: The signal intensities of affected muscles were isointense or of slightly high signal intensity as compared with the adjacent unaffected skeletal muscle on the T1-weighted MR images. Affected muscles showed heterogenous high signal intensity relative to the adjacent unaffected skeletal muscle on the T2- weighted images. The gadolinium-enhanced T1-weighted images showed diffuse inhomogeneous enhancement or peripheral rim enhancement of the affected muscles. The angiographic findings of the arterial injuries showed complete occlusion in three patients, severe stenosis in two patients and sluggish flow in one patient. Of these, the five patients with complete occlusion or severe stenosis on angiography showed non-perfused and non-viable areas of edematous muscle on

  6. Methodology for the detection of land cover changes in time series of daily satellite images. Application to burned area detection

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    J.A. Moreno-Ruiz


    Full Text Available We have developed a methodology for detection of observable phenomena at pixel level over time series of daily satellite images, based on using a Bayesian classifier. This methodology has been applied successfully to detect burned areas in the North American boreal forests using the LTDR dataset. The LTDR dataset represents the longest time series of global daily satellite images with 0.05° (~5 km of spatial resolution. The proposed methodology has several stages: 1 pre-processing daily images to obtain composite images of n days; 2 building of space of statistical variables or attributes to consider; 3 designing an algorithm, by selecting and filtering the training cases; 4 obtaining probability maps related to the considered thematic classes; 5 post-processing to improve the results obtained by applying multiple techniques (filters, ranges, spatial coherence, etc.. The generated results are analyzed using accuracy metrics derived from the error matrix (commission and omission errors, percentage of estimation and using scattering plots against reference data (correlation coefficient and slope of the regression line. The quality of the results obtained improves, in terms of spatial and timing accuracy, to other burned area products that use images of higher spatial resolution (500 m and 1 km, but they are only available after year 2000 as MCD45A1 and BA GEOLAND-2: the total burned area estimation for the study region for the years 2001-2011 was 28.56 millions of ha according to reference data and 12.41, 138.43 and 19.41 millions of ha for the MCD45A1, BA GEOLAND-2 and BA-LTDR burned area products, respectively.

  7. Prescribed burning supports grassland biodiversity - A multi-species study (United States)

    Valkó, Orsolya; Deák, Balázs; Magura, Tibor; Török, Péter; Kelemen, András; Tóth, Katalin; Horváth, Roland; Nagy, Dávid; Debnár, Zsuzsanna; Zsigrai, György; Kapocsi, István; Tóthmérész, Béla


    During ancient times, fire was an important factor shaping European landscapes. Nowadays, prescribed burning can be one of the most effective conservation tools for the management of open landscapes, controlling dominant species, reducing accumulated litter or decreasing wildfire risk. In a prescribed burning experiment, we studied the effects of fire on dry alkaline grasslands. We tested whether autumn prescribed burning can be an alternative conservation measure in these grasslands. We selected six sites in Hungary: in three sites, prescribed burning was applied in November 2011, while three sites remained unburnt. We studied the effects of fire on soil characteristics, plant biomass and on the vegetation and arthropod assemblages (isopods, spiders, ground beetles and rove beetles). Soluble salt content increased significantly in the burnt sites, but soil pH, organic matter, potassium and phosphorous did not change. We found that prescribed fire had several positive effects from the nature conservation viewpoint. Diversity and the number of flowering shoots were higher, and the cover of the dominant grass was lower in the burnt sites. Graminoid biomass was lower, while total, green and forb biomass were higher in the burnt plots compared to the control ones. Our findings suggest that prescribed burning fire did not harm arthropods; species-level analyses showed that out of the most abundant invertebrate species, the abundance of ten was not affected, one decreased and one increased after burning. Our findings highlight that mosaic prescribed fire is a viable management tool in open landscapes, because it supports plant diversity and does not threaten arthropods.

  8. Anatomical study on Commelina diffusa burn F. and Commelina ...

    African Journals Online (AJOL)

    Commelina diffusa Burn. f. and Commelina erecta L. (Commelinaceae) are known from tropical and subtropical regions of the world. In the present work, the leaf epidermal characters, midrib and stem anatomy were studied in relation to their taxonomic values. Voucher specimens collected from different parts of Abia, Rivers ...

  9. Measurement of depth of burns by laser Doppler perfusion imaging

    NARCIS (Netherlands)

    Droog, E.J.; Droog, E.J.; Steenbergen, Wiendelt; Sjöberg, F.


    Laser Doppler perfusion imaging (LDPI), is a further development in laser Doppler flowmetry (LDF). Its advantage is that it enables assessment of microvascular blood flow in a predefined skin area rather than, as for LDF, in one place. In many ways this method seems to be more promising than LDF in

  10. Accuracy of acute burns diagnosis made using smartphones and tablets: a questionnaire-based study among medical experts. (United States)

    Blom, Lisa; Boissin, Constance; Allorto, Nikki; Wallis, Lee; Hasselberg, Marie; Laflamme, Lucie


    Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults. A web-based questionnaire was created with 51 images of burns representing those cases. Burns specialists from two countries (South Africa and Sweden (n = 8 and 7 respectively)) and emergency medicine specialists from South Africa (n = 11) were contacted by email and asked to assess each burn's total body surface area (TBSA) and depth using a smartphone or tablet. The accuracy and inter-rater reliability of the assessments were measured using intraclass correlation coefficients (ICC), both for all cases aggregated and for paediatric and adult burn cases separately. Eight participants repeated the questionnaire on a computer and intra-rater reliability was calculated. The assessments of TBSA are of high accuracy all specialists aggregated (ICC = 0.82 overall and 0.81 for both child and adult cases separately) and remain high for all three participant groups separately. The burn depth assessments have low accuracy all specialists aggregated, with ICCs of 0.53 overall, 0.61 for child and 0.46 for adult cases. The most accurate assessments of depth are among South African burns specialists (reaching acceptable for child cases); the other two groups' ICCs are low in all instances. Computer-based assessments were similar to those made on handheld devices. As was the case for computer-based studies, burns images viewed on handheld devices may be a suitable means of seeking expert advice even with limited additional information when it comes to burn size but

  11. Pediatric burns in military hospitals of China from 2001 to 2007: a retrospective study. (United States)

    Xu, Jian-Hong; Qiu, Jun; Zhou, Ji-Hong; Zhang, Liang; Yuan, Dan-Feng; Dai, Wei; Gao, Zhi-Ming


    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.

  12. Development and Validation of the Satisfaction with Appearance Scale: Assessing Body Image among Burn-Injured Patients. (United States)

    Lawrence, John W.; Heinberg, Leslie J.; Roca, Robert; Munster, Andrew; Spence, Robert; Fauerbach, James A.


    The Satisfaction with Appearance Scale (SWAP) was administered to 165 burn victims. SWAP showed a high level of internal consistency (Cronbach's alpha, r(a)=0.87); an 84-subject retest measured reliability (r(tt)=0.59). SWAP is both a reliable and valid measure of body image for a burn-injured population. (Author/MAK)

  13. Comparative study on direct burning of oil shale and coal (United States)

    Hammad, Ahmad; Al Asfar, Jamil


    A comparative study of the direct burning processes of oil shale and coal in a circulating fluidized bed (CFB) was done in this study using ANSYS Fluent software to solve numerically the governing equations of continuity, momentum, energy and mass diffusion using finite volume method. The model was built based on an existing experimental combustion burner unit. The model was validated by comparing the theoretical results of oil shale with proved experimental results from the combustion unit. It was found that the temperature contours of the combustion process showed that the adiabatic flame temperature was 1080 K for oil shale compared with 2260 K for coal, while the obtained experimental results of temperatures at various locations of burner during the direct burning of oil shale showed that the maximum temperature reached 962 K for oil shale. These results were used in economic and environmental analysis which show that oil shale may be used as alternative fuel for coal in cement industry in Jordan.

  14. Use of sugammadex on burn patients: descriptive study


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


    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, incl...

  15. An intercomparison of Satellite Burned Area Maps derived from MODIS, MERIS, SPOT-VEGETATION, and ATSR images. An application to the August 2006 Galicia (Spain forest fires

    Directory of Open Access Journals (Sweden)

    M. Huesca


    Full Text Available Aim of study: The following paper presents an inter-comparison of three global products: MCD45A1 (MODIS - MODerate resolution Imaging Spectrometer - Burned Area Product, L3JRC (Terrestrial Ecosystem Monitoring Global Burnt Area Product, and GLOBCARBON Burnt Area Estimate (BAE Product; and three local products, two of them based on MODIS data and the other one based on MERIS (MEdium Resolution Imaging Spectrometer data.Area of study: The study was applied to the Galician forest fires occurred in 2006.Materials and Methods: Materials used involved the three already mentioned global products together with two MODIS and one MERIS reflectance images, and MODIS thermal anomalies. The algorithm we used, which is based on the determination of thresholds values on infrared bands, allowed the identification of burned pixels. The determination of such threshold values was based on the maximum spatial correlation between MODIS thermal anomalies, and infrared reflectance values. This methodology was applied to MODIS and MERIS reflectance bands, and to the NBR (Normalized Burn Ratio. Burned area validation was evaluated using burned area polygons as derived from an AWiFS (Advanced Wide Field Sensor image of 60m pixel size.Main results: Best results were reached when using the MERIS infrared bands, followed by the MODIS infrared bands. Worst results were reached when using the MCD45A1 product, which clearly overestimated; and when using the L3JRC product, which clearly underestimated.Research highlights: Since the efficiency of the performance of the available burned area products is highly variable, much work is needed in terms of comparison among the available sensors, the burned area mapping algorithms and the resulting products.Keywords: forest fires; MODIS; MERIS; MCD45A1; L3JRC; GLOBCARBON-BAE; SPOT-VEGETATION; ATSR.Abbreviations used: ATSR: Along Scanning Radiometer; AVHRR: Advanced Very High Resolution Radiometer; AWiFS: Advanced Wide Field Sensor; EOS

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

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


    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 (pdressing (p=0.017), silver staining (pdressings 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.

  17. Use of sugammadex on burn patients: descriptive study

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez Sánchez M.


    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.

  18. Severity of burn and its related factors: A study from the developing country Pakistan. (United States)

    Adil, Syed Omair; Nisar, Nighat; Ehmer-Al-Ibran; Shafique, Kashif; Baig-Ansari, Naila


    Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  19. Study of Burn Scar Extraction Automatically Based on Level Set Method using Remote Sensing Data (United States)

    Liu, Yang; Dai, Qin; Liu, JianBo; Liu, ShiBin; Yang, Jin


    Burn scar extraction using remote sensing data is an efficient way to precisely evaluate burn area and measure vegetation recovery. Traditional burn scar extraction methodologies have no well effect on burn scar image with blurred and irregular edges. To address these issues, this paper proposes an automatic method to extract burn scar based on Level Set Method (LSM). This method utilizes the advantages of the different features in remote sensing images, as well as considers the practical needs of extracting the burn scar rapidly and automatically. This approach integrates Change Vector Analysis (CVA), Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR) to obtain difference image and modifies conventional Level Set Method Chan-Vese (C-V) model with a new initial curve which results from a binary image applying K-means method on fitting errors of two near-infrared band images. Landsat 5 TM and Landsat 8 OLI data sets are used to validate the proposed method. Comparison with conventional C-V model, OSTU algorithm, Fuzzy C-mean (FCM) algorithm are made to show that the proposed approach can extract the outline curve of fire burn scar effectively and exactly. The method has higher extraction accuracy and less algorithm complexity than that of the conventional C-V model. PMID:24503563

  20. Characteristics of adult scald burn patients-a single center study in western Kanagawa Prefecture. (United States)

    Morita, S; Higami, S; Aoki, H; Yamagiwa, T; Akieda, K; Inokuchi, S


    Burns sustained in bathtubs are a social and medical problem in Japan, especially among the elderly. Between October 2003 and March 2009, 22 adult scald burn patients (men, 17; average age, 65.3 ± 21.2 years) were transferred to Tokai University. In this study, we investigated the characteristics of these patients, and compared clinical parameters among patients with burns sustained in a bathtub (n = 10) and those with burns sustained due to other causes (n = 12). The average percentage total body surface area (%TBSA), dermal and deep burn area, and abbreviated burn severity index (ABSI) were 27.6 ± 23.8, 19.9 ± 20.5%, 7.8 ± 13.1%, and 7.7 ± 3.1, respectively. All patients in the bathtub burn group were elderly, 6 developed internal diseases, 3 had alcohol-related burns, and 4 died. Additionally, their %TBSA and ABSI were higher than those of the non-bathtub burn group patients. Burns sustained in bathtubs were more severe than those sustained due to other causes. The bathtub-related burn patients were elderly, and their burns were extensive and deep; hence, they were at a higher risk of developing internal diseases. Thus, introduction of safer bathing styles and bath systems will decrease incidences of bathtub-related burns. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  1. Fire walking in Singapore-a study of the distribution of burns. (United States)

    Sayampanathan, Andrew A


    Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore. Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area. A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury: Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  2. Preserving Self-Concept in the Burn Survivors: A Qualitative Study


    Vahid Zamanzadeh; Llila Valizadeh; Mojgan Lotfi; Feridoon Salehi


    Background: Burn injury is a devastating experience affecting all aspects of a person′s essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients′ cultural and religious context. Therefore, this study was conducted aiming at investigating burn pat...

  3. Raman Micro-spectroscopy Study of Healthy and Burned Biological Tissue (United States)

    Zarnani, Faranak; Glosser, Robert; Idris, Ahamed


    Burn injuries are a significant medical problem, and need to be treated quickly and precisely. Burned skin needs to be removed early, within hours (less than 24 hrs) of injury, when the margins of the burn are still hard to define. Studies show that treating and excising burn wounds soon after the injury prevents the wound from becoming deeper, reduces the release of proinflammatory mediators, and reduces or prevents the systemic inflammatory reaction syndrome. Also, removing burned skin prepares the affected region for skin grafting. Raman micro-spectroscopy could be used as an objective diagnostic method that will assist burn surgeons in distinguishing unburned from burned areas. As a first step in developing a diagnostic tool, we present Raman micro-spectroscopy information from normal and burned ex vivo rat skin.

  4. Study of the Spatial Distribution of Burning Particles in a Pyrotechnic Flame Based on Particle Velocity (United States)

    Zhu, Chen-Guang; Xu, Chungen; Xue, Rui


    The burning particles in the pyrotechnic flame play an important role in the ignition and spectral radiance of the pyrotechnic. We used particle image velocimetry (PIV) and high-speed camera (HSC) photography to investigate the 3D spatial pattern and velocity of the burning particles in the flame of pyrotechnics. The original images captured by the HSC were preprocessed through threshold selection, image bivalency, edge detection, and contour extraction and segmentation to obtain the particle coordinates and velocity. Consequently, the particle tracking model was established and the velocity and spatial distribution of the burning particles were obtained. A comparison of the flame flow field with particle image velocimetry demonstrated the typical characteristics of the two-phase flow of the pyrotechnic flame between burning particles and gas. Compared with the convergent gas flow field, the higher velocity burning particles had a discrete distribution in the "comet tail" shape region and showed the same direction of motion as the flame flow field, whereas the lower velocity burning particles had larger outlying regions and showed inconsistent directions of motion. The flow field of the burning particles was more chaotic than the flame flow field of the burning pyrotechnics.

  5. A comparative study of the ignition and burning characteristics of after burning aluminum and magnesium particles

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ji Hwan; Lee, Sang Hyup; Yoon, Woong Sup [Yonsei University, Seoul (Korea, Republic of)


    Ignition and the burning of air-born single aluminum and magnesium particles are experimentally investigated. Particles of 30 to 106 μm-diameters were electrodynamically levitated, ignited, and burnt in atmospheric air. The particle combustion evolution was recorded by high-speed cinematography. Instant temperature and thermal radiation intensity were measured using two-wavelength pyrometry and photomultiplier tube methods. Ignition of the magnesium particle is prompt and substantially advances the aluminum particle by 10 ms. Burning time of the aluminum particles is extended 3 to 5 times longer than the magnesium particles. Exponents of a power-law fit of the burning rates are 1.55 and 1.24 for aluminum and magnesium particles, respectively. Flame temperature is slightly lower than the oxide melting temperature. For the aluminum, dimensionless flame diameter is inert to the initial particle size, but for the magnesium inversely proportional to the initial diameter.

  6. Daytime Variation of Shortwave Direct Radiative Forcing of Biomass Burning Aerosols from GOES-8 Imager. (United States)

    Christopher, Sundar A.; Zhang, Jianglong


    Hourly Geostationary Operational Environmental Satellite-8 (GOES-8) imager data (1344-1944 UTC) from 20 July-31 August 1998 were used to study the daytime variation of shortwave direct radiative forcing (SWARF) of smoke aerosols over biomass burning regions in South America (4°-16°S, 51°-65°W). Vicarious calibration procedures were used to adjust the GOES visible channel reflectance values for the degradation in signal response. Using Mie theory and discrete ordinate radiative transfer (DISORT) calculations, smoke aerosol optical thickness (AOT) was estimated at 0.67 m. The GOES-retrieved AOT was then compared against ground-based AOT retrieved values. Using the retrieved GOES-8 AOT, a four-stream broadband radiative transfer model was used to compute shortwave fluxes for smoke aerosols at the top of the atmosphere (TOA). The daytime variation of smoke AOT and SWARF was examined for the study area. For selected days, the Clouds and the Earth's Radiant Energy System (CERES) TOA shortwave (SW) fluxes are compared against the model-derived SW fluxes.Results of this study show that the GOES-derived AOT is in excellent agreement with Aerosol Robotic Network (AERONET)-derived AOT values with linear correlation coefficient of 0.97. The TOA CERES-estimated SW fluxes compare well with the model-calculated SW fluxes with linear correlation coefficient of 0.94. For August 1998 the daytime diurnally averaged AOT and SWARF for the study area is 0.63 ± 0.39 and 45.8 ± 18.8 W m2, respectively. This is among the first studies to estimate the daytime diurnal variation of SWARF of smoke aerosols using satellite data.

  7. [Application of laser speckle perfusion imaging in predicting wound healing time of burn patients]. (United States)

    Jiang, M J; Chu, Z G; Xie, Q H; Huang, W W; Ruan, J J; Xie, W G


    Objective: To explore the application effect of laser speckle perfusion imaging (LSPI) in predicting wound healing time of burn patients. Methods: LSPI was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital within post injury hour (PIH) 24 to 72 to detect the blood perfusion values of the wounds. The wound healing time was recorded. The 128 wounds were divided into superficial group (wound healing time shorter than or equal to 14 d, n=57) and deep group (wound healing time longer than 14 d and shorter than or equal to 28 d, n=71) according to the healing time. The blood perfusion values of the two groups were compared. Data were processed with t test or chi-square test. The receiver operating characteristic (ROC) curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups, and the validity of the critical value was assessed by Kappa consistency test. Results: (1) The blood perfusion value of woundsin superficial group was (6.8±1.8) perfusion unit (PU), which was significantly higher than (3.5±1.3) PU in deep group (t=11.404, Phealing time was 0.931 (with 95% confidence interval 0.887-0.975, Phealing time of the two groups, with sensitivity of 76.9% and specificity of 94.7%. (3) The healing time of 44 wounds predicted was shorter than or equal to 14 d, and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d, while the actual number of wounds was 57 and 71, respectively. The Kappa coefficient of consistency test was 0.754 (Phealing time of burn wounds.

  8. 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. (United States)

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


    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.

  9. Factors associated with chemical burns in Zhejiang province, China: An epidemiological study

    Directory of Open Access Journals (Sweden)

    Jiang Rui M


    Full Text Available Abstract Background Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. Methods Questionnaires were developed, reviewed and validated by experts, and sent to 25 hospitals in Zhejiang province to prospectively collect data of 492 chemical burn patients admitted during one year from Sept. 1, 2008 to Aug. 31, 2009. Questions included victims' characteristics and general condition, injury location, causes of accident, causative chemicals, total body surface area burn, concomitant injuries, employee safety training, and awareness level of protective measures. Surveys were completed for each of burn patients by burn department personnel who interviewed the hospitalized patients. Results In this study, 417 victims (87.61% got chemical burn at work, of which 355 victims (74.58% worked in private or individual enterprises. Most frequent chemicals involved were hydrofluoric acid and sulfuric acid. Main causes of chemical injury accidents were inappropriate operation of equipment or handling of chemicals and absence of or failure to use effective individual protection. Conclusions Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns.

  10. Factors associated with chemical burns in Zhejiang province, China: an epidemiological study. (United States)

    Zhang, Yuan H; Han, Chun M; Chen, Guo X; Ye, Chun J; Jiang, Rui M; Liu, Li P; Ni, Liang F


    Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. Questionnaires were developed, reviewed and validated by experts, and sent to 25 hospitals in Zhejiang province to prospectively collect data of 492 chemical burn patients admitted during one year from Sept. 1, 2008 to Aug. 31, 2009. Questions included victims' characteristics and general condition, injury location, causes of accident, causative chemicals, total body surface area burn, concomitant injuries, employee safety training, and awareness level of protective measures. Surveys were completed for each of burn patients by burn department personnel who interviewed the hospitalized patients. In this study, 417 victims (87.61%) got chemical burn at work, of which 355 victims (74.58%) worked in private or individual enterprises. Most frequent chemicals involved were hydrofluoric acid and sulfuric acid. Main causes of chemical injury accidents were inappropriate operation of equipment or handling of chemicals and absence of or failure to use effective individual protection. Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns.

  11. Temporomandibular Disorders in Burning Mouth Syndrome Patients: An Observational Study (United States)

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


    BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. PMID:24273452

  12. Three-dimensional reconstruction of computed tomography scan images for estimating skull damage in electrical burned patients. (United States)

    Chen, Jian; Yan, Hong; Peng, Yizhi; Li, Xiaolu; Hu, Jianian; Wu, Jun


    Three cases of skull osteomyelitis due to electrical burn and delayed wound closure are presented. For better estimating skull damage before operation, 3-dimensional reconstruction of computed tomography scan images were used. Three-dimensional computed tomography could provide superior and visible stereoscopic images and help clinicians "see" the damage before operation and make more detailed therapeutic planning.

  13. A 10 year epidemiological study of paediatric burns at the Welsh Centre for burns and plastic surgery. (United States)

    Sanyaolu, Leigh; Javed, Muhammad Umair; Eales, Micheal; Hemington-Gorse, Sarah


    Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period. A retrospective analysis was performed for paediatric patients referred to our centre receiving fluid resuscitation and intensive care support from 2003 to 2013. We also analysed the patterns of referrals, admissions and need for surgical intervention over the same time period retrospectively. Children less than 5 years old made up 65% of admissions to intensive care and scald injuries (56%) were the commonest aetiology. Both total length of stay (25 days in 2003 to 10 days in 2013) and intensive care length of stay (7.2 days in 2003 to 3 days in 2013) decreased during the study and less patients underwent operative intervention. Referrals to our centre increased from 261 in 2003 to 366 in 2013, however admission rates declined from 145 to 85 during that time period. Currently there is limited data on severe burns within the paediatric population. Our study provides epidemiological data in this area, an important step for developing future prevention strategies. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study. (United States)

    Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M


    To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P10 years from injury (50% vs 42.5%, Preintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. The Fenix II Study: A longitudinal study of psychopathology among burn patients


    Fidel-Kinori, Sara Guila; Eiroá-Orosa, Francisco José; Giannoni-Pastor, Anna; Tasqué-Cebrián, Ruth; Arguello, Jose Maria; Casas, Miguel


    Psychological symptoms are common among burn survivors. However, knowledge about epidemiology and predictors of psychopathology has shown great heterogeneity in this population. The Fenix-II Project was the first epidemiological study on the psychopathological consequences of burn injuries developed in Spain, providing a detailed analysis of the progression of psychological symptoms during the first six months after injury. Three hundred and thirty-three patients were monitored and 183 were i...

  16. Exploring possible causes of fatal burns in 2007 using Haddon's Matrix: a qualitative study


    Homayoun Sadeghi-Bazargani; Saber Azami-Aghdash; Shahnam Arshi; Mirkazem Mohammad Hosseini; Bahram Samadirad; Mehryar Nadir Mohammadi; Amin Daemi; Reza Mohammadi


    Abstract: Background: Burns are a major factor in injury mortality. The aim of this study was to explore the possible causes of fatal burns using Haddon?s Matrix. Methods: This is a qualitative study using a phenomenological approach. We collected elicitation interview data using nine corroborators who were the most knowledgeable about the index burn event. Immediately after recording, the data was verbatim. Each event was analyzed using Haddon?s Matrix. Results: Interviewees provided detaile...

  17. Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: a prospective study of admissions and outpatients. (United States)

    Othman, Nasih; Kendrick, Denise; Al-Windi, Ahmad


    While it is globally observed that young children are at a higher risk of burn injuries, little is known about childhood burns in Iraqi Kurdistan. This study was undertaken to describe the epidemiology of burns amongst pre-school children in this region. A prospective study was undertaken from November 2007 to November 2008 involving all children aged 0-5 years attending the burns centre in Sulaimaniyah province for a new burn injury whether treated as an outpatient or admitted to hospital. 1,122 children attended the burns centre of whom 944 (84%) were interviewed (male 53%, female 47%). Mean age was 1.9 years with children aged 1 year comprising 32% and those aged 2 years comprising 21% of the sample. The incidence of burns was 1044/100,000 person-years (1030 in females and 1057 in males). Mechanisms of injury included scalds (80%), contact burns (12%) flames (6%) and other mechanisms (2%). Almost 97% of burns occurred at home including 43% in the kitchen. Winter was the commonest season (36%) followed by autumn (24%). There were 3 peak times of injury during the day corresponding to meal times. The majority of burns were caused by hot water (44%) and tea (20%) and the most common equipment/products responsible were tea utensils (41%). There were 237 admissions with an admission rate of 95 per 100,000 person-years. Scald injuries accounted for most admissions (84%). Median total body surface area affected by the burn or scald (TBSA) was 11% and median hospital stay was 7 days. In-hospital mortality was 8%. Mortality rate was 4% when TBSA was ≤25%, and 100% when TBSA was over 50%. Burn incidence is high in young children especially those aged 1-2 years. Preventive interventions targeted at families with young children & focusing on home safety measures could be effective in reducing childhood burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  18. Multiframe, Single Line-of-Sight X-Ray Imager for Burning Plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Kevin L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    The purpose of this LDRD project was to demonstrate high spatial and temporal resolution x-ray imaging using optical detectors, and in particular the VISAR and OHRV diagnostics on the OMEGA laser. The x-ray source being imaged was a backlighter capsule being imploded by 39 beams of the OMEGA laser. In particular this approach utilized a semiconductor with the side facing the backlighter capsule coated with a thin aluminum layer to allow x rays to pass through the metal layer and then get absorbed in the semiconductor. The other side of the semiconductor was AR coated to allow the VISAR or OHRV probe beam to sample the phase change of the semiconductor as the x rays were absorbed in the semiconductor. This technique is capable of acquiring sub-picosecond 2-D or 1-D x-ray images, detector spatial resolution of better than 10 um and the ability to operate in a high neutron flux environment expected on ignition shots with burning plasmas. In addition to demonstrating this technique on the OMEGA laser, several designs were made to improve the phase sensitivity, temporal resolution and number of frames over the existing diagnostics currently implemented on the OMEGA laser. These designs included both 2-d imaging diagnostics as well as improved 1-D imaging diagnostics which were streaked in time.

  19. The accuracy of burn diagnosis codes in health administrative data: A validation study. (United States)

    Mason, Stephanie A; Nathens, Avery B; Byrne, James P; Fowler, Rob; Gonzalez, Alejandro; Karanicolas, Paul J; Moineddin, Rahim; Jeschke, Marc G


    Health administrative databases may provide rich sources of data for the study of outcomes following burn. We aimed to determine the accuracy of International Classification of Diseases diagnoses codes for burn in a population-based administrative database. Data from a regional burn center's clinical registry of patients admitted between 2006-2013 were linked to administrative databases. Burn total body surface area (TBSA), depth, mechanism, and inhalation injury were compared between the registry and administrative records. The sensitivity, specificity, and positive and negative predictive values were determined, and coding agreement was assessed with the kappa statistic. 1215 burn center patients were linked to administrative records. TBSA codes were highly sensitive and specific for ≥10 and ≥20% TBSA (89/93% sensitive and 95/97% specific), with excellent agreement (κ, 0.85/κ, 0.88). Codes were weakly sensitive (68%) in identifying ≥10% TBSA full-thickness burn, though highly specific (86%) with moderate agreement (κ, 0.46). Codes for inhalation injury had limited sensitivity (43%) but high specificity (99%) with moderate agreement (κ, 0.54). Burn mechanism had excellent coding agreement (κ, 0.84). Administrative data diagnosis codes accurately identify burn by burn size and mechanism, while identification of inhalation injury or full-thickness burns is less sensitive but highly specific. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. Aloe versus silver sulfadiazine creams for second-degree burns: a randomized controlled study. (United States)

    Khorasani, Ghasemali; Hosseinimehr, Seyed Jalal; Azadbakht, Mohammad; Zamani, Arman; Mahdavi, Mohammad Reza


    Burn injury is associated with a high incidence of death and disability; yet its management remains problematic and costly. We conducted this clinical study to evaluate the efficacy of aloe vera cream for partial thickness burn wounds and compare its results with those of silver sulfadiazine (SSD). Thirty patients with similar types of second-degree burns at two sites on different parts of the body were included in this study. Each patient had one burn treated with topical SSD and one treated with aloe cream, randomly. The rate of re-epithelialization and healing of the partial thickness burns was significantly faster in the site treated with aloe than in the site treated with SSD (15.9 +/- 2 vs 18.73 +/- 2.65 days, respectively; P cream over SSD cream for treating second-degree burns.

  1. Audit of burn deaths among older adults in North India – An autopsy-based study

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    Sachil Kumar


    Conclusion: Results of this study shows that incidence of burn mortality was significantly higher among females. Most common manner of deaths among elderly is accident. Women in all three groups are more to the risk of burn deaths. Majority of burn victims were between the ages of 60–69 years. The percentage of TBSA was found to be significantly higher among suicidal subjects. Results of this study provide the necessary information to implement programs for health education relating to prevention of burns.

  2. Epidemiology of pediatric burns requiring hospitalization in China: a literature review of retrospective studies. (United States)

    Kai-Yang, Lv; Zhao-Fan, Xia; Luo-Man, Zhang; Yi-Tao, Jia; Tao, Tan; Wei, Wei; Bing, Ma; Jie, Xiong; Yu, Wang; Yu, Sun


    This review was an effort to systematically examine the nationwide data available on pediatric burns requiring hospitalization to reveal burn epidemiology and guide future education and prevention. The China Biomedical Disk Database, Chongqing VIP Database, and China Journal Full-Text Database were searched for articles reporting data on children and their burns from January 2000 through December 2005. Studies were included that systematically investigated the epidemiology of pediatric burns requiring hospitalization in China. Twenty-eight articles met the inclusion criteria, all of which were retrospective analyses. For each study included, 2 investigators independently abstracted the data related to the population description by using a standard form and included the percentage of patients with burn injury who were burn; anatomical sites of burn; severity of burn; and mortality and cause of death. These data were extracted, and a retrospective statistical description was performed with SPSS11.0 (SPSS Inc, Chicago, IL). Of the pediatric patients studied, the proportion of children with burn injury ranged from 22.50% to 54.66%, and the male/female ratio ranged from 1.25:1 to 4.42:1. The ratio of children aged 3 years was 0.19:1 to 4.18:1. The rural/urban ratio was 1.60:1 to 12.94:1. The ratio of those who were burned indoors versus outdoors was 1.62 to 17.00, and there were no effective hints on the distribution of seasons and anatomical sites of burn that could be found. The peak hours of pediatric burn were between 17:00 and 20:00. Most articles reported the sequence of reasons as hot liquid > flame > electricity > chemical, and scalding was, by far, the most predominant reason for burn. The majority of the studies reported the highest proportion involved in moderate burn, and the lowest proportion was for critical burn. The mortality rate ranged from 0.49% to 9.08%, and infection, shock, and multiple organ dysfunction syndrome were the most common causes of

  3. Epidemiological Study Of Burn Cases And Their Mortality Experiences Amongst Adults From A Tertiary Level Care Centre

    Directory of Open Access Journals (Sweden)

    Kumar P


    Full Text Available Research question: How to use hospital statistics in establishing epidemiology of burns amongst adults? Objectives: To identify epidemiological determinants for Ii Various burn injuries and ii their mortality experiences. Study design: Hospital based study carried out for a period of one year (1st January 1991 to 31st December 1991. Settings: Wards of department of Burn & Plastic Surgery, BJ Medical College, Ahmedabad. Participants: 386 adults (20 years and above admitted at the centre for burn injuries during 1991. Study variables: Epidemiological determinants (age, sex, temporal, place, etc. for various burn injuries and the determinants of mortality (type of burn, extent of burn, referral time lag etc. Outcome profile: Common profile of burn victims with relation to the epidemiological factors and other factors responsible for high mortality in burn cases. Statistical analysis: Chi- square and Z tests. Results:Burns occured more in females specially in the age group of 20-24 years. Eighty five percent were flame burns. Flame burns were more in females, while electric burns were more in males. Burns were less during monsoon (27.7% than winter (32.6% and summer (39.6%, but electric burns were twice more common during monsoon. Maximum burns (81.9% were domestic, occurring mainly either in kitchen or living room. They were seen more in late evening. Sixty two percent cases were severe as total burn surface area (TBSA was >40%. Case fatality correlated positively with TBSA and death was almost universal with TBSA >60%. Early referral reduced fatality significantly in less severe burns (TBSA<40% but failed to influence it in severe burns. Appraisal of alleged suicide cases (2.6% and of stove bursting (4.4% revealed that young females carry additional risk of burn injuries.

  4. A psychological morbidity study of patients with major burns seen at ...

    African Journals Online (AJOL)

    ... occurred among the patients that were studied. This psychological morbidity developed by 72 hours after sustaining the injury. The need for specialized multidisciplinary approach in burns is emphasized. Keywords: Burns, psychometric study, psychological morbidity. Nigerian Journal of Plastic Surgery Vol. 4 (2) 2008: pp.

  5. 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 ...

  6. A pilot study exploring the relationship between trauma symptoms and appearance concerns following burns. (United States)

    Shepherd, Laura


    Individuals who have experienced burns often have to adjust to distressing changes to their appearance. Trauma symptoms are another common psychological difficulty in the burn-injured population. However, there has been a lack of research exploring the possible relationship between trauma symptoms and appearance concerns in populations where incidents have led to appearance changes, including burns. The aim of this pilot study was to investigate the relationship between trauma symptoms and appearance concerns in the burn-injured population. Burn-injured patients (n=33) referred to a Burns Clinical Psychology service completed measures of trauma symptom severity, appearance concerns and changes in outlook. Analyses revealed a statistically significant positive relationship between trauma symptoms and appearance concerns (r=0.41, pappearance concerns. Furthermore, negative changes in outlook following the burns were positively related to trauma symptoms (r=0.69, pappearance concerns (r=0.50, pappearance concerns (r=-0.41, pappearance concerns. Burn injury factors (% TBSA, primary location of the injury, cause of the injury and time since the injury) were not related to trauma symptoms or appearance concerns. In conclusion, trauma symptoms and appearance concerns following burns may be positively related and further research in this area is needed. Theoretical and clinical implications are discussed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  7. Agents, mechanisms and clinical features of non-scald burns in children: A prospective UK study. (United States)

    Johnson, E L; Maguire, S; Hollén, L I; Nuttall, D; Rea, D; Kemp, A M


    To inform childhood burn prevention by identifying demographics, clinical features and circumstances of unintentional non-scald burns. A prospective cross-sectional study was conducted across Cardiff, Bristol and Manchester, including six emergency departments, three minor injury units and one burns unit between 13/01/2013-01/10/2015. Data collected for children aged burn (scald, contact, flame, radiation, chemical, electrical, friction) included: demographics, circumstances of injury and clinical features. Scalds and burns due to maltreatment were excluded from current analysis. Of 564 non-scald cases, 60.8% were boys, 51.1% were burns affected one anatomical site. Contact burns accounted for 86.7% (489/564), 34.8% (137/394) of which were from objects placed at >0.6m and 76.5% (349/456) affected the hands. Hairstyling devices were the most common agent of contact burns (20.5%, 100/487); 34.1% (30/88) of hairstyling devices were on the floor. Of children aged 10-15 years, 63.7% (65/102), sustained contact burns of which 23.2% (13/56) were preparing food, and when burnt from hairstyling devices, 73.3% (11/15) were using them at the time of injury. Parents of toddlers must learn safe storage of hazardous items. Older children should be taught skills in safe cooking and hairstyling device use. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  8. In vivo imaging of human burn injuries with polarization-sensitive optical coherence tomography

    NARCIS (Netherlands)

    Kim, K.H.; Pierce, M. C.; Maguluri, G. N.; Park, B. H.; Yoon, S.J.; Lydan, M.; Sheridan, R.; de Boer, J.F.


    The accurate determination of burn depth is critical in the clinical management of burn wounds. Polarization- sensitive optical coherence tomography (PS-OCT) has been proposed as a potentially non-invasive method for determining burn depth by measuring thermally induced changes in the structure and

  9. An epidemiologic study of burns: Standards of care and patients’ outcomes (United States)

    Goodarzi, Mohamad; Reisi-Dehkordi, Negar; Daryabeigi, Reza; Zargham-Boroujeni, Ali


    Background: Many people suffer from burn injuries every year, and burns make the patients undergo surgeries and years of rehabilitation. Burns lead to more years of disability, compared to cancer or heart diseases. Epidemiologic studies are needed to reveal the span, impact, and related factors of burns to help take appropriate efforts to reduce its mortality and morbidity. Materials and Methods: This study was conducted in two phases. The first phase was a descriptive retrospective study conducted on 836 burn patients who were admitted to the main special burn hospital of Isfahan, Iran. Data were collected from archived patients’ files using a checklist approved by the faculties of epidemiology and nursing. In the second phase, a survey was done based on the professional task checklist of burn ward nurses to assess the fulfillment of each task by the nurses. Results: Burns were found to occur more among those in the age groups of 20-30 (26.2%) and 0-10 years (22.9%). The most common causes of burns were flammables and gas explosions due to imprudence at home and workplaces, or self-infliction. Mortality rate was 21.7% due to sepsis, shock, and inhalation injuries, respectively. Nurses gave 19.78 out of 50 points (39.56%) to their performance in the prevention of sepsis. Conclusions: Based on the findings of this study, it can be concluded that there is still an increasing need for safety education and using environmental safety measures, as well as developing high-quality methods to transport burn patients and administer care to decrease the mortality and morbidity associated with burns. PMID:25183980

  10. Case study of water-soluble metal containing organic constituents of biomass burning aerosol (United States)

    Alexandra L. Chang-Graham; Luisa T. M. Profeta; Timothy J. Johnson; Robert J. Yokelson; Alexander Laskin; Julia Laskin


    Natural and prescribed biomass fires are a major source of aerosols that may persist in the atmosphere for several weeks. Biomass burning aerosols (BBA) can be associated with long-range transport of water-soluble N-, S-, P-, and metal-containing species. In this study, BBA samples were collected using a particle-into-liquid sampler (PILS) from laboratory burns of...

  11. An epidemiological study of 500 paediatric burn patients in Mumbai, India

    Directory of Open Access Journals (Sweden)

    Verma S


    Full Text Available Aim: To study the epidemiological data of paediatric burn patients to determine the role of demographic distribution and epidemiological parameters for assessment of mortality rate and development of burn prevention strategy. Materials and Methods : Epidemiological data of 500 patients admitted to the Burns and Plastic Surgery Unit of B.J. Wadia Hospital, Mumbai over a period of six years (2000-2005 was reviewed from medical records. Age, sex, demographic distribution, seasonal variation, total body surface area (TBSA involved, type and place of burn injury, parental occupation, family size, first aid and mortality rate were studied. Result: Median age group for patient was 3.44 years (range one month to 14 years. The majority (24% of burns occurred in children between the one to two years age group. Male to female sex ratio was 1.38:1. Most of the patients were from the defined demographic region served by the hospital. A significant number of patients however were from outside this region. Burn injury occurred predominantly during winter. Most common type of burn was scalds which occurred mainly in domestic circumstances. In the majority of patients, less than 10% TBSA was involved. All patients were managed as per the unit protocol. Mortality rate was 10.4%. Mortality rate was high in patients having more than 40% TBSA involvement. Seventy-three per cent of the total deaths occurred in the patients coming from regions outside the demographic region served by the hospital. Parental occupation, family size and the first aid did not affect the mortality rate. Conclusion: Availability of a burn care unit in the vicinity can decrease the mortality rates in the paediatric burn patients. An intense and focused burn prevention campaign to educate the general population about dangerous aetiological factors will decrease the incidence of paediatric burns.

  12. Quality of life and psychosocial adjustment to burn injury: social functioning, body image, and health policy perspectives. (United States)

    Corry, Nida; Pruzinsky, Thomas; Rumsey, Nichola


    This paper reviews four major topics related to the long-term psychosocial rehabilitation for burn survivors; (1) Body image adjustment process; (2) Social functioning challenges; (3) Interventions designed to address psychosocial rehabilitation challenges; and (4) Current policy developments in the USA and the UK that focus on raising the rehabilitation standards for psychosocial care for burn survivors. While acknowledging the close relationship between body image distress and social functioning, these two areas are reviewed separately with the goal of addressing two specific questions. First, what does current empirical research and clinical experience teach us about each of these areas, and second, what are the most important gaps in current knowledge about body image and social functioning, respectively? The final section of the paper specifically addresses the question of what can be done, from a practical and a health policy perspective, to ensure that existing body image and social difficulties are appropriately addressed.

  13. Preserving self-concept in the burn survivors: a qualitative study. (United States)

    Zamanzadeh, Vahid; Valizadeh, Llila; Lotfi, Mojgan; Salehi, Feridoon


    Burn injury is a devastating experience affecting all aspects of a person's essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients' cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients' experiences regarding how to preserve self-concept in life after burn injury in Iran. This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. During the qualitative content analysis process, the concept of "locating" as the essence of the participants' experience was extracted as follows: (A) self-exploration (exploring the changes in one's life), (B) others' exploration (exploring the changes in the life of family members and the relationship between self and others), (C) position evaluation (self-position analysis), and (D) self-concept preservation. The present study has developed new understandings of mental experiences of burn patients' self-concept by describing the concept of "self-locating". It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran.

  14. Quantitative Assessment of Graded Burn Wounds in a Porcine Model using Spatial Frequency Domain Imaging (SFDI) and Laser Speckle Imaging (LSI) (United States)


    employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non- invasive technologies to characterize in-vivo burn severity. We...debridement (days 0 and 4 respectively), the pig was premedicated with glycopyrrolate (0.01mg/kg, IM) to minimize salivation and bradycardia during...was used to mark areas for burn wound placement. These were located 1.5 cm from the spine and 2.5 cm away from each other (Fig. 2(a)) in order to

  15. Cytological studies of Brassicaceae burn. (Cruciferae juss.) from Western Himalayas. (United States)

    Jeelani, S M; Rani, S; Kumar, S; Kumari, S; Gupta, R C


    Cytological studies have been carried out on 12 species of Brassicaceae Burn. on population basis from different geographical areas of Kashmir and Himachal Pradesh in the Western Himalayas. Variable chromosome reports for Barbaraea intermedia (n = 16), Cardamine loxostemonoides (n = 8), Nasturtium officinale (n = 8), Sisymbrium orientale (n = 14) on world-wide basis have been added to the previous reports of these species. The chromosome numbers in seven species as Barbaraea intermedia (n = 8), B. vulgaris (n = 8), Capsella bursa-pastoris (n = 8), Descuriania sophia (n = 10), Rorippa islandica (n = 8), Sisymbrium strictum (n = 7) and Thlaspi alpestre (n = 7) have been worked out for the first time from India. The meiotic course in the populations of seven species such as Barbaraea intermedia, Capsella bursa-pastoris, Coronopus didymus, Descuriania sophia, Nasturtium officinale, Sisymbrium orientale and S. strictum varies from normal to abnormal while all the populations of two species Barbaraea vulgaris and Sisymbrium irio show abnormal meiotic course. Meiotic abnormalities are in the form of cytomixis, chromosomal stickiness, unoriented bivalents, inter-bivalent connections, formation of laggards and bridges, all resulting into abnormal microsporogenesis. Heterogenous sized fertile pollen grains and reduced reproductive potentialities have invariably been observed in all the meiotically abnormal populations. However, the meiotic course in all the populations of Cardamine loxostemonoides, Rorippa islandica and Thalspi alpestre is found to be normal with high pollen fertility.

  16. Epidemiology of operative burns at Kijabe Hospital from 2006 to 2010: Pilot study of a web-based tool for creation of the Kenya Burn Repository (United States)

    Dale, Elizabeth L.; Mueller, Melissa A.; Wang, Li; Fogerty, Mary D.; Guy, Jeffrey S.; Nthumba, Peter M.


    Introduction In order to implement effective burn prevention strategies, the WHO has called for improved data collection to better characterize burn injuries in low and middle income countries (LMIC). This study was designed to gather information on burn injury in Kenya and to test a model for such data collection. Methods The study was designed as a retrospective case series study utilizing an electronic data collection tool to assess the scope of burn injuries requiring operation at Kijabe Hospital from January 2006 to May 2010. Data were entered into a web-based tool to test its utility as the potential Kenya Burn Repository (KBR). Results 174 patients were included. The median age was 10 years. There was a male predominance (59% vs. 41%). Findings included that timing of presentation was associated with burn etiology (p = 0.009). Length of stay (LOS) was associated with burn etiology (p Burn injuries in Kenya show similarities with other LMIC in etiology and pediatric predominance. Late presentation for care and prolonged LOS are areas for further investigation. The web-based database is an effective tool for data collection and international collaboration. PMID:23040425

  17. The Role of Hyperglycemia in Burned Patients: Evidence-Based Studies (United States)

    Mecott, Gabriel A.; Al-Mousawi, Ahmed M.; Gauglitz, Gerd G.; Herndon, David N.; Jeschke, Marc G.


    Severely burned patients typically experience a systemic response expressed as increased metabolism, inflammation, alteration of cardiac and immune function, and associated hyperglycemia. Hyperglycemia has been associated with an increased risk of morbidity and mortality in critically ill patients. Until recently and for many years, hyperglycemia has been expectantly managed and considered a normal and desired response of an organism to stress. However, findings reported from recent studies now suggest beneficial effects of intensive insulin treatment for critically-ill patients. The literature on the management of hyperglycemia in severely burned patients is sparse, with most of the available studies involving only small numbers of burned patients. The purpose of this article is to describe the pathophysiology of hyperglycemia following severe burns and review the available literature on the outcome of intensive insulin treatment and other anti-hyperglycemic modalities in burned patients in an evidence-based-medicine approach. PMID:19503020

  18. Epidemiology and mortality of burns in the Lucknow Region, India--a 5 year study. (United States)

    Kumar, Sachil; Ali, Wahid; Verma, Anoop K; Pandey, Abhishek; Rathore, Shiuli


    Nearly 95% of global burn deaths and disabilities are estimated to occur in low and middle income countries of the world. Burns are extremely common and are a major public health problem in a developing country like India. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burns retrospectively. An analysis of autopsy records revealed 2225 (10.7%) cases of burns among the total autopsies done over 5 years period (1st January 2008-27th November 2012) in the mortuary of Forensic Medicine & Toxicology, K.G.M.U., Lucknow. The majority of deaths (88.8%) occurred between 10 and 49 years of age group with a preponderance of females (87.5%). The flame burns were seen in 60.1% of the victims. The majority of burn incidents were suicidal (38.6%) in nature followed by accidental (37.3%) and homicidal (24.1%) deaths. The percentages of burns with a total body surface area (TBSA) over 50% were observed in most of the cases (82.5%). In most of the cases deaths occurred within a week (82%) and most of the victims died from septicaemia and pneumonia (43.7%) followed by neurogenic shock (28.5%). The results of this study provide the necessary information to implement programmes for health education relating to prevention of burns focusing on the domestic setting. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  19. Economic Spillovers From Public Investments in Medical Countermeasures: A Case Study of a Burn Debridement Product. (United States)

    Farahati, Farah; Nystrom, Scott; Howell, David R; Jaffe, Richard


    The US federal government invests in the development of medical countermeasures for addressing adverse health effects to the civilian population from chemical, biological, and radiological or nuclear threats. We model the potential economic spillover effects in day-to-day burn care for a federal investment in a burn debridement product for responding to an improvised nuclear device. We identify and assess 4 primary components for projecting the potential economic spillover benefits of a burn debridement product: (1) market size, (2) clinical effectiveness and cost-effectiveness, (3) product cost, and (4) market adoption rates. Primary data sources were the American Burn Association's 2015 National Burn Repository Annual Report of Data and published clinical studies used to gain European approval for the burn debridement product. The study results showed that if approved for use in the United States, the burn debridement product has potential economic spillover benefits exceeding the federal government's initial investment of $24 million a few years after introduction into the burn care market. Economic spillover analyses can help to inform the prioritizing of scarce resources for research and development of medical countermeasures by the federal government. Future federal medical countermeasure research and development investments could incorporate economic spillover analysis to assess investment options. (Disaster Med Public Health Preparedness. 2017;page 1 of 9).

  20. A 12-year retrospective study of non-burn skin loss (burn-like syndromes) at a tertiary burns unit in a developing country. (United States)

    Ugburo, A O; Temiye, E O; Ilombu, C A


    A retrospective study of the presentation, etiology, and prognosis of non-burn epidermal loss managed at the Lagos University Teaching Hospital Nigeria over a 12-year period. Admission records of patients managed for non-burn skin loss were retrieved from the medical records. Demographic details of the patients, the initial diagnosis, final diagnosis, treatment and outcome of treatment was noted. A total of 23 patients were identified, 17 (74%) had idiosyncratic drug reactions. Of this 17, 6 (26%) had Steven Johnson Syndrome, 6 (26%) had Steven Johnson Syndrome/toxic epidermal necrolysis while 5 (22%) presented with toxic epidermal necrolysis. Three of the five patients with toxic epidermal necrolysis died. The age range of patients with idiosyncratic adverse drug reactions was 2-28 years, mean, 10.18+/-1.44 years and male to female ratio of 1:1.83. The body surface area involved ranged from 8 to 78%; mean 26.65+/-6.08%. The agents suspected for the reactions were Co-trimoxazole (41.2%) and combination of Co-trimoxazole, and Fansidar (17.6%). Other conditions seen were two (9%) Staphylococcal Scalded Skin Syndrome, three (13%) had Necrotizing Faciitis, one of whom was HIV positive and died. One (4%) patient presented with pemphigus vulgaris. The presentation and management of the patients was discussed.

  1. Ten-year epidemiological study of chemical burns in Jinshan, Shanghai, PR China. (United States)

    Li, Wei; Wu, Xiaofeng; Gao, Chengjin


    The epidemiological pattern of chemical burns varies widely in different areas of the world. To analyse effective preventive approaches, an insight into the pattern of injury is desirable. However, our data are only limited to Shanghai area, China. A 10-year retrospective review includes all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2001 to December 2010; those who were admitted to the ophthalmologic department or other departments were excluded. The data collected included age, gender, injury pattern, patient workplaces, aetiological agents, incidence by month and year, burn size, burn depth and site, time for immediate irrigation, length of hospital stay and outcome. A total of 615 patients admitted to our department for in-hospital treatment of chemical burn injury were included in the study. The mean age was 32.1±12.3 years with a range of 2-66 years. A total of 562 cases (91.4%) were male and 53 cases (8.6%) female. The mean total burn surface area (TBSA) was 30.3±24.7% with a mean full-thickness burn area of 17.5±23.8%. Most chemical burns took place in summer and fall. The majority of chemical burns were work related (93.0%); among them accidents that happened in private factories were predominant (70.8%). Although caustic soda was the leading cause of all chemical burns (15.8%), acid burn was the most common (45.2%). The extremities were the most frequent areas of injuries, followed by head and neck. Most cases had none (30.4%) or insufficient (61.1%) immediate irrigation after injury. In all patients, 47 cases had inhalation injuries, 94 cases accompanying ophthalmologic burns, 51 cases accompanying other associated injuries and 67 cases chemical toxicity. A total of 212 cases (34.5%) underwent early total or tangential excision and skin or skin flap grafting in the first week after injury. The mean length of hospital stay was 44.1±24.7 days. Sixteen cases died of respiratory failure, sepsis or

  2. Evolution of the complex permittivity of biological tissue at microwaves ranges: correlation study with burn depth. (United States)

    Matthieu, Brusson; Jerome, Rossignol; Stephane, Binczak; Gabriel, Laurent


    The evolution of the muscle tissue's complex permittivity represents a growing interest in terms of characterization in medicine and biology. The influence of a burned part on the permittivity is not very developed. In this work, an estimation of the complex permittivity of biological tissues is performed as a function of the depth of burn tissues. The sensor, an open-ended coaxial probe, is placed directly against each sample. The evolution of the complex permittivity is studied for two measurements conditions (in the air and in a physiological solution). A correlation study is attempted with the depth of burn tissue.

  3. Epidemiological and socio-cultural study of burn patients in M. Y. Hospital, Indore, India

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    Jaiswal Ashish


    Full Text Available Background: Developing countries have a high incidence of burn injuries, creating a formidable public health problem. The exact number of cases is difficult to determine: however in a country like India, with a population of over 1 billion, we would estimate 700,000 to 800,000 burn admissions annually. Objective: The study was done to investigate the epidemiology of various causations and their outcomes in terms of morbidity and mortality. Also, the effect of social stigma and cultural issues associated with burns on the victim and his family was assessed. Materials and Methods: All burn cases (n=412 admitted to the burns unit of M. Y. Hospital, Indore over a period of one year (2005-2006 were investigated. The data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. Clinical assessment was done in the form of depth and extent of injury and complications. In case of mortality, again various factors like age, sex and cause of death were analyzed. The data was analyzed by SPSS 11.0 version. The interrelationship between various factors was studied using multivariate logistic regression analysis. Results: Burns were found more commonly in middle-aged groups. The incidence was more in females as an absolute number (70.3% as well as when stratified by age. Most burns were domestic, with cooking being the most prevalent activity. Flame (80.3% was the most common agent. Most of the cases of burn were accidental (67.7%. Moreover, the patients had third degree burn that leads to more mortality in our circumstances. Death occurred in more than one-half (62.3% of cases with septicaemia and disseminated intravascular coagulation (35.4% as the leading causes. When using logistic regression analysis, the outcome of the burn injury was significantly associated with degree, depth, extent and mode of injury. Conclusion: This series provides an overview of the most

  4. Epidemiology of pediatric burns and future prevention strategies-a study of 475 patients from a high-volume burn center in North India. (United States)

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


    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.

  5. A 6-Year Case-Control Study of the Presentation and Clinical Sequelae for Noninflicted, Negligent, and Inflicted Pediatric Burns. (United States)

    Collier, Zachary J; Ramaiah, Veena; Glick, Jill C; Gottlieb, Lawrence J

    Inflicted burns are one of the leading causes of abuse-related fatalities in children. Between 30 and 60% of children accidentally returned to abusive homes suffer reabuse. Given the high chance for abuse recurrence and the associated morbidity/mortality, it is critical that inflicted burns are promptly identified to guide appropriate medical and child welfare management. Although previous studies proposed historical and mechanistic features using noncomparative or poorly powered data, this study utilized comparative data from a 6-year period (2009-2014) at a certified burn center along with expert analysis from Child Advocacy and Protective Services (CAPS) to provide higher level evidence supporting classical findings while elucidating new features with respect to burn severity and required interventions. A retrospective chart review of 408 pediatric burns was cross-referenced with the respective CAPS consultations to construct a multidisciplinary, deidentified database. The average age was 2.9 years (0.04-17 years) with 232 (57%) males and 330 (81%) African-Americans. CAPS investigations confirmed burn etiologies: noninflicted (346 [85%]), negligent (30 [7%]), and inflicted (32 [8%]). In comparing the three etiologies, statistical significance (P burn age, child welfare history, burn size and depth, distribution, concomitant injury rates, number of surgical interventions, infectious complications, and hospital length of stay. In addition to reaffirming classical features of abusive burns to fortify etiologic diagnoses, this study elucidated appreciable differences in burn severity, interventional sequelae, and burn-related complications, which will help guide medical and surgical interventions for future pediatric burn patients.

  6. Computerized decision support system improves fluid resuscitation following severe burns: an original study. (United States)

    Salinas, José; Chung, Kevin K; Mann, Elizabeth A; Cancio, Leopoldo C; Kramer, George C; Serio-Melvin, Maria L; Renz, Evan M; Wade, Charles E; Wolf, Steven E


    Several formulas have been developed to guide resuscitation in severely burned patients during the initial 48 hrs after injury. These approaches require manual titration of fluid that may result in human error during this process and lead to suboptimal outcomes. The goal of this study was to analyze the efficacy of a computerized open-loop decision support system for burn resuscitation compared to historical controls. Fluid infusion rates and urinary output from 39 severely burned patients with >20% total body surface area burns were recorded upon admission (Model group). A fluid-response model based on these data was developed and incorporated into a computerized open-loop algorithm and computer decision support system. The computer decision support system was used to resuscitate 32 subsequent patients with severe burns (computer decision support system group) and compared with the Model group. Burn intensive care unit of a metropolitan Level 1 Trauma center. Acute burn patients with >20% total body surface area requiring active fluid resuscitation during the initial 24 to 48 hours after burn. We found no significant difference between the Model and computer decision support system groups in age, total body surface area, or injury mechanism. Total crystalloid volume during the first 48 hrs post burn, total crystalloid intensive care unit volume, and initial 24-hr crystalloid intensive care unit volume were all lower in the computer decision support system group. Infused volume per kilogram body weight (mL/kg) and per percentage burn (mL/kg/total body surface area) were also lower for the computer decision support system group. The number of patients who met hourly urinary output goals was higher in the computer decision support system group. Implementation of a computer decision support system for burn resuscitation in the intensive care unit resulted in improved fluid management of severely burned patients. All measures of crystalloid fluid volume were reduced

  7. A method for extracting burned areas from Landsat TM/ETM+ images by soft aggregation of multiple Spectral Indices and a region growing algorithm (United States)

    Stroppiana, D.; Bordogna, G.; Carrara, P.; Boschetti, M.; Boschetti, L.; Brivio, P. A.


    Since fire is a major threat to forests and wooded areas in the Mediterranean environment of Southern Europe, systematic regional fire monitoring is a necessity. Satellite data constitute a unique cost-effective source of information on the occurrence of fire events and on the extent of the area burned. Our objective is to develop a (semi-)automated algorithm for mapping burned areas from medium spatial resolution (30 m) satellite data. In this article we present a multi-criteria approach based on Spectral Indices, soft computing techniques and a region growing algorithm; theoretically this approach relies on the convergence of partial evidence of burning provided by the indices. Our proposal features several innovative aspects: it is flexible in adapting to a variable number of indices and to missing data; it exploits positive and negative evidence (bipolar information) and it offers different criteria for aggregating partial evidence in order to derive the layers of candidate seeds and candidate region growing boundaries. The study was conducted on a set of Landsat TM images, acquired for the year 2003 over Southern Europe and pre-processed with the LEDAPS (Landsat Ecosystem Disturbance Adaptive Processing System) processing chain for deriving surface spectral reflectance ρi in the TM bands. The proposed method was applied to show its flexibility and the sensitivity of the accuracy of the resulting burned area maps to different aggregation criteria and thresholds for seed selection. Validation performed over an entire independent Landsat TM image shows the commission and omission errors to be below 21% and 3%, respectively.

  8. Household related predictors of burn injuries in an Iranian population: a case–control study

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    Sadeghi-Bazargani Homayoun


    Full Text Available Abstract Background To prevent burn injuries it is vital to have sound information on predictors of its occurrence in different settings. Ardabil Province is the coldest province of Iran with high burden of burn injuries. The aim of this study was to determine the household related predictors of unintentional burns in Ardabil Province located at North-West of Iran. Methods The study was conducted through a hospital based case–control design. 239 burn victims as well as 246 hospital-based controls were enrolled. Both bivariate and multivariate analysis methods were used. Results Males comprised 55.2% of all the study subjects. Mean age of the participants was 21.8 years (95% CI: 19.17-24.4. The economic ability of the households was associated with risk of burn injuries. Multivariate conditional logistic regression results showed the following variables to be independent factors associated with burn injuries. Using non-conventional pipe-less air heaters instead of conventional piped kerosene- or gas-burning heaters (Odds ratio: 1.98, 95% CI: 1.1-3.6. Common use of picnic gas-stove for cooking at home (odds ratio = 1.6, 95%CI: 1–2.4. Using electric samovars instead of other types of samovars (Odds ratio = 0.3, 95% CI: 0.1-1. Using samovars lacking the national standard authorization mark (Odds ratio = 2.2, 95% CI: 1.4-3.6. Conclusion Using some types of specific heating or cooking appliances, and unsafe use of conventional appliances were major risk predictors of burn injuries in this population.

  9. Preserving self-concept in the burn survivors: A qualitative study

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    Vahid Zamanzadeh


    Full Text Available Background: Burn injury is a devastating experience affecting all aspects of a person′s essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients′ cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients′ experiences regarding how to preserve self-concept in life after burn injury in Iran. Materials and Methods: This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. Results: During the qualitative content analysis process, the concept of "locating" as the essence of the participants′ experience was extracted as follows: (A self-exploration (exploring the changes in one′s life, (B others′ exploration (exploring the changes in the life of family members and the relationship between self and others, (C position evaluation (self-position analysis, and (D self-concept preservation. Conclusion: The present study has developed new understandings of mental experiences of burn patients′ self-concept by describing the concept of "self-locating." It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran.

  10. A study on burning behavior and convective flows in Methanol pool fires bound by ice

    DEFF Research Database (Denmark)

    Farahani, Hamed Farmahini; Jomaas, Grunde; Rangwala, Ali S.


    boundaries of the ice cavity/pan act as a heat sink causing considerable heat losses. Thus, burning rates and burning efficiencies are found to be lower with cold boundaries. However, the burning rate values in ice cavity are found to be the highest because of the melting of the ice and expansion......An experimental study on methanol pool fires bound by ice was carried to research the burning behavior and flow field (within the liquid-phase) of methanol. The experiments were conducted in two parts: 1- in a cylindrical ice cavity/pan (10.2 cm diameter and 6 cm depth) at three different....... Later on, mixing of melt-water with methanol and sinking of this mixture caused a cycle in the tray that resulted in a vortex appearing in the middle of the pool. Magnitudes of velocity were also observed to increase after ignition. The increase in the velocity magnitudes is expected to significantly...

  11. The dynamic experience of pain in burn patients: A phenomenological study. (United States)

    Pérez Boluda, M T; Morales Asencio, J M; Carrera Vela, A; García Mayor, S; León Campos, A; López Leiva, I; Rengel Díaz, C; Kaknani-Uttumchandani, S


    Although pain is one of the main sources of suffering during the acute phase and rehabilitation in burn patients, it remains as a major challenge for burn care, and clinical management not always correlates with the experience felt by patients. The aim of this study was to understand the experience of pain from people who has suffered severe burns, to identify personal strategies used to cope with this challenging event. A qualitative phenomenological study with purposive sampling was carried out with severe burn patients admitted to a Burn Unit. Through individual in-depth interviews, verbatim transcription and content analysis, two main categories were isolated: a dynamic and changing experience of pain, from the onset to the hospital discharge, and diverse strategies developed by patients to cope with pain, being distraction the most frequently used. Pain experienced acquires its maximum intensity during wound care, and divergent patients' opinions about sedation are present. This study highlights how understanding subjective experiences is an invaluable aid to improve care in pain assessment and management. Furthermore, it points out the need to guarantee patient involvement in the organization and improvement of burn care, inasmuch as traditional professional centered approach is not ensuring an optimal management. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. Burns and long-term infectious disease morbidity: A population-based study. (United States)

    Duke, Janine M; Randall, Sean M; Wood, Fiona M; Boyd, James H; Fear, Mark W


    There is a growing volume of data that indicates that serious injury suppresses immune function, predisposing individuals to infectious complications. With recent evidence showing long-term immune dysfunction after less severe burn, this study aimed to investigate post-burn infectious disease morbidity and assess if burn patients have increased long-term hospital use for infectious diseases. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia for all persons hospitalised for a first burn (n=30,997) in 1980-2012. A frequency matched non-injury comparison cohort was randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Direct standardisation was used to assess temporal trends in infectious disease admissions. Crude annual admission rates and length of stay for infectious diseases were calculated. Multivariate negative binomial and Cox proportional hazards regression modeling were used to generate adjusted incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for demographic factors and pre-existing health status, the burn cohort had twice (IRR, 95% confidence interval (CI): 2.04, 1.98-2.22) as many admissions and 3.5 times the number of days in hospital (IRR, 95%CI: 3.46, 3.05-3.92) than the uninjured cohort for infectious diseases. Higher rates of infectious disease admissions were found for severe (IRR, 95%CI: 2.37, 1.89-2.97) and minor burns (IRR, 95%CI: 2.22, 2.11-2.33). Burns were associated with significantly increased incident admissions: 0-30days (HR, 95%CI: 5.18, 4.15-6.48); 30days-1year (HR, 95%CI: 1.69, 1.53-1.87); 1-10 years (HR, 95%CI: 1.40:1.33-1.47); >10years (HR, 95%CI: 1.16, 1.08-1.24). Respiratory, skin and soft tissue and gastrointestinal infections were the most common. The burn cohort had a 1.75 (95%CI: 1.37-2.25) times greater rate of mortality caused by infectious diseases during the 5-year period after discharge than

  13. Burn Depth Estimation Based on Infrared Imaging of Thermally Excited Tissue

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    Dickey, F.M.; Hoswade, S.C.; Yee, M.L.


    Accurate estimation of the depth of partial-thickness burns and the early prediction of a need for surgical intervention are difficult. A non-invasive technique utilizing the difference in thermal relaxation time between burned and normal skin may be useful in this regard. In practice, a thermal camera would record the skin's response to heating or cooling by a small amount-roughly 5 C for a short duration. The thermal stimulus would be provided by a heat lamp, hot or cold air, or other means. Processing of the thermal transients would reveal areas that returned to equilibrium at different rates, which should correspond to different burn depths. In deeper thickness burns, the outside layer of skin is further removed from the constant-temperature region maintained through blood flow. Deeper thickness areas should thus return to equilibrium more slowly than other areas. Since the technique only records changes in the skin's temperature, it is not sensitive to room temperature, the burn's location, or the state of the patient. Preliminary results are presented for analysis of a simulated burn, formed by applying a patch of biosynthetic wound dressing on top of normal skin tissue.

  14. Impact of Work-Related Burn Injury on Social Reintegration Outcomes: A Life Impact Burn Recovery Evaluation (LIBRE) Study. (United States)

    Schneider, Jeffrey C; Shie, Vivian L; Espinoza, Leda F; Shapiro, Gabriel D; Lee, Austin; Acton, Amy; Marino, Molly; Jette, Alan; Kazis, Lewis E; Ryan, Colleen M


    To examine differences in long-term social reintegration outcomes for burn survivors with and without work-related injuries. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Older participants, those who were married, and men were more likely to be burned at work (Preintegration outcomes than those without work-related injuries. Identification of those at higher risk for work reintegration challenges after burn injury may enable survivors, providers, employers, and insurers to better use appropriate resources to promote and target optimal employment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Bacterial isolates from burn wound infections and their antibiograms: A eight-year study

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    Mehta Manjula


    Full Text Available Background: Infection is an important cause of mortality in burns. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and antibiogram in the burn ward. Aim: Keeping this in mind, the present retrospective study from wounds of patients admitted to burns unit was undertaken to determine the bacteriological profile and the resistance pattern from the burn ward over a period of three years (June 2002 to May 2005 and was compared with the results obtained during the previous five years (June 1997-May 2002, to ascertain any change in the bacteriological profile and antimicrobial resistance pattern. Materials and Methods: Bacterial isolates from 268 wound swabs taken from burn patients were identified by conventional biochemical methods and antimicrobial susceptibility was performed. Statistical comparison of bacterial isolates and their resistance pattern with previous five years data was done using c2 test. Results and Conclusions: During the period from 2002 to 2005 Pseudomonas species was the commonest pathogen isolated (51.5% followed by Acinetobacter species (14.28%, Staph. aureus (11.15%, Klebsiella species (9.23% and Proteus species (2.3%. When compared with the results of the previous five years i.e., 1997 to 2002, Pseudomonas species was still the commonest pathogen in the burns unit. However, the isolation of this organism and other gram-negative organisms had decreased in comparison to previous years. Newer drugs were found to be effective.

  16. Factors associated with length of hospital stay in minor and moderate burns at Popayan, Colombia. Analysis of a cohort study. (United States)

    Sierra Zúñiga, Marco Fidel; Castro Delgado, Oscar Eduardo; Merchán-Galvis, Angela María; Caicedo, Juan Carlos Caicedo; Calvache, Jose Andrés; Delgado-Noguera, Mario


    To determine the independent contribution of prognostic factors to length of hospital stay of minor and moderate burn victims at the Hospital Universitario San José (HUSJ), Popayán, Colombia, 2000-2010. This was a retrospective cohort study of minor and moderate burn victims admitted between 2000 and 2010, at the burn unit (HUSJ). This is a further analysis of a same cohort previously published in Burns. The following variables were recorded and analyzed: age, gender, origin, depth and extent of burn, causal agent, length of hospital stay and mortality. The main outcome under study was length of stay. Survival analysis was done to explore the association of covariates and length of hospital stay and Cox regression model to adjust the effect of covariates in the outcome. During the study period 2000-2010, 842 of 921 (91.5%) patients treated at the Burn Unit of HUSJ that had complete data were included. There were 520 (61.8%) males and 322 (38.2%) females with a male to female ratio of 1.6:1. Their median age was 9 years (IQR 3-28). The median of percent total body surface area burned (TBSA) was 12% (IQR 7-21) and the most common degree of burn was 2nd degree with 58% (488 patients). There were 12 deaths (censored data) and 830 patients were discharged alive. After multivariate adjustment, significant associations with length of hospital stay remained for age group, burn degree and extension of the burn. The strongest relationship found was for burn degree (2nd degree superficial vs. 3rd degree hazard ratio=2.66 CI 95% [2.13-3.33]). In patients admitted with mild and moderate burns at HUSJ, the main predictors of length of stay were age, burn degree and extension of the burn. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  17. [Bibliometric analysis of scientific articles on epidemiological study of burns in China]. (United States)

    Cheng, W F; Shen, Z A; Zhao, D X; Li, D W; Shang, Y R


    Objective: To analyze the current status of epidemiological study of burns in China, and to explore the related strategies. Methods: Retrospective or cross-sectional scientific articles in Chinese or English on epidemiological study of burns in China published from January 2005 to December 2015 were systemically retrieved from 4 databases. The databases include PubMed, Embase, China Biology Medicine disc, and Chinese Journals Full - text Database . From the results retrieved, data with regard to publication year, journal distribution, number of institutions participated in the study, affiliation of the first author and its location, and admission time span and age of patients in all the scientific articles were collected. Furthermore, the definition of age range and the grouping method of age of pediatric patients in English articles on epidemiological study of pediatric burns of China were recorded. Data were processed with descriptive statistical analysis. Results: A total of 256 scientific articles conforming to the study criteria were retrieved, among which 214 (83.59%) articles were in Chinese, and 42 (16.41%) articles were in English; 242 (94.53%) articles were retrospective studies, and 14 (5.47%) articles were cross-sectional studies. During the 11 years, the number of the relevant articles was fluctuant on the whole. The scientific articles were published in 130 journals, with 42 English articles in source journals for SCIENCE CITATION INDEX EXPANDED - JOURNAL LIST, accounting for 16.41%, and 116 Chinese articles in Source Journal for Chinese Scientific and Technical Papers, accounting for 45.31%. Totally 215 (83.98%) articles were single-center studies, and 29 (11.33%) articles were multicenter studies which were conducted by three or more centers. The number of affiliations of the first author of articles was 161 in total. The top 10 institutions regarding the article publishing number published 58 articles, accounting for 22.66%. Scientific articles on

  18. A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department. (United States)

    Brown, Matthew; Dalziel, Stuart R; Herd, Eleanor; Johnson, Kathryn; Wong She, Richard; Shepherd, Michael


    Silver-impregnated dressings are increasingly preferred over silver sulfadiazine cream in the management of pediatric burns. An ideal burns dressing would provide a moist, sterile environment, discourage infection, and not require painful dressing changes. This study sought to determine whether silver sodium carboxymethyl cellulose (Aquacel Ag, ConvaTec, Greensboro, NC) dressing is a superior treatment to nanocrystalline silver-coated polyethylene (Acticoat, Smith & Nephew, London, United Kingdom) dressing in pediatric patients with partial thickness burns. The authors conducted a single-blind, randomized controlled trial in 89 patients presenting to Starship Children's Emergency Department with uncomplicated partial-thickness burns. Patients were randomized to receive either an Acticoat (n = 45) or Aquacel Ag (n = 44) dressing. Photographs of the burn before dressing and at day 10 were assessed by two blinded pediatric burn surgeons to determine the primary outcome and percentage epithelialization. Secondary outcomes were number of dressing changes required and number and type of adverse events. Both treatment groups achieved satisfactory rates of burn healing. There was no difference between groups in the percentage epithelialization at day 10 (Acticoat [mean ± SD] = 93 ± 14%; Aquacel Ag = 94 ± 17%, P = .89). Adverse events such as infection and escalation of care were rare, with no difference detected between groups. Compared with Acticoat, Aquacel Ag dressings required significantly less dressing changes per patient {Acticoat [median (interquartile range)] = 2 (2-2), Aquacel Ag=1 (1-1), P = .03}. Both Acticoat and Aquacel Ag dressings are effective burn dressings, allowing reepithelialization and preventing infection in a subset of uncomplicated partial-thickness burns in pediatric patients. Aquacel Ag requires fewer dressing changes. This decrease in frequency of dressing changes and direct manipulation of the wound, which can be distressing or

  19. Predictors of re-epithelialization in pediatric burn. (United States)

    Brown, Nadia J; Kimble, Roy M; Gramotnev, Galina; Rodger, Sylvia; Cuttle, Leila


    An important treatment goal for burn wounds is to promote early wound closure. This study identifies factors associated with delayed re-epithelialization following pediatric burn. Data were collected from August 2011 to August 2012, at a pediatric tertiary burn center. A total of 106 burn wounds were analyzed from 77 participants aged 4-12 years. Percentage of wound re-epithelialization at each dressing change was calculated using Visitrak™. Mixed effect regression analysis was performed to identify the demographic factors, wound and clinical characteristics associated with delayed re-epithelialization. Burn depth determined by laser Doppler imaging, ethnicity, pain scores, total body surface area (TBSA), mechanism of injury and days taken to present to the burn center were significant predictors of delayed re-epithelialization, accounting for 69% of variance. Flame burns delayed re-epithelialization by 39% compared to all other mechanisms (p = 0.003). When initial presentation to the burn center was on day 5, burns took an average of 42% longer to re-epithelialize, compared to those who presented on day 2 post burn (p Burn depth, mechanism of injury and TBSA are always considered when developing the treatment and surgical management plan for patients with burns. This study identifies other factors influencing re-epithelialization, which can be controlled by the treating team, such as effective pain management and rapid referral to a specialized burn center, to achieve optimal outcomes. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  20. Individual-level predictors of inpatient childhood burn injuries: a case–control study

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    Homayoun Sadeghi-Bazargani


    Full Text Available Abstract Background Burn injuries are considered one of the most preventable public health issue among children; however, are a cause of significant morbidity and mortality in Iran. The aim of this study was to assess individual-level predictors of severe burn injuries among children leading to hospitalization, in East Azerbaijan Province, in North-West of Iran. Methods The study was conducted through a hospital based case–control design involving 281 burn victims and 273 hospital-based controls who were frequency matched on age, gender and urbanity. Both bivariate and multivariate methods were used to analyze the data. Results Mean age of the participants was 40.5 months (95 % CI: 37–44 with the majority of burns occurring at ages between 2 months-13.9 years. It was demonstrated that with increase in the caregiver’s age there was a decrease in the odds of burn injuries (OR = 0.94, 95 % CI: 0.92-0.97. According to the multivariate logistic regression there were independent factors associated with burn injuries including childhood ADHD (OR = 2.82, 95 % CI: 1.68 - 4.76, child’s age (OR = 0.73, 95%CI: 0.67 - 0.80, flammability of clothing (OR = 1.60, 95 % CI: 1.12 - 2.28, daily length of watching television (OR = 1.31, 95 % CI: 1.06 - 1.61, playing outdoors (OR = 1.32, 95 % CI: 1.16 - 1.50 and increment in the economic status (OR = 1.37, 95 % CI: 1.18 - 1.60. Conclusion Major risk predictors of burn injuries among the Iranian population included childhood ADHD, child’s age, watching television, playing outdoors, high economic status and flammable clothing.

  1. Independent Predictive Factors of Hospitalization in a North-West Burn Center of Iran; an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Samad Shams Vahdati


    Full Text Available Introduction: A high grade burn is one of the most devastating injuries with several medical, social, economic, and psychological effects. These injuries are the most common cause of accidental deaths after traffic injuries in both the developed and developing countries. Therefore this research was aimed to determine demographic characteristics of patients with burn injury admitted to the emergency department and identify predictive factors of hospitalization. Methods: This is a cross sectional descriptive study, which is done in 20 March up to 20 September 2011 in emergency department of Sina Hospital, Tabriz, Iran. Patients’ information including demographic characteristic, cause of burn, place of accident, anatomical areas burned, grading and percent of burning and disposition were gathered and analyzed using SPSS version 18.0 statistical software. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of hospitalization in burned patients. Results: One hundred and sixty patients were enrolled (54.4% female. The average age of those was 20.47±13.5 years. The prevalence of burn was significantly higher in ages under 20 years (p<0.001. Lower limb (37.5%, head and neck (21.25% and upper limb (17.5% were three frequent site of burn. The most common cause of burns was boiling water scalding (34.4%. Home related burn was significantly higher than other place (p<0.001. The most frequent percent of burn was <5% (46.25%. Finally 50 (31.25% cases hospitalized. Univariate analysis demonstrated that age under 20 years old (p=0.02 female gender (p=0.02, burning site (p=0.002, cause (p=0.005, place (p<0.001, grade (p<0.001, and percent (p<0.001 was related to disposition of patients. Stepwise multiple logistic regression showed female gender (OR=3.52; 95% CI: 1.57-7.88; p=0.002, work related burning (OR=1.78; 95% CI: 1.26-2.52; p=0.001, and burning over 5 percent (OR=2.15; 95% CI: 1.35-3.41; p=0.001 as

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

    Directory of Open Access Journals (Sweden)

    Nilgün Aksoy


    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

  3. In vivo time-lapse imaging of skin burn wound healing using second-harmonic generation microscopy (United States)

    Yasui, Takeshi; Tanaka, Ryosuke; Hase, Eiji; Fukushima, Shu-ichiro; Araki, Tsutomu


    Wound healing is a process to repair the damaged tissue caused by thermal burn, incised wound, or stab wound. Although the wound healing has many aspects, it is common for dynamics of collagen fiber, such as decomposition, production, or growth, to be closely related with wound healing. If such the healing process can be visualized as a timelapse image of the collagen fiber in the same subject, one may obtain new findings regarding biological repairing mechanisms in the healing process. In this article, to investigate the temporal modoification of dermal collagen fiber in the burn wound healing, we used second-harmonic-generation (SHG) microscopy, showing high selectivity and good image contrast to collagen molecules as well as high spatial resolution, optical three-dimensional sectioning, minimal invasiveness, deep penetration, the absence of interference from background light, and in vivo measurement without additional staining. Since SHG light arises from a non-centrosymmetric triple helix of three polypeptide chains in the collagen molecule, SHG intensity sensitively reflects the structure maturity of collagen molecule and its aggregates. A series of time-lapse SHG images during the wound healing process of 2 weeks clearly indicated that condensation and melting of dermal collagen fibers by the deep dermal burn, decomposition of the damaged collagen fibers in the inflammation phase, production of new collagen fibers in the proliferation phase, and the growth of the new collagen fibers in the remodeling phase. These results show a high potential of SHG microscopy for optical assessment of the wound healing process in vivo.

  4. Formation of secondary aerosols from biomass burning plumes: chamber simulation study (United States)

    Wang, X.; Hu, Q.; Fang, Z.; Deng, W.


    Biomass burning contributed substantially to carbonaceous aerosols in China's ambient air, even in its highly industrialized megacities, based on recent source attributions by receptor modeling or by molecular and isotopic tracers. Although chemical evolution of biomass burning plumes in the ambient is a vital issue for the study of climatic and health effects, the understanding of secondary pollutants formation during the aging of biomass burning plumes is far from complete. Here we collected typical agriculture residues and forest plant branches in the Pearl River Delta in south China, and got them burned in laboratory-controlled conditions and introduced the plumes from burning these biomass directly into the GIGCAS indoor smog chamber with a reactor of 30 m3 to investigate the photochemical aging of the plumes. The inorganic trace gases, including SO2, NOx, NH3 and O3, were monitored online with chemiluminescence gas analyzers, precursor volatile organic compounds (VOCs) were monitor online with a PTR-ToF-MS and offline by a preconcentrator coupled with a gas chromatography-mass selective detector/flame ionization detector/electron capture detector (GC-MSD/FID/ECD), particle number concentrations and size distributions were obtained using a scanning mobility particle sizer (SMPS), and a high-resolution time-of-flight aerosol mass spectrometer (HR-TOF-AMS) was used to measure the chemical compositions and evolutions of submicron aerosols and to trace the change in the average element ratios of organics, like H/C, O/C, and N/C. The results from the study were summarized in the following aspects: 1) primary emission factors of gaseous and particulate pollutants from burning of typical biomass including agricultural remains and forest wood plants; 2) yields of secondary pollutants, including secondary inorganic and organic aerosols and gaseous products (like O3) during photochemical aging of biomass burning plumes; 3) relationship between the formed secondary

  5. Optimization of burn referrals

    DEFF Research Database (Denmark)

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


    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), Denmark....... METHODS: We included burn patients referred to the NBC in a three-months period. Patient records were systematically analyzed and compared with the national guidelines for referral of burn injured patients. RESULTS: A total of 97 burn injured patients were transferred for treatment at the NBC and the most...... common reason for referral was partial thickness burn exceeding 3% estimated area of burn (55% of the patients) while facial burns (32%) and inhalational injury (25%) were other common reasons. We found that 29 (30%) of the referrals were considered potentially unnecessary according to the guidelines...

  6. Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study (United States)

    Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Coombes, Julieann; Fraser, Sarah; Lo, Serigne; Gabbe, Belinda; Hendrie, Delia; Read, David; Kimble, Roy; Sparnon, Anthony; Stockton, Kellie; Simpson, Renee; Quinn, Linda; Towers, Kurt; Potokar, Tom; Mackean, Tamara; Grant, Julian; Lyons, Ronan A; Jones, Lindsey; Eades, Sandra; Daniels, John; Holland, Andrew J A


    Introduction Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. Methods and analysis All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. Ethics and dissemination The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and

  7. Block selective redaction for minimizing loss during de-identification of burned in text in irreversibly compressed JPEG medical images. (United States)

    Clunie, David A; Gebow, Dan


    Deidentification of medical images requires attention to both header information as well as the pixel data itself, in which burned-in text may be present. If the pixel data to be deidentified is stored in a compressed form, traditionally it is decompressed, identifying text is redacted, and if necessary, pixel data are recompressed. Decompression without recompression may result in images of excessive or intractable size. Recompression with an irreversible scheme is undesirable because it may cause additional loss in the diagnostically relevant regions of the images. The irreversible (lossy) JPEG compression scheme works on small blocks of the image independently, hence, redaction can selectively be confined only to those blocks containing identifying text, leaving all other blocks unchanged. An open source implementation of selective redaction and a demonstration of its applicability to multiframe color ultrasound images is described. The process can be applied either to standalone JPEG images or JPEG bit streams encapsulated in other formats, which in the case of medical images, is usually DICOM.

  8. Experimental Study on the Influence of Thermal Feedback on the Burning Behavior of Flexible Polyurethane

    DEFF Research Database (Denmark)

    Poulsen, Annemarie; Bwalya, Alex; Jomaas, Grunde


    A series of experiments were carried out to study the effect of thermal feedback on the flame spread rate and the heat release rate for a horizontally positioned slab of polyurethane under pre-flashover conditions. Two experiments were performed in a slightly modified ISO 9705 Room Corner Test...... a different thermal inertia. The third experiment was performed as a free burn under a hood. The experiments showed that the flame spread rate increased in the room experiments as compared with the free burn experiments. Also, the experiments showed that the thermal feedback may increase the heat release rate...... and lead to flashover conditions, something which may not be predicted based on free burn experiments. Given the profound difference between the results from the different experimental conditions, it is recommended to take detailed room effects, such as thermal feedback, into considerations...

  9. Effects of Pediatric Burns on Gastrointestinal Diseases: A Population-Based Study. (United States)

    Boyd, James H; Wood, Fiona M; Randall, Sean M; Fear, Mark W; Rea, Suzanne; Duke, Janine M

    The systemic responses triggered by burns have been shown to include effects on the gastrointestinal tract. However, it is not clear if these changes lead to long-term gastrointestinal morbidity in patients with burns. The aim of this study was to assess if pediatric burns are associated with increased hospital use for gastrointestinal diseases after discharge for the initial injury. A population-based longitudinal study was performed using linked hospital and death data from Western Australia for children younger than 15 years when hospitalized for a first burn injury (n = 10,436) between 1980 and 2012, along with a frequency-matched noninjury comparison cohort, randomly selected from Western Australia's birth registrations (n = 40,819). Crude admission rates and cumulative length of stay for digestive diseases were calculated. Negative binomial and Cox proportional hazards regression modeling were used to generate incidence rate ratios (IRRs) and hazard ratios, respectively. After discharge, the pediatric burn cohort experienced twice the rate of gastrointestinal disease admissions (IRR, 95% confidence interval [CI]: 2.03, 1.56-2.65), spent over twice as long in hospital (IRR, 95% CI: 2.23, 1.67-2.98), and had a higher rate of first-time or incident gastrointestinal disease admissions (hazard ratio, 95% CI: 1.18, 1.08-1.29) when compared with the uninjured cohort, after adjusting for demographic and preexisting health factors. Children who experience a burn injury hospitalization are at increased risk of postburn hospital service use for gastrointestinal diseases when compared with uninjured children.

  10. Procalcitonin for the early diagnosis of sepsis in burn patients: A retrospective study. (United States)

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


    The gold standard for sepsis diagnosis in burn patient still relies on microbiological cultures, which take 48-72h to provide results, delaying the start of antimicrobial therapy. Thus, biomarkers allowing an earlier sepsis diagnosis in burn patients are needed. This retrospective observational study included 150 burn patients with total burned surface area ≥15%. Clinical diagnosis of sepsis among these patients was done according to the American Burn Association criteria. Biomarker (procalcitonin, white blood cells and platelet countings, prothrombinemia, D-dimers, C-reactive protein, blood lactate and temperature) values were available for 48 patients without sepsis (2767 timepoints) and 102 patients with sepsis (652 timepoints). Quantitative variables were compared with Mann-Whitney tests and qualitative variables were compared with Pearson chi-square test. Effect size was measured by the probability of superiority. Receiver operating characteristic (ROC) curves evaluate capacity for sepsis diagnosis. Sensitivity, specificity, positive and negative predictive values were calculated for some cut-off values, including the best cut-off defined by the maximum of Youden index. Statistically significant differences between the groups of septic and non-septic patients, with medium to large effect size, were detected for all the biomarkers considered, except temperature. PCT was the biomarker with the largest AUC and effect size (AUC=0.71). Analysis of the PCT ROC curve showed that 0.5ng/mL cut-off presented highest sensitivity and lowest specificity, whereas 1.5ng/mL cut-off was associated with lowest sensitivity and highest specificity. Procalcitonin showed to be the best of the biomarkers studied for an early diagnosis of sepsis. Its use should be considered in antimicrobial stewardship programs in Burn Units. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  11. Respiratory Morbidity After Childhood Burns: A 10-Year Follow-up Study. (United States)

    Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; Rea, Suzanne; Wood, Fiona M


    The systemic responses triggered by burns and resuscitative measures may cause pulmonary damage and edema in the acute phase. These effects may occur in the absence of inhalation injury. Currently, there is a paucity of data on the recovery of the respiratory system postburn. This study aimed to examine 10-year hospital service use for respiratory morbidity in children with cutaneous burns and no smoke inhalation injury. A population-based longitudinal study with 10-year follow-up using linked hospital and death from Western Australia for children burn injury (n = 5290) between 1980 and 2012 and a frequency matched noninjury comparison cohort, randomly selected from Western Australia's birth registrations (n = 27 061). Multivariate negative binomial and Cox proportional hazards regression models were used to generate adjusted incidence rate ratios (IRR) and hazard ratios, respectively. After adjustment for demographic factors and preexisting health status, the burn cohort had higher rates of admissions for influenza and viral pneumonia (IRR, 1.78; 95% confidence interval [CI], 1.10-2.87), bacterial pneumonia (IRR, 1.34; 95% CI, 1.06-1.70), and other respiratory infections (IRR, 1.65; 95% CI, 1.43-1.90. No significant difference was found for other upper respiratory tract conditions (IRR, 1.10; 95% CI, 0.98-1.23) or chronic lower respiratory diseases (IRR, 0.99; 95% CI, 0.80-1.23) compared with the uninjured cohort. These findings demonstrated increased respiratory infection admissions after burns. These outcomes suggest that immune changes triggered by a burn injury may persist in some children for at least 10 years after wound healing. Copyright © 2016 by the American Academy of Pediatrics.

  12. Acute Blood Loss During Burn and Soft Tissue Excisions: An Observational Study of Blood Product Resuscitation Practices and Focused Review (United States)


    pediatric burn patients. J Trauma. 1993;34(2):262Y263. 17. Kheirabadi BS, Terrazas IB, Williams JF, Hanson MA, Dubick MA, Blackbourne LH. Negative-pressure...Acute blood loss during burn and soft tissue excisions: An observational study of blood product resuscitation practices and focused review Heather F...coagulopathy with a balanced ratio of platelets and plasma to red blood cells. It is unclear to what degree this strategy is used during burn or soft tissue

  13. Urban-Rural Dichotomy of Burn Patients in Georgia and South Carolina: A Geographic Information System Study. (United States)

    Mian, Mohammad Anwarul Huq; Haque, Akhlaque; Mullins, Robert Fred; Fiebiger, Barbara; Hassan, Zaheed


    This study uses a 4-year (2006-2009) cross-section of epidemiological burn injury data from Georgia and South Carolina. The results from the study show that the burn patients from rural areas differ from their urban counterparts in terms of relative burn injury incidence. Younger population groups that live in lower socioeconomic status communities especially in the urban areas are at a higher risk than other population groups. The differences in the types of burns in the urban-rural communities can give us further insights to the patients' association with injury sites. The presence of fewer burn injury treatment and care facilities in rural areas and the high incidence of burn in low-income communities in the urban areas should carry important policy implications for health planners. This study will enable researchers to understand the epidemiology of burn injuries at the local and national levels in the United States. It also carries important implications for using Geographic Information Systems for studying spatial distribution of burn injuries for disaster planning and mitigation of burn injuries.

  14. Impression cytological study for ocular surface disorders of late stage eye burns. (United States)

    Zhu, Y-F; Zheng, L-B; Yao, Y-F


    This study aims to explore the ocular surface of late stage eye burns by impression cytology (IC) and analyze the cytological changes and their relationship to ocular surface abnormalities. 68 eyes with late stage eye burns (thermal burn: 28 eyes; alkali burn: 26 eyes; acid burn: 14 eyes), procured from 68 patients (aged ranges from 17 to 70 years old). Ocular surface abnormalities were assessed under slit lamp and graded. These were broadly classified as eyelid, corneal, conjunctival, and tear film abnormalities. Impression cytological examination was taken by cellulose acetate filter paper for all eyes. Samples were analyzed and scored under light microscope, including the status of epithelial cells, goblet cells, mucus and inflammatory cells. All the results and data were compared and analyzed by SPSS software (version 16.0). According to the IC results, loosed cell-to-cell density and nuclear abnormality, keratinization, reduced goblet cell amount, disorder of mucus, and existing of inflammatory cells were observed in almost all the cases. The IC results were significantly correlated to the ocular surface injury severity (r=0.458, pocular surface injury severity mostly contains three aspects: the corneal neovascularization scales, the present or absent of recurrent epithelial erosion and the tear film break-up time. Eyes with the foreword three symptoms were inclined to have higher IC scores. The epithelial cell-to-cell density, goblet cell and mucus amount were all correlated to tear film break-up time. However, inflammatory cell density showed no significant correlation to the conjunctival hyperemia grade. But inflammatory cell density correlated to the corneal opacity grade and epithelial stability status. IC examinations could reflect the cytological disorders and relative injury severity of the ocular surface in late stage eye burns. It provides further information which will be useful in surgery and therapy.

  15. Study on core physics characteristics of high burn-up full MOX PWR core. 2

    Energy Technology Data Exchange (ETDEWEB)

    Kugo, Teruhiko; Okubo, Tsutomu; Shimada, Syoichiro [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment


    As one of options for future light water reactors, we have been studying a new concept of a high burn-up full MOX PWR core with a discharge burn-up of 100 GWd/t and a 3-year operation cycle being based on the existing light water reactor technology. We have already confirmed the feasibility of the core, in which a moderator to fuel volume ratio(Vm/Vf) is increased to 2.6 with the same fuel pin diameter of 9.5 mm as in the current PWR but with the enlarged fuel pin pitch of 13.8 mm. In this report, to improve the neutronics and thermal hydraulic performance of the high burn-up core, we subsequently propose a 600 MWe core ensuring discharge burn-up of 100 GWd/t by increasing Vm/Vf to 3.0 with the same fuel pin pitch of 12.6 mm as in the current PWR and the smaller fuel rod diameter of 8.3 mm instead of 9.5 mm. We have investigated its core characteristics in neutronics and confirmed its feasibility. The core neutronics performance is compared between Vm/Vf = 2.6 and 3.0. From the comparison, it is found that the proposed core with Vm/Vf 3.0 has more promising characteristics than with Vm/Vf = 2.6 such as saving of a fissile plutonium content of 0.3wt%, improvement in a departure from nucleate boiling ratio (DNBR) and so on, except for a shortened cycle length by 9%. In addition, we have investigated a low-leakage refueling scheme for both types of high burn-up cores. Without modification to fuel material such as addition of burnable poison and/or transuranium isotopes, it can not be expected to improve the burn-up efficiency by the low-leakage refueling scheme. (author)

  16. Characteristics of fatal and hospital admissions for burns in Fiji: A population-based study (TRIP Project-2) (United States)

    Taoi, Mable; Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Naisaki, Asilika; McCaig, Eddie; Ameratunga, Shanthi


    Background Over 95% of burn deaths are estimated to occur in low-and-middle-income countries. However, the epidemiology of burn-related injuries in Pacific Island Countries is unclear. This study investigated the incidence and demographic characteristics associated with fatal and hospitalised burns in Fiji. Methods This cross-sectional study utilised the Fiji Injury Surveillance in Hospital database to estimate the population-based incidence and contextual characteristics associated with burns resulting in death or hospital admission (≥12 h) during a 12-month period commencing 1st October 2005. Results 116 people were admitted to hospital or died as a result of burns during the study period accounting for an overall annual incidence of 17.8/100,000 population, and mortality rate of 3.4/100,000. Most (92.2%) burns occurred at home, and 85.3% were recorded as unintentional. Burns were disproportionately higher among Fijian children compared with Fijian–Indian children with the converse occurring in adulthood. In adults, Indian women were at particularly high risk of death from self-inflicted burns as a consequence of ‘conflict situations’. Conclusion Burns are a significant public health burden in Fiji requiring prevention and management strategies informed by important differences in the context of these injuries among the major ethic groups of the country. PMID:22342176

  17. Characteristics of fatal and hospital admissions for burns in Fiji: a population-based study (TRIP Project-2). (United States)

    Taoi, Mable; Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Naisaki, Asilika; McCaig, Eddie; Ameratunga, Shanthi


    Over 95% of burn deaths are estimated to occur in low-and-middle-income countries. However, the epidemiology of burn-related injuries in Pacific Island Countries is unclear. This study investigated the incidence and demographic characteristics associated with fatal and hospitalised burns in Fiji. This cross-sectional study utilised the Fiji Injury Surveillance in Hospital database to estimate the population-based incidence and contextual characteristics associated with burns resulting in death or hospital admission (≥12h) during a 12-month period commencing 1st October 2005. 116 people were admitted to hospital or died as a result of burns during the study period accounting for an overall annual incidence of 17.8/100,000 population, and mortality rate of 3.4/100,000. Most (92.2%) burns occurred at home, and 85.3% were recorded as unintentional. Burns were disproportionately higher among Fijian children compared with Fijian-Indian children with the converse occurring in adulthood. In adults, Indian women were at particularly high risk of death from self-inflicted burns as a consequence of 'conflict situations'. Burns are a significant public health burden in Fiji requiring prevention and management strategies informed by important differences in the context of these injuries among the major ethic groups of the country. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  18. Identification of factors predicting scar outcome after burn in adults: A prospective case-control study. (United States)

    Wallace, Hilary J; Fear, Mark W; Crowe, Margaret M; Martin, Lisa J; Wood, Fiona M


    This study examined influences on scarring after burn in a prospective study using a defined outcome measure: scar height measured by a modified Vancouver Scar Scale (mVSS). A prospective case-control study was conducted among 616 adult subjects who sustained a burn in Western Australia. Patient factors influencing scar outcome including gender, Fitzpatrick skin type and selected co-morbidities were explored, as well as injury and clinical factors. A logistic regression model for raised scar after burn was developed which achieved an overall correct prediction rate of 81.1%; 74.8% for those with raised scar and 86.0% for those without raised scar. From this study, injury and clinical predictors for raised scar after adjustment for other variables are: increasing %TBSA, greater burn depth as indicated by level of surgical intervention, wound complications and prolonged hospital stay. Intrinsic patient predictors for raised scar in patients with comparable injuries are: young age (≤30 years), female gender and Fitzpatrick skin types 4-6. The strength of association statistics (odds ratios and 95% confidence intervals) reported will be of practical benefit for clinical decision-making and counselling of patients, and plausible biological explanations for the findings support the validity of the results. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  19. Cross Sectional Study of Burn Infections and Antibiotic Susceptibility Pattern for the Improvement of Treatment Policy

    Directory of Open Access Journals (Sweden)

    Neda Pirbonyeh


    Conclusion: By evaluating the infectious agents during the period of the study, it was found that due to the focus on treatment of Gram negative bacteria, Gram positive bacteria especially Staphylococcus aureus and Coagulase Negative Staphylococcus have at least doubled. This increase in two important nosocomial infections is a next threat of infection and septicemia for burn victims.

  20. A prospective study evaluating tobramycin pharmacokinetics and optimal once daily dosing in burn patients. (United States)

    Lee, Colin; Walker, Sandra A N; Walker, Scott E; Seto, Winnie; Simor, Andrew; Jeschke, Marc


    Once-daily aminoglycoside dosing (ODA) is used in most patient populations to optimize antibacterial activity and reduce toxicity. Unfortunately, burn patients are excluded from ODA due to concerns over altered pharmacokinetics resulting in a shortened half-life and low peak aminoglycoside concentrations. Retrospective studies suggest that ODA may be appropriate if higher milligram/kilogram doses are used. However, no prospective clinical trials in burn patients exist to confirm these findings. To determine the adequacy of once daily tobramycin dosed at 10mg/kg in adult burn patients. This prospective single dose pharmacokinetic clinical trial was conducted at the Ross Tilley Burn Centre. Patients with a total burn surface area (TBSA) of 50mL/min were eligible. A first-order one compartment model was used to determine the pharmacokinetic profile from 3 or 5 tobramycin levels over a 24h period per patient. Monte Carlo simulation (MCS) was performed to determine the probability of target level attainment. The mean percent TBSA, partial, and full thickness burn were 10%, 6%, and 4%, respectively. Nine of the ten patients recruited achieved peak concentrations of ≥20mg/L (mean of 29.4±5.7mg/L) and all patients had a trough level ≤0.5mg/L. The mean half-life, volume of distribution, and clearance were 2.58h, 0.33L/kg, and 7.40L/h, respectively. The MCS determined probability of attaining target peak concentrations with the 10mg/kg dose was 97%, which almost doubled that predicted with the usual 7mg/kg dose. Burn patients with adequate renal function and <20% TBSA are candidates for ODA. Tobramycin half-life was similar to healthy, non-burn patients. The larger than normal volume of distribution supports the use of the higher empiric dose of 10mg/kg total body or adjusted weight in non-obese and obese patients, respectively, with further dose adjustment based on therapeutic drug monitoring. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  1. [Burn out in health care providers: a Tunisian study about 142 nurses]. (United States)

    Aloulou, Jihen; Damak, Rahma; Masmoudi, Fatma; Sidhom, Oussama; Amami, Othman


    Burnout is a syndrome which affects preferentially help professions, having a strong emotional interpersonal implication. To assess the prevalence of burn out in a sample of Tunisian nurses, and to determine its causes and perceived repercussions. In a first step, we assessed the work conditions, the perceived burn out and its possible consequences in 142 nurses from 12 different wards. In a second step, we used the Malasch Burn Inventory to assess the burn out symptoms in ours ample. More than two thirds (69%) of our sample had a burn out. Forty five point eight percent of the affected professionals had a high level of emotional distress, 36.6% had a high level of depersonalization and 22.5% had a low level of professional fulfillment. The high caseload was the first cause of burn out (72.5% of professionals) and was associated to a moderate level of burn out (OR=3.80; 95%IC: 1.079-13.420 ; p = 0.038). Role ambiguity and undefined responsibilities were associated to a high level of emotional distress (p=0.04) and depersonalization (p=0.03), and a low level of professional fulfillment (p=0.0001). High scores of emotional distress were associated to a high number of work hours (p=0.006) and less than 10 years in carrier duration (p=0.008). In our study, feelings of uselessness were associated to high levels of emotional distress (p=0.05) and depersonalization (p=0.002) on the one hand, and to a lower level of personal fulfillment on the other hand (p=0.04). Moreover, we found that cases with suicide ideations had a higher level of burn out (p=0.04). Concerning physical symptoms, emotional distress was associated to multiples somatic complains. Our results corroborate partially with those of the literature and illustrate some parameters that can be the cause of burnout, such as working conditions, role ambiguity, and lack of experience among the young nurse. Therefore, it is important to take into consideration this various factors had their impact on quality of life

  2. The Significance of Brain Transcranial Sonography in Burning Mouth Syndrome: a Pilot Study

    Directory of Open Access Journals (Sweden)

    Iris Zavoreo


    Full Text Available Objective: Burning mouth syndrome (BMS is a chronic disorder which is affecting mostly postmenopausal women and is characterized by burning symptoms in the oral cavity on the clinically healthy oral mucosa. The results of previous studies suggested a possible role of peripheral and/or central neurological disturbances in these patients. The aim of this study was to analyze patients with burning mouth syndrome using transcranial sonography. Methods: By use of transcranial sonography of the brain parenchyma, substantia nigra, midbrain raphe and brain nucleus were evaluated in 20 patients with BMS (64.7±12.3 years and 20 controls with chronic pain in the lumbosacral region (61.5±15. Statistical analysis was performed by use of Student t test with significance set at p<0.05. Results: The results of this study have shown hypoechogenicity of the substantia nigra and midbrain raphe as well as hyperechogenicity of the brain nucleus in BMS patients (p<0,05 as compared to controls. Conclusions: Altered transcranial sonography findings of the brain parenchyma, midbrain raphe and brain nucleus in patients with burning mouth syndrome might reflect central disturbances within this syndrome.

  3. Burning mouth syndrome and associated factors: A case-control retrospective study. (United States)

    Chimenos-Küstner, Eduardo; de Luca-Monasterios, Fiorella; Schemel-Suárez, Mayra; Rodríguez de Rivera-Campillo, María E; Pérez-Pérez, Alejandro M; López-López, José


    Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P=.003), parafunctional habits (P=.006), and oral hygiene (P=.012). There were neither statistically significant differences in BMS incidence between sex groups (P=.408) nor association of BMS with the pathogenic factors of substance abuse (P=.915), systemic pathology (P=.685), and dietary habits (P=.904). Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  4. Modeling study of biomass burning plumes and their impact on urban air quality; a case study of Santiago de Chile (United States)

    Cuchiara, G. C.; Rappenglück, B.; Rubio, M. A.; Lissi, E.; Gramsch, E.; Garreaud, R. D.


    On January 4, 2014, during the summer period in South America, an intense forest and dry pasture wildfire occurred nearby the city of Santiago de Chile. On that day the biomass-burning plume was transported by low-intensity winds towards the metropolitan area of Santiago and impacted the concentration of pollutants in this region. In this study, the Weather Research and Forecasting model coupled with Chemistry (WRF/Chem) is implemented to investigate the biomass-burning plume associated with these wildfires nearby Santiago, which impacted the ground-level ozone concentration and exacerbated Santiago's air quality. Meteorological variables simulated by WRF/Chem are compared against surface and radiosonde observations, and the results show that the model reproduces fairly well the observed wind speed, wind direction air temperature and relative humidity for the case studied. Based on an analysis of the transport of an inert tracer released over the locations, and at the time the wildfires were captured by the satellite-borne Moderate Resolution Imaging Spectroradiometer (MODIS), the model reproduced reasonably well the transport of biomass burning plume towards the city of Santiago de Chile within a time delay of two hours as observed in ceilometer data. A six day air quality simulation was performed: the first three days were used to validate the anthropogenic and biogenic emissions, and the last three days (during and after the wildfire event) to analyze the performance of WRF/Chem plume-rise model within FINNv1 fire emission estimations. The model presented a satisfactory performance on the first days of the simulation when contrasted against data from the well-established air quality network over the city of Santiago de Chile. These days represent the urban air quality base case for Santiago de Chile unimpacted by fire emissions. However, for the last three simulation days, which were impacted by the fire emissions, the statistical indices showed a decrease in

  5. Burning Feet (United States)

    Symptoms Burning feet By Mayo Clinic Staff Burning feet — the sensation that your feet are painfully hot — can be mild or severe. In some cases, your burning feet may be so painful that the pain interferes ...

  6. Analysis of factorial time-course microarrays with application to a clinical study of burn injury (United States)

    Zhou, Baiyu; Xu, Weihong; Herndon, David; Tompkins, Ronald; Davis, Ronald; Xiao, Wenzhong; Wong, Wing Hung; Toner, Mehmet; Warren, H. Shaw; Schoenfeld, David A.; Rahme, Laurence; McDonald-Smith, Grace P.; Hayden, Douglas; Mason, Philip; Fagan, Shawn; Yu, Yong-Ming; Cobb, J. Perren; Remick, Daniel G.; Mannick, John A.; Lederer, James A.; Gamelli, Richard L.; Silver, Geoffrey M.; West, Michael A.; Shapiro, Michael B.; Smith, Richard; Camp, David G.; Qian, Weijun; Storey, John; Mindrinos, Michael; Tibshirani, Rob; Lowry, Stephen; Calvano, Steven; Chaudry, Irshad; West, Michael A.; Cohen, Mitchell; Moore, Ernest E.; Johnson, Jeffrey; Moldawer, Lyle L.; Baker, Henry V.; Efron, Philip A.; Balis, Ulysses G.J.; Billiar, Timothy R.; Ochoa, Juan B.; Sperry, Jason L.; Miller-Graziano, Carol L.; De, Asit K.; Bankey, Paul E.; Finnerty, Celeste C.; Jeschke, Marc G.; Minei, Joseph P.; Arnoldo, Brett D.; Hunt, John L.; Horton, Jureta; Cobb, J. Perren; Brownstein, Bernard; Freeman, Bradley; Maier, Ronald V.; Nathens, Avery B.; Cuschieri, Joseph; Gibran, Nicole; Klein, Matthew; O’Keefe, Grant


    Time-course microarray experiments are capable of capturing dynamic gene expression profiles. It is important to study how these dynamic profiles depend on the multiple factors that characterize the experimental condition under which the time course is observed. Analytic methods are needed to simultaneously handle the time course and factorial structure in the data. We developed a method to evaluate factor effects by pooling information across the time course while accounting for multiple testing and nonnormality of the microarray data. The method effectively extracts gene-specific response features and models their dependency on the experimental factors. Both longitudinal and cross-sectional time-course data can be handled by our approach. The method was used to analyze the impact of age on the temporal gene response to burn injury in a large-scale clinical study. Our analysis reveals that 21% of the genes responsive to burn are age-specific, among which expressions of mitochondria and immunoglobulin genes are differentially perturbed in pediatric and adult patients by burn injury. These new findings in the body’s response to burn injury between children and adults support further investigations of therapeutic options targeting specific age groups. The methodology proposed here has been implemented in R package “TANOVA” and submitted to the Comprehensive R Archive Network at It is also available for download at PMID:20479259

  7. Measuring distress in South African children during burns dressing changes: A pilot study. (United States)

    Louw, Q; Firfirey, N; Grimmer, K; van Niekerk, S-M


    To establish and trial a practical, evidence-based, sensitive, language-fair, and culture-fair test battery to measure South African children's distress during burns dressing change. We previously identified a broad test battery for pediatric procedural distress from the literature. This comprised child and parent heart rate; three instruments for observed distress behaviors-(1) Face, Legs, Activity, Cry, Consolability (FLACC); (2) Pain Behavior Check List (PBCL); and (3) Children's Hospital Eastern Ontario Pain Scale (CHEOPS); and dressing change time, number of nurses required, and nurses' perspectives of child's distress. A consecutive cohort of South African inpatient children with burns was recruited. In the first study, three observers independently piloted the broad set of measures on four children. This set was subsequently modified to increase practicality of application and measurement sensitivity. In the second study, the modified battery was tested on 16 children for sensitivity to different children's distress levels during burns dressing change phases. The modified test battery was comprised of the CHEOPS, dressing change time, number of nurses required, and nurses' qualitative perspectives of child's distress. In combination, these tests were practical and sensitive to children's distress. South African children's distress during burn dressing changes manifests in different ways. Adequate capture of it requires a comprehensive set of objective, observational, and qualitative measures, which are independent of language and culture.

  8. Cultured epithelial autografts in massive burns: a single-center retrospective study with 63 patients. (United States)

    Cirodde, Audrey; Leclerc, Thomas; Jault, Patrick; Duhamel, Patrick; Lataillade, Jean-Jacques; Bargues, Laurent


    Cultured epithelial autografts (CEAs) have long been used to tackle limited donor site availability and difficulty of permanent skin coverage in massive burns, but this approach still has limited documentation. In this retrospective, single-center study, medical records of patients treated with CEAs in our burn center from 1991 until 2008 were analyzed in search of factors associated with outcome. Out of 68 patients, 63 records were analyzable. Patients were aged 29 [17-41.5] years (seven children). Total body surface area (TBSA) burned was 81±10%, of which 69±14% TBSA full thickness. CEAs were first applied after 45±34 days, on a surface of 32±14% TBSA. Success rate at take down was 65±19%, correlating only with young age (r(2)=0.18; p=0.0006). At discharge, CEAs covered 26±15% TBSA. Infections (4.3±2 per patient), most frequently of skin, often complicated the clinical course. Mortality was 16% (10 patients). In multivariate analysis, the number of infections was the only factor associated with mortality (OR=2.05 per single infection, 95%CI 1.03-4.07, p=0.04). Although complex and costly, CEAs can be used with reasonable success and satisfying survival results for the treatment of massive burns. In this study, favorable outcome was principally associated with young age and low number of infectious complications. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  9. Aromatherapy massage seems to enhance relaxation in children with burns: an observational pilot study. (United States)

    O'Flaherty, Linda-Anne; van Dijk, Monique; Albertyn, Rene; Millar, Alastair; Rode, Heinz


    This observational pilot study investigated effects of aromatherapy massage in paediatric burn patients. The setting was a 17 beds level I burn unit in Cape Town, South Africa. Between January and October 2009 heart rates and respiratory rates of patients who underwent aromatherapy massage sessions were read before and after the sessions. Primary outcomes were decline in heart rates and respiratory rates, a sign of relaxation. Behavioural responses (sleep/awake state, facial expression, body posture) were documented as secondary outcomes. A convenience sample of 71 paediatric burn patients (median age 3 years) underwent a total of 126 massage sessions. Mean heart rate decreased significantly from 118 (SD 20) to 109 (SD 21), t=9.8, pchild fell asleep, calmed or asked to continue. Nine patients (7.2%) with a median age of 15 months who underwent a single massage session did not show positive behaviour but cried, wriggled or were distressed. Aromatherapy massage seems to be a helpful nonpharmacological approach to reduce hospitalized paediatric burn patients' distress. Future studies with better research designs and validated outcome measures should confirm our findings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  10. Effects of mobility training on severe burn patients in the BICU: A retrospective cohort study. (United States)

    Deng, Huan; Chen, Jian; Li, Frank; Li-Tsang, Cecilia W P; Liu, Qiushi; Ma, Xiaohong; Ao, Ming; Chen, Nan; Zhou, Yaqin; Zhong, Xiaoyun; Chen, Zhiyu; Cao, Lei; He, Guiyang; Wu, Jun


    To assess the effects of mobility training on severe burn patients in the Burn Intensive Care Unit (BICU). This was a retrospective cohort study. Severe burn patients with equal to or more than 50% Total Body Surface Area (TBSA) burns who received early rehabilitation in the BICU were included in this study. Based on the different early rehabilitation strategies during the two periods, patients admitted to the BICU from January 2011 to April 2013 were identified as the passive training cohort (n=49) while patients admitted to the BICU from May 2013 to December 2013 were identified as the mobility training cohort (n=24). Data on length of BICU stay, length of hospital stay, length of rehabilitation in the BICU, ventilator dependent days, strict bed rest time, range of motion (ROM), the Barthel Index (BI) and the Functional Independence Measure (FIM) were collected. Compared with the passive training cohort, patients in the mobility training cohort had significantly shorter length of BICU stay (p=0.002), length of hospital stay (p=0.010), strict bed rest time (pburn patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. Factors influencing psychological, social and health outcomes after major burn injuries in adults: cohort study protocol. (United States)

    Druery, Martha; Newcombe, Peter A; Cameron, Cate M; Lipman, Jeffrey


    The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. Australia New

  12. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, Linus Mattias Valdemar; Jomaas, Grunde


    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... to the predictions of four conceptual models that describe the burning mechanism of multicomponent fuels. Based on the comparisons, hydrocarbon liquids were found to be best described by the Equilibrium Flash Vaporization model, showing a constant gas composition and gasification rate. The multicomponent fuels...... followed the diffusion-limited gasification model, showing a change in the hydrocarbon composition of the fuel and its evaporating gases, as well as a decreasing gasification rate, as the burning progressed. This burning mechanism implies that the residue composition and burning efficiency mainly depend...

  13. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    Directory of Open Access Journals (Sweden)

    Disseldorp Laurien M


    Full Text Available Abstract Background Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children and adolescents after burn injury is limited and pertains only to children with major burns. The current multidimensional study aims to determine the level of physical fitness, the level of physical activity, health-related quality of life and perceived fatigue in children after a burn injury. Furthermore, interrelations between those levels will be explored, as well as associations with burn characteristics. Methods/design Children and adolescents in the age range of 6 up to and including 18 years are invited to participate in this cross-sectional descriptive study if they have been admitted to one of the three Dutch burn centers between 6 months and 5 years ago with a burn injury involving at least 10% of the total body surface area and/or were hospitalized ≥ 6 weeks. Physical fitness assessments will take place in a mobile exercise lab. Quantitative measures of cardiorespiratory endurance, muscular strength, body composition and flexibility will be obtained. Outcomes will be compared with Dutch reference values. Physical activity, health-related quality of life and fatigue will be assessed using accelerometry and age-specific questionnaires. Discussion The findings of the current study will contribute to a better understanding of the long-term consequences of burn injury in children and adolescents after burns. The results can guide rehabilitation to facilitate a timely and optimal physical recovery. Trial registration The study is registered in

  14. Burns: dressings (United States)


    Introduction Burns are classified according to depth. This overview concerns the treatments for partial-thickness burns, which can be expected or have the potential to heal spontaneously (superficial partial-thickness and mid-dermal partial-thickness burns). Injuries that involve the deeper part of the dermis and require surgical treatments to achieve healing are not the focus of this overview. Methods and outcomes We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of treatments for partial-thickness burns? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (BMJ Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this review). Results At this update, searching of electronic databases retrieved 322 studies. After deduplication and removal of conference abstracts, 193 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 160 studies and the further review of 33 full publications. Of the 33 full articles evaluated, two systematic reviews and two RCTs were added at this update. We performed a GRADE evaluation for 30 PICO combinations. Conclusions In this systematic overview, we categorised the efficacy for 10 interventions, based on information relating to the effectiveness and safety of alginate dressing, biosynthetic dressing, chlorhexidine-impregnated paraffin gauze dressing, hydrocolloid dressing, hydrogel dressing, paraffin gauze dressing, polyurethane film, silicone-coated nylon dressing, silver-impregnated dressing, and silver sulfadiazine cream. PMID:26173045

  15. The impact of socio-economic deprivation on burn injury: A nine-year retrospective study of 6441 patients. (United States)

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


    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.

  16. Application of spectral hole burning to the study of in vitro cellular systems

    Energy Technology Data Exchange (ETDEWEB)

    Milanovich, Nebojsa [Iowa State Univ., Ames, IA (United States)


    Chapter 1 of this thesis describes the various stages of tumor development and a multitude of diagnostic techniques used to detect cancer. Chapter 2 gives an overview of the aspects of hole burning spectroscopy important for its application to the study of cellular systems. Chapter 3 gives general descriptions of cellular organelles, structures, and physical properties that can serve as possible markers for the differentiation of normal and cancerous cells. Also described in Chapter 3 are the principles of cryobiology important for low temperature spectroscopy of cells, characterization of MCF-10F (normal) and MCF-7 (cancer) cells lines which will serve as model systems, and cellular characteristics of aluminum phthalocyanine tetrasulfonate (APT), which was used as the test probe. Chapters 4 and 5 are previously published papers by the author pertaining to the results obtained from the application of hole burning to the study of cellular systems. Chapter 4 presents the first results obtained by spectral hole burning of cellular systems and Chapter 5 gives results for the differentiation of MCF-10F and MCF-7 cells stained with APT by an external applied electric (Stark) field. A general conclusion is presented in Chapter 6. Appendices A and B provide additional characterization of the cell/probe model systems. Appendix A describes the uptake and subcellular distribution of APT in MCF-10F and MCF-7 cells and Appendix B compares the hole burning characteristics of APT in cells when the cells are in suspension and when they are examined while adhering to a glass coverslip. Appendix C presents preliminary results for a novel probe molecule, referred to as a molecular thumbtack, designed by the authors for use in future hole burning applications to cellular systems.

  17. Fenoldopam use in a burn intensive care unit: a retrospective study

    Directory of Open Access Journals (Sweden)

    Cotant Casey L


    Full Text Available Abstract Background Fenoldopam mesylate is a highly selective dopamine-1 receptor agonist approved for the treatment of hypertensive emergencies that may have a role at low doses in preserving renal function in those at high risk for or with acute kidney injury (AKI. There is no data on low-dose fenoldopam in the burn population. The purpose of our study was to describe our use of low-dose fenoldopam (0.03-0.09 μg/kg/min infusion in critically ill burn patients with AKI. Methods We performed a retrospective analysis of consecutive patients admitted to our burn intensive care unit (BICU with severe burns from November 2005 through September 2008 who received low-dose fenoldopam. Data obtained included systolic blood pressure, serum creatinine, vasoactive medication use, urine output, and intravenous fluid. Patients on concomitant continuous renal replacement therapy were excluded. Modified inotrope score and vasopressor dependency index were calculated. One-way analysis of variance with repeated measures, Wilcoxson signed rank, and chi-square tests were used. Differences were deemed significant at p Results Seventy-seven patients were treated with low-dose fenoldopam out of 758 BICU admissions (10%. Twenty (26% were AKI network (AKIN stage 1, 14 (18% were AKIN stage 2, 42 (55% were AKIN stage 3, and 1 (1% was AKIN stage 0. Serum creatinine improved over the first 24 hours and continued to improve through 48 hours (p p p p = NS. Modified inotrope score and vasopressor dependency index both decreased over 48 hours (p p = 0.0012. Conclusions These findings suggest that renal function was preserved and that urine output improved without a decrease in systolic blood pressure, increase in vasoactive medication use, or an increase in resuscitation requirement in patients treated with low-dose fenoldopam. A randomized controlled trial is required to establish the efficacy of low-dose fenoldopam in critically ill burn patients with AKI.

  18. [Self-concept level in children with burns sequelae: A comparative study]. (United States)

    Castillo C, Carmen; Santander M, Dolores; Solís F, Fresia


    Self-concept is the set of ideas and attitudes that a person has about him/herself. To evaluate whether there are differences in the level of self-concept in children 8-12 years old with and without burns sequelae. To identify predictive variables of self-concept in children with sequelae. A comparative cross-sectional study of self-concept in 109 children with burns sequelae, from 8 to 12 years old, with 109 children without burns sequelae, and of the same age and socioeconomic status. The Piers-Harris self-concept scale is used, which provides a general measurement of self-concept and behavioural, intellectual and school status, appearance, and physical attributes, anxiety, popularity, happiness and satisfaction dimensions. There were no significant differences in the level of general self-concept or their dimensions (P>.05). In the group with burns sequelae, the protective factor was the variable number of sequels was associated with the dimensions of anxiety, popularity, happiness-satisfaction and general self-concept. The location variable emerged as a risk factor for the behavioural dimension. The absence of differences in self-concept between children with burns sequelae and children without them is similar to that reported in the literature. The finding in the risk and protective factors encourages to further research, and perhaps incorporating pre-morbidity and family background. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Anatomical Study on Commelina diffusa Burn f. and Commelina ...

    African Journals Online (AJOL)


    Commelinaceae) are known from tropical and subtropical regions of the world. In the present work, the leaf epidermal characters, midrib and stem anatomy were studied in relation to their taxonomic values. Voucher specimens collected from different parts of ...

  20. Improving burn care and preventing burns by establishing a burn database in Ukraine. (United States)

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


    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.

  1. Theoretical Study on Nano-Catalyst Burn Rate (United States)


    adsorption energy of 4.98 eV) is associated with formation NH3 and HClO4 molecules as shown in Figure 4. Thus, from the cluster calculations, it...Following the adsorption process of AP on anatase TiO2 (001) surface as well as on TiO2 clusters, the formation of NH3 and HClO4 molecules was studied


    Directory of Open Access Journals (Sweden)

    Ariadna Pires Damaceno


    Full Text Available The infection in burnings is very common, involve of the main mechanism of defense: the skin. Thus,this study aimed to identify and to analyze the measures adopted for the prevention and control of the infectionsrelated to this area. The research was constituted by a case study and data were obtained from systemizeobservation and of a questionnaire applied to the teams medical and of nursing of a unit of handling of burnnings ofthe city of Goiânia. The results showed deficiencies related to the infection control and pointed to the need of thetrainmen and update in infection control as direct patient’s care as in articles processing used for this care.Therefore the adequacy of procedure to the prevention and control of the nosocomial infections becomesnecessary.

  3. Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study. (United States)

    Simons, Megan; Price, Nathaniel; Kimble, Roy; Tyack, Zephanie


    The aim of this study was to understand the impact of burn scars on health-related quality of life (HRQOL) from the perspective of adults and children with burn scars, and caregivers to inform the development of a conceptual model of burn scar HRQOL. Twenty-one participants (adults and children) with burn scars and nine caregivers participated in semi-structured, face-to-face interviews between 2012 and 2013. During the interviews, participants were asked to describe features about their (or their child's) burn scars and its impact on everyday life. Two coders conducted thematic analysis, with consensus achieved through discussion and review with a third coder. The literature on HRQOL models was then reviewed to further inform the development of a conceptual model of burn scar HRQOL. Five themes emerged from the qualitative data: 'physical and sensory symptoms', 'impact of burn scar interventions', 'impact of burn scar symptoms', 'personal factors' and 'change over time'. Caregivers offered further insights into family functioning after burn, and the impacts of burn scars and burn scar interventions on family life. In the conceptual model, symptoms (sensory and physical) of burn scars are considered proximal to HRQOL, with distal indicators including functioning (physical, emotional, social, cognitive), individual factors and the environment. Overall quality of life was affected by HRQOL. Understanding the impact of burn scars on HRQOL and the development of a conceptual model will inform future burn scar research and clinical practice. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  4. Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China (United States)

    Li, Haisheng; Yao, Zhihui; Tan, Jianglin; Zhou, Junyi; Li, Yi; Wu, Jun; Luo, Gaoxing


    Burns are a major cause of injury worldwide. We investigated the epidemiology and outcomes of burn patients in a major burn center in southwest China between 2011 and 2015 to provide guidance for burn prevention. Of the 6,325 included burn patients, 66.8% were male and 34.7% were 0 ~ 6 years old. The incidence of burns peaked in autumn. Scald was the most common cause of burns, which was predominant in patients aged 0 ~ 6 years. The mean total body surface area (TBSA) of burns was 13.4%, and patients with burns ≤10% TBSA comprised 64.1% of all cases. Patients with full-thickness burns accounted for 40.1% of all patients and 81.0% of operated patients; these burns were primarily caused by flame (34.8%), scald (21.0%), and electricity (20.4%). Fifty-six deaths occurred (mortality 0.9%), and risk factors included full-thickness burns, larger TBSA and older age. The median length of stay was 17 days, and major risk factors included more operations, better outcomes and larger TBSA. Our data showed that closer attention should be paid to children under 6 years old, males, incidents in autumn and scald burns to prevent burn injuries. Furthermore, individualized burn prevention and treatment measures based on related risk factors should be adopted. PMID:28383066

  5. Burn Patient Expectations from Nurses

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    Sibel Yilmaz sahin


    Full Text Available AIM: Burn is a kind of painful trauma that requires a long period of treatment and also changes patients body image. For this reason, nursing care of burn patients is very important. In this study in order to provide qualified care to the burned patients, patient and #8217;s expectations from nurses were aimed to be established. METHODS: Patients and #8217; expectations were evaluated on 101 patients with burn in Ministry of Health Ankara Numune Education and Research Hospital Burn Service and Gulhane Military Medical Academy Education and Research Hospital Burn Center. A questionnaire which was developed by the researchers was used for collecting data. The questions on the questionnaire were classified into four groups to evaluate the patients and #8217; expectations about communication, information, care and discharge. Data was evaluated by using SPSS 12 package software. RESULTS: In this study, 48.5% of patients were at 18-28 age group, 79.2% were male and 51.5% of patients were employed. Almost all of patients expect nurses to give them confidence (98% and to give them information about latest developments with the disease. Patients prior expectation from nurses about care was to do their treatments regularly (100% and to take the necessary precautions in order to prevent infection (100%. 97% of patient expect nurses to give them information about the drugs, materials and equipment that they are going to use while discharge. CONCLUSION: As a result we found that burn patient expectations from nurses about communication, information, care and discharge were high. [TAF Prev Med Bull 2014; 13(1.000: 37-46

  6. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India. (United States)

    Daruwalla, Nayreen; Belur, Jyoti; Kumar, Meena; Tiwari, Vinay; Sarabahi, Sujata; Tilley, Nick; Osrin, David


    Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause - accidental or non-accidental, suicidal or homicidal - is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women's understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women's understandable reticence to describe burns as non-accidental. The contested status of

  7. Cost-utility of burns management in Nigeria: a case study of the National Orthopaedic Hospital, Enugu. (United States)

    Okafor, C E; Onunka, O; Idoko, L N


    A major problem of burns is the high cost of management, as well as the discrimination and disability they can cause to patients. Maximising resource utilisation is of key importance for lower-middle-income countries (LMICs) like Nigeria. There is a need to know if Nigerian patients who were victims of burns get the best value for money. This study aimed to evaluate the average cost of managing burns in Nigeria, and determine if the treatment approach is cost-effective. The study was a cost-utility analysis from the perspective of health service providers in Nigeria, a case study of the National Orthopaedic Hospital Enugu (NOHE) using 2013 Microsoft excel. Data on the cost of burn management were obtained from a retrospective study conducted in NOHE in 2012 on 285 patients. Costs were adjusted to reflect the future (2015) value using a real interest rate of 3%. These costs were presented in 2015 US dollars, and a discount rate of 3% was used for both cost and outcome. Health outcome was presented in disability adjusted life years (DALYs). Based on a cost-effectiveness threshold of $2,758.4 (i.e. representing Nigerian GDP/capita), burn management is cost-effective in Nigeria ($526.68/DALY averted). The result also showed that the cost of managing burns in Nigeria is $7,123.28 per patient, which is more than the average income. Burn management in Nigeria is cost-effective but too expensive for most Nigerians to afford.

  8. Study on the pathogenesis of pathophysiological changes of burn systemic infection

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    Li Ao (Ngao


    Full Text Available The present prospective study showed that incidence of systemic infection in severe burn patients was 30.9%. Toxic shock and multiple organ failure (MOF developed in all patients with uncontrolled systemic infection. Both morbidity and mortality of MOF were 76.5%. In the infection group, plasma TXB2 and TXB2/6-keto-PGF1α ratio increased markedly. Their changes were closely correlated with the clinical course and deterioration of systemic infection. Circulatory platelet aggregate ratio decreased significantly, while myocardiac enzyme spectrum greatly increased. Thrombi were observed in visceral tissues from patients dying of systemic infection. These suggested that TXA2/PGI2. imbalance promoting microaggregate and thrombus formation may be one of the pathogenic effects of toxic shock and MOF in burn patients.

  9. Spatial analysis of pediatric burns shows geographical clustering of burns and 'hotspots' of risk factors in New South Wales, Australia. (United States)

    Goltsman, David; Li, Zhe; Bruce, Eleanor; Connolly, Siobhan; Harvey, John G; Kennedy, Peter; Maitz, Peter K M


    Pediatric burns are a significant cause of morbidity and mortality, and it is estimated that more than 80% are preventable. Studies among adults have shown that burns risk are geographically clustered, and higher in socioeconomically-disadvantaged areas. Few studies among children have examined whether burns are geographically clustered, and if burn prevention programs are best targeted to high-risk areas. Retrospective analyses examined the 2005-to-2014 NSW Severe Burns Injury Service data. Geospatial imaging software was used to map the relative-risk and clustering of burns by postcodes in Greater Sydney Area (GSA). Cluster analyses were conducted using Getis-Ord and Global Moran's I statistics. High- and low-risk populations and areas were examined to ascertain differences by sociodemographic characteristics, etiology and the extent of the burn. Scalds were the most common types of burns and boys were at greater risk than girls. There was significant clustering of burns by postcode area, with a higher relative risk of burns in western and north-western areas of Sydney. The high-risk clusters were associated with socioeconomic disadvantage, and areas of low burns risk were associated with socioeconomic advantage. In both high- and low-risk areas burns occurred more frequently in the 12-24 months and the 24-36 months age groups. The implication of this study is that pediatric burns risk clustering occurs in specific geographic regions that are associated with socioeconomic disadvantage. The results of this study provide greater insight into how pediatric populations can be targeted when devising intervention strategies, and suggest that an area-targeted approach in socioeconomically-disadvantaged areas may reduce burns risk. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  10. Effect of intense pulsed light on immature burn scars: A clinical study

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    Arindam Sarkar


    Full Text Available Introduction: As intense pulsed light (IPL is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. Materials and Methods: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. Results: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05 in 13, 14 and 11 scars respectively following IPL treatment. Conclusions: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar.

  11. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

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    Nasir Nur-Azida


    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  12. Effects of pain Scrambler therapy for management of burn scar pruritus: A pilot study. (United States)

    Joo, So Young; Cho, Yoon Soo; Cho, Sung-Rae; Kym, Dohern; Seo, Cheong Hoon


    Pain Scrambler therapy is a patient-specific electrocutaneous nerve stimulation device. Burn pruritus is a common form of chronic and disabling neuropathic pain that is often difficult to treat effectively. Pruritus is mediated by histamines, which are effector molecules stored in mast cells and released locally during injury or inflammation. Burn pruritus may be accompanied by peripheral neuropathic pain, which may result from injury to sensory nerves that hampers conductance of neuronal messages along the large A and small C afferent fibers to the spinal cord. In this study, we investigated the effect of pain Scrambler therapy on burn scar pruritus. Sixteen subjects were recruited to participate in this study. The subjects complained of severe pruritus that was rated at least 5 on the visual analogue scale (VAS), despite treatments with antihistamines, gabapentin medication, and other physical modalities. Each Scrambler Therapy with the MC-5A Pain Scrambler Therapy(®) technology device was performed for 40min daily (Monday through Friday) for 10 consecutive days. The stimulus was increased to the maximum intensity bearable by the individual patient without causing any additional pain or discomfort. The numerical rating scale (NRS), 5-D Itch Scale, and Leuven Itch Scale were administered and evaluated immediately before Scrambler therapy, and then immediately after 5 and 10 therapy sessions. For all 16 patients, NRS showed mean values of 6.75±1.13 before therapy, 5.06±1.53 after 5 sessions, and 4.13±1.45 after 10 sessions. The NRS values before therapy and after 10 sessions were significantly different (ptreatment option for burn survivors with severe pruritus. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  13. Anti-inflammatory agents’ effect on esophageal alkali burn: An experimental study

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    Semih Koçyiğit


    Full Text Available Objective: Corrosive burns of the esophagus are some reports demonstrating that the stricture ratio exceeds 50% in the case of a severe burn. In this experimental animal study of rats, we aimed to investigate the effects of the anti-inflammatory agents in esophageal alkali burns. Methods: Twenty-eight Wistar albino rats, weighing from 220 to 250 gr, were used in the study. And following a starving period of 12 hours, we provided general anesthesia with intramuscular ketamin HCL (90 mg/kg and xylazine (10mg/kg. A corrosive burn just like the corrosive esophagitis was done under general anesthesia. The rats were divided into four groups (7 rats for each. The intraluminal area of 1cm in the esophagus of the rats of the first group was washed using serum physiologic (1 ml. Group II received parenteral antibiotic treatment. Group III received antibiotic and dexamethasone regiment, while the Group IV received antibiotic and prednisolone. Each animal was sacrificed on the 21st day, and their abdominal esophagus was resected for histopathological investigation. The submucosal increase in the collagen, damage to the muscularis mucosa and to the tunica muscularis were three parameters demonstrating the injury histopathologically. Results: There was no injury in the Group I. There was injury in each parameter in the Group II, III, and IV compared with Group I. In the comparison between Group II and III, there was less injury in the Group III. In comparison with Group II there was also significant injury in the muscularis mucosa and the tunica muscularis in the Group I (p<0.05. Conclusion: Prednisolone may decrease the new collagen synthesis that progresses up to muscularis mucosa, but the effect on the lowering the stricture formation is not better than dexamethasone.

  14. Burns dressings. (United States)

    Douglas, Helen E; Wood, Fiona


    Burn injuries are common and costly; each year, there are more than 200,000 cases, costing the Australian community $150 million. Management of smaller burn injuries in the community can be improved by appropriate first aid, good burn dressings and wound management. This can reduce the risk of the burn becoming deeper or infected, and can potentially reduce the requirement for specialist review or surgery. The objective of this article is to provide healthcare professionals with information about the pathophysiology of burn wound progression. This information includes the aims of burn wound dressings and indications for different types of dressings in different burn depths, advantages of blister debridement, and the reasoning behind advice given to patients after healing of the burn wound. This article provides a framework used by the State Burn Service of Western Australia, by which clinicians can understand the needs of a specific burn wound and apply these principles when choosing an appropriate burn dressing for their patient. Every intervention in the journey of a patient with a burn injury affects their eventual outcome. By managing all burn injuries effectively at every single step, we can reduce burn injury morbidity as a community.

  15. Management of pediatric hand burns. (United States)

    Liodaki, Eirini; Kisch, Tobias; Mauss, Karl L; Senyaman, Oezge; Kraemer, Robert; Mailänder, Peter; Wünsch, Lutz; Stang, Felix


    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. Secondary organic aerosol formation in biomass-burning plumes: Theoretical analysis of lab studies and ambient plumes


    Bian, Qijing; Jathar, Shantanu H.; Kodros, John K.; Barsanti, Kelley C.; Hatch, Lindsay E.; May, Andrew A.; Kreidenweis, Sonia M.; Pierce, Jeffrey R.


    Secondary organic aerosol (SOA) has been shown to form in biomass-burning emissions in laboratory and field studies. However, there is significant variability among studies in mass enhancement, which could be due to differences in fuels, fire conditions, dilution, and/or limitations of laboratory experiments and observations. This study focuses on understanding processes affecting biomass-burning SOA formation in laboratory smog-chamber experiments and in ambient plumes. Vapor wall losses hav...

  17. Study on nuclear physics of high burn-up full MOX-BWR core

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    Shirakawa, Toshihisa; Okubo, Tsutomu; Ochiai, Masa-aki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment


    In this report, neutronics study of full Mixed-oxide (MOX) high burn-up BWR core is presented. Our design goals are about 3-year cycle length, four-batch refueling scheme and more than 100GWd/t fuel discharge burn-up. Base core configuration is 1,350MWe US version of ABWR with 9 x 9 type fuel assembly. Investigation of the reactor core has been carried out by arranging Gd{sub 2}O{sub 3} contents in fuel rods and changing water to fuel volume ratio (V{sub m}/V{sub f}) through the number of water rods or adjustment of fuel clad diameter. JAERI`s general purpose neutronics code system SRAC95 was used for two dimensional XY fuel assembly cell neutronics calculations. Calculated cases are for a comparatively high moderated fuel assembly with 9 water rods, a fuel assembly without water rods and a comparatively low moderated fuel assembly without water rods and with larger fuel clad diameter. All these 3 cases seem to achieve our design goals mentioned above. For the last case, three dimensional core burn-up calculation was performed by this code system. This case seems to attain a low linear power density and the operation with all control rod out. (author)

  18. Boston Keratoprosthesis Outcomes in Severe Ocular Chemical Burns in Southern China: A Retrospective Study. (United States)

    Gu, Jianjun; Zhai, Jiajie; Zhou, Sheng; Chen, Jiaqi


    The objective of this study was to report clinical outcomes (functional and anatomic) of Boston keratoprosthesis (KPro) after severe chemical burns in Southern China. Nineteen patients (19 eyes) that sustained severe chemical injuries in Southern China were enrolled in this retrospective study in our hospital between May 2009 and June 2015. KPro implantation in these patients was performed by a single experienced surgeon (Jiaqi Chen). The parameters evaluated in this study included diagnosis, comorbidity, preoperative and postoperative visual acuity (VA), complications, KPro retention, histological and immunohistochemical results of retroprosthetic membrane (RPM) and mucous membrane over the optic cylinder. The mean age of the patients was 42.7 ± 11.3 years (range 29-62 years). All patients were male. Of the 19 included eyes, nine had acid burns, and 10 had alkali burns. Ten patients had previously undergone failed penetrating keratoplasty. The mean follow-up time was 41.3 ± 5.5 months (range 36-56 months). Preoperatively, the VA of the patients ranged from hand movement to light perception. Postoperatively, 17 patients (89.4%) achieved at least 20/200 once, and 7 patients (36.8%) achieved at least 20/200 and maintained this acuity until the last follow-up. The initial KPro was retained in 14 (73.6%) eyes and successfully replaced in one eye. Postoperative complications included RPM in 10 eyes, glaucoma in 6 eyes, retinal detachment in 2 eyes, corneal melting in 5 eyes, ischemic optic neuropathy in 1 eye, and overgrowth of the mucous membrane over the optical cylinder in 2 eyes. The histological and immunohistochemical results of the RPM showed granulomatous disorders and mucous membrane over the optic cylinder of conjunctival origin. KPro surgery can restore useful vision in patients suffering from severe chemical burns. However, postoperative VA declined with the development of complications, and ocular surface disorders caused by the chemical burns

  19. Chemical Debridement of Burns (United States)

    Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli


    The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and

  20. Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001-2004: An observational register based study

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    Laflamme L


    Full Text Available Abstract Background Burns are a persisting public health problem in low- and middle-income countries; however, epidemiologic data for these settings is scarce. South Africa is no exception although there is an emerging knowledge base, especially for paediatric burns. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001, one of the six South African metropolitan centres. Methods The distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using four year (2001 to 2004 surveillance data from the National Injury Mortality Surveillance System (n = 1024 cases. Results Burn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI: 7.3-8.3. Males sustained fatal rates 2.2 times more than that for females (p Conclusion Besides paediatric burns, the high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that there be greater prioritisation of prevention activities that involve the control or management of kerosene heat sources, the provision of alternatives to flammable housing materials, and the implementation of strategies to reduce harmful drinking practices.

  1. [The pain from burns]. (United States)

    Latarjet, J


    The painful events associated with the treatment of a severe burn can, because of their long-lasting and repetitive characteristics, be one of the most excruciating experiences in clinical practice. Moreover, burn pain has been shown to be detrimental to burn patients. Although nociception and peripheral hyperalgesia are considered the major causes of burn pain, the study of more hypothetical mechanisms like central hyperalgesia and neuropathic pain may lead to a better understanding of burn pain symptoms and to new therapeutic approaches. Continuous pain and intermittent pain due to therapeutic procedures are two distinct components of burn pain. They have to be evaluated and managed separately. Although continuous pain is by far less severe than intermittent pain, the treatment is, in both cases, essentially pharmacological relying basically on opioids. Because of wide intra- and inter-individual variations, protocols will have to leave large possibilities of adaptation for each case, systematic pain evaluation being mandatory to achieve the best risk/benefit ratio. Surprisingly, the dose of medication decreases only slowly with time, a burn often remaining painful for long periods after healing. Non pharmacological treatments are often useful and sometimes indispensable adjuncts; but their rationale and their feasibility depends entirely on previous optimal pharmacological control of burn pain. Several recent studies show that burn pain management is inadequate in most burn centres.

  2. Landsat-Based Detection and Severity Analysis of Burned Sugarcane Plots in Tarlac, Philippines Using Differenced Normalized Burn Ratio (dNBR) (United States)

    Baloloy, A. B.; Blanco, A. C.; Gana, B. S.; Sta. Ana, R. C.; Olalia, L. C.


    The Philippines has a booming sugarcane industry contributing about PHP 70 billion annually to the local economy through raw sugar, molasses and bioethanol production (SRA, 2012). Sugarcane planters adapt different farm practices in cultivating sugarcane, one of which is cane burning to eliminate unwanted plant material and facilitate easier harvest. Information on burned sugarcane extent is significant in yield estimation models to calculate total sugar lost during harvest. Pre-harvest burning can lessen sucrose by 2.7% - 5% of the potential yield (Gomez, et al 2006; Hiranyavasit, 2016). This study employs a method for detecting burn sugarcane area and determining burn severity through Differenced Normalized Burn Ratio (dNBR) using Landsat 8 Images acquired during the late milling season in Tarlac, Philippines. Total burned area was computed per burn severity based on pre-fire and post-fire images. Results show that 75.38% of the total sugarcane fields in Tarlac were burned with post-fire regrowth; 16.61% were recently burned; and only 8.01% were unburned. The monthly dNBR for February to March generated the largest area with low severity burn (1,436 ha) and high severity burn (31.14 ha) due to pre-harvest burning. Post-fire regrowth is highest in April to May when previously burned areas were already replanted with sugarcane. The maximum dNBR of the entire late milling season (February to May) recorded larger extent of areas with high and low post-fire regrowth compared to areas with low, moderate and high burn severity. Normalized Difference Vegetation Index (NDVI) was used to analyse vegetation dynamics between the burn severity classes. Significant positive correlation, rho = 0.99, was observed between dNBR and dNDVI at 5% level (p = 0.004). An accuracy of 89.03% was calculated for the Landsat-derived NBR validated using actual mill data for crop year 2015-2016.

  3. Study of complement activation, C3 and interleukin-6 levels in burn patients and their role as prognostic markers

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    S Modi


    Full Text Available Purpose: The management of burn patients is always challenging for the clinician due to high risk of bacterial sepsis, multi-organ failure and death. Our objective was to study complement activation, C3 and interleukin-6 (IL-6 levels in burn patients and evaluate their role as prognostic markers. Materials and Methods: A total of 63 burn patients and 60 healthy controls were included in this study. Blood was collected from patients within 24 h and at 7 th day of injury. Complement activation was determined by crossed electrophoresis and counter-current immunoelectrophoresis. C3 levels were measured using a single radial immunodiffusion. IL-6 was detected by ELISA. Results: All patients showed initial complement activation. Mean C3 levels showed an inverse correlation with the severity of burn. Patients with ≥20% burns had lower C3 than the controls (P < 0.001 and those with <20% burns (P < 0.001. Patients with ≥40% burns had activated complement and low C3 in 2 nd week; they subsequently developed infection. Complement was inactive and C3 levels recovered in patients with <40% burns. The non-survivors showed significantly lower C3 than the survivors (P < 0.05 in 2 nd samples. Patients who developed infection had C3 significantly lower than those who remained free of infection (P < 0.05. All patients showed initial elevation in IL-6 levels. Patients with ≥60% burns had significantly higher IL-6 than controls (P < 0.001 and those with <60% burns (P < 0.001. Non-survivors had higher IL-6 than survivors in both samples (P < 0.001. Patients who developed infection showed significantly higher IL-6 in 2 nd samples than those without infection (P < 0.001. Conclusions: Complement activation, C3 and IL-6 levels correlated well with the severity of injury and development of infection in burn patients. These parameters can be used to predict the onset of infection, septicaemia and mortality in burn patients.

  4. Burn mortality in Iraq. (United States)

    Qader, Ari Raheem


    Mortality rates are important outcome parameters after burn, and can serve as objective end points for quality control. Causes of death after severe burn have changed over time. In a prospective study, eight hundred and eighty-four burn patients were admitted to the Burns and Plastic surgery Hospital in Sulaimani-Kurdistan region of Iraq in 2009. Age, gender, nationality, cause of burn, extent of injury, cause of death and mortality rate were tabulated and analyzed, 338 (38.2%) were male and 546 (61.8%) were female. The highest number of cases occurred in January, with the highest short period incidence occurring in April. Out of 884 cases, 260 persons died. Burn injuries were more frequent and larger with higher mortality in females than in males. Flame was the major cause of burns. Self-inflicted burns were noted mainly in young women. A large number of burns which affect children and females, occur in the domestic setting and could have been prevented. Therefore, it is necessary to implement programs for health education relating to prevention of burn injuries focusing on the domestic setting. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  5. Nutritional Therapy in Burns

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    Muzaffer Durmuş


    Full Text Available A burn is characterized by the damage to one’s body tissues caused by heat, chemicals, electricity, or radiation. The incidence of burn injuries has recently been decreasing. However, it is a fact that burns constitute a significant problem all over the world, with a few million people being affected by burns each year. A burn is an extensive trauma that affects the whole organism and determines the prognosis through its physiopathology. The case of the burn patient is also characterized by the acute phase response. Since burn patients have a non-functional skin barrier, they experience loss of liquids, minerals, proteins and electrolytes. They can also develop protein, energy and micro-nutrition deficiencies due to intense catabolic processes, infections and increased bodily needs in case of wound healing. Therefore, nutritional therapy is one of the major steps that need to be monitored from the initial moments of the burn injury through to the end of the burn treatment. This study focuses on the significance of nutritional therapy for burn patients in the light of current literature.

  6. Iatrogenic Burns

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    Burak Kaya


    Full Text Available Iatrogenic burns are rare complications that can occur after using medical devices and chemicals in hospitals. Usually, these burns are deep and cause additional morbidity to patients. In this article, 6 iatrogenic burn patients referred to our department are presented, and predisposing factors and preventive measures are discussed.

  7. Using satellite image-based maps to improve sugarcane straw burning emission estimates in the state of São Paulo, Brazil (United States)

    França, D.; Longo, K.; Rudorff, B.; Aguiar, D.; Freitas, S. R.; Stockler, R.; Pereira, G.


    Since the last decade, the global demand for biofuel production has been increasing every year due to the growing need for energy supply security and mitigation of greenhouse gases (GHG). Currently, sugarcane ethanol is one of the most widely used biofuels and Brazil is already the world's largest sugarcane producer, devoting almost 50% of it to ethanol production. The state of São Paulo is the major sugarcane producer in this country, with a cultivated area of about 5.4 Mha in 2011. Approximately 2 million hectares were harvested annually from 2006 to 2011 with the pre-harvest straw burning practice, which emits trace gases and particulate material to the atmosphere. The assessment and monitoring of sugarcane burning impacts are fundamental in order to mitigate the negative impacts of pre-harvest burning and consolidate the environmental benefits of sugarcane ethanol. Although some official inventories created by the Brazilian government have indicated the prevalence of emissions from sugarcane straw burning in total agricultural residue emissions, specific information about emissions of gases and aerosols during pre-harvest burning of sugarcane is still scarce in Brazil. This study aimed to contribute to the improvement of estimates of emissions from sugarcane burning through the use of specific parameters for sugarcane straw burning and a method which has avoided underestimations resulting from the unique characteristics of this type of biomass fire. In this investigation, emissions of several air pollutants released by sugarcane burning during the harvest season were estimated through the integrated use of remote sensing based maps of sugarcane burned area and a numerical tool for the state of São Paulo from 2006 to 2011. Average estimated emissions (Gg/year) were 1,130 ± 152 for CO, 26 ± 4 for NOX, 16 ± 2 for CH4, 45 ± 6 for PM2.5, 120 ± 16 for PM10 and 154 ± 21 for NMHC (non-methane hydrocarbons). An intercomparison among annual emissions from this

  8. Water First Aid Is Beneficial In Humans Post-Burn: Evidence from a Bi-National Cohort Study. (United States)

    Wood, Fiona M; Phillips, Michael; Jovic, Tom; Cassidy, John T; Cameron, Peter; Edgar, Dale W


    Reported first aid application, frequency and practices around the world vary greatly. Based primarily on animal and observational studies, first aid after a burn injury is considered to be integral in reducing scar and infection, and the need for surgery. The current recommendation for optimum first aid after burn is water cooling for 20 minutes within three hours. However, compliance with this guideline is reported as poor to moderate at best and evidence exists to suggest that overcooling can be detrimental. This prospective cohort study of a bi-national burn patient registry examined data collected between 2009 and 2012. The aim of the study was to quantify the magnitude of effects of water cooling first aid after burn on indicators of burn severity in a large human cohort. The data for the analysis was provided by the Burn Registry of Australia and New Zealand (BRANZ). The application of first aid cooling prior to admission to a dedicated burn service, was analysed for its influence on four outcomes related to injury severity. The patient related outcomes were whether graft surgery occurred, and death while the health system (cost) outcomes included total hospital length of stay and admission to ICU. Robust regression analysis using bootstrapped estimation adjusted using a propensity score was used to control for confounding and to estimate the strength of association with first aid. Dose-response relationships were examined to determine associations with duration of first aid. The influence of covariates on the impact of first aid was assessed. Cooling was provided before Burn Centre admission for 68% of patients, with at least twenty minutes duration for 46%. The results indicated a reduction in burn injury severity associated with first aid. Patients probability for graft surgery fell by 0.070 from 0.537 (13% reduction) (p = 0.014). The probability for ICU admission fell by 0.084 from 0.175 (48% reduction) (pfirst aid. The size of burn and age interacted

  9. Perspectives of caregivers towards physiotherapy treatment for children with burns in Harare, Zimbabwe: A cross-sectional study


    Chiwaridzo, Matthew; Zinyando, Vimbayinashe Juliet; Dambi, Jermaine Matewu; Kaseke, Farayi; Munambah, Nyaradzai; Mudawarima, Tapfuma


    Background Physiotherapy is an integral part of treatment for paediatric burns. In Zimbabwe, children are admitted in paediatric burn unit with their caregivers, who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy, which is often uncomfortable or painful to the patient. The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospital...

  10. Management of Hand Burns

    Directory of Open Access Journals (Sweden)

    Fatih Irmak


    Full Text Available Objective: The hand is one of the most frequently affected body parts by burn injuries with a rate of 80% among all burn wounds. Early and effective treatment ensures the best chance of survival as well as a good functional prognosis. The aim of this study was to determine the epidemiology, variation, relationship between etiology and hospital stay, clinical features, and management of hand burns. Material and Methods: This retrospective study was conducted the University of Health Sciences; Şişli Hamidiye Etfal Application and Research Center, Departmant of Plastic, Reconstructive and Aesthetic Surgery and the Intensive Burn Care Unit between April 2009 and April 2014. Burns were assessed based on etiology, anatomical location, percentage of total body surface area affected, and depth of injury. Treatment was categorized as conservative, elective operative, or urgent operative. Results: In the study period, 788 patients were admitted to our Burn Unit. Of these, 240 were females (30.5% and 548 were males (69.5%. The most common type of burn injury in this study was thermal injury (695 cases; 88.2%, followed by electrical injury (67 cases; 8.5%, and chemical, frictional or unknown injuries (26 cases; 3.3%. Majority (more than 85% of the patients had second-degree burns, and some had third-degree burns. Conclusions: Burns commonly affect the hands, and many functional problems may develop if appropriate basic treatments are neglected. The best treatment for burns is prevention. Appropriate indoor arrangement and simple but effective measures that can be taken at home can significantly reduce burn trauma exposure.

  11. Studying the Infleunce of Burning Fireworks on Air Quality and Human Health in a Residential Area (United States)

    Kota, S. H.; Garaga, R.


    India observes Diwali as the celebration of lights, which fully brightens the nation with its splendour, and amazes all with its happiness. To understand the impact of fireworks on air quality and human health, a ten-day short term study was conducted in one of the residential colleges in North-East India. The PM10 concentration during fireworks was 311µg/m3, which was 81% higher than a normal day. Additionally, ambient noise level measured during fireworks day was found to be 101 dB, which was 65% higher than a normal day's mean noise level. SO42-, NO3-, Cl-, F-, Na+, Ca2+, NH4+, K+, Zn, Fe, Cd, Co, Ni and Sr increased by 1.29, 0.51, 0.48, 1.08, 0.6, 0.54, 1.79, 1.43, 1.72, 0.34, 0.42, 0.82, 0.56, 0.17 times respectively, on fireworks compared to a normal day. Additionally, microorganisms decreased by 40% to the concentration of CFU/m3, on fireworks day. This implies that the fireworks burning inhibit the growth of microbial activity. The source apportionment studies carried out using principal component analysis revealed five factors related to fireworks, construction activities, biomass burning, vehicle emission and industries. The average number of patients in the hospital increased three folds, evidently signifying the negative impact of fireworks on human health. Patients suffering from cough, sneezing, headache and nasal congestion increased by 64, 69, 65 and 82%, respectively. This study stresses the importance of regulated and monitored practice of burning of fireworks in regions with high population density.

  12. Burns and epilepsy. (United States)

    Berrocal, M


    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.

  13. Case study: The World is Burning (Krogerup Højskole), DK

    DEFF Research Database (Denmark)

    Milana, Marcella; Bernt Sørensen, Tore


    . The course The World is Burning, which is being the specific objective of an in-depth case study, is, to the authors? acknowledgement, a unique example of non formal learning activity aimed at rising political awareness among well-educated young adults in Denmark, which is worth special attention for several.......g. knowledge sharing on the political situation effecting less economically developed countries at local and national level. Secondly the course seems to respond to the need of enhancing internal political efficacy among the young population. In fact, as a recent research report on political efficacy1 has...

  14. Toxic shock syndrome toxin level in wound samples of hospitalized children with burn: a case control study

    Directory of Open Access Journals (Sweden)

    Shima Javadinia


    Full Text Available Background: Toxic shock syndrome (TSS, a dangerous consequence of Toxic shock syndrome toxin-1 (TSST-1 caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the pre-vention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 pro-duction. Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound’s specimens of two groups febrile and afebrile in the hospitalized burned chil-dren in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile (cases group and afebrile (control group. All of burned children under went wound biopsy, and then all of wound’s specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR. Results: The positive result for PCR test, production of TSST-1 in febrile burned chil-dren (cases group was 37.7% and in afebrile burned children (control group was 11.1% that this different was statistically significant (P=0.003. The mean and stan-dard deviation for percentage of burned surface (severity in samples with positive re-sult for PCR test was 30.9±16.93 and in samples with negative result for PCR test was 20.09±11.02 that this different was statistically significant (P=0.01. There was no dif-ference between positive PCR result and negative PCR result of age and sex. Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity of burns also re-lated to the production of TSST-1. Further research is recommended.

  15. Hypnosis for reduction of background pain and pain anxiety in men with burns: A blinded, randomised, placebo-controlled study. (United States)

    Jafarizadeh, Hossein; Lotfi, Mojgan; Ajoudani, Fardin; Kiani, Arezou; Alinejad, Vahid


    'Background pain' and 'pain anxiety' are among the numerous problems of patients with burns. Non-pharmacological and pharmacological interventions have been used to reduce background pain and pain anxiety. This study compared the effectiveness of hypnosis and 'neutral hypnosis' (as a placebo in the control group) in decreasing the background burn pain and pain anxiety of adult male survivors with burns. This is a blinded, randomised, placebo-controlled study. Sixty men with burns were included in the minimisation method (30 individuals in the intervention group and 30 individuals in the control group). Four hypnotherapy sessions were performed every other day for each participant in the intervention group. Four neutral hypnosis sessions were performed every other day in the control group. Burn pain and pain anxiety of the patients in both groups were measured at the end of the second and fourth sessions. Repeated measures ANOVA was used for data analysis. There was no significant difference between the groups in the reduction in background pain intensity. There was a significant reduction in background pain quality and pain anxiety in the intervention group during the four hypnosis sessions. After two hypnotherapy sessions, a significant reduction was observed in the level of background pain quality and pain anxiety of participants. Hypnosis is effective in reducing background pain quality and pain anxiety of men with burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  16. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir


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

  17. Fuel assembly assessment from CVD image analysis: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Lindsay, C.S.; Lindblad, T. [Royal Inst. of Tech., Stockholm (Sweden). Dept. of Physics


    The Swedish Nuclear Inspectorate commissioned a feasibility study of automatic assessment of fuel assemblies from images obtained with the digital Cerenkov viewing device currently in development. The goal is to assist the IAEA inspectors in evaluating the fuel since they typically have only a few seconds to inspect an assembly. We report results here in two main areas: Investigation of basic image processing and recognition techniques needed to enhance the images and find the assembly in the image; Study of the properties of the distributions of light from the assemblies to determine whether they provide unique signatures for different burn-up and cooling times for real fuel or indicate presence of non-fuel. 8 refs, 27 figs.

  18. The safety of nanocrystalline silver dressings on burns: a study of systemic silver absorption. (United States)

    Vlachou, Evangelia; Chipp, Elizabeth; Shale, Elizabeth; Wilson, Yvonne T; Papini, Remo; Moiemen, Naiem S


    Wound dressings containing silver have been in widespread use for many years. However, there are few quantitative data on the systemic absorption of silver or whether there is associated clinical risk. To assess systemic silver levels when Acticoat dressings containing nanocrystalline silver were used, and to determine whether increases in such levels were associated with haematological or biochemical indicators of toxicity. A prospective, single-centre, open-label study of 30 patients with relatively small burns that required skin grafting. Serum silver levels were measured before, during and at discontinuation of the use of the Acticoat dressings, and again at 3 and 6 months following completion of treatment. The median total postoperative wound size was 12% of the total body surface area. The median time to maximum silver levels was 9 days. The median maximum serum silver level was 56.8 microg/l. The median serum level at 6 months was 0.8 microg/l. There were no haematological or biochemical indicators of toxicity associated with the silver absorption observed in this study. This study has confirmed our view that Acticoat products are safe for use on burns and they remain a standard part of treatment at our centre.

  19. A case study on biomass burning aerosols: effects on aerosol optical properties and surface radiation levels

    Directory of Open Access Journals (Sweden)

    A. Arola


    Full Text Available In spring 2006, biomass burning aerosols from eastern Europe were transported extensively to Finland, and to other parts of northern Europe. They were observed as far as in the European Arctic. In the first part of this paper, temporal and spatial evolution and transport of these biomass burning aerosols are monitored with MODIS retrieved aerosol optical depth (AOD imagery at visible wavelengths (0.55 μm. Comparison of MODIS and AERONET AOD is conducted at Tõravere, Estonia. Then trajectory analyses, as well as MODIS Fire Mapper products are used to better understand the type and origin of the air masses. During the studied four-week period AOD values ranged from near zero up to 1.2 at 0.55 μm and the linear correlation between MODIS and AERONET was very high (~0.97. Temporal variability observed within this four-week period was also rather well explained by the trajectory analysis in conjunction with the fire detections produced by the MODIS Rapid Response System. In the second part of our study, the surface measurements of global and UV radiation at Jokioinen, Finland are used to study the effect of this haze episode on the levels of surface radiation. We found reductions up to 35% in noon-time surface UV irradiance (at 340 nm as compared to typical aerosol conditions. For global (total solar radiation, the reduction was always smaller, in line with the expected wavelength dependence of the aerosol effect.

  20. Drug utilization study in a burn care unit of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Santoshkumar R Jeevangi


    Full Text Available Objective: To evaluate drug utilization and associated costs for the treatment of patients admitted in burn care unit of a tertiary care hospital. Methods: A prospective cross sectional study was conducted for a period of 15 months at Basaweshwara Teaching and General Hospital (BTGH, Gulbarga and the data collected was analyzed for various drug use indicators. Results: A total of 100 prescriptions were collected with 44% belonging to males and 56% to females. The average number of drugs per prescription ranged from 4.5 to 9.5. 9.5% of generics and 92% of essential drugs were prescribed. The opioid analgesics and sedatives were prescribed to all the patients who were admitted in burn care unit. The (Defined daily dose DDD/1 000/day for amikacin (359 was the highest followed by diclofenac sodium (156, pantoprazole (144, diazepam (130, ceftazidime (124, tramadol (115, ceftriaxone (84 and for paracetamol (4 which was the lowest. Conclusions: Significant amount of the money was spent on procurement of drugs. Most of the money was spent on prescribed antibiotics. The prescription of generic drugs should be promoted, for cost effective treatment. Hence the results of the present study indicate that there is a considerable scope for improvement in the prescription pattern.


    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Dora


    Full Text Available BACKGROUND Burn is one of the most devastating condition. It is seen in all age groups from a baby to the elderly. Burn injuries pose a big challenge to the medical fraternity. Burn injuries can have an effect on the skin, respiratory, cardio vascular, renal, haematological, G.I, musculoskeletal, eye, immune system, metabolism and nutrition. Burns may be Superficial or partial thickness where the epidermis is involved, full thickness when all the layers of skin are involved and deep burn. MATERIALS AND METHODS Total of 64 patients who have attended the OPD and Casualty with burn injuries and given consent for the study were studied in a period of 2 years duration in the Department of Surgery, S.C.B. Medical College and Hospital, Cuttack. RESULTS Burn injury is a common health hazard. These injurues are seen in low socio economic status because of poverty, overcrowding, poor condition of living and ignorance regarding precautions to be taken during fire accidents Incidence is high in females. Male burns are attributed to. Male burns may be attributed to alcohol, smoking and domestic violence which is seen in our study. Burns can be due to accidents, suicidal or homicidal. The percentage of body surface area in burns is calculated as per Wallace rule of nine’s. It helps to estimate the percentage of burn and the fluid estimation is done. Burn injuries produce irreversible cell protein denaturation. Cytoplasmic coagulation, blockage of thermolabile enzymes and cell death. Most burn deaths occur in the developing world particularly in South East Asia CONCLUSION Burn injuries are frequently seen. The contribute to almost 20% of admissions in the tertiary care hospitals. In the present study in S.C.B. Medical College and hospital, Cuttack, Odisha female burn patients in the third decade of life was the commonest. Those patients are mostly house wives and they have a close proximity to the kitchen. Some of the deaths were dowry related and are either

  2. Experimental Study on the Burning Behavior of Pool Fires in Rooms with Different Wall Linings

    DEFF Research Database (Denmark)

    Poulsen, Annemarie; Jomaas, Grunde


    An experimental test series, comprising 10 experiments with varying pool sizes, lining materials and amounts of liquid burning, was conducted under free burn and room burn conditions. The thermal feedback from the enclosure (ISO 9705 Room Corner Test facility) enhanced the burning rate of the pools...... and resulted in a thermal runaway in some of the runs. The onset of the thermal runaway, which can be associated with flashover, varied with all the input parameters. The lining with the lowest thermal inertia lead to the fastest increase in the heat release rate (HRR) in the enclosure and caused flashover...... in the shortest time. Given the profound difference between the enclosure tests and the free burn tests and also between enclosure tests with different linings, it is recommended to show great caution if free burn tests are to be used in design fire scenarios....

  3. A New Metric for Quantifying Burn Severity: The Relativized Burn Ratio

    Directory of Open Access Journals (Sweden)

    Sean A. Parks


    Full Text Available Satellite-inferred burn severity data have become increasingly popular over the last decade for management and research purposes. These data typically quantify spectral change between pre-and post-fire satellite images (usually Landsat. There is an active debate regarding which of the two main equations, the delta normalized burn ratio (dNBR and its relativized form (RdNBR, is most suitable for quantifying burn severity; each has its critics. In this study, we propose and evaluate a new Landsat-based burn severity metric, the relativized burn ratio (RBR, that provides an alternative to dNBR and RdNBR. For 18 fires in the western US, we compared the performance of RBR to both dNBR and RdNBR by evaluating the agreement of these metrics with field-based burn severity measurements. Specifically, we evaluated (1 the correspondence between each metric and a continuous measure of burn severity (the composite burn index and (2 the overall accuracy of each metric when classifying into discrete burn severity classes (i.e., unchanged, low, moderate, and high. Results indicate that RBR corresponds better to field-based measurements (average R2 among 18 fires = 0.786 than both dNBR (R2 = 0.761 and RdNBR (R2 = 0.766. Furthermore, the overall classification accuracy achieved with RBR (average among 18 fires = 70.5% was higher than both dNBR (68.4% and RdNBR (69.2%. Consequently, we recommend RBR as a robust alternative to both dNBR and RdNBR for measuring and classifying burn severity.

  4. Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study. (United States)

    Wang, Hai-Xia; Li, Yu-Xiang; Zhou, Ru-Zhen; Zhao, Ji-Jun


    Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  5. Influence of early childhood burns on school performance: an Australian population study. (United States)

    Azzam, Nadin; Oei, Ju-Lee; Adams, Susan; Bajuk, Barbara; Hilder, Lisa; Mohamed, Abdel-Latif; Wright, Ian M R; Holland, Andrew J A


    To determine the influence of burn injuries on childhood performance in national standardised curriculum-based school tests. Birth and health records of 977 children who were hospitalised with a burn injury between 2000 and 2006 in the state of New South Wales, Australia, were linked to performance scores in the National Assessment Program: Literacy and Numeracy test, a compulsory nationwide curriculum-based test (CBT) and compared with children who were not hospitalised for burns and who were matched for birth year, gender, gestation and socioeconomic status. Test scores in years 3 (ages 8-9), 5 (ages 10-11) and 7 (ages 13-14) in numeracy, writing, reading, spelling, grammar and punctuation. Mean age at first burn injury was 28 months (median: 20, range: 0-140). Children with burns were significantly more likely to have younger mothers (28.5 vs 29.6 years) (Pwriting. Most childhood burn injuries occur before the start of formal schooling. Children who are hospitalised for burns perform more poorly in CBT even after accounting for family and socioeconomic disadvantage. Rehabilitation of children with burn injuries must address school performance to decrease any long-term negative societal impact of burns. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. [An epidemiological investigation of pediatric patients under 14 with large area burns: a multicenter study]. (United States)

    Cheng, W F; Zhao, D X; Shen, Z A; Zhang, H Y; Tu, J J; Yuan, Z Q; Duan, P; Song, G D


    Objective: To investigate and evaluate the epidemiological characteristics of patients under 14 with large area burns in China. Methods: Data of pediatric patients aged 0-14yr with ≥30% total body surface area (TBSA) burned admitted into 106 burn centers in the mainland of China in 2014 were retrieved. The children were divided into three age groups: 0-3, 4-6 and 7-14 years according to the age. Information of age, gender, time of burn injury, causes of burns, admission time, prehospital emergency care of burn wound, burn area, inhalation injuries, the case fatality rate and length of hospital stay were collected for analysis. Results: Of the 486 cases included, 285 (58.6%) were boys and 201 (41.4%) were girls. The mean age of the children was (3.4±2.8) years. Children under 3 years old accounted for 67.5% of all the cases. 271 of the burn injuries (55.8%) occurred from April through August. Scalds and flames were the main causes of burns, which were the causes of 394 cases (81.1%) and 71 cases (14.6%), respectively. The burn injuries resulted from scalds and flames accounted for 89.6% and 7.3%, 70.8% and 21.9%, 51.6% and 41.9% in the age group of 0-3, 4-6 and 7-14 years respectively. The distribution of burn etiology in different age groups differed significantly (χ(2)=21.239, 59.442, 7.333, all Parea of 236 patients (48.6%) were treated improperly with toothpaste, soy sauce, eggs or other non-standard disposal. The mean TBSA area of the patients was (42.1±14.5)%, while 288 (59.3%) of the patients suffered full thickness burns with mean TBSA of (24.5±17.9)%. The case fatality rate (CFR) was 4.1%, and the CFR of patients complicated with inhalation injury was significantly higher than those without (P<0.01). The average length of stay for pediatric burn patients was (52.3±40.2) days. Conclusions: Children under 3 years old are important target population of severe burns. Scald is the most common type of burns, while the proportion of flames increases as age

  7. Epidemiology of fatal burns in rural South Africa: a mortuary register-based study from Mpumalanga Province. (United States)

    Blom, Lisa; van Niekerk, Ashley; Laflamme, Lucie


    The study investigates the epidemiology of fatal burns in the predominantly rural province of Mpumalanga, South Africa. The study is cross-sectional and investigates region specific data extracted from a National Injury Mortality Surveillance System (NIMSS) and originally gathered at mortuaries. Fatal burns sustained during the 2 year period 2007 and 2008 are analysed (n=304 cases). Mortality rates by age group, sex and district were compiled and attention was paid to manner of death, location, and temporal characteristics (time of day, weekday, season). The overall fatal burn rate was 3.8 per 100,000 inhabitants (95% CI 3.4-4.3). The highest rates were among the oldest age group (8.2/100,000; 95% CI 6.1-10.7), males (5.3/100,000; 95% CI 4.6-6.2) and in one of the three districts, Nkangala (4.8/100,000; 95% CI 3.9-5.6). Most burns were accidental (68.4%) and intentional ones (13.5%) occurred in particular among older people and in the home. Burns were sustained frequently at home (55.6%), between midnight and 5a.m. and towards the end of the week. Seasonal variations were more pronounced in Nkangala. Fatal burns could be less common in rural than urban South Africa. As in urban South Africa, however, older people, young children, and males are more at risk. Not surprisingly, the occurrence of fatal burns is strongly related to living conditions and lifestyle, which vary even within rural areas of South Africa. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  8. [Electrical flash burns, about 33 cases. A 10-year retrospective study. Epidemiology, treatment and prevention]. (United States)

    Carloni, R; Pechevy, L; Quignon, R; Yassine, A-H; Forme, N; Zakine, G


    The electric flash burns are a common cause of accident at workplace, especially among electricians. The aim of this study is to determine the parts of the body most often burned by the flash, to define the usual course and finally to give some simple rules of care and prevention. This is a retrospective, observational and descriptive study including all patients treated at the University Hospital of Tours for electrical flash burns between 1 January 2003 and 01 January 2013. A collection of medical and socio-economic data was achieved. We present 3 cases of patients hospitalized in our department. Thirty-three patients were included. In our series, all hospitalized patients were men. The average age was 43.2years (range 18 to 82years). In 81% of cases, the burn was due to a low voltage source, in 19% of cases to a high voltage source. It was an accident at workplace for 71% of patients, of whom 67% were electricians. The average total burned area was 9,52% (from 1.5% to 24%). The main locations included the face (86%), upper limbs (86%) and hands (86%). Medical treatment has healed 95% of patients. A surgical procedure was required in 5% of cases. A post-traumatic stress was found in 41% of patients. Outpatient treatment was performed in 36% of cases. Flash burns remain a common cause of hospitalization. Screening for hearing and eye disorders, a post-traumatic stress, as well as the prescription of early physiotherapy for burned hands are important components of their management. Following simple rules of prevention would limit their morbidity. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. (United States)

    Tanaka, H; Matsuda, T; Miyagantani, Y; Yukioka, T; Matsuda, H; Shimazaki, S


    High-dose ascorbic acid (vitamin C) therapy (66 mg/kg per hour) attenuates postburn lipid peroxidation, resuscitation fluid volume requirements, and edema generation in severely burned patients. A prospective, randomized study at a university trauma and critical care center in Japan. Thirty-seven patients with burns over more than 30% of their total body surface area (TBSA) hospitalized within 2 hours after injury were randomly divided into ascorbic acid and control groups. Fluid resuscitation was performed using Ringer lactate solution to maintain stable hemodynamic measurements and adequate urine output (0.5-1.0 ml/kg per hour). In the ascorbic acid group (n = 19; mean burn size, 63% +/- 26% TBSA; mean burn index, 57 +/- 26; inhalation injury, 15/ 19), ascorbic acid was infused during the initial 24-hour study period. In the control group (n = 18; mean burn size, 53% +/- 17% TBSA; mean burn index, 47 +/- 13; inhalation injury, 12/18), no ascorbic acid was infused. We compared hemodynamic and respiratory measurements, lipid peroxidation, and fluid balance for 96 hours after injury. Two-way analysis of variance and Tukey test were used to analyze the data. Heart rate, mean arterial pressure, central venous pressure, arterial pH, base deficit, and urine outputs were equivalent in both groups. The 24-hour total fluid infusion volumes in the control and ascorbic acid groups were 5.5 +/- 3.1 and 3.0 +/- 1.7 mL/kg per percentage of burn area, respectively (Preduction in the severity of respiratory dysfunction was also apparent in these patients.

  10. Comparison of three different dressings for partial thickness burns in children: study protocol for a randomised controlled trial. (United States)

    Gee Kee, Emma; Kimble, Roy M; Cuttle, Leila; Stockton, Kellie


    In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat™, Acticoat™ combined with Mepitel™ and Mepilex Ag™ dressings for acute, paediatric partial thickness burns. Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of ≤ 10% will be eligible for the trial. Patients will be randomised to one of the three dressing groups: (1) Acticoat™ or (2) Acticoat™ combined with Mepitel™ or (3) Mepilex Ag™. A minimum of 28 participants will be recruited for each treatment group. Primary measures of pain, distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. Australian New Zealand Clinical Trials Registry ACTRN12613000105741.

  11. Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia. (United States)

    Duke, Janine M; Bauer, Jacqui; Fear, Mark W; Rea, Suzanne; Wood, Fiona M; Boyd, James


    To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury. Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia. Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Information Service Division Scotland and the Western Australian Data Linkage Service. Total and gender-specific number of observed and expected cases of total ('all sites') and site-specific cancers and standardised incidence ratios (SIRs). From 1983 to 2008, for female burn survivors, there was a greater number of observed versus expected notifications of total cancer with 1011 (SIR, 95% CI 1.3, 1.2 to 1.4) and 244 (SIR, 95% CI 1.12, 1.05 to 1.30), respectively, for Scotland and Western Australia. No statistically significant difference in total cancer risk was found for males. Significant excesses in observed cancers among burn survivors (combined gender) in Scotland and Western Australian were found for buccal cavity, liver, larynx and respiratory tract and for cancers of the female genital tract. Results from the Scotland data confirmed the increased risk of total ('all sites') cancer previously observed among female burn survivors in Western Australia. The gender dimorphism observed in this study may be related to the role of gender in the immune response to burn injury. More research is required to understand the underlying mechanism(s) that may link burn injury with an increased risk of some cancers.

  12. Perspectives of caregivers towards physiotherapy treatment for children with burns in Harare, Zimbabwe: A cross-sectional study. (United States)

    Chiwaridzo, Matthew; Zinyando, Vimbayinashe Juliet; Dambi, Jermaine Matewu; Kaseke, Farayi; Munambah, Nyaradzai; Mudawarima, Tapfuma


    Physiotherapy is an integral part of treatment for paediatric burns. In Zimbabwe, children are admitted in paediatric burn unit with their caregivers, who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy, which is often uncomfortable or painful to the patient. The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospitals in Harare, Zimbabwe. A descriptive cross-sectional study was conducted using self-administered questionnaires. The study was carried out at two large central hospitals (Parirenyatwa Hospital and Harare Central Hospital). The study targeted all the caregivers of children below the age of 12 years with a diagnosis of burns, irrespective of severity or area affected, who were admitted in the two paediatric burn units. Of the 34 caregivers eligible to participate, 31 (91.1 %) questionnaires had complete data and were analysed. The analyses were done using Statistica version 12.0. The median age of the caregivers was 28 years (IQR = 24-33 years). Female caregivers constituted 90.3 % of the sample. The majority of the caregivers (n = 26, 83.9 %) were biological mothers to the hospitalised child. The majority of children (n = 20, 64.5 %) hospitalised were between 0 and 4 years. The commonest cause of burns was scalding (n = 19, 61.2 %). The burns were mainly in the upper extremities (n = 11, 35.5 %). Physiotherapy for the burns was mainly active and passive joint range of motion exercises (n = 30, 96.8 %). The caregivers' perceptions towards physiotherapy were mainly positive (n = 20, 64.5 %) indicating that physiotherapy plays an important role in burn management. Of the 21 caregivers given a ward exercise programme, 13 (61.9 %) were not compliant. Caregivers' perspectives towards physiotherapy were largely positive and are similar to those found in

  13. The use of tannins in the local treatment of burn wounds – a pilot study

    African Journals Online (AJOL)

    Twenty patients aged 3 years and above with fresh partial thickness burns of less than 20% total body surface area were randomly assigned to local treatment of the burn wound either with a solution containing tannins (tannin group), or one of the other commonly used topical agents, such as honey and ghee, silver ...

  14. Epidemiological Studies of Health Outcomes among Troops Deployed to Burn Pit Sites (United States)


    eye, throat and sinus irritation, cough, headache, chest pain and fever, acute bronchitis, bronchiolitis, dermatitis, and allergic rhinitis , as well...depositing it into the burn pit to prevent unapproved items from being burned, separating out the plastics, and diverting food waste to the incinerators

  15. Pain in burn patients. (United States)

    Latarjet, J; Choinère, M


    While severe pain is a constant component of the burn injury, inadequate pain management has been shown to be detrimental to burn patients. Pain-generating mechanisms in burns include nociception, primary and secondary hyperalgesia and neuropathy. The clinical studies of burn pain characteristics reveal very clear-cut differences between continuous pain and pain due to therapeutic procedures which have to be treated separately. Some of the main features of burn pain are: (1) its long-lasting course, often exceeding healing time, (2) the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. Pharmaco-therapy with opioids is the mainstay for analgesia in burned patients, but non-pharmacological techniques may be useful adjuncts. Routine pain evaluation is mandatory for efficient and safe analgesia. Special attention must be given to pain in burned children which remains too often underestimated and undertreated. More educational efforts from physicians and nursing staff are necessary to improve pain management in burned patients.

  16. [An experimental study on the fate of the amniotic membrane after amniotic membrane transplantation for acute alkaline burn of rat cornea]. (United States)

    Chen, You; Yan, Xiao-ming; Wu, Hai-rong; Rong, Bei


    Use three different methods of amniotic membrane transplantation for acute alkaline burn of rat cornea, to investigate the difference on operation time, reabsorption time of amniotic membrane, integration patterns of amniotic membrane into the cornea among the three amniotic membrane transplantation methods. SD rats were randomly assigned into five groups. Group A: simply alkaline burn of cornea; Group B: inlay method; Group C: overlay method; Group D: sutureless method; Group E: normal. Prepared the model of corneal alkaline burn of the right eyes of group A-D rats, performed three different methods of amniotic membrane transplantation on Group B-D rats respectively within 24 hours after alkaline burn. The operation time was recorded. Observed the eyes with slit-lamp microscopy after transplantation, recorded the reabsorption time of amniotic membrane. HE staining and immunohistochemical staining against human collagen IV were performed for pathological study. The results were analysed with Image-Pro Plus 6.0 software. The integration patterns of amniotic membrane into the cornea after amniotic membrane reabsorbed were observed. (1) Operation time: Group B was (35.500 ± 2.878) minutes; Group C was (33.375 ± 2.973) minutes; Group D was (9.875 ± 1.246) minutes. There was statistical significance between group B and group D (P cornea after amniotic membrane reabsorption: superficial localization, intraepithelial and intrastromal. We could find one or more integration patterns in same method of amniotic membrane transplantation, there was no statistical significance among group B, C, D (P = 0.86). Amniotic membrane can integrate into the cornea after amniotic membrane reabsorption. Sutureless amniotic membrane transplantation which has short operation time and inconspicuous inflammatory reaction is better than traditional amniotic membrane transplantation, and it will be used extensively in the ophthalmology field in future.

  17. [Chickenpox, burns and grafts]. (United States)

    Rojas Zegers, J; Fidel Avendaño, L


    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 there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  18. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    K A Kamala


    Full Text Available Burning mouth syndrome (BMS is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS.


    Directory of Open Access Journals (Sweden)

    Valentin K. Stojanov


    Full Text Available Correct time determination for beginning of the first bougienage in cases with Stomatoesophagitis corrosiva is probably the most important step for successful outcome of treatment procedures. The aim of this study was to describe patterns of acid burns of the oesophagus in Guinea pigs. We tested 20 animals (mean initial weight of 520 g on average divided into two groups: Group 1 (subjected to 98% H2S04 and Group 2 (15% H2S04. Changes in weight, pathohistological findings (biopsy, time and cause of death (after International Classification of Diseases - 9th revision were analysed. The results revealed that animals from Group 1 died about the day 6 from ingestion of the acid with mean decrease of weight of 9.83% as the difference with the initial one was statistically significant (p<0.05 Peritonitis (ICD9 Dx:567 was the cause of death with highest frequency. During the study period of 1 month, Peritonitis and Mediastinids acuta (Dx:518 were pathohistological diagnoses with highest frequency. Only 3 animals from Group 2 died during the period of observation while the rest (n=7 survived afterwards. The relative risk of dying up to the day 9 included after ingestion of 98% against 15% H2SO4 was 9 (p<0.05. The histological analysis on the day 10 from ingestion revealed severe necrotic changes of all layers of the oesophageal wall. Our conclusion from these preliminary results was to sustain the idea to refrain from early bougienage in cases with massive damage of the oesophagus by concentrated acids. Above results might be found useful in planning larger experimental studies on acid burns of the oesophagus in the future.

  20. Taste function assessed by electrogustometry in burning mouth syndrome: a case-control study. (United States)

    Braud, A; Descroix, V; Ungeheuer, M-N; Rougeot, C; Boucher, Y


    Idiopathic burning mouth syndrome (iBMS) is characterized by oral persistent pain without any clinical or biological abnormality. The aim of this study was to evaluate taste function in iBMS subjects and healthy controls. Electrogustometric thresholds (EGMt) were recorded in 21 iBMS patients and 21 paired-matched controls at nine loci of the tongue assessing fungiform and foliate gustatory papillae function. Comparison of EGMt was performed using the nonparametric Wilcoxon signed-rank test. A correlation between EGMt and self-perceived pain intensity assessed using a visual analogic scale (VAS) was analyzed with the Spearman coefficient. The level of significance was fixed at P taste sensitivity in iBMS patients within fungiform and foliate taste bud fields and support potent gustatory/nociceptive interaction in iBMS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Time-series of biomass burning products from ground-based FTIR measurements at Reunion Island (21°S, 55°E) and comparisons with the CTM IMAGES (United States)

    Vigouroux, Corinne; de Mazière, Martine; Dils, Bart; Müller, Jean-François; Senten, Cindy; Stavrakou, Trissevgeni; Vanhaelewyn, Gauthier; Fally, Sophie; Duflot, Valentin; Baray, Jean-Luc


    Reunion Island (21°S, 55°E) is part of the Network for the Detection of Atmospheric Composition Change (NDACC), a network dedicated to performing high-quality long-term ground-based observations of atmospheric trace gases at globally distributed sites. Up to now, only a few NDACC stations are located in the Southern Hemisphere, and particularly very few at tropical and subtropical latitudes. Furthermore, Reunion Island is situated in the Indian Ocean, at 2000 km from southeast Africa and at only 700 km from Madagascar. It is therefore a good location to study the transport of biomass burning products from these regions to Reunion Island. Ground-based Fourier transform infrared (FTIR) solar absorption observations are sensitive to a large number of biomass burning products. At present, we have a record of such FTIR observations at Reunion Island from three measurement campaigns, namely in October 2002, from August to October 2004, and from May to October 2007, and from continuous observations that started in May 2009. The measurements in 2007 and 2009-2010 allow the observation of seasonal variability. In this work, we present retrieved time-series of several biomass burning products such as C2H2, C2H6 and HCN. These ground-based data are compared to the CTM IMAGES. The Lagrangian particle dispersion model FLEXPART is used to explain the day-to-day variability of these species by the transport pathways.

  2. Nonphotochemical Hole-Burning Studies of Energy Transfer Dynamics in Antenna Complexes of Photosynthetic Bacteria

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, Satoshi [Iowa State Univ., Ames, IA (United States)


    This thesis contains the candidate's original work on excitonic structure and energy transfer dynamics of two bacterial antenna complexes as studied using spectral hole-burning spectroscopy. The general introduction is divided into two chapters (1 and 2). Chapter 1 provides background material on photosynthesis and bacterial antenna complexes with emphasis on the two bacterial antenna systems related to the thesis research. Chapter 2 reviews the underlying principles and mechanism of persistent nonphotochemical hole-burning (NPHB) spectroscopy. Relevant energy transfer theories are also discussed. Chapters 3 and 4 are papers by the candidate that have been published. Chapter 3 describes the application of NPHB spectroscopy to the Fenna-Matthews-Olson (FMO) complex from the green sulfur bacterium Prosthecochloris aestuarii; emphasis is on determination of the low energy vibrational structure that is important for understanding the energy transfer process associated within three lowest energy Qy-states of the complex. The results are compared with those obtained earlier on the FMO complex from Chlorobium tepidum. In Chapter 4, the energy transfer dynamics of the B800 molecules of intact LH2 and B800-deficient LH2 complexes of the purple bacterium Rhodopseudomonas acidophila are compared. New insights on the additional decay channel of the B800 ring of bacteriochlorophylla (BChla) molecules are provided. General conclusions are given in Chapter 5. A version of the hole spectrum simulation program written by the candidate for the FMO complex study (Chapter 3) is included as an appendix. The references for each chapter are given at the end of each chapter.

  3. Imaging study on acupuncture points (United States)

    Yan, X. H.; Zhang, X. Y.; Liu, C. L.; Dang, R. S.; Ando, M.; Sugiyama, H.; Chen, H. S.; Ding, G. H.


    The topographic structures of acupuncture points were investigated by using the synchrotron radiation based Dark Field Image (DFI) method. Four following acupuncture points were studied: Sanyinjiao, Neiguan, Zusanli and Tianshu. We have found that at acupuncture point regions there exists the accumulation of micro-vessels. The images taken in the surrounding tissue out of the acupuncture points do not show such kind of structure. It is the first time to reveal directly the specific structure of acupuncture points by X-ray imaging.

  4. Oral ketamine and dexmedetomidine in adults' burns wound dressing--A randomized double blind cross over study. (United States)

    Kundra, Pankaj; Velayudhan, Savitri; Krishnamachari, Srinivasan; Gupta, Suman Lata


    Study was designed to compare analgesic efficacy and side effects of oral dexmedetomidine and ketamine in adults for burn wound dressing. Sixty healthy adults with thermal burns with burn area (20-50%) were randomly assigned into 2 groups. In Group K 5mg/kg ketamine and in Group D 4 mcg/kg dexmedetomidine was given orally. Patients crossed over to the other group the following day. Visual analogue score, sedation score, haemodynamic parameters were recorded from 30min after drug administration to 2h after procedure. Patients' preference was also recorded. Mean VAS score was significantly reduced from baseline in both the groups at all time points (Pburns wound dressing. Oral ketamine produced significantly better pain relief than dexmedetomidine but was associated with delirium and excessive salivation. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  5. One year prevalence of critically ill burn wound bacterial infections in surgical ICU in Egypt: Retrospective study

    Directory of Open Access Journals (Sweden)

    Hossam Mohamed


    Results: The main finding of the current study described herein was the percent of isolates from burn wound (60%. The most common organism was pseudomonas (49%. Multidrug resistant gram negative organisms represent about 60% of the isolates. Pattern of antibiotic sensitivity was 84% for colistin, 39% for amikacin and 35% for imipenem. The mortalities in our study were 80%.

  6. EPR and UV spectral study of gamma-irradiated white and burned sugar, fructose and glucose (United States)

    Yordanov, Nicola D.; Georgieva, Elka


    The EPR and UV spectral properties of γ-irradiated white and burned sugar, fructose and glucose are studied with the accent on their suitability as dosimetric materials. It is shown that γ-irradiation of solid samples of white sugar and fructose yields stable EPR spectra whereas glucose signal remains time-dependent even 11 months later. Sugar and glucose exhibit linear EPR dose response in the region 0.44-21 kGy and fructose only up to ca. 10 kGy. The relative radiation sensitivity obtained for sugar and fructose is up to 10 kGy and slightly lower for glucose. Burned saccharides provide 2-3 orders of magnitude lower EPR radiation sensitivity making them not suitable for the proposed designation. According to the UV spectra water solutions of γ-irradiated solid white saccharides show well pronounced absorption bands at 267 and 286 nm for sugar and fructose with time-dependent intensities reaching steady values ca. 11 days after dissolution. The intensities of these absorption bands are in linear relation with the absorbed dose of γ-radiation. Glucose shows low sensitively because irradiation with 5.5 kGy yields only a shoulder at about 260-280 nm with decreasing to ca. 40% intensity in the first few days after dissolution. Excellent correlation between the intensities of the EPR- and UV-absorbed dose response is found for sugar and fructose in the region 0.44-10 kGy. This opens new possibilities for independent calibration the EPR dose response. Finally, the comparison suggests sugar as the best, universal material for EPR- and/or UV-dosimetry in the region 0.44-160 kGy.

  7. Firefighter willingness to participate in a stem cell clinical trial for burns: A mixed methods study. (United States)

    Horch, Jenny D; Carr, Eloise C J; Harasym, Patricia; Burnett, Lindsay; Biernaskie, Jeff; Gabriel, Vincent


    Adult stem cells represent a potentially renewable and autologous source of cells to regenerate skin and improve wound healing. Firefighters are at risk of sustaining a burn and potentially benefiting from a split thickness skin graft (STSG). This mixed methods study examined firefighter willingness to participate in a future stem cell clinical trial, outcome priorities and factors associated with this decision. A sequential explanatory mixed methods design was used. The quantitative phase (online questionnaire) was followed by the qualitative phase (semi-structured interviews). A sample of 149 firefighters completed the online survey, and a purposeful sample of 15 firefighters was interviewed. A majority (74%) reported they would participate in a future stem cell clinical trial if they experienced burn benefiting from STSG. Hypothetical concerns related to receiving a STSG were pain, itch, scarring/redness and skin durability. Participants indicated willingness to undergo stem cell therapy if the risk of no improvement was 43% or less. Risk tolerance was predicted by perceived social support and having children. Interviews revealed four main themes: a desire to help others, improving clinical outcomes, trusting relationships, and a belief in scientific investigation. Many participants admitted lacking sufficient knowledge to make an informed decision regarding stem cell therapies. Firefighters indicated they were largely willing to participate in a stem cell clinical trial but also indicated a lack of knowledge upon which to make a decision. Public education of the role of stem cells in STSG will be increasingly important as clinical trials are developed. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  8. Identification of factors predicting scar outcome after burn injury in children: a prospective case-control study. (United States)

    Wallace, Hilary J; Fear, Mark W; Crowe, Margaret M; Martin, Lisa J; Wood, Fiona M


    There is a lack of rigorous research investigating the factors that influence scar outcome in children. Improved clinical decision-making to reduce the health burden due to post-burn scarring in children will be guided by evidence on risk factors and risk stratification. This study aimed to examine the association between selected patient, injury and clinical factors and the development of raised scar after burn injury. Novel patient factors were investigated including selected immunological co-morbidities (asthma, eczema and diabetes type 1 and type 2) and skin pigmentation (Fitzpatrick skin type). A prospective case-control study was conducted among 186 children who sustained a burn injury in Western Australia. Logistic regression was used to explore the relationship between explanatory variables and a defined outcome measure: scar height measured by a modified Vancouver Scar Scale (mVSS). The overall correct prediction rate of the model was 80.6%; 80.9% for children with raised scars (>1 mm) and 80.4% for children without raised scars (≤1 mm). After adjustment for other variables, each 1% increase in % total body surface area (%TBSA) of burn increased the odds of raised scar by 15.8% (95% CI = 4.4-28.5%). Raised scar was also predicted by time to healing of longer than 14 days (OR = 11.621; 95% CI = 3.727-36.234) and multiple surgical procedures (OR = 11.521; 1.994-66.566). Greater burn surface area, time to healing of longer than 14 days, and multiple operations are independently associated with raised scar in children after burn injury. Scar prevention strategies should be targeted to children with these risk factors.

  9. MR scanning, tattoo inks, and risk of thermal burn: An experimental study of iron oxide and organic pigments: Effect on temperature and magnetic behavior referenced to chemical analysis. (United States)

    Alsing, K K; Johannesen, H H; Hvass Hansen, R; Dirks, M; Olsen, O; Serup, J


    Tattooed persons examined with magnetic resonance imaging (MRI) can develop burning sensation suggested in the literature to be thermal burn from the procedure. MRI-induced thermal effect and magnetic behavior of known tattoo pigments were examined ex vivo. Magnetic resonance imaging effects on 3 commonly used commercial ink stock products marketed for cosmetic tattooing was studied. A main study tested 22 formulations based on 11 pigment raw materials, for example, one line of 11 called pastes and another called dispersions. Samples were spread in petri dishes and tested with a 0.97 T neodymium solid magnet to observe visual magnetic behavior. Before MRI, the surface temperature of the ink was measured using an infrared probe. Samples were placed in a clinical 3T scanner. Two scans were performed, that is, one in the isocenter and one 30 cm away from the center. After scanning, the surface temperature was measured again. Chemical analysis of samples was performed by mass spectroscopy. Mean temperature increase measured in the isocenter ranged between 0.14 and 0.26°C (P tattoo pigments after MRI. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. [Ocular burns]. (United States)

    Merle, H; Gérard, M; Schrage, N


    Ocular or thermal burns account for 7.7%-18% of ocular trauma. The majority of victims are young. The burns occur in the setting of accidents at work or in the home, or during a physical attack. Chemical burns by strong acids or bases are responsible for the most serious injuries. Associated with the destruction of limbal stem cells, they present as recurrent epithelial ulcerations, chronic stromal ulcers, deep stromal revascularization, conjunctival overlap, or even corneal perforation. The initial clinical exam is sometimes difficult to perform in the presence of burning symptoms. Nevertheless, it enables the physician to classify the injury, establish a prognosis, and most importantly, guide the therapeutic management. The Roper-Hall modification of the Hughes classification system is the most widely utilized, broken down into stages based on the size of the stromal opacity and the extent of possible limbal ischemia. This classification is now favorably supplemented by those proposed by Dua and Wagoner, which are based on the extent of the limbal stem cell deficiency. The prognosis of the more serious forms of ocular burns has markedly improved over the last decade because of a better understanding of the physiology of the corneal epithelium. Surgical techniques aimed at restoring the destroyed limbal stem cells have altered the prognosis of severe corneal burns. In order to decrease the incidence of burns, prevention, particularly in industry, is essential.

  11. Epidemiological characterization of Acinetobacter baumannii bloodstream isolates from a Chinese Burn Institute: A three-year study. (United States)

    Huang, Guangtao; Yin, Supeng; Xiang, Lijuan; Gong, Yali; Sun, Kedai; Luo, Xiaoqiang; Zhang, Cheng; Yang, Zichen; Deng, Liuyang; Jiang, Bei; Jin, Shouguang; Chen, Jing; Peng, Yizhi


    Acinetobacter baumannii infection is a serious threat to burn patients. Bacteremia due to A. baumannii is becoming the most common cause of mortality following burn. However, the epidemiology of A. baumannii causing burn-related bloodstream infections has rarely been reported. We retrospectively collected 81 A. baumannii isolates from the bloodstream of burn patients over a three-year period. Antibiotic susceptibility tests, the prevalence of antibiotic-resistant genes and sequence typing (ST) were conducted to characterize these strains. Most of the isolates showed an extensive drug-resistant phenotype. The resistance frequencies to imipenem and meropenem were 94% and 91%, respectively. The blaOXA-23-like gene, AmpC, IS-AmpC, PER and SIM are the five most prevalent resistant genes, and their prevalence rates are 93% (75/81), 86% (70/81), 73% (59/81), 73% (59/81) and 52% (42/81), respectively. The 81 isolates were grouped into 10 known and 18 unknown ST types, with ST368 (38%) being the most prevalent. Except for ST457 and four new types (STn2, STn6, STn11 and STn14), the remaining 23 ST types belonged to one clonal complex 92, which is most common among clinical isolate in China. The above results indicated that ST368 isolates possessing both the blaOXA-23-like gene and ampC gene were the main culprits of the increasing nosocomial A. baumannii infection in this study. More attention should be paid to monitoring the molecular epidemiology of A. baumannii isolates from burn patients to prevent further distribution. Such information may help clinicians with therapeutic decisions and infection control in the Burns Institute. Copyright © 2016. Published by Elsevier Ltd.

  12. Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study. (United States)

    Gal, Shaili; Ramirez, Jesus Ignacio; Maguina, Pirko


    It has been proposed that fat grafts can improve the appearance of mature burn scars. The pluripotent progenitor cells contained within autologous adipose tissue grafts are believed to induce skin repair and improve scar appearance. We conducted a prospective, randomized, double-blinded, placebo-controlled study to evaluate the effects of fat grafts on the appearance of mature burn scars. Pediatric burn survivors with mature scars were recruited for this study. A homogeneous scar measuring 10×5cm was randomized into two halves: one was injected with autologous fat graft and the other with normal saline. Scar injection was performed using standard Coleman technique. Appearance of the two scar halves was assessed, six to twelve months later by the operating surgeon, by blinded observers and by the blinded patients. Eight patients completed the study pilot with 6-12 month follow-up. Assessment by the patients did not clearly favor fat grafts or saline injections; the operating surgeon did not identify any differences on any of the patients; the blinded observers measured all scars using Vancouver Scar Scale and noticed no differences in pigmentation, vascularity and height; differences in pliability showed similar changes in both the fat grafted and control arms. After the pilot was completed, decision was made to stop enrolling patients for this study since no benefit to fat grafting was observed. Single treatment with autologous fat grafts did not improve mature pediatric burn scars when compared to normal saline injections. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  13. Experimental study and large eddy simulation of effect of terrain slope on marginal burning in shrub fuel beds (United States)

    Xiangyang Zhou; Shankar Mahalingam; David Weise


    This paper presents a combined study of laboratory scale fire spread experiments and a three-dimensional large eddy simulation (LES) to analyze the effect of terrain slope on marginal burning behavior in live chaparral shrub fuel beds. Line fire was initiated in single species fuel beds of four common chaparral plants under various fuel bed configurations and ambient...

  14. Issues to address in burn care for ethnic minority children: A qualitative study of the experiences of health care staff

    NARCIS (Netherlands)

    Suurmond, J.; Dokter, J.; van Loey, N.; Essink-Bot, M. L.


    Introduction: Numerous studies have shown that ethnic minority children in the developed world are at greater risk of sustaining burns compared to children from non-ethnic minority backgrounds. However, little is known about the experiences of hospital health care staff with ethnic minority children

  15. Too hot to trot (barefoot)… A study of burns in children caused by sun heated surfaces in Queensland, Australia. (United States)

    Asquith, Catherine; Kimble, Roy; Stockton, Kellie


    The aim of this study was to quantify and describe the characteristics of burns in children caused by sun heated surfaces. Children presenting between January 2013 and February 2014 with a burn due to sun heated surfaces were included in the study. Fifteen children were identified representing 1.7% of new burns. The mean age was 18.3 months. All burns occurred during the warmer months between 11a.m. and 4p.m. and the feet were commonly involved. Most cases occurred in the child's home garden but six cases occurred in public play areas. Metal was the most common surface involved. Most burns were superficial partial thickness with two burns deep dermal partial thickness and one child needed a skin graft. Burns due to sun heated surfaces are relatively frequent. Parents need to be aware that in summer surfaces can become hot enough to cause burns to bare feet in young children. Play areas need to be shaded or covered in surfaces that do not become hot enough to cause burns and metal objects should not be left in the sun in children's play areas. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  16. The low level laser therapy in the management of neurological burning mouth syndrome. A pilot study. (United States)

    Romeo, Umberto; Del Vecchio, Alessandro; Capocci, Mauro; Maggiore, Claudia; Ripari, Maurizio


    Burning Mouth Syndrome (BMS) is a common disease but still a diagnostic and therapeutic challenge for clinicians. Despite many studies its nature remains obscure and controversial; nowadays there is no consensus about definition, diagnosis and classification. BMS is characterized clinically by burning sensations in the tongue or other oral sites, often without clinical and laboratory findings. According to the etiology, BMS cases should be subdivided into three subtypes: BMS by local factors (lfBMS), BMS by systemic factors (sfBMS) and neurological BMS (nBMS), the most frequent, in which the symptom is caused by central or peripheral neurological malfunctions affecting in particular the taste pathway. To establish the type of BMS, both anamnesis and clinical examination, including laboratory tests, are necessary; nBMS cases will be recognized by exclusion of any other type. In case of lfBMS or sfBMS, the treatment of the main pathology will be resolutive; in nBMS cases many Authors proposed different pharmacological trials without satisfactory results and the current opinion is that a multidisciplinary approach is required to keep the condition under control. This pilot study aimed to investigate whether the biostimulative effect of Low Level Laser Therapy (LLLT) could enhance the symptoms of nBMS cases, improving patients' quality of life. Among 160 patients affected by oral burning sensation attending to the Oral Pathology Complex Operative Unit of the Department of Stomatological Sciences of Sapienza University of Rome, 77 resulted affected by nBMS. Twenty-five of these patients, 16 females and 9 males, were randomly selected for low level laser applications. All the patients were irradiated with a double diode laser (Lumix 2 Prodent, Italy) emitting contemporarily at 650 nm and 910 nm, with a fluence of 0.53 J/cm(2) for 15 minutes twice a week for 4 weeks. The areas of irradiation were the sides of the tongue on the path of taste fibers. A NRS (numerical rating

  17. Burning mouth and saliva. (United States)

    Chimenos-Kustner, Eduardo; Marques-Soares, Maria Sueli


    Stomatodynia is the complaint of burning, tickling or itching of the oral cavity, and can be associated with other oral and non-oral signs and symptoms. However, the oral mucosa often appears normal, with no apparent underlying organic cause to account for the symptomatology. The etiology is unknown, though evidence points to the participation of numerous local, systemic and psychological factors. Among the local factors, saliva may play an important role in the symptoms of burning mouth. Saliva possesses specific rheological properties as a result of its chemical, physical and biological characteristics - these properties being essential for maintaining balanced conditions within the oral cavity. Patients with burning mouth present evidence of changes in salivary composition and flow, as well as a probable alteration in the oral mucosal sensory perception related particularly to dry mouth and taste alterations. On the other hand, alterations in salivary composition appear to reflect on its viscosity and symptomatology of burning mouth. Saliva is a field open to much research related to burning mouth, and knowledge of its properties (e.g., viscosity) merits special attention in view of its apparent relationship to the symptoms of burning mouth. The present study describes our clinical experience with burning mouth, and discusses some of the aspects pointing to salivary alterations as one of the most important factors underlying stomatodynia.

  18. Spectrophotometric intracutaneous analysis for the assessment of burn wounds: A service evaluation of its clinical application in 50 burn wounds. (United States)

    Tan, A; Pedrini, F A; Oni, G; Frew, Q; Philp, B; Barnes, D; Dziewulski, P


    The assessment of burn depth can be challenging even to the experienced burn clinician. Clinical assessment is most widely used to determine burn depth. Because of this subjective nature, various imaging modalities have been invented. The use of photospectometry as a novel technique in burn wound depth analysis has been previously described but the literature is very limited. We carried out a single blinded non-randomized comparative study of healing potential of 50 burn wounds between tissue spectrophotometry analysis versus clinical evaluation. ScanOSkin™ technology has an overall sensitivity of 75% and specificity of 86% in predicting healing potential of wounds. Analysis of Inter Rater Agreement (IRA) using Kappa calculations showed strengths of agreement varied from fair to moderate in perfusion and burn depth. IRA for assessing pigmentation however, was poor and this was reflected in user feedback. There is a potential role for ScanOSkin™ tissue spectrophotometric analysis in burn depth assessment. Future studies comparing several imaging modalities with ScanOSkin(®), taking into account costs comparison may be useful for future health resources planning. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  19. A new algorithm for mapping burned areas in Colombia

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    Federico González-Alonso


    Full Text Available Every year, between 2.5 and 4.0 million km² of vegetation are burned around the world, emitting an annual average of 2,013 Tg of C, at least 50% of which is estimated to represent net emissions that are not compensated for by the regeneration of vegetation. In Colombia, the official statistics of burned areas are not well known, but it is estimated that burned areas vary between 15,000 and 20,000 km² per year. The main objective of this study was the development and application of a new algorithm for mapping burned areas in Colombia, using a synergistic combination of reflectance images and thermal anomalies detected by the MODIS sensors installed on NASA 's TERRA and AQUA satellites. Upon applying the developed algorithm, a burned surface area in Orinoquía of 998,473 ha was obtained for the month of February, 2007. The validation of the algorithm was performed using high spatial resolution Landsat images and the comparison of the data with the global MODIS MCD45A1 burned area product. The developed algorithm performed very similar to MCD45A1, with an overall accuracy of 79% in both cases. The new algorithm, which was developed for the mapping of burned areas in Colombia, can be used to complement deforestation and forest degradation monitoring procedures that are being implemented in Colombia in the context of the REDD+ mechanism initiation

  20. Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study

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    Atefe Kamaloo


    Full Text Available Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome.Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software.Results: Data were categorized in 4 themes as follow: (1 the characteristics of emergency medicine; (2 ambiguity in residents’ duties; (3 educational planning; and (4 careers.Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1 changes in personal life; (2 arrangement in shifts; and  (3 educational issues.Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out.

  1. Burning Issue: Handling Household Burns (United States)

    ... to injury. , as your immune system shifts into gear. “The immune system response is intended to limit ... maintain blood pressure. Grafting—placing healthy skin on top of the burn wound—might help promote new ...

  2. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, L.M.V.; Jomaas, Grunde


    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... height, mass loss rate and residues of three hydrocarbon liquids (n-octane, dodecane and hexadecane), two crude oils (DUC and REBCO) and one hydrocarbon liquid mixture of the aforementioned hydrocarbon liquids were studied using the Crude Oil Flammability Apparatus. The experimental results were compared...... on the highest achievable oil slick temperature. Based on this mechanism, predictions can then be made depending on the hydrocarbon composition of the fuel and the measured surface temperature....

  3. Fluid replacement in burned patients. (United States)

    Bortolani, A; Governa, M; Barisoni, D


    Burn injury involves a large amount of water, electrolytes and proteins loss trough the burn wound. For this reason, to avoid shock, a wide infusion of fluid is necessary in the first hours after trauma. Many reanimation formulas were proposed in the past years, with different composition: saline, colloids, plasma. The authors have studied 40 burned patients admitted in Verona Burn Center within 4 hours after burn, with burns over 30% of the body surface area. Twenty of them were treated with Baxter reanimation formula (ringer lactated saline, RLS) while the others with Monafo hypertonic lactated saline (HLS), modified by Milan Burn Center. The two randomized groups were assessed and compared. In RLS group total fluid volume infused was higher while sodium requirements was lower than in HLS patients, with statistically significative difference (p electrolytes balance with lower fluid load, reducing tissue oedema and complication rate. Mortality rate was higher in HLS, may be for an higher Roy index in this group.

  4. Primary Burning Mouth Syndrome: A Questionnaire Study of Neuropathic and Psychological Components. (United States)

    Sevrain, Morgane; Brenaut, Emilie; Le Toux, Guy; Misery, Laurent


    The pathophysiology of primary burning mouth syndrome (BMS) is extensively debated but poorly understood. The aim of the study was to evaluate neuropathic and psychological components of BMS in patients with primary BMS. Subjects were recruited through a consultation dedicated to mouth diseases, during which a diagnosis of primary BMS was assessed. Patients answered the abbreviated Douleur Neuropathique 4 questionnaire (DN4i), the Hospital Anxiety and Depression Scale (HADS) and the questionnaire de la douleur de Saint-Antoine (QDSA), the French version of the McGill pain questionnaire. Thirty-five patients with primary BMS were included in the study: 31 % of them had a DN4i score in favour of neuropathic pain and 34.3 % had a HADS overall score in favour of anxiety and depressive disorder. Both physiological and psychological aspects of BMS need to be actively investigated by clinicians to successfully manage these patients. The physiological and psychological aspects are not mutually exclusive. The DN4i and the HADS are easy-to-use tools and could be used in an initial assessment of BMS patients.

  5. Burn injury-specific home safety assessment: a cross-sectional study in Iran.

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    Shahnam Arshi

    Full Text Available BACKGROUND: The aim of this study was to assess the feasibility of injury specific home safety investigation and to examine the home safety status focused on burn related safety in a rural population in the North-West of Iran. METHODS: A cross-sectional study was conducted on 265 rural households of rural Meshkinshahr, Iran. Cluster sampling method was used in 38 clusters with 7 households in each cluster. Clusters were selected on a probability proportional to size (PPS basis using the available health census database called D-Tarh. Data were analyzed using the statistical software package STATA 8. RESULTS: Possible risks were explored in fields of house structure; cooking and eating attitudes and behaviors; cooking appliances, specific appliances such as picnic gas burners, valors (traditional heaters, samovars (traditional water boilers, and air-heating appliances. Many safety concerns were explored needing to draw the attention of researchers and public health policy makers. CONCLUSION: Injury specific home safety surveys are useful and may provide useful information for safety promotion interventions.

  6. Tests and studies of USSR materials at the US coal burning MHD facility UTSI-2

    Energy Technology Data Exchange (ETDEWEB)

    Telegin, G P; Romanov, A I; Rekov, A I; Spiridonov, E G; Barodina, T I; Vysotsky, D A


    In accordance with the overall program of the US--USSR cooperation in the field of MHD power generation tests of Soviet electrode materials were conducted at the coal burning MHD facility UTSI-2 of the University of Tennessee Space Institute. The main purposes of the tests are evaluation of electrode materials behavior in the channel of the MHD generator operating with combustion products of coal containing ionizing alkali seed, study of thermal and physical stability of materials in the presence of corrosive slag, study of electrophysical characteristics of electrode materials when they are subjected to the passage of current through the plasma-slag-electrode system. Tests were conducted on electrodes made of silicon carbide doped with titanium and LaCrO/sub 3/--Cr cermet. Results are reported on the phase and chemical composition and structure of these two materials, their thermophysical and electrophysical properties, and the electrode fabrication methods. The MHD facility UTSI-2, where the tests were conducted is one of few utilizing actual coal as the fuel. A description of this facility is given, and its main operating parameters and the methods used to conduct electrode tests with and without an applied current are described.

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

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    Shilpi Singh Gupta


    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.

  8. A Study of Image Colourfulness


    Amati, C.; Mitra, N.; Weyrich, T.


    Colourfulness is often thought of as a mere measure of quantity of colour, but user studies suggest that there are more factors influencing the perception of colourfulness. Boosting and enhancing colours are operations often performed for improving image aesthetics, but the relationship between colourfulness and aesthetics has not been thoroughly explored. By gathering perceptual data from a large-scale user study we have shown how existing colourfulness metrics relate to it and that there is...

  9. An experimental burn wound-healing study of non-thermal atmospheric pressure microplasma jet arrays. (United States)

    Lee, Ok Joo; Ju, Hyung Woo; Khang, Gilson; Sun, Peter P; Rivera, Jose; Cho, Jin Hoon; Park, Sung-Jin; Eden, J Gary; Park, Chan Hum


    In contrast with a thermal plasma surgical instrument based on coagulative and ablative properties, low-temperature (non-thermal) non-equilibrium plasmas are known for novel medicinal effects on exposed tissue while minimizing undesirable tissue damage. In this study we demonstrated that arrays of non-thermal microplasma jet devices fabricated from a transparent polymer can efficiently inactivate fungi (Candida albicans) as well as bacteria (Escherichia coli), both in vitro and in vivo, and that this leads to a significant wound-healing effect. Microplasma jet arrays offer several advantages over conventional single-jet devices, including superior packing density, inherent scalability for larger treatment areas, unprecedented material flexibility in a plasma jet device, and the selective generation of medically relevant reactive species at higher plasma densities. The therapeutic effects of our multi-jet device were verified on second-degree burns in animal rat models. Reduction of the wound area and the histology of the wound after treatment have been investigated, and expression of interleukin (IL)-1α, -6 and -10 was verified to evaluate the healing effects. The consistent effectiveness of non-thermal plasma treatment has been observed especially in decreasing wound size and promoting re-epithelialization through collagen arrangement and the regulation of expression of inflammatory genes. Copyright © 2015 John Wiley & Sons, Ltd.

  10. The role of xerostomia in burning mouth syndrome: a case-control study

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    Luciana Alvarenga da Silva


    Full Text Available Objective : To assess the efficacy of anti-xerostomic topical medication (urea 10% in patients with burning mouth syndrome (BMS. Method : Thirty-eight subjects diagnosed with BMS according to the International Association for the Study of Pain guidelines were randomized to either placebo (5% sodium carboxymethylcellulose, 0.15% methyl paraben, and 10% glycerol in distilled water qsp 100 g or treatment (urea 10% to be applied to the oral cavity 3-4 times per day for 3 months. The patients were evaluated before and after treatment with the following instruments: the EDOF-HC protocol (Orofacial Pain Clinic – Hospital das Clínicas, a xerostomia questionnaire, and quantitative sensory testing. Results : There were no differences in salivary flow or gustative, olfactory, or sensory thresholds (P>0.05. Fifteen (60% patients reported improvement with the treatments (P=0.336. Conclusion : In conclusion, there were no differences between groups, and both exhibited an association between reported improvement and salivation.

  11. [Eye irritation and chemical eye burns. Review of experimental and clinical studies]. (United States)

    Cordes, A K; Frentz, M; Schrage, N F


    Chemical burns of the eye are becoming rare due to improvements in occupational protection. Effective decontamination is the foundation for good clinical results of this ophthalmological emergency. The toxicological aspect focuses on classifying the specific toxicity of a chemical substance by evaluating the degree of eye irritation and eye burns. Chemical substances are classified into defined risk levels by specific tests. The traditional ophthalmological approach is based on the clinical presentation of eye burns as a result of contact with a specific toxic substance. In an integral approach it is shown that substance-specific characteristics, such as concentration and specific reactivity as well as individual features, such as mode and duration of exposition have an influence on the clinical appearance of the tissue damage. The decontamination is dependent on the mode of action and the effectiveness of the decontamination solution. Amphoteric substances have the best effectiveness for decontamination of the eye due to their specific characteristics.

  12. Ongoing Research on Herding Agents for In Situ Burning in Arctic Waters: Studies on Fate and Effects

    DEFF Research Database (Denmark)

    Fritt-Rasmussen, Janne; Gustavson, Kim; Wegeberg, Susse

    surface, and only small concentrations of herders were found in the water column (0.2-22.8 mg/L). The inherent properties of herders in relation to toxicity and bioaccumulation on the high Arctic copepods (Calanus hyperboreus), as well as the biodegradability of herders were studied under arctic......Research on the fate and effects of herding agents used to contain and thicken oil slicks for in situ burning in Arctic waters continues under the auspices of the International Association of Oil and Gas Producers Arctic Oil Spill Response Technology – Joint Industry Program (JIP). In 2014....../2015 laboratory studies were conducted on the fate and effects of herders. The purpose of the studies was to improve the knowledge base used to evaluate the environmental risk of using herders in connection with in situ burning for oil spill response in Arctic seas. Two herding agents were studied (OP 40...

  13. Smartphone applications in burns. (United States)

    Wurzer, Paul; Parvizi, Daryousch; Lumenta, David B; Giretzlehner, Michael; Branski, Ludwik K; Finnerty, Celeste C; Herndon, David N; Tuca, Alexandru; Rappl, Thomas; Smolle, Christian; Kamolz, Lars P


    Since the introduction of applications (apps) for smartphones, the popularity of medical apps has been rising. The aim of this review was to demonstrate the current availability of apps related to burns on Google's Android and Apple's iOS store as well as to include a review of their developers, features, and costs. A systematic online review of Google Play Store and Apple's App Store was performed by using the following search terms: "burn," "burns," "thermal," and the German word "Verbrennung." All apps that were programmed for use as medical apps for burns were included. The review was performed from 25 February until 1 March 2014. A closer look at the free and paid calculation apps including a standardized patient was performed. Four types of apps were identified: calculators, information apps, book/journal apps, and games. In Google Play Store, 31 apps were related to burns, of which 20 were calculation apps (eight for estimating the total body surface area (TBSA) and nine for total fluid requirement (TFR)). In Apple's App Store, under the category of medicine, 39 apps were related to burns, of which 21 were calculation apps (19 for estimating the TBSA and 17 for calculating the TFR). In 19 out of 32 available calculation apps, our study showed a correlation of the calculated TFR compared to our standardized patient. The review demonstrated that many apps for medical burns are available in both common app stores. Even free available calculation apps may provide a more objective and reproducible procedure compared to manual/subjective estimations, although there is still a lack of data security especially in personal data entered in calculation apps. Further clinical studies including smartphone apps for burns should be performed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  14. Burned area detection based on Landsat time series in savannas of southern Burkina Faso (United States)

    Liu, Jinxiu; Heiskanen, Janne; Maeda, Eduardo Eiji; Pellikka, Petri K. E.


    West African savannas are subject to regular fires, which have impacts on vegetation structure, biodiversity and carbon balance. An efficient and accurate mapping of burned area associated with seasonal fires can greatly benefit decision making in land management. Since coarse resolution burned area products cannot meet the accuracy needed for fire management and climate modelling at local scales, the medium resolution Landsat data is a promising alternative for local scale studies. In this study, we developed an algorithm for continuous monitoring of annual burned areas using Landsat time series. The algorithm is based on burned pixel detection using harmonic model fitting with Landsat time series and breakpoint identification in the time series data. This approach was tested in a savanna area in southern Burkina Faso using 281 images acquired between October 2000 and April 2016. An overall accuracy of 79.2% was obtained with balanced omission and commission errors. This represents a significant improvement in comparison with MODIS burned area product (67.6%), which had more omission errors than commission errors, indicating underestimation of the total burned area. By observing the spatial distribution of burned areas, we found that the Landsat based method misclassified cropland and cloud shadows as burned areas due to the similar spectral response, and MODIS burned area product omitted small and fragmented burned areas. The proposed algorithm is flexible and robust against decreased data availability caused by clouds and Landsat 7 missing lines, therefore having a high potential for being applied in other landscapes in future studies.

  15. Low Intensity laser therapy in patients with burning mouth syndrome: a randomized, placebo-controlled study

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    Norberto Nobuo SUGAYA

    Full Text Available Abstract The aim of this study was to assess the effectiveness of low intensity laser therapy in patients with Burning Mouth Syndrome (BMS. Thirty BMS subjects were randomized into two groups – Laser (LG and Placebo (CG. Seven patients dropped out, leaving 13 patients in LG and 10 patients in CG. Each patient received 4 irradiations (laser or placebo twice a week, for two consecutive weeks (blinded to the type of irradiation received. Infrared laser (AsGaAI irradiations were applied to the affected mucosa in scanning mode, wavelength of 790 nm, output power of 20 mW and fluence of 6 J/cm2. A visual analogue scale (VAS was used to assess the therapeutic effect before and after each irradiation, and at all the control time periods: 7, 14, 30, 60 and 90 days after the last irradiation. One researcher delivered irradiation and another recorded the results. Both researchers were blinded, the first to the results, and the second to the type of radiation applied. The results were categorized according to the percentage of symptom level variation, and showed a statistically better response in LG in only two categories of the control checkpoints (p=0.02; Fisher’s Exact Test. According to the protocol used in this study, low intensity laser therapy is as beneficial to patients with BMS as placebo treatment, indicating a great emotional component of involvement in BMS symptomatology. Nevertheless, there were positive results in some statistical analyses, thus encouraging further research in BMS laser therapy with other irradiation parameters.

  16. [Preliminary study of Boston keratoprosthesis in treatment of severe late stage ocular chemical burns]. (United States)

    Chen, Jia-qi; Zhai, Jia-jie; Gu, Jian-jun; Shao, Ying-feng; Liu, Yong-min; Yuan, Jin; Zhou, Shi-you


    To evaluate preliminary clinical outcome of Boston type I keratoprosthesis in ocular chemical burn patients. Six keratoprosthesis were implanted into 6 patients of bilateral blindness. Visual acuity in these patients before the operation was light perception and all of them were unsuitable for standard penetrating corneal transplantation. The causes for corneal opacity were alkali burn in 2, sulfate acid burn in 3 and ethanol injury in 1 patient. Shirmer's test revealed severe dry eye in 3 patients, only one eye had normal lacrimal secretion. All patients were male, with follow-up period ranged from 17 to 26 months (mean 24 months). The postoperative visual acuity ranged from 0.05 to 0.5, 5 of them was better than 0.1. The retention rate within the follow-up period was 100%. Intraocular pressure was in normal limit, no retinal detachment was detected by type B ultrasonic examination. Postoperatively, retro-keratoprosthestic membrane occurred in 2 cases and was treated with YAG laser membranectomy, one eye complicated with elevated intraocular pressure and treated with shunt implantation. The Boston type 1 keratoprosthesis is a viable option for patients with obsolete chemical burns.

  17. Internalizing problem behavior and family environment of children with burns: A Dutch pilot study

    NARCIS (Netherlands)

    Liber, J.M.; List, D.; van Loey, N.E.E.; Kef, S.


    The psychosocial development of children with burns is at risk. Children with health care issues tend to develop internalizing problems. Several areas of protective or risk factors were composed into a conceptual model on how internalizing problems might develop or might be prevented after getting

  18. Predictions of the Pharmacokinetics in Burn Injury Patients using Regression Models - Case Study with Levofloxacin. (United States)

    Srinivas, N R


    Owing to its excellent safety, tolerability, pharmacokinetic and pharmacodynamic profile levofloxacin is widely used. Although pharmacokinetics of levofloxacin was somewhat more variable in burn injury patients, it appeared to be comparable to healthy subjects or other patients. Linear regression model was established for Cmax or Cmin vs. [AUCtau, CL and Vd] of levofloxacin using individual values from burn injury patients. Appropriate regression lines for Cmax or Cmin were subjected to internal and external validation on the ability to predict CL, Vd and AUCtau parameters. The mean absolute error (MAE) and root mean square error (RMSE) of the predictions were used to judge the appropriateness of either Cmax or Cmin models. Cmax models developed for levofloxacin showed moderate to strong correlations with the various parameters such as CL, Vd and AUCtau. The Cmin models showed strong correlation for CL and AUCtau but not for Vd where the correlation was weak. Internal validation using data from individual burn patients showed RMSE of 13.47-25.42% for various predictions. External validation that used mean data from healthy subjects showed RMSE of 13.86-27.13%. Despite the pharmacokinetic variability, linear regression models using either Cmax or Cmin were established for levofloxacin rendering predictions of several key pharmacokinetic parameters. Although there was limitation of Cmin model for predicting Vd, both models may be used as a prospective tool for the prediction of levofloxacin pharmacokinetics in burn care patients. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Recommendations on the use of prescribed burning practices in grassland conservation - An evidence-based study from Hungary (United States)

    Tóthmérész, Béla; Valkó, Orsolya; Török, Péter; Végvári, Zsolt; Deák, Balázs


    Fire as a natural disturbance has been present in most European grasslands. In parallel controlled use of burning was an important part of the traditional landscape management for millennia. It was used to reduce litter and suppress woody vegetation as well as to maintain open landscapes suitable for farming. Recently, human activities have a considerable impact on natural fire regimes through habitat fragmentation, cessation of traditional grassland management and climate change. Nowadays the majority of human-ignited fires are uncontrolled burnings and arson, which have serious negative impacts on human life, property and can be detrimental also from the nature conservation point of view. Despite fire was widely applied in the past and the considerable extension and frequency of current grassland fires, the impact of fire on the grassland biodiversity is still scarcely documented in Europe. The aim of our study was to gather practical knowledge and experiences from Hungary concerning the effects of fire on grasslands. To fulfil this aim we sent questionnaires to experts from Hungarian national park directorates to gather unpublished data and field observations concerning the effects of burning on grasslands. Based on the answers for the questionnaires fire regularly occur in almost every grassland types in Hungary. We found that effects of fire are habitat-specific. One hand uncontrolled burning and arson have serious detrimental impacts on many endangered species (ground-dwelling birds, such as Asio flammeus, Tringa totanus and Vanellus vanellus; or lizards, such as Ablepharus kitaibelii). On the other hand in several cases fire has a positive effect on the habitat structure and favours species of high nature conservation interest (plant species, such as Adonis volgensis, Chamaecytisus supinus and Pulsatilla grandis; butterflies, such as Euphydryas aurinia; bird species such as Circus aeruginosus and Larus cachinnans). Our results suggest that even uncontrolled

  20. In vivo visualization of dermal collagen fiber in skin burn by collagen-sensitive second-harmonic-generation microscopy (United States)

    Tanaka, Ryosuke; Fukushima, Shu-ichiro; Sasaki, Kunihiko; Tanaka, Yuji; Murota, Hiroyuki; Matsumoto, Takeshi; Araki, Tsutomu; Yasui, Takeshi


    Optical assessment of skin burns is possible with second-harmonic-generation (SHG) microscopy due to its high sensitivity to thermal denaturation of collagen molecules. In contrast to previous studies that were performed using excised tissue specimens ex vivo, in vivo observation of dermal collagen fibers in living rat burn models with SHG microscopy is demonstrated. Changes in signal vanishing patterns in the SHG images are confirmed to be dependent on the burn degree. Comparison of the SHG images with Masson's trichrome-stained images indicated that the observed patterns were caused by the coexistence of molten and fibrous structures of dermal collagen fibers. Furthermore, a quantitative parameter for burn assessment based on the depth profile of the mean SHG intensity across the entire SHG image is proposed. These results and discussions imply a potential of SHG microscopy as a minimally invasive, highly quantitative tool for skin burn assessment.

  1. Cooking fuel choices and garbage burning practices as determinants of birth weight: a cross-sectional study in Accra, Ghana

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    Amegah Adeladza K


    Full Text Available Abstract Background Effect of indoor air pollution (IAP on birth weight remains largely unexplored but yet purported as the most important environmental exposure for pregnant women in developing countries due to the effects of second-hand smoke. We investigated the associations between the determinants of indoor air quality in households and birth weight. Methods A cross-sectional study of 592 mothers and their newborns using postnatal services at the Korle Bu Teaching Hospital located in Accra, Ghana was conducted in 2010 to collect information on characteristics of indoor environment and other potential determinants of fetal growth. Birth weight was recorded from hospital records. Results Household cooking fuel choices and garbage burning practices were determinants of birth weight. Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, and sex of neonate resulted in a 243g (95% CI: 496, 11 and 178g (95% CI: 421, 65 reduction in birth weight for use of charcoal, and garbage burning respectively compared with use of LPG only. The estimated reductions in birth weight was not statistically significant. Applying the ordinal scale exposure parameter nonetheless revealed a significant exposure-response relationship between maternal exposures from charcoal use and garbage burning, and birth weight. Generalized linear models adjusting for confounders resulted in a 41% (risk ratio [RR] = 1.41; 95% CI: 0.62, 3.23 and 195% (RR=2.95; 95% CI: 1.10, 7.92 increase in the risk of low birth weight (LBW for use of charcoal, and garbage burning respectively compared with use of LPG only. A combination of charcoal use and household garbage burning during pregnancy on fetal growth resulted in a 429g (95% CI: 259, 599 reduction in birth weight and 316% (RR=4.16; 95% CI: 2.02, 8.59 excess risk of LBW. Sensitivity analysis performed by restricting the analysis to term births produced similar results

  2. Water uptake by biomass burning aerosol at sub- and supersaturated conditions: closure studies and implications for the role of organics

    Directory of Open Access Journals (Sweden)

    U. Dusek


    Full Text Available We investigate the CCN activity of freshly emitted biomass burning particles and their hygroscopic growth at a relative humidity (RH of 85%. The particles were produced in the Mainz combustion laboratory by controlled burning of various wood types. The water uptake at sub- and supersaturations is parameterized by the hygroscopicity parameter, κ (c.f. Petters and Kreidenweis, 2007. For the wood burns, κ is low, generally around 0.06. The main emphasis of this study is a comparison of κ derived from measurements at sub- and supersaturated conditions (κG and κCCN, in order to see whether the water uptake at 85% RH can predict the CCN properties of the biomass burning particles. Differences in κGand κCCN can arise through solution non-idealities, the presence of slightly soluble or surface active compounds, or non-spherical particle shape. We find that κG and κCCN agree within experimental uncertainties (of around 30% for particle sizes of 100 and 150 nm; only for 50 nm particles is κCCN larger than κG by a factor of 2. The magnitude of this difference and its dependence on particle size is consistent with the presence of surface active organic compounds. These compounds mainly facilitate the CCN activation of small particles, which form the most concentrated solution droplets at the point of activation. The 50 nm particles, however, are only activated at supersaturations higher than 1% and are therefore of minor importance as CCN in ambient clouds. By comparison with the actual chemical composition of the biomass burning particles, we estimate that the hygroscopicity of the water-soluble organic carbon (WSOC fraction can be represented by a κWSOC value of approximately 0.2. The effective hygroscopicity of a typical wood burning particle can therefore be represented by a linear mixture of an inorganic component with κ ≅ 0.6, a WSOC

  3. Clinical study of burn patients requiring admission: A single center experience at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences

    Directory of Open Access Journals (Sweden)

    Donkupar Khongwar


    Full Text Available Background: Although burns are a major problem in health care, a lot of the variation in risk factors exists from region to region which if uncovered correctly could help take effective prevention measures. Aims and Objectives: To assess the 3-year (January 2012 to January 2015 epidemiology of burn injuries admitted to our hospital (primary objective and to find areas of improvement in burn care (secondary objective. Materials and Methods: After obtaining ethical approval data were obtained from the medical record section regarding age, sex, residence, occupation, marital status, socioeconomic status, dates of admission and discharge, circumstances regarding the place, intent, cause, and source of heat. Clinical assessment was done using Wallace's “Rule of Nine” in adult and “Lund and Browder” chart in the pediatric age groups. The interrelationships between clinical and epidemiological variables with burn injury were studied. Results: An increasing trend in the admission rates of burn victims noted in last 3 years males (55.47% outnumbered females (44.52%. The most common age group affected is older children, adolescents, and young adults (between 11 and 30 years. Flame (38.3% and scald (25.3% burns contributed to most of the injuries. Females (52.30% are the major victim of flame burns. Electrical and chemical burns affected only the males suggesting work-related injuries. Trunk (30.8% is the most severely affected site in all cases. Depression (6.8% and power line workers (4.7% seem to be important risk factors in our study. Inability to complete treatment (26.7% was a major concern in our study. Conclusions: This study highlights the need for proper burn care that could be provided at the primary health-care level. The majority of burns were accidental in nature in school going children, young adults, and females. Flame and scald burns were the most common cause. Preventive measures directed toward burn safety and first aid measures

  4. Accuracy of real time radiography burning rate measurement (United States)

    Olaniyi, Bisola

    The design of a solid propellant rocket motor requires the determination of a propellant's burning-rate and its dependency upon environmental parameters. The requirement that the burning-rate be physically measured, establishes the need for methods and equipment to obtain such data. A literature review reveals that no measurement has provided the desired burning rate accuracy. In the current study, flash x-ray modeling and digitized film-density data were employed to predict motor-port area to length ratio. The pre-fired port-areas and base burning rate were within 2.5% and 1.2% of their known values, respectively. To verify the accuracy of the method, a continuous x-ray and a solid propellant rocket motor model (Plexiglas cylinder) were used. The solid propellant motor model was translated laterally through a real-time radiography system at different speeds simulating different burning rates. X-ray images were captured and the burning-rate was then determined. The measured burning rate was within 1.65% of the known values.


    Directory of Open Access Journals (Sweden)



    Full Text Available The peri - operative management of post - burn contractures of the neck is a challenge not only to the surgeon but also the anaesthesiologist. A proper co - ordination between them is needed for providing a hassle - free patient care. This is a prospective study done on 30 consecutive patients of post burn contractures of the neck to compare the surgeon’s assessment of the type and pattern of post - burn contracture of the neck and the anaesthesiologist’s assessment of the airway. T he association of this with the peri - operative management of patients was also studied. The data analysed was type of contracture , mento - sternal distance , and preoperative grading of the airway. The method of securing intra - operative airway was documented . A direct co - relation was noted between the type of contracture with the Mallampatti grading of the airway and the sterno - mental distance. All type III contractures required release before intubation. In conclusion , it is advisable for the surgeon to be w ell - versed with the anaesthesiologist’s assessment of the airway and the anaesthesiologist to aware of the types of neck contracture in order to properly plan and execute the peri - operative management of these patients.

  6. Forensic aspects of carbon monoxide poisoning by charcoal burning in Denmark, 2008-2012: an autopsy based study. (United States)

    Nielsen, Pia Rude; Gheorghe, Alexandra; Lynnerup, Niels


    Carbon monoxide (CO) inhalation is a well-known method of committing suicide. There has been a drastic increase in suicide by inhalation of CO, produced from burning charcoal, in some parts of Asia, and a few studies have reported an increased number of these deaths in Europe. CO-related deaths caused by charcoal burning have, to our knowledge, not been recorded in the Danish population before. In this retrospective study we present all autopsied cases of CO poisoning caused by charcoal burning in the period 2008-2012. 19 autopsied cases were identified, comprising 11 suicides, 4 accidents, and 2 cases of maternal/paternal filicide-suicide. The mean age of decedents was 38.2 years and the majority of the decedents were men. In 16 cases carboxyhemoglobin levels were above 50 % and in 14 cases we found distinctive cherry red livor mortis. Various concentrations of ethanol and drugs were found in 9 cases. Data suggest that this method of death has increased significantly in Denmark. Therefore, it is highly relevant to draw attention to the subject, to increase awareness as well as prevent future escalation.

  7. A Descriptive Study of the Temporal Patterns of Volume and Contents Change in Human Acute Burn Edema: Application in Evidence-Based Intervention and Research Design. (United States)

    Edgar, Dale W; Fear, Mark; Wood, Fiona M


    Edema after burn contributes significantly to burn wound depth conversion. In humans after burn injury, there is a lack of detailed understanding of the contents and temporal changes in volume of acute tissue edema. The novel findings of these studies relate to the collection of edema fluid after partial-thickness burn injury. Edema volume peaks on day 1 after burn without formal fluid resuscitation. The studies indicated that the peak was on day 2 for a resuscitated burn. In contrast, animal studies suggest that the peak of edema occurs by or before day 1 after injury. The findings confirm the pitfalls of evidence derived from animal models and assuming direct transference to humans. Postburn edema was demonstrated to be a high-protein fluid (ie, ≥10 g/L) for the duration of the inflammatory period. The presence of high-protein edema presents greater challenges to clinicians developing novel treatment options. The rate of volume change over time tapered to insignificant levels after day 4 following burn. Greater than 98% of the edema contents was fluid. However, the size of particulate matter did not preclude it passing through patent lymphatic collectors. The results indicate a necessity for urgent postburn intervention, which should incorporate the active stimulation of the lymphatic system to improve efficacy of edema removal.

  8. Burns, biofilm and a new appraisal of burn wound sepsis. (United States)

    Kennedy, Peter; Brammah, Susan; Wills, Edward


    Following a burn, the wound may become colonized and septic complications may ensue. Many organisms, commonly isolated from burn wounds produce biofilms, which are defined as a collection of organisms on a surface surrounded by a matrix. Biofilms are associated with development of antibiotic resistant organisms and are refractory to the immune system. The presence of biofilm in the burn wound has not been documented. A study was undertaken using light and electron microscopy to determine the presence of biofilm in the burn wound. Specific stains were used to detect the presence of micro-organisms and associated carbohydrate, a major constituent of the biofilm matrix. A concurrent microbiological study of the burn wound was also carried out. Biofilm was detected in ulcerated areas of the burn wound. Bacterial wound invasion with mixed organisms was also commonly detected. The finding of biofilm in the burn wound has significance in our understanding of burn wound sepsis and supports the evidence for early excision and closure of the burn wound. Due to the recalcitrant nature of biofilm associated sepsis and the difficulty in disrupting biofilm it has implications for the future development of wound care dressings. Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved.

  9. Effects of aging on organic aerosol from open biomass burning smoke in aircraft and laboratory studies

    Directory of Open Access Journals (Sweden)

    M. J. Cubison


    Full Text Available Biomass burning (BB is a large source of primary and secondary organic aerosols (POA and SOA. This study addresses the physical and chemical evolution of BB organic aerosols. Firstly, the evolution and lifetime of BB POA and SOA signatures observed with the Aerodyne Aerosol Mass Spectrometer are investigated, focusing on measurements at high-latitudes acquired during the 2008 NASA ARCTAS mission, in comparison to data from other field studies and from laboratory aging experiments. The parameter f60, the ratio of the integrated signal at m/z 60 to the total signal in the organic component mass spectrum, is used as a marker to study the rate of oxidation and fate of the BB POA. A background level of f60~0.3% ± 0.06% for SOA-dominated ambient OA is shown to be an appropriate background level for this tracer. Using also f44 as a tracer for SOA and aged POA and a surrogate of organic O:C, a novel graphical method is presented to characterise the aging of BB plumes. Similar trends of decreasing f60 and increasing f44 with aging are observed in most field and lab studies. At least some very aged BB plumes retain a clear f60 signature. A statistically significant difference in f60 between highly-oxygenated OA of BB and non-BB origin is observed using this tracer, consistent with a substantial contribution of BBOA to the springtime Arctic aerosol burden in 2008. Secondly, a summary is presented of results on the net enhancement of OA with aging of BB plumes, which shows large variability. The estimates of net OA gain range from ΔOA/ΔCO(mass = −0.01 to ~0.05, with a mean ΔOA/POA ~19%. With these ratios and global inventories of BB CO and POA a global net OA source due to aging of BB plumes of ~8 ± 7 Tg OA yr−1 is estimated, of the order of 5 % of recent total OA source estimates. Further field data

  10. A pilot study of a hand-held camera in a busy burn centre: Prediction of patient length of recuperation with wound temperature. (United States)

    Mazurek, Maciej J; Frew, Quentin; Sadeghi, Abtin M M; Tan, Alethea; Syed, Mobinulla; Dziewulski, Peter


    The aim of our study was to evaluate temperature differences of burns looking at their prognostic ability to predict healing at the 21 day mark. Thirty two burns in 26 patients aged 1-71 years old were photographed with a FLIR T650 camera. Environment, reflected, and body core temperature of the patients were measured. Skin emissivity was constant 0.98. Pictures were analyzed with R&D FLIR Software. Minimal and average burn temperatures and skin temperature in 255 pixel squares were measured. Patients were divided into healed and not healed groups. Statistical analysis was performed with SPSS 20 (IBM Armonk, USA) and pburns at 21 days. Healed burns were significantly warmer than non-healed burns (pburns temperatures and healthy skin temperatures with days needed to heal the burns (p=0.001; rho=-0.564). Infrared camera seems to be useful equipment in predicting burns' healing time. However further clinical studies need to be done. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  11. Ablative CO2 fractional resurfacing in treatment of thermal burn scars: an open-label controlled clinical and histopathological study. (United States)

    El-Zawahry, Bakr M; Sobhi, Rehab M; Bassiouny, Dalia A; Tabak, Sahar A


    Burn scars can cause permanent disfiguring problems with limited treatments available. To assess and correlate the clinical and histopathological effects of fractional CO2 laser on thermal burns in a controlled study. Fifteen patients 11 with hypertrophic and four with keloidal scars received three CO2 fractional laser sessions every 4-6 weeks. Half of the scar was untreated as a control. Clinical evaluation by Vancouver, PSOAS scores, and photography before, monthly, and 3 months after the last laser session was performed. Ten patients were evaluated histopathologically by standard H&E, Masson trichrome, and Elastica von Gieson special stains. Hypertrophic scars (HTSs) showed textural improvement and a significant decrease of Vancouver, POSAS observer, and patient scores by the end of follow-up period in the laser-treated area (P = 0.011, 0.017 and 0.018, respectively) unlike keloidal scars. Histopathology revealed significant decrease in scar thickness in HTSs only (P < 0.001) as well as a significant decrease in collagen bundle thickness and density in the upper dermis in both types of scars. Fractional CO2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically. © 2015 Wiley Periodicals, Inc.

  12. Heparin/N-acetylcysteine: an adjuvant in the management of burn inhalation injury: a study of different doses. (United States)

    Elsharnouby, Noha M; Eid, Hala E A; Abou Elezz, Nahla F; Aboelatta, Yasser A


    Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. Twenty-nine patients admitted to burn intensive care unit (ICU) within 24 hours of burn inhalation injury were included in this prospective double-blinded randomized study. Group H5 received nebulized heparin sulfate 5,000 IU, and group H10 received nebulized heparin sulfate 10,000 IU. Heparin was given in alternation with N-acetylcysteine every 2 hours. Lung injury score assessed daily for 7 days was the primary outcome. Duration of mechanical ventilation, coagulation profile, length of ICU stay, and mortality were the secondary outcomes. Median lung injury scores were significantly lower in group H10 on days 5 (1.9 vs 1), 6 (1.4 vs 0.5), and 7 (1.3 vs 0.5). Group H10 had also a lower duration of mechanical ventilation than did group H5 (P = .037). The groups had no significant difference in coagulation parameters, length of ICU stay (P = .17), and mortality (P = .6). Nebulized heparin 10,000 IU decreased lung injury scores and duration of mechanical ventilation but had no effect on length of ICU stay and mortality. Moreover, nebulized heparin 10,000 IU was safe and had no effect on coagulation parameters. © 2013.

  13. Global Burned Area and Biomass Burning Emissions from Small Fires (United States)

    Randerson, J. T.; Chen, Y.; vanderWerf, G. R.; Rogers, B. M.; Morton, D. C.


    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity

  14. Global burned area and biomass burning emissions from small fires (United States)

    Randerson, J. T.; Chen, Y.; van der Werf, G. R.; Rogers, B. M.; Morton, D. C.


    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity

  15. [Behavior of free amino acids in severely burned patients (II: In the urine). Clinical studies]. (United States)

    Balogh, D


    Urinary amino acids were measured in 10 severely burned patients weekly during 4 weeks after burning. For control the same measurements have been made in 12 multiple injured patients during the first two weeks after the accident. In burned patients the renal loss of free amino acids was up to 3 g/24 h +/- 1 in the first week, together with a high excreation of sodium (450 mmol/24 h +/- 73) in the first week. Urinary output of ornithin (highest value in the 2nd week: 1093 +/- 525% of normal) and lysin (highest value in the 2nd week: 1093 +/- 525% of normal) and Lysin (highest value in the 1st week: 654 +/- 166% of normal) was increased and caused an augmented loss of cystin (645 +/- 133% of normal in the first week) and 742 +/- 64% of normal in the second week. In the first and second week after burning the excretion of valin was up to 12 times the normal. Methionine-excretion staid high (5 times the normal) during all 4 weeks. The mean rate of 3-methylhistidine output in urine (80 +/- 38 mg/24 h) was elevated from the second until fourth week, suggesting muscle protein breakdown. In the control group urinary excretion of glutamin and asparagin (1st week: 608 +/- 97% of normal), threonin (2nd week: 693 +/- 240% of normal), serin (2nd week: 517 +/- 232% of normal) and histidin (1st week: 358 +/- 115% of normal) was high. Only urinary citrullin, isoleucin, prolin and taurin were not elevated in both groups during all 4 weeks.

  16. Controlled study of enteral arginine supplementation in burned children: impact on immunologic and metabolic status. (United States)

    Marin, Veronica B; Rodriguez-Osiac, Lorena; Schlessinger, Liana; Villegas, Jorge; Lopez, Marcelo; Castillo-Duran, Carlos


    We compared the effects of an arginine-supplemented diet with those of an isocaloric isonitrogenous diet on immune and metabolic response of children with burns. This was a double-blind, randomized, placebo-controlled trial in a burn treatment center of a pediatric hospital in Santiago, Chile. All children (1-5 y of age) admitted within 48 h of a moderate to deep burn injury covering 10% to 40% of total body surface area were evaluated. Twenty-eight children met the criteria and were randomly assigned to receive an arginine-supplemented diet (AG; n = 14) or an isocaloric isonitrogenous diet (CG; control, n = 14) for 14 d. Samples were collected at admission (baseline) and on days 7 and 14 for lymphoproliferative response to mitogens, plasma interleukins (interleukin-1, interleukin-6, tumor necrosis factor-alpha), plasma arginine and ornithine levels, serum C-reactive protein, prealbumin, albumin, glucose, and total urinary nitrogen. The AG enhanced lymphoproliferative responses (analysis of variance, P responses increased to 144% in the AG group and decreased to 56% in the CG group; both groups returned to normal by day 14. Baseline interleukin-6 was significantly increased in all children. There were no differences in plasma concentrations of interleukin-1, interleukin-6, tumor necrosis factor-alpha, C-reactive protein, prealbumin, albumin, or glucose between the AG and CG groups. On day 7 plasma ornithine levels increased significantly in the AG versus CG group (P change. An exclusively AG improves mitogen-stimulated lymphocyte proliferation in burned children. The benefits of arginine for the immune system do not appear to be related to a metabolic response. The biological significance of this finding remains to be determined.

  17. Nutrition Support in Burn Patients

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    Cem Aydoğan


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

  18. Oxygen therapy for acute ocular chemical or thermal burns: a pilot study. (United States)

    Sharifipour, Farideh; Baradaran-Rafii, Alireza; Idani, Esmaeil; Zamani, Mitra; Jabbarpoor Bonyadi, Mohammad Hossein


    To evaluate the effect of systemic oxygen therapy in the management of acute ocular chemical and thermal burns. Prospective, nonrandomized, comparative, interventional case series. Twenty-four eyes of 22 patients with grade III to IV acute ocular chemical and thermal burns received conventional medical therapy. The oxygen therapy group (13 eyes) additionally received 100% oxygen using a simple mask at a flow rate of 10 L/minute for 1 hour twice daily. Main outcome measures were time for healing of the corneal epithelial defect and improvement in perilimbal ischemia. Secondary outcome measures included visual acuity, corneal transparency and vascularization, and complications. Corneal epithelial defects healed within 15.23 ± 3.94 days (range, 10 to 21 days) in the oxygen group versus 59.9 ± 23.33 days (range, 28 to 95 days) in controls (P ocular chemical or thermal burns, oxygen therapy improves limbal ischemia, accelerates epithelialization, increases corneal transparency, and decreases corneal vascularization. It also may improve visual acuity and reduce complications. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Intensive swallowing and orofacial contracture rehabilitation after severe burn: A pilot study and literature review. (United States)

    Clayton, Nicola A; Ward, Elizabeth C; Maitz, Peter K


    Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation. Therapy was prescribed, consisting of scar stretching, splinting and pharyngeal swallow tasks. Horizontal and vertical range of movement (HROM; VROM), physiological swallow features, functional swallowing outcomes and related distress, were collected at baseline and routinely until dysphagia resolution and scar stabilisation. At presentation, both cases demonstrated severely reduced HROM and VROM, profound dysphagia and moderate dysphagia related distress. Therapy adherence was high. Resolution of dysphagia to full oral diet, nil physiological swallowing impairment, and nil dysphagia related distress was achieved by 222 and 77 days post injury respectively. VROM and HROM achieved normal range by 237 and 204 days. Active rehabilitation achieved full functional outcomes for swallowing and orofacial range of movement. A protracted duration of therapy can be anticipated in this complex population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design

    National Research Council Canada - National Science Library

    Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J


    This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes...

  1. Separability Analysis of Sentinel-2A Multi-Spectral Instrument (MSI Data for Burned Area Discrimination

    Directory of Open Access Journals (Sweden)

    Haiyan Huang


    Full Text Available Biomass burning is a global phenomenon and systematic burned area mapping is of increasing importance for science and applications. With high spatial resolution and novelty in band design, the recently launched Sentinel-2A satellite provides a new opportunity for moderate spatial resolution burned area mapping. This study examines the performance of the Sentinel-2A Multi Spectral Instrument (MSI bands and derived spectral indices to differentiate between unburned and burned areas. For this purpose, five pairs of pre-fire and post-fire top of atmosphere (TOA reflectance and atmospherically corrected (surface reflectance images were studied. The pixel values of locations that were unburned in the first image and burned in the second image, as well as the values of locations that were unburned in both images which served as a control, were compared and the discrimination of individual bands and spectral indices were evaluated using parametric (transformed divergence and non-parametric (decision tree approaches. Based on the results, the most suitable MSI bands to detect burned areas are the 20 m near-infrared, short wave infrared and red-edge bands, while the performance of the spectral indices varied with location. The atmospheric correction only significantly influenced the separability of the visible wavelength bands. The results provide insights that are useful for developing Sentinel-2 burned area mapping algorithms.



  3. First aid practices, beliefs, and sources of information among caregivers regarding paediatric burn injuries in Harare, Zimbabwe: A cross-sectional study. (United States)

    Chirongoma, Farai; Chengetanai, Samson; Tadyanemhandu, Cathrine


    While burns take seconds to occur, injuries incurred result in pain and undesirable long term effects that might take a lifetime to overcome. The study was carried out to determine the measures of first aid delivered by caregivers after a burn injury and sources of the information. A cross- sectional study was carried out over a period of 3 months at two central hospitals in Harare. A questionnaire was administered to the caregivers of children within the age group of 0-60 months admitted in burns wards to elicit information on the circumstances of the burn injury and the first aid methods which were administered. Out of the 50 children who were recruited, 54.0% were females and the mean age was 29.5 months (SD= 15.5). After the burn injury 30(60.0%) of the caregivers, cooled the burn injury with cold running water whilst some caregivers also applied eggs, margarine and some traditional herbs as first aid. The other practices reported by the caregivers included use of urine and crushed cockroaches after burn injury in 40 (80.0%) whilst 20 (40.0%) reported used aloe vera gel after a burn injury. About half of the caregivers got first aid information mainly from family members and very few indicated that the information was obtained from mass media, 3 (6.0%). The first aid measures used by the majority of caregivers were either incomplete or inadequate. Although some caregivers had adequate knowledge of what to do after an injury, there still was widespread use of alternatives therapies in burn management.

  4. Perceived fatigue following pediatric burns. (United States)

    Akkerman, Moniek; Mouton, Leonora J; Dijkstra, Froukje; Niemeijer, Anuschka S; van Brussel, Marco; van der Woude, Lucas H V; Disseldorp, Laurien M; Nieuwenhuis, Marianne K


    Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Perceived fatigue was assessed in 23 children and adolescents (15 boys and 8 girls, aged 6-18 years, with burns covering 10-46% of the total body surface area, 1-5 years post burn) using both child self- and parent proxy reports of the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. Outcomes were compared with reference values of non-burned peers. At group level, pediatric burn survivors did not report significantly more symptoms of fatigue than their non-burned peers. Individual assessments showed, however, that four children experienced substantial symptoms of fatigue according to the child self-reports, compared to ten children according to the parent proxy reports. Furthermore, parents reported significantly more symptoms of fatigue than the children themselves. Age, gender, extent of burn, length of hospital stay, and number of surgeries could not predict the level of perceived fatigue post-burn. Our results suggest that fatigue is prevalent in at least part of the pediatric burn population after 1-5 years. However, the fact that parents reported significantly more symptoms of fatigue then the children themselves, hampers evident conclusions. It is essential for clinicians and therapists to consider both perspectives when evaluating pediatric fatigue after burn and to determine who needs special attention, the pediatric burn patient or its parent. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  5. The epidemiology, management, outcomes and areas for improvement of burn care in central Malawi: an observational study. (United States)

    Samuel, J C; Campbell, E L P; Mjuweni, S; Muyco, A P; Cairns, B A; Charles, A G


    This report describes the epidemiology of burn injuries and quantifies the appropriateness of use of available interventions at Kamuzu Central Hospital, Malawi, between July 2008 and June 2009 (370 burn patients). Burns accounted for 4.4% of all injuries and 25.9% of all burns presenting to the hospital were admitted. Most patients (67.6%) were Burns occurred most frequently in the cool, dry season and in the evening. The mean burn surface area (second/third degree) was 14.1% and most burns (74%) presented within 8 h. The commonest procedure was debridement and/or amputation. The mean hospital stay was 21.1 days, in-hospital mortality was 27% and wound infection rate was 31%. Available interventions (intravenous fluids, nutrition therapy, physiotherapy) were misapplied in 59% of cases. It is concluded that primary prevention should address paediatric and scald burns, and secondary prevention should train providers to use available interventions appropriately.

  6. Outcomes of outpatient management of pediatric burns. (United States)

    Brown, Matthew; Coffee, Tammy; Adenuga, Paul; Yowler, Charles J


    The literature surrounding pediatric burns has focused on inpatient management. The goal of this study is to characterize the population of burned children treated as outpatients and assess outcomes validating this method of burn care. A retrospective review of 953 patients treated the burn clinic and burn unit of a tertiary care center. Patient age, burn etiology, burn characteristics, burn mechanism, and referral pattern were recorded. The type of wound care and incidence of outcomes including subsequent hospital admission, infection, scarring, and surgery served as the primary outcome data. Eight hundred and thirty children were treated as outpatients with a mean time of 1.8 days for the evaluation of burn injury in our clinic. Scalds accounted for 53% of the burn mechanism, with burns to the hand/wrist being the most frequent area involved. The mean percentage of TBSA was 1.4% for the outpatient cohort and 8% for the inpatient cohort. Burns in the outpatient cohort healed with a mean time of 13.4 days. In the outpatient cohort, nine (1%) patients had subsequent admissions and three (0.4%) patients had concern for infection. Eight patients from the outpatient cohort were treated with excision and grafting. The vast majority of pediatric burns are small, although they may often involve more critical areas such as the face and hand. Outpatient wound care is an effective treatment strategy which results in low rates of complications and should become the standard of care for children with appropriate burn size and home support.

  7. The changing pattern of pediatric burns. (United States)

    Abeyasundara, Sandun L; Rajan, Vasant; Lam, Lawrence; Harvey, John G; Holland, Andrew J A


    After scalds, flame burns have been considered the next most common mode of burn injury in childhood. Recent experience in the authors' unit suggested that contact burns were becoming more frequent. The authors sought to determine the contemporary frequency of different burn modalities in children presenting to a burns unit. A retrospective review of 3621 children treated in the burns unit, both ambulatory and inpatient, at the authors' institution between January 2003 and December 2007 was performed. Patients were identified using the Burns Unit database. Data collected included age, gender, burn etiology and site, TBSA, and whether operative surgery was required. Of the 3515 patients eligible for inclusion, scalds accounted for 55.9%, contact 30.5%, and flame 7.9% of all burns. Contact burns were shown to be consistently more frequent than flame burns for every year of the study (z = 17.30, P burns, reflecting the variety of mechanisms involved. The data suggest a change in the historical pattern of pediatric burns previously reported in the literature. These findings have implications for public health awareness and burns prevention campaigns.

  8. Epidemiology and trends in severe burns in the Netherlands

    NARCIS (Netherlands)

    Dokter, J.; Vloemans, A.F.; Beerthuizen, G.I.J.M.; van der Vlies, C.H.; Boxma, H.; Breederveld, R.; Tuinebreijer, W.E.; Middelkoop, E.; van Baar, M.E.


    Introduction: The aim of this study was to characterize the epidemiology of severe burns in the Netherlands, including trends in burn centre admissions, non burn centre admissions and differences by age.

  9. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

    NARCIS (Netherlands)

    Disseldorp, Laurien M.; Mouton, Leonora J.; Takken, Tim; Van Brussel, Marco; Beerthuizen, Gerard I. J. M.; Van der Woude, Lucas H. V.; Nieuwenhuis, Marianne K.


    Background: Burn injuries have a major impact on the patient's physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of

  10. Coping styles and quality of life in adults with burn. (United States)

    Rothman, David J; Sutter, Megan; Perrin, Paul B; LiBrandi, Heather; Feldman, Michael J


    The purpose of this study was to examine the pattern of connections between coping strategies and indices of burn-related quality of life (BRQOL). Burn patients (n=83) were recruited from an outpatient burn clinic in the critical care hospital of a South Atlantic medical college. Participants completed measures of coping and BRQOL while in the waiting room before or after their medical appointment. A canonical correlation found that coping strategies and BRQOL were highly correlated with 47.6% overlapping variance. Within this canonical correlation, body image and dysfunctional coping had the largest loadings, suggesting that individuals with burn who exhibit negative perceptions of their body tend to engage in more dysfunctional coping styles. A multiple regression then found that a set of dysfunctional coping styles explained 39.2% of the variance in body image, with self-blame and self-distraction as independent predictors of negative perceptions of their body. Targeted intervention research that focuses on the reduction of psychological distress related to body image, self-blame, and self-distraction may have the potential to increase quality of life among individuals with burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    Dalal P


    Full Text Available Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

  12. Chemical, physical, and optical evolution of biomass burning aerosols: a case study

    Directory of Open Access Journals (Sweden)

    G. Adler


    Full Text Available In-situ chemical composition measurements of ambient aerosols have been used for characterizing the evolution of submicron aerosols from a large anthropogenic biomass burning (BB event in Israel. A high resolution Time of Flight Aerosol Mass Spectrometer (HR-RES-TOF-AMS was used to follow the chemical evolution of BB aerosols during a night-long, extensive nationwide wood burning event and during the following day. While these types of extensive BB events are not common in this region, burning of agricultural waste is a common practice. The aging process of the BB aerosols was followed through their chemical, physical and optical properties. Mass spectrometric analysis of the aerosol organic component showed that aerosol aging is characterized by shifting from less oxidized fresh BB aerosols to more oxidized aerosols. Evidence for aerosol aging during the day following the BB event was indicated by an increase in the organic mass, its oxidation state, the total aerosol concentration, and a shift in the modal particle diameter. The effective broadband refractive index (EBRI was derived using a white light optical particle counter (WELAS. The average EBRI for a mixed population of aerosols dominated by open fires was m = 1.53(±0.03 + 0.07i(±0.03, during the smoldering phase of the fires we found the EBRI to be m = 1.54(±0.01 + 0.04i(±0.01 compared to m = 1.49(±0.01 + 0.02i(±0.01 of the aged aerosols during the following day. This change indicates a decrease in the overall aerosol absorption and scattering. Elevated levels of particulate Polycyclic Aromatic Hydrocarbons (PAHs were detected during the entire event, which suggest possible implications for human health during such extensive event.

  13. Perceived fatigue following pediatric burns

    NARCIS (Netherlands)

    Akkerman, Moniek; Mouton, Leonora J.; Dijkstra, Froukje; Niemeijer, Anuschka S.; van Brussel, Marco; van der Woude, Lucas H. V.; Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.


    Purpose: Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Methods: Perceived fatigue was

  14. Perceived fatigue following pediatric burns

    NARCIS (Netherlands)

    Akkerman, Moniek; Mouton, Leonora J.; Dijkstra, Froukje; Niemeijer, Anuschka S.; van Brussel, Marco|info:eu-repo/dai/nl/30481962X; Van der Woude, Lucas H. V.; Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.


    Purpose Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Methods Perceived fatigue was

  15. Exploratory study of burn time, duty factor, and fluence on ITER activation hazards

    Energy Technology Data Exchange (ETDEWEB)

    Piet, S.J.


    The safety analyses for the Conceptual Design Activity (CDA) of the International Thermonuclear Experimental Reactor (ITER) were based on the simplifying assumption that the activation of materials occurs continuously. Since the analyses showed a significant hazard, it is appropriate to examine how much hazard reduction might occur if this conservative assumption were relaxed. This report explores how much reduction might be gained by considering non-continuous operation, that is, by considering plasma burn time, duty factor, and integrated fluence. Other factors impacting activation hazards - material choice, flux, and size - are not considered here.

  16. The Epidemiology, Management, Outcomes and Areas for Improvement of Burn Care in Central Malawi: an Observational Study


    Samuel, JC; Campbell, ELP; Mjuweni, S; Muyco, AP; Cairns, BA; Charles, AG


    This report describes the epidemiology of burn injuries and quantifies the appropriateness of use of available interventions at Kamuzu Central Hospital, Malawi, between July 2008 and June 2009 (370 burn patients). Burns accounted for 4.4% of all injuries and 25.9% of all burns presenting to the hospital were admitted. Most patients (67.6%) were < 15 years old and 56.2% were male. The most frequent cause was scalding (51.4%). Burns occurred most frequently in the cool, dry season and in the ev...

  17. A population-based study of the epidemiology of acute adult burns in Ecuador from 2005 to 2014. (United States)

    Ortiz-Prado, Esteban; Armijos, Luciana; Iturralde, Ana Lucia


    To describe the demographic, risk factor, occupational, and morbidity and mortality characteristics of burns in adults in Ecuador using national data. These data are from the only specialized public hospital in Ecuador that has a 12-bed burn unit. The National Institute of Statistics and Census provided data from the burn unit of the Hospital Eugenio Espejo, in Quito. Three different datasets pertaining to burn deaths, burn unit inpatient admissions, and hospital discharge were analyzed. Patients who died or were discharged before entering the burn unit were not included in this analysis. During the 10-year period, 1106 patients were admitted to the burn unit, men represent 69.37% with 768 cases and women represent 30.62% with 337 patients; the number of patients per year was on average 123 cases; the average age was 33-34 years old, with a range between 16 and 96 years old. Heat (thermal) burns represent 65.78% followed by electrical with 30.53%, friction burns with 2.06%, and chemical burns with 1.62%. Domestic methane gas was the most frequent agent causing thermal burns and the most affected occupational groups are construction workers and people who stay at home. The overall mortality is 10.2% and the average length of stay was 23 days. Thermal burns are more frequent than any other cause of burns. Electrical burns are more frequent in Ecuador than anywhere else according to our research, meaning that control and prevention of workplace safety, urban planning, and home safety are scarce. The most affected groups are those dedicated to labor work. Finally, mortality in hospitalized patient is higher when compared with developed countries. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  18. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out. (United States)

    Stoyanov, Drozdstoj S; Cloninger, C Robert


    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the 'burn-out' syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed 'flame-out'. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other

  19. Interaction of Burning Metal Particles (United States)

    Dreizin, Edward L.; Berman, Charles H.; Hoffmann, Vern K.


    Physical characteristics of the combustion of metal particle groups have been addressed in this research. The combustion behavior and interaction effects of multiple metal particles has been studied using a microgravity environment, which presents a unique opportunity to create an "aerosol" consisting of relatively large particles, i.e., 50-300 m diameter. Combustion behavior of such an aerosol could be examined using methods adopted from well-developed single particle combustion research. The experiment included fluidizing relatively large (order of 100 m diameter) uniform metal particles under microgravity and igniting such an "aerosol" using a hot wire igniter. The flame propagation and details of individual particle combustion and particle interaction have been studied using a high speed movie and video-imaging with cameras coupled with microscope lenses to resolve individual particles. Interference filters were used to separate characteristic metal and metal oxide radiation bands from the thermal black body radiation. Recorded flame images were digitized and various image processing techniques including flame position tracking, color separation, and pixel by pixel image comparison were employed to understand the processes occurring in the burning aerosol. The development of individual particle flames, merging or separation, and extinguishment as well as induced particle motion have been analyzed to identify the mechanisms governing these processes. Size distribution, morphology, and elemental compositions of combustion products were characterized and used to link the observed in this project aerosol combustion phenomena with the recently expanded mechanism of single metal particle combustion.

  20. Excitation energy transfer in natural photosynthetic complexes and chlorophyll trefoils: hole-burning and single complex/trefoil spectroscopic studies

    Energy Technology Data Exchange (ETDEWEB)

    Ryszard Jankowiak, Kansas State University, Department of Chemistry, CBC Bldg., Manhattan KS, 66505; Phone: (785) 532-6785


    In this project we studied both natural photosynthetic antenna complexes and various artificial systems (e.g. chlorophyll (Chl) trefoils) using high resolution hole-burning (HB) spectroscopy and excitonic calculations. Results obtained provided more insight into the electronic (excitonic) structure, inhomogeneity, electron-phonon coupling strength, vibrational frequencies, and excitation energy (or electron) transfer (EET) processes in several antennas and reaction centers. For example, our recent work provided important constraints and parameters for more advanced excitonic calculations of CP43, CP47, and PSII core complexes. Improved theoretical description of HB spectra for various model systems offers new insight into the excitonic structure and composition of low-energy absorption traps in very several antenna protein complexes and reaction centers. We anticipate that better understanding of HB spectra obtained for various photosynthetic complexes and their simultaneous fits with other optical spectra (i.e. absorption, emission, and circular dichroism spectra) provides more insight into the underlying electronic structures of these important biological systems. Our recent progress provides a necessary framework for probing the electronic structure of these systems via Hole Burning Spectroscopy. For example, we have shown that the theoretical description of non-resonant holes is more restrictive (in terms of possible site energies) than those of absorption and emission spectra. We have demonstrated that simultaneous description of linear optical spectra along with HB spectra provides more realistic site energies. We have also developed new algorithms to describe both nonresonant and resonant hole-burn spectra using more advanced Redfield theory. Simultaneous description of various optical spectra for complex biological system, e.g. artificial antenna systems, FMO protein complexes, water soluble protein complexes, and various mutants of reaction centers

  1. Chemical burn or reaction (United States)

    ... this page: // Chemical burn or reaction To use the sharing features on ... the burned area from pressure and friction. Minor chemical burns will generally heal without further treatment. However, if ...

  2. Costs of burn care: A systematic review

    NARCIS (Netherlands)

    Hop, M.J.; Polinder, S.; van der Vlies, C.H.; Middelkoop, E.; van Baar, M.E.


    Burn care is traditionally considered expensive care. However, detailed information about the costs of burn care is scarce despite the increased need for this information and the enhanced focus on healthcare cost control. In this study, economic literature on burn care was systematically reviewed to

  3. Development of Animal Model for Studying Deep Second-Degree Thermal Burns

    Directory of Open Access Journals (Sweden)

    Danielle dos Santos Tavares Pereira


    Full Text Available Thermal lesions were produced in 12 male Wistar rats, positioning a massive aluminum bar 10 mm in diameter (51 g, preheated to 99°C ± 2°C/10 min. on the back of each animal for 15 sec. After 7, 14, 21, and 28 days, animals were euthanized. The edema intensity was mild, with no bubble and formation of a thick and dry crust from the 3rd day. The percentage of tissue shrinkage at 28 days was 66.67 ± 1.66%. There was no sign of infection, bleeding, or secretion. Within 28 days reepithelialization was incomplete, with fibroblastic proliferation and moderate fibrosis and presence of modeled dense collagen fibers. It is concluded that the model established is applicable in obtaining deep second-degree thermal burns in order to evaluate the healing action of therapeutic agents of topical use.

  4. The effectiveness of multimedia learning education programs on knowledge, anxiety and pressure garment compliance in patients undergoing burns rehabilitation in Taiwan: an experimental study. (United States)

    Lo, Shu-Fen; Hayter, Mark; Hsu, Ma; Lin, Su-Er; Lin, Shu-In


    This study examined the effectiveness of multimedia learning education programmes (MLEPs) on knowledge, anxiety and pressure garment compliance behaviour of burn patients. MLEPs are increasingly suggested as education methods that can be used by health professionals in daily practice. A systematic review of the effectiveness of computer-based education demonstrates its acceptability to patients. However, few studies have empirically tested this approach. Experimental study. An experimental study was conducted at a burn centre of a medical centre in Taipei, Taiwan. Participants were randomly assigned to either experimental (n = 28) or control groups (n = 30). Both groups were given pre-tests and post-tests to measure their knowledge, anxiety and pressure garment compliance behaviour. At two weeks, the results of this study showed that the MLEP had 'statistically' significantly improved patients' burn knowledge, reduced individual anxiety and enhanced pressure garment compliance behaviour. This controlled study demonstrated that a two week MLEP can be a useful intervention to improve care compliance and reduce anxiety in patients undergoing burns rehabilitation period. Burn injury patients undergoing rehabilitation are likely to benefit from multimedia learning education intervention programmes. More comprehensive health economic evaluation needs to be undertaken. Further studies exploring a longer term follow-up are also required.

  5. Genotoxic potential generated by biomass burning in the Brazilian Legal Amazon by Tradescantia micronucleus bioassay: a toxicity assessment study

    Directory of Open Access Journals (Sweden)

    Artaxo Paulo


    Full Text Available Abstract Background The Brazilian Amazon has suffered impacts from non-sustainable economic development, especially owing to the expansion of agricultural commodities into forest areas. The Tangará da Serra region, located in the southern of the Legal Amazon, is characterized by non-mechanized sugar cane production. In addition, it lies on the dispersion path of the pollution plume generated by biomass burning. The aim of this study was to assess the genotoxic potential of the atmosphere in the Tangará da Serra region, using Tradescantia pallida as in situ bioindicator. Methods The study was conducted during the dry and rainy seasons, where the plants were exposed to two types of exposure, active and passive. Results The results showed that in all the sampling seasons, irrespective of exposure type, there was an increase in micronucleus frequency, compared to control and that it was statistically significant in the dry season. A strong and significant relationship was also observed between the increase in micronucleus incidence and the rise in fine particulate matter, and hospital morbidity from respiratory diseases in children. Conclusions Based on the results, we demonstrated that pollutants generated by biomass burning in the Brazilian Amazon can induce genetic damage in test plants that was more prominent during dry season, and correlated with the level of particulates and elevated respiratory morbidity.

  6. Why burn patients are referred? (United States)

    Latifi, Noor-Ahmad; Karimi, Hamid


    Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital. For 2 years, we prospectively surveyed the burn patients referred to a tertiary teaching burn hospital. Data for the following variables were collected and analyzed with SPSS software V21.0: causes of burn; age; gender; total body surface area (TBSA) measured at the referring center; TBSA measured at the receiving center; concomitant diseases and traumas; the reason for referral; condition of patients before and during the transportation; transportation time; presence of infection; presence of inhalation injury, electrical injury, and chemical injury; child abuse; insurance coverage; and results and outcomes of patients. A total of 578 burn patients (33.6% of the total admissions) were referred in the study period. Among these patients, 70.9% were females. The mean (SD) age of the patients was 35.3 (19.69) years. The mean (SD) of TBSA was 45.2 (26.3). Of the 578 patients, 45% were referred by request of the family or patients; 9% were referred because lack of diagnostic facility, approximately 43% were referred because of the need to be admitted in a tertiary burn center, 0.7% were referred because of a lack of capacity at other hospitals, and 0.5% were referred because of an error in the estimation of TBSA. A total of 45% of the referrals were by request of the family and patients. Tele-medicine may help to establish a direct contact between expert burn physicians and the patients and thus reduce unnecessary transfers. Approximately 9% of the referrals were because of lack of some diagnostic facilities. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. Microwave Imaging of Human Forearms: Pilot Study and Image Enhancement

    Directory of Open Access Journals (Sweden)

    Colin Gilmore


    Full Text Available We present a pilot study using a microwave tomography system in which we image the forearms of 5 adult male and female volunteers between the ages of 30 and 48. Microwave scattering data were collected at 0.8 to 1.2 GHz with 24 transmitting and receiving antennas located in a matching fluid of deionized water and table salt. Inversion of the microwave data was performed with a balanced version of the multiplicative-regularized contrast source inversion algorithm formulated using the finite-element method (FEM-CSI. T1-weighted MRI images of each volunteer’s forearm were also collected in the same plane as the microwave scattering experiment. Initial “blind” imaging results from the utilized inversion algorithm show that the image quality is dependent on the thickness of the arm’s peripheral adipose tissue layer; thicker layers of adipose tissue lead to poorer overall image quality. Due to the exible nature of the FEM-CSI algorithm used, prior information can be readily incorporated into the microwave imaging inversion process. We show that by introducing prior information into the FEM-CSI algorithm the internal anatomical features of all the arms are resolved, significantly improving the images. The prior information was estimated manually from the blind inversions using an ad hoc procedure.

  8. Car radiator burns: a prevention issue. (United States)

    Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W


    Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

  9. Epidemiologic evaluation of patients with major burns and recommendations for burn prevention. (United States)

    Ciftçi, Ilhan; Arslan, Kemal; Altunbaş, Zeynep; Kara, Fatih; Yilmaz, Hüseyin


    Burns are an important health problem in our country and in the world. In our study, we aimed to epidemiologically analyze the patients who were hospitalized in a burn unit that serves 3 million individuals in Central Anatolia. Records of 457 patients who had been hospitalized in the burn unit during the period 2008-2010 were analyzed retrospectively. Patients were assessed in terms of gender, age, burn area, burn depth, admission time to the health center, burn region, and factors causing burns. Most (44.6%) of the patients were in the 0-5 age group. Burn surface area was detected as 11.6 +/- 8.5%. Patients had reached the health center in 252.8 +/- 892.5 minutes. While 82.7% of the patients had second degree bums, 17.3% had third degree burns. Most burns were on the extremities (39.6%). The most common burn agent was scalds with hot liquids (54.1%). In our study, children in the 0-5 age group were found to be the most commonly affected group with respect to indoor burns. The basic contributing factor is that children spend more time in the house and are more active. Scalding burns may be prevented when greater care is taken when using hot liquids that may lead to indoor burns. Informing parents on this issue is of first priority.

  10. Spectral Hole Burning via Kerr Nonlinearity (United States)

    Khan, Anwar Ali; Abdul Jabar, M. S.; Jalaluddin, M.; Bacha, Bakht Amin; Iftikhar, Ahmad


    Spectral hole burning is investigated in an optical medium in the presence of Doppler broadening and Kerr nonlinearity. The Kerr nonlinearity generates coherent hole burning in the absorption spectrum. The higher order Kerr nonlinearity enhances the typical lamb dip of the hole. Normal dispersion in the hole burning region while Steep anomalous dispersion between the two hole burning regions also enhances with higher order Kerr effect. A large phase shift creates large delay or advancement in the pulse propagation while no distortion is observed in the pulse. These results provide significant steps to improve optical memory, telecom devices, preservation of information and image quality. Supported by Higher Education Commission (HEC) of Pakistan

  11. Cutaneous osteosarcoma arising from a burn scar

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)


    Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

  12. Thermodynamic and kinetic studies of dioxin formation and emissions from power boilers burning salt-laden wood waste

    Energy Technology Data Exchange (ETDEWEB)

    Duo, W.; Leclerc, D. [Pulp and Paper Research Institute of Canada (Paprican) (Canada)


    Wikstrom et al. investigated PCDD/F formation in the combustion of an artificial fuel with PVC or CaCl{sub 2} added. They found no correlation between the levels of dioxin formation and the fuel chlorine content. However, Yasuhara et al. observed increases in dioxin formation with the NaCl content when impregnated newspapers were incinerated. In power boilers burning salt-laden hog fuel, the chlorine is introduced mainly as NaCl. To our knowledge, high temperature salt chemistry and its influence on dioxin formation in combustion and thermal processes have not been thoroughly studied. A thermodynamic analysis of the salt chemistry will be provided in this paper. Though largely empirical, most of the kinetic models developed to describe PCDD/F formation rates are complicated, containing 8 - 12 parameters that need to be estimated. Everaert and Baeyens reported a very simple correlation between stack PCDD/F emissions and the electrostatic precipitator (ESP) temperature: log(PCDD/F){sub T} = (0.016T - 3.001). Although this correlation cannot quantitatively predict dioxin emissions measured on the Canadian west coastal power boilers burning salt-laden hog fuel, the effect of ESP temperature given in the correlation agrees qualitatively. In this work, we will attempt to develop a semi-empirical model based upon both thermodynamic analysis and kinetic considerations.

  13. Total level and release of silver from a nanoparticles containing dressing used in burns care – a pilot study

    Directory of Open Access Journals (Sweden)

    Rigo C.


    Full Text Available For centuries silver and its compounds have been in use to control infection and avoid septicaemia in the care of burns and chronic wounds. Renewed interest has resulted in a number of silver-based dressings exploiting nanotechnology that are now widely employed in burns centers. Despite extensive use, a systematic study of the chemical composition, release kinetics and biochemical action of these products has yet to be published. In this work we have characterized the morphology and elemental composition of a commercial dressings containing Ag by SEM-EDS. The silver content was determined by ICP-MS to be about 1.4 mg cm-2. Release kinetics in ultra pure water, physiological saline solution and human serum substitute were then deeply investigated. The highest release rates were found in serum substitute, with a maximum of 2.6 μg hr-1 cm-2. Our results show that the mean inhibitory concentrations are exceeded for most common pathogens in serum substitute and sterile water, while the presence of high Cllevels inactivates the dressings.

  14. Detecting post-fire burn severity and vegetation recovery using multitemporal remote sensing spectral indices and field-collected composite burn index data in a ponderosa pine forest (United States)

    Chen, Xuexia; Vogelmann, James E.; Rollins, Matt; Ohlen, Donald; Key, Carl H.; Yang, Limin; Huang, Chengquan; Shi, Hua


    It is challenging to detect burn severity and vegetation recovery because of the relatively long time period required to capture the ecosystem characteristics. Multitemporal remote sensing data can providemultitemporal observations before, during and after a wildfire, and can improve the change detection accuracy. The goal of this study is to examine the correlations between multitemporal spectral indices and field-observed burn severity, and to provide a practical method to estimate burn severity and vegetation recovery. The study site is the Jasper Fire area in the Black Hills National Forest, South Dakota, that burned during August and September 2000. Six multitemporal Landsat images acquired from 2000 (pre-fire), 2001 (post-fire), 2002, 2003, 2005 and 2007 were used to assess burn severity. The normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), normalized burn ratio (NBR), integrated forest index (IFI) and the differences of these indices between the pre-fire and post-fire years were computed and analysed with 66 field-based composite burn index (CBI) plots collected in 2002. Results showed that differences of NDVI and differences of EVI between the pre-fire year and the first two years post-fire were highly correlated with the CBI scores. The correlations were low beyond the second year post-fire. Differences of NBR had good correlation with CBI scores in all study years. Differences of IFI had low correlation with CBI in the first year post-fire and had good correlation in later years. A CBI map of the burnt area was produced using regression tree models and the multitemporal images. The dynamics of four spectral indices from 2000 to 2007 indicated that both NBR and IFI are valuable for monitoring long-term vegetation recovery. The high burn severity areas had a much slower recovery than the moderate and low burn areas.

  15. Unsupervised Spatio-Temporal Data Mining Framework for Burned Area Mapping (United States)

    Boriah, Shyam (Inventor); Kumar, Vipin (Inventor); Mithal, Varun (Inventor); Khandelwal, Ankush (Inventor)


    A method reduces processing time required to identify locations burned by fire by receiving a feature value for each pixel in an image, each pixel representing a sub-area of a location. Pixels are then grouped based on similarities of the feature values to form candidate burn events. For each candidate burn event, a probability that the candidate burn event is a true burn event is determined based on at least one further feature value for each pixel in the candidate burn event. Candidate burn events that have a probability below a threshold are removed from further consideration as burn events to produce a set of remaining candidate burn events.

  16. Domination and Composition Structure Change at Hemic Peat Natural Regeneration Following Burning; A Case Study in Pelalawan, Riau Province

    Directory of Open Access Journals (Sweden)



    Full Text Available Biomass burning is the burning of the world’s living and dead vegetation, including grasslands, forests and agricultural lands following the harvest for land clearing and land-use change. One of the important information needed following this biomass burning is how long the burnt forest or land can be recovered, and how worst the changing occurred. Repeated burning occurred at the same place trend to clean the vegetation which leads to have the land with lower number and quality of species left. The research objective is to understand the vegetation changing following peat fires in the sapric peat type at the land preparation using belong to the local community located in the Pelalawan district, Riau province, Indonesia during the dry season in the year 2001. Before burning, logging, slashing, drying and burning the site was dominated by Uncaria glabrata at seedling stage, Ficus sundaica at sapling stage, Ficus sundaica at pole stage and Stenochlaena palustris at understorey. After logging, slashing and followed by 4 weeks drying then continued by burning with high flame temperature range from 900-1100oC, it had been found that 3-months following burning the site was dominated by Uncaria glabrata at seedling stage and Nephrolepis flaccigera at understorey while 6-months following burning the site was dominated by Parastemon uruphyllus at seedling stage and Erechites valeriantifolia at understorey stage.

  17. Effect of a combined continuous and intermittent transcutaneous electrical nerve stimulation on pain perception of burn patients evaluated by visual analog scale: a pilot study

    Directory of Open Access Journals (Sweden)

    Pérez-Ruvalcaba I


    Full Text Available Irma Pérez-Ruvalcaba,1 Viridiana Sánchez-Hernández,1 Arieh R Mercado-Sesma2,3 1Burn Unit, Hospital de Especialidades, Centro Médico Nacional de Occidente, Mexican Institute of Social Security, 2Health Sciences Department, Centro Universitario de Tonalá, University of Guadalajara, Guadalajara, Mexico; 3Diabetes sin Complicaciones, Zapopan, Mexico Aim: The aim of this study was to assess the effect of continuous and intermittent electrical transcutaneous nerve stimulation on the perception of pain in patients with burns of different types. Materials and methods: A pilot study was conducted in 14 patients (age 30.9±7.5 years with second- and third-degree burns of different types. The burn types included electrical, fire/flame, and chemical. All patients received continuous and intermittent electrical transcutaneous nerve stimulation sessions three times per week for 4 weeks. Each session had a duration of 30 minutes. A pair of electrodes were placed around the burn. The primary efficacy endpoint was the perception of pain assessed by a visual analog scale at baseline and at the 30th day. Results: A significant reduction of pain perception was reported (8.0±1.7 vs 1.0±0.5; P=0.027 by all patients after electrical stimulation therapy. There were no reports of adverse events during the intervention period. Conclusion: Electrical stimulation could be a potential nonpharmacological therapeutic option for pain management in burn patients. Keywords: TENS, burn pain, pain management, electrotherapy

  18. Preliminary study of rabbit model with corneal neovascularization after thermal burn under the constant temperature

    Directory of Open Access Journals (Sweden)

    Yong Jia


    Full Text Available AIM:To explore the suitable conditions in rapid model of corneal neovascularization(CNVafter thermal burn under different constant temperature in rabbit. METHODS: Total 45 New Zealand white rabbits were divided randomly into five groups(A, B, C, D, E. A groups: 100℃(n=10, B groups: 200℃(n=10, C groups: 300℃(n=10, D groups: 400℃(n=10, and E groups: control group(n=5. All left eyes of rabbits in A,B,C,D groups were induced corneal neovascularization by constant temperature burning device. The growth of CNV was observed by slit lamp microscope and the area of CNV were recorded on 4 th, 7 th, 14th, 30th days postoperatively. SPSS 19.0 statistical package was used for data analysis, and the data was recorded by mean±standard deviation. Comparison by analysis of variance was made by repeated measures in the area of neovascularization at each time point in groups. Statistical tests were considered significantly when P values were less than 0.05. RESULTS: On postoperative 4th, 7th, 14th, 30th days: no neovascularization was found after corneal thermal burn in A group, but only a few nebula left(n=2; the area of CNV were(9.16±1.45mm2,(37.73±5.49mm2,(62.44±7.54mm2,(40.28±7.39mm2 in B group respectively; and(11.45±1.04mm2,(44.51±4.64mm2,(66.13±4.13mm2,(43.04±2.33mm2 in C group respectively; and(13.23±0.86mm2,(47.26±4.59mm2,(67.57±4.56mm2,(45.59±4.44mm2 in D group respectively, and part corneal carbide(n=4was observed as well as corneal perforation(n=6were found on 3d in D group. No neovascularization was found in normal control group. Comparison of the areas of CNV at each time point between groups was statistically different, PPCOCLUSION: In 4 to 7d, the higher the temperature is, the more the neovascularization area of CNV are. It has no significant difference in 14 to 30d. But corneal carbide and corneal perforation are often found in 400℃ group, so its modeling failure rate is high. It is between 200℃ and 300℃ that

  19. Generation of crystalline silica from sugarcane burning. (United States)

    Le Blond, Jennifer S; Horwell, Claire J; Williamson, Ben J; Oppenheimer, Clive


    Sugarcane leaves contain amorphous silica, which may crystallise to form crystalline silica polymorphs (cristobalite or quartz), during commercial sugarcane harvesting where sugarcane plants are burned. Respirable airborne particulate containing these phases may present an occupational health hazard. Following from an earlier pilot study (J. S. Le Blond, B. J. Williamson, C. J. Horwell, A. K. Monro, C. A. Kirk and C. Oppenheimer, Atmos. Environ., 2008, 42, 5558-5565) in which experimental burning of sugarcane leaves yielded crystalline silica, here we report on actual conditions during sugarcane burning on commercial estates, investigate the physico-chemical properties of the cultivated leaves and ash products, and quantify the presence of crystalline silica. Commercially grown raw sugarcane leaf was found to contain up to 1.8 wt% silica, mostly in the form of amorphous silica bodies (with trace impurities e.g., Al, Na, Mg), with only a small amount of quartz. Thermal images taken during several pre-harvest burns recorded temperatures up to 1056 degrees C, which is sufficient for metastable cristobalite formation. No crystalline silica was detected in airborne particulate from pre-harvest burning, collected using a cascade impactor. The sugarcane trash ash formed after pre-harvest burning contained between 10 and 25 wt% SiO(2), mostly in an amorphous form, but with up to 3.5 wt% quartz. Both quartz and cristobalite were identified in the sugarcane bagasse ash (5-15 wt% and 1-3 wt%, respectively) formed in the processing factory. Electron microprobe analysis showed trace impurities of Mg, Al and Fe in the silica particles in the ash. The absence of crystalline silica in the airborne emissions and lack of cristobalite in trash ash suggest that high temperatures during pre-harvest burning were not sustained long enough for cristobalite to form, which is supported by the presence of low temperature sylvite and calcite in the residual ash. The occurrence of quartz and

  20. Incidence and characteristics of chemical burns. (United States)

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol


    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  1. Experimental and numerical studies of a lean-burn internally-staged combustor

    Directory of Open Access Journals (Sweden)

    Fu Zhenbo


    Full Text Available A lean-burn internally-staged combustor for low emissions that can be used in civil aviation gas turbines is introduced in this paper. The main stage is designed and optimized in terms of fuel evaporation ratio, fuel/air pre-mixture uniformity, and particle residence time using commercial computational fluid dynamics (CFD software. A single-module rectangular combustor is adopted in performance tests including lean ignition, lean blowout, combustion efficiency, emissions, and combustion oscillation using aviation kerosene. Furthermore, nitrogen oxides (NOx emission is also predicted using CFD simulation to compare with test results. Under normal inlet temperature, this combustor can be ignited easily with normal and negative inlet pressures. The lean blowout fuel/air ratio (LBO FAR at the idle condition is 0.0049. The fuel split proportions between the pilot and main stages are determined through balancing emissions, combustion efficiency, and combustion oscillation. Within the landing and take-off (LTO cycle, this combustor enables 42% NOx reduction of the standard set by the 6th Committee on Aviation Environmental Protection (CAEP/6 with high combustion efficiency. The maximum board-band pressure oscillations of inlet air and fuel are below 1% of total pressure during steady-state operations at the LTO cycle specific conditions.

  2. Imaging studies of crystalline arthritides

    Directory of Open Access Journals (Sweden)

    G. Garlaschi


    Full Text Available Gout, calcium pyrophosphate dihydrate (CPPD deposition disease, and calcium hydroxyapatite deposition disease (HADD are the three most common crystal-induced arthropathies. Multimodality imaging may help in their diagnosis, and is useful for a precise and comprehensive assessment and grading of the related osteoarticular damage. Plain film radiography, due to its low cost and wide availability, is the first imaging technique to be used in crystal deposition diseases, providing well-known and specific findings for CPPD deposition disease and HADD, while it may undergrade the early osteoarticular lesions in gouty patients. Ultrasonography (US is a radiation-free approach that accurately depicts crystal deposits in cartilage, peri- and intra-articular soft tissues, but it does not give a panoramic view of the affected joints. Cross-sectional imaging techniques can examine crystal deposits in the spine and axial joints. CT has the potential to distinguish monosodium urate (MSU crystals from calcium containing crystals, due to their different attenuation values. MRI may demonstrate synovitis, erosions and bone marrow edema in gouty patients and it may differentiate tophi from other soft tissue nodules due to its high contrast resolution and power of tissue characterization.

  3. Evaluating the Effectiveness of a Commercial Portable Air Purifier in Homes with Wood Burning Stoves: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Julie F. Hart


    Full Text Available Wood burning for residential heating is prevalent in the Rocky Mountain regions of the United States. Studies have shown that wood stoves can be a significant source of PM2.5 within homes. In this study, the effectiveness of an electrostatic filter portable air purifier was evaluated (1 in a home where a wood stove was the sole heat source and (2 in a home where a wood stove was used as a supplemental heat source. Particle count concentrations in six particle sizes and particle mass concentrations in two particle sizes were measured for ten 12-hour purifier on and ten purifier off trials in each home. Particle count concentrations were reduced by 61–85 percent. Similar reductions were observed in particle mass concentrations. These findings, although limited to one season, suggest that a portable air purifier may effectively reduce indoor particulate matter concentrations associated with wood combustion during home heating.

  4. Comparative study of Low-level laser therapy and microcurrent on the healing of skin burns in rats

    Directory of Open Access Journals (Sweden)

    Rodrigo Pegado de Abreu Freitas


    This study investigated and compared the effects of low-level laser therapy (LLLT and microcurrent in the burn healing process in Wistar rats. We conducted a randomized controlled study with 30 rats divided into 3 groups (n = 10; control group (CG, laser group (LG and microcurrent group (MG. After thermal damage, 10 applications of 660 nm diode laser were performed in GL and 10 applications of 60 Hz microcurrent (160 μA in MG. The semi-quantitative histological analysis was done using scores (0–3, in sections stained by hematoxylin and eosin and Masson’s trichrome. The results indicated a significant improvement in the fibroblasts proliferation, collagen fibers deposition, neoangiogenesis, and cutaneous appendages regeneration in MG and LG. When microcurrent and LLLT were compared, no difference was detected, except the regeneration and formation of new cutaneous appendages, observed in MG. Despite the similar effects, GM showed faster tissue repair with the formation of skin appendages.

  5. First Aid: Burns (United States)

    ... to the Gynecologist? Blood Test: Thyroid Peroxidase Antibodies First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Scald burns from ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  6. Minor burns - aftercare (United States)

    ... If this is not possible, put a cool, clean wet cloth on the burn, or soak the burn in a cool water bath for 5 minutes. ... After the burn is cooled, make sure it is a minor burn. If it is deeper, ... You may put a thin layer of ointment, such as petroleum ...

  7. The clinical efficacy of Diphoterine® in the management of cutaneous chemical burns: a 2-year evaluation study. (United States)

    Zack-Williams, S D L; Ahmad, Z; Moiemen, N S


    Diphoterine(®) is an amphoteric irrigating agent for the treatment of chemical burns and rapidly neutralises both acids and alkalis faster than water alone. Diphoterine(®) is widely used as a first aid agent in a wide range of industries globally. This is a retrospective review of the clinical use of Diphoterine(®) on chemical burns in an adult tertiary referral burn centre, often with a delay of several hours after the injury. patients admitted with chemical burns within 24 hours of the incident with an abnormal wound pH or in pain, were treated with Diphoterine(®) spray. Over a 32-month period, 1,875 burn referrals were admitted of which 131 (7%) were chemical burns. Diphoterine(®) was used in 47 patients (36%). The male to female ratio for the 131 patients was 4:1. Alkaline burns were the commonest (55%). patients who received Diphoterine(®) were significantly younger (38 vs 43 years; p=0.05) and presented earlier (0.5 vs 2.55 days; p=0.004). There was a significant change in the wound pH pre- and post-application of Diphoterine(®), compared to patients who were treated with water irrigation only, with a pH change of 1.076 vs 0.4 (p burns.

  8. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı


    Full Text Available Burn injury is one of the most serious injuries that mankind may face. In addition to serious inflammation, excessive fluid loss, presence of hemodynamic instability due to intercurrent factors such as debridements, infections and organ failure, very different levels and intensities of pain, psychological problems such as traumatic stress disorder, depression, delirium at different levels that occur in patient with severe burn are the factors which make it difficult to provide the patient comfort. In addition to a mild to moderate level of baseline permanent pain in burn patients, which is due to tissue damage, there is procedural pain as well, which occurs by treatments such as grafting and dressings, that are severe, short-term burst style 'breakthrough' pain. Movement and tactile stimuli are also seen in burn injury as an effect to sensitize the peripheral and central nervous system. Even though many burn centers have established protocols to struggle with the pain, studies show that pain relief still inadequate in burn patients. Therefore, the treatment of burn pain and the prevention of possible emergence of future psychiatric problems suc as post-traumatic stress disorder, the sedative and anxiolytic agents should be used as a recommendation according to the needs and hemodynamic status of individual patient. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 26-30

  9. Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial. (United States)

    Chester, Stephen J; Stockton, Kellie; De Young, Alexandra; Kipping, Belinda; Tyack, Zephanie; Griffin, Bronwyn; Chester, Ralph L; Kimble, Roy M


    Burns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients. This is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ≥95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress

  10. Green and ecofriendly synthesis of silver nanoparticles: Characterization, biocompatibility studies and gel formulation for treatment of infections in burns. (United States)

    Jadhav, Kiran; Dhamecha, Dinesh; Bhattacharya, Debdutta; Patil, Mrityunjaya


    The current study summarizes a unique green process for the synthesis of silver nanoparticles (AgNPs) by simple treatment of silver nitrate with aqueous extract of Ammania baccifera. Phytosynthesized AgNPs were characterized by various advanced analytical methods and studied for its use against infections associated with burns. Formation of AgNPs was observed by visual color change from colorless to dark brown and confirmed by UV-visible characteristic peak at 436 nm. Zeta potential, particle size and polydispersity index of nano-silver were found to be -33.1 ± 1.12, 112.6 ± 6.8 nm and 0.3 ± 0.06 respectively. XRD spectra revealed crystalline nature of AgNPs whereas TEM confirmed the presence of mixed morphology of AgNPs. The overall approach designated in the present research investigation for the synthesis of AgNPs is based on all 12 principles of green chemistry, in which no man-made chemical other than the silver nitrate was used. Synthesized nano-silver colloidal dispersion was initially tested for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against a panel of organisms involved in infections associated with burns (Pseudomonas aeruginosa (PA), Staphylococcus aureus (SA) and methicillin resistant S. aureus (MRSA)). MIC and MBC were found to be in range of 0.992 to 7.93 and 7.93 to 31.75 μg/mL respectively. MBC was used for formulation of AgNP gel and tested for its efficacy using agar well diffusion method against PA, SA and MRSA. Comparative bactericidal efficacy of formulated gel (0.03% w/w) and marked formulation Silverex™ ionic (silver nitrate gel 0.2% w/w) showed equal zone of inhibition against all pathogenic bacteria. Formulated AgNP gel consisting of 95% lesser concentration of silver compared to marketed formulation was found to be equally effective against all organisms. Hence, the formulated AgNP gel could serve as a better alternative with least toxicity towards the treatment presently available for

  11. Vaporization order and burning efficiency of crude oils during in-situ burning on water

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, Linus M.V.; Jomaas, Grunde


    In order to improve the understanding of the burning efficiency and its observed size dependency of in-situ burning of crude oil on water, the vaporization order of the components in crude oils was studied. The vaporization order of such multicomponent fuels was assessed by studying the surface...... scale fires can overcome these heat losses, as they typically have higher burning rates, which increase the heat feedback to the fuel surface and therefore can result in the higher burning efficiencies....

  12. Randomized controlled single center study comparing a polyhexanide containing bio-cellulose dressing with silver sulfadiazine cream in partial-thickness dermal burns. (United States)

    Piatkowski, A; Drummer, N; Andriessen, A; Ulrich, D; Pallua, N


    A prospective, randomized, controlled single center study was designed to evaluate clinical efficacy of a polyhexanide containing bio-cellulose dressing (group B) compared to a silver-sulfadiazine cream (group A) in sixty partial-thickness burn patients. Local ethics committee approval was obtained and patients consented. Parameters were: pain reduction (VAS), healing time and wound bed condition, comparing day 0 (start) versus day 14 (end), as well as, ease of dressing use and treatment costs. All completed the study (n=30/n=30) and were included in the ITT analysis, with a total of 72 burns (group A: n=38, group B: n=34). We noted no differences in healing time. Pain reduction was significantly faster and better in group B (ppolyhexanide containing bio-cellulose dressing to be a safe and cost effective treatment for partial-thickness burns. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  13. Impact of hypernatremia on burn wound healing: results of an exploratory, retrospective study. (United States)

    Namdar, Thomas; Stollwerck, Peter L; Stang, Felix H; Eisenbeiss, Werner; Siemers, Frank; Mailander, Peter; Lange, Thomas


    Severely burned patients need extensive initial fluid resuscitation. Formulas to calculate fluid needs during burn shock are well established. However, protocols for normalizing circulating fluid volume after cellular integrity has recovered do not exist. Resultant electrolyte shifts can cause hypernatremia, a possible sign of hypovolemia, which may in turn result in decreased tissue perfusion, subsequently affecting burn wound healing. The purpose of this retrospective chart review was to explore the hypothesis that hypernatremia in burn patients is a possible sign of systemic dehydration and that dehydration may affect burn wound skin graft take. Medical chart data from otherwise healthy burn victims with deep partial-thickness burns (total burn surface area [TBSA] >10%) who underwent skin grafting 7 days post injury were reviewed. Thirty (11 female; 19 male) patients with an average TBSA of 30% (± 11%) and an Abbreviated Burn Severity Index (ABSI) score of 7.9 (± 1.8) were included. Of those, 17 had normal average serum levels between day 2 and 6 following injury and 13 developed hypernatremia (serum sodium ≥146 mmol/L) an average of 5.5 days (± 1.5) after injury. Patients in this group underwent an average of 1.3 (± 0.8) re-grafting procedures compared to 0.35 (± 0.5) for patients without hypernatremia (P = 0.001). There was good correlation (r = 0.525) between daily infusion-diuresis ratios (IDR) and serum sodium levels, as well as between serum sodium levels and re-skin grafting occurrences (r = 0.62). The results indicate that research to confirm that hypernatremia is an indicator of dehydration and affects skin graft take is warranted and that protocols to optimize fluid volume following burn shock treatment are needed.

  14. Perineal burn care: French working group recommendations. (United States)

    Bordes, Julien; Le Floch, Ronan; Bourdais, Ludovic; Gamelin, Alexandre; Lebreton, Françoise; Perro, Gérard


    Burns to the perineum are frequently exposed to faeces. Diverting colostomy is often described to prevent faecal soiling. Because this technique is invasive with frequent complications, use of non-surgical devices including specifically designed faecal management systems has been reported in perineal burns. In order to standardise the faecal management strategy in patients with perineal burns, a group of French experts was assembled. This group first evaluated the ongoing practice in France by analysing a questionnaire sent to every French burn centre. Based on the results of this study and on literature data, the experts proposed recommendations on the management of perineal burns in adults. Specifically designed faecal management systems are the first-line method to divert faeces in perineal burns. The working group proposed recommendations and an algorithm to assist in decisions in the management of perineal burns in four categories of patients, depending on total burn skin area, depth and extent of the perineal burn. In France, non-surgical devices are the leading means of faecal diversion in perineal burns. The proposed algorithm may assist in decisions in the management of perineal burns. The expert group emphasises that large clinical studies are needed to better evaluate these devices. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  15. Chemical burns in children: Aetiology and prevention. (United States)

    D'Cruz, Rachel; Pang, Tony C Y; Harvey, John G; Holland, Andrew J A


    Chemical burns account for a small proportion of total burns in children, but may require specific first aid and different modes of prevention. A retrospective study between 2006 and 2012 of children ≤16 years treated with chemical burns at a specialist paediatric burn centre. Data were extracted from a prospectively maintained database. 56 episodes of chemical burns occurred during the study period. The majority (54%) occurred in boys. There were 39 (72%) patients chemical burns occurred in the domestic setting, especially in the chemicals by an unattended child accounted for half of all (n=22, 49%) chemical burns burns in patients ≥10 years resulted from self-harm. The most common aetiological agents were household cleaners and aerosols in the younger and older age groups respectively. Chemical burns remain infrequent but potentially preventable. These burns mainly occur in the domestic setting due to non-intentional exposure of household chemicals in children burns in children <10. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  16. Photographic assessment of burn size and depth: reliability and validity

    NARCIS (Netherlands)

    Hop, M.; Moues, C.; Bogomolova, K.; Nieuwenhuis, M.; Oen, I.; Middelkoop, E.; Breederveld, R.; de Baar, M.


    Objective: The aim of this study was to examine the reliability and validity of using photographs of burns to assess both burn size and depth. Method: Fifty randomly selected photographs taken on day 0-1 post burn were assessed by seven burn experts and eight referring physicians. Inter-rater

  17. Display of nuclear medicine imaging studies

    CERN Document Server

    Singh, B; Samuel, A M


    Nuclear medicine imaging studies involve evaluation of a large amount of image data. Digital signal processing techniques have introduced processing algorithms that increase the information content of the display. Nuclear medicine imaging studies require interactive selection of suitable form of display and pre-display processing. Static imaging study requires pre-display processing to detect focal defects. Point operations (histogram modification) along with zoom and capability to display more than one image in one screen is essential. This album mode of display is also applicable to dynamic, MUGA and SPECT data. Isometric display or 3-D graph of the image data is helpful in some cases e.g. point spread function, flood field data. Cine display is used on a sequence of images e.g. dynamic, MUGA and SPECT imaging studies -to assess the spatial movement of tracer with time. Following methods are used at the investigator's discretion for inspection of the 3-D object. 1) Display of orthogonal projections, 2) Disp...

  18. Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: an audit of 698 patients. (United States)

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


    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 (Ppatients, severe burns (≥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.

  19. Clinical significance of nutritional risk screening tool for hospitalised children with acute burn injuries: a cross-sectional study. (United States)

    Bang, Y K; Park, M K; Ju, Y S; Cho, K Y


    We assessed the nutritional risks among children hospitalised with acute burn injuries and their associated clinical outcomes using three nutritional risk screening (NRS) tools: Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGKIDS ), Pediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for the Assessment for Malnutrition in Pediatrics (STAMP). This prospective cross-sectional study was conducted from October 2015 to November 2016, in a regional burn centre. Patients were screened by two independent observers, using the three NRS tools. A total of 100 children aged 3 months to 16.5 years were included. STRONGKIDS identified 16% of patients as having high risk, with being identified 45% by PYMS and 44% by STAMP. After adjustment for confounding factors in multivariate regression analysis, patients in the high-risk group had significantly longer median (SD) lengths of stay [medium versus high risk: STRONGKIDS , 9.5 (6.6) versus 15.0 (24.2) days; PYMS, 8.5 (4.4) versus 13.0 (16.1) days; STAMP, 9.0 (5.7) versus 11.0 (17.4) days] and greater median (SD) weight loss [medium versus high risk: STRONGKIDS, 0.15 (0.8) versus -0.35 (0.8) kg; STAMP, 0.5 (0.7) versus 0 (0.1) kg] than patients in the medium-risk group (P nutritional risk classification between the two observers were good (κ for STRONGKIDS = 0.61; PYMS = 0.79; STAMP = 0.75) (P nutritional intervention. © 2017 The British Dietetic Association Ltd.

  20. A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients (United States)


    objectives were met and study equipment was distributed. • Reliability testing of goniometry measurement methods within and between investigators...1 AD______________ AWARD NUMBER: W81XWH-14-2-0148 TITLE: A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients...SUBTITLE A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-2-0148 5c

  1. In-Situ Burning of Crude Oil on Water

    DEFF Research Database (Denmark)

    van Gelderen, Laurens

    The fire dynamics and fire chemistry of in-situ burning of crude oil on water was studied in order to improve predictions on the suitability of this oil spill response method. For this purpose, several operational parameters were studied to determine the factors that control the burning efficiency...... of in-situ burning, i.e. the amount of oil (in wt%) removed from the water surface by the burning process. The burning efficiency is the main parameter for expressing the oil removal effectiveness of in-situ burning as response method and is thus relevant for suitability predictions of in-situ burning...... as oil spill response method. The parameters studied were the initial slick thickness of the oil, the vaporization order of burning crude oil, the ignition of fresh and weathered crude oils on water, the influence of the burning area, the effect of the water layer below the burning oil and the use...

  2. Study of ignition, combustion, and production of harmful substances upon burning solid organic fuel at a test bench with a vortex chamber (United States)

    Burdukov, A. P.; Chernetskiy, M. Yu.; Dekterev, A. A.; Anufriev, I. S.; Strizhak, P. A.; Greben'kov, P. Yu.


    Results of investigation of furnace processes upon burning of pulverized fuel at a test bench with a power of 5 MW are presented. The test bench consists of two stages with tangential air and pulverized coal feed, and it is equipped by a vibrocentrifugal mill and a disintegrator. Such milling devices have an intensive mechanical impact on solid organic fuel, which, in a number of cases, increases the reactivity of ground material. The processes of ignition and stable combustion of a mixture of gas coal and sludge (wastes of concentration plant), as well as Ekibastus coal, ground in the disintegrator, were studied at the test bench. The results of experimental burning demonstrated that preliminary fuel grinding in the disintegrator provides autothermal combustion mode even for hardly inflammable organic fuels. Experimental combustion of biomass, wheat straw with different lignin content (18, 30, 60%) after grinding in the disintegrator, was performed at the test bench in order to determine the possibility of supporting stable autothermal burning. Stable biofuel combustion mode without lighting by highly reactive fuel was achieved in the experiments. The influence of the additive GTS-Powder (L.O.M. Leaders Co., Ltd., Republic of Korea) in the solid and liquid state on reducing sulfur oxide production upon burning Mugun coal was studied. The results of experimental combustion testify that, for an additive concentration from 1 to 15% of the total mass of the burned mixture, the maximum SO2 concentration reduction in ejected gases was not more than 18% with respect to the amount for the case of burning pure coal.

  3. Long term sensory function after minor partial thickness burn: a pilot study to determine if recovery is complete or incomplete. (United States)

    Lim, Joel Y; Lum, Charis H; Tan, Ashley J; Jackson, Teresa; Burrows, Sally; Edgar, Dale W; Wood, Fiona M


    Acute burn damages skin architecture, including nerve endings, altering sensation and influencing recovery of quality of life and participation. It is established that sensation is reduced in scars after deep burn. However, it is unclear if sensory deficits exist in mild scars. The aim of this trial was to determine if sensory deficits persist in mature scars after minor partial thickness burn. This observational pilot involved 30 patients with 'good quality' scars (defined as VSS ≤5 at ≥6 months post-burn). Sensory function was compared in scars and site matched uninjured skin using von Frey filaments and two-point discrimination (2-PD). Multivariable regression was used to predict the influence of burn and confounders on sensory outcomes. Both pressure and 2-PD distance were significantly greater in scar compared to uninjured sites, indicating reduced sensory function. For von Frey filaments, the median was 3.84 (IQR=1) in scars and 3.22 (IQR=1) for uninjured (p=0.001). For 2-PD, the median was 3.9cm (IQR=1.8) for scars and 2.6cm (IQR=1.6) for control sites (p=0.001). Measureable sensory deficits persist in mature, good quality burn scars. These deficits may influence long-term recovery after minor partial thickness burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  4. Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN

    Hypothesis: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. Design: Before-after trial. Setting: A 30-bed burn referral center in a private, university-affiliated hospital. Methods: We studied 35 severely burned children who were divided into 2

  5. How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns (United States)

    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 burn care professionals with the WeeFIM[R]…

  6. [Experimental study on the recycling of denatured acellular dermal matrix after burn]. (United States)

    Wang, Xiao-chuan; Li, Chuan; Shan, Fei; Wang, Wen-ting; Zhu, Xu-guo; Jiang, Du-yin


    To explore the feasibility of burn denatured acellular dermal matrix (DADM) as dermal substitute in repairing wounds. (1) Nine Wistar rats received a deep partial-thickness scald on the back. Full-thickness wounded skin was collected on post scald day (PBD) 1, 2, and 3 (with 3 rats at each time point), and it was treated with 2.5 g/L trypsin/0.5% Triton X-100 to remove cells to prepare DADM, respectively called DADM-1 d, DADM-2 d, and DADM-3 d. Another 3 rats without scald injury were treated with the same method as above to prepare acellular dermal matrix (ADM) to serve as control. Gross and histological observations and microbiological and biomechanical tests, including ultimate tensile strength, maximum tension, stretched length at breaking, stress-strain relationship, were conducted for the resulting ADM and DADM. (2) Another 64 rats were divided into ADM group and DADM-1 d, DADM-2 d, and DADM-3 d groups according to the random number table, with 16 rats in each group. A skin flap in size of 2.0 cm×1.8 cm was raised on the back of each rat. The above-mentioned ADM, DADM-1 d, DADM-2 d, and DADM-3 d were cut into pieces in the size of 1.8 cm×1.5 cm, and they were respectively implanted under the skin flaps of rats in corresponding group. At post surgery week (PSW) 1, 3, 5, or 9, 4 rats in each group were used to observe wound healing condition and change in implants with naked eye, and histological observation of the implants was conducted. Data were processed with one-way analysis of variance and t test. (1) The freshly prepared DADM was milky white, soft in texture with flexibility, but poor in elasticity as compared with ADM. No epithelial structure or cellular component was observed in ADM or DADM under light microscope. Collagen fibers of DADM were seen to be thickened unevenly and arranged in disorder and eosinophilic. All microbiological results of DADM were negative. There was no statistically significant difference among DADM-1 d, DADM-2 d, and DADM-3

  7. Honey dressing in pediatric burns

    Directory of Open Access Journals (Sweden)

    Bangroo A


    Full Text Available The medicinal properties of honey have been recognized since antiquity. Although used as an adjuvant method of accelerating wound healing from ancient times, honey has been sporadically used in the treatment of burns. Honey acts mainly as a hyperosmolar medium and prevents bacterial growth. Because of its high viscosity, it forms a physical barrier, and the presence of enzyme catalase gives honey an antioxidant property. Its high-nutrient content improves substrate supply in local environment promoting epithelialization and angiogenesis. In pediatric burn patients no exclusive study has been conducted using honey as a burn dressing. An attempt is being made to evaluate the effect of honey in the management of burns in pediatric patients.

  8. [Clinical effect of three dimensional human body scanning system BurnCalc in the evaluation of burn wound area]. (United States)

    Lu, J; Wang, L; Zhang, Y C; Tang, H T; Xia, Z F


    Objective: To validate the clinical effect of three dimensional human body scanning system BurnCalc developed by our research team in the evaluation of burn wound area. Methods: A total of 48 burn patients treated in the outpatient department of our unit from January to June 2015, conforming to the study criteria, were enrolled in. For the first 12 patients, one wound on the limbs or torso was selected from each patient. The stability of the system was tested by 3 attending physicians using three dimensional human body scanning system BurnCalc to measure the area of wounds individually. For the following 36 patients, one wound was selected from each patient, including 12 wounds on limbs, front torso, and side torso, respectively. The area of wounds was measured by the same attending physician using transparency tracing method, National Institutes of Health (NIH) Image J method, and three dimensional human body scanning system BurnCalc, respectively. The time for getting information of 36 wounds by three methods was recorded by stopwatch. The stability among the testers was evaluated by the intra-class correlation coefficient (ICC). Data were processed with randomized blocks analysis of variance and Bonferroni test. Results: (1) Wound area of patients measured by three physicians using three dimensional human body scanning system BurnCalc was (122±95), (121±95), and (123±96) cm(2,) respectively, and there was no statistically significant difference among them ( F =1.55, P >0.05). The ICC among 3 physicians was 0.999. (2) The wound area of limbs of patients measured by transparency tracing method, NIH Image J method, and three dimensional human body scanning system BurnCalc was (84±50), (76±46), and (84±49) cm(2,) respectively. There was no statistically significant difference in the wound area of limbs of patients measured by transparency tracing method and three dimensional human body scanning system BurnCalc ( P >0.05). The wound area of limbs of patients

  9. In vivo classification of human skin burns using machine learning and quantitative features captured by optical coherence tomography (United States)

    Singla, Neeru; Srivastava, Vishal; Singh Mehta, Dalip


    We report the first fully automated detection of human skin burn injuries in vivo, with the goal of automatic surgical margin assessment based on optical coherence tomography (OCT) images. Our proposed automated procedure entails building a machine-learning-based classifier by extracting quantitative features from normal and burn tissue images recorded by OCT. In this study, 56 samples (28 normal, 28 burned) were imaged by OCT and eight features were extracted. A linear model classifier was trained using 34 samples and 22 samples were used to test the model. Sensitivity of 91.6% and specificity of 90% were obtained. Our results demonstrate the capability of a computer-aided technique for accurately and automatically identifying burn tissue resection margins during surgical treatment.

  10. Efficacy of intense pulsed light for the treatment of burn scar dyschromias: a pilot study to assess patient satisfaction, safety, and willingness to pay. (United States)

    Hultman, Charles Scott; Friedstat, Jonathan S; Edkins, Renee E


    No treatment algorithms exist to reliably treat burn scar dyschromias. Intense pulsed light (IPL) has been used successfully to treat hyperpigmentation disorders, but has not been studied extensively in the treatment of burn scars. The purpose of this investigation was to assess clinical efficacy and patient satisfaction with IPL for the treatment of burn scar dyschromia. Patients with burn scar dyschromias were treated using the Lume 1 platform (Lumenis) to target pigmented lesions, using fluences between 10 and 22 joules/cm and filters ranging from 560 to 650 nm. At the conclusion of the study, providers assessed changes in burn scar dyschromia, whereas patients were queried regarding satisfaction and perceived efficacy, using a 1 to 5 Likert scale. The patients, who were not charged for the IPL treatment, were queried regarding willingness to pay. Twenty patients (mean age, 35.4 years; mean total body surface area, 27.6%; mean composite Fitzpatrick score, 3.9) underwent IPL treatment of burn scar dyschromias, an average of 3.2 years after injury. Mean fluence was 15.4 J/cm (range, 10-22 J/cm), and the most common filter used was 590 nm (range, 560-650 nm). Mean area treated was 90.7 cm, with a range of 4 to 448 cm. Complications included pain (4), hyperpigmentation (1), and blistering (2). Sixteen patients noted mild to moderate improvement, reporting a 4.5 for efficacy and a 4.4 for satisfaction. Regarding willingness to pay, patients would spend a mean of U.S. $7429 to completely remove their scars, but only a median of U.S. $350 to get the actual results that they received. Mean length of follow-up was 3.8 months, with a standard deviation of 2.2 months. Patients perceived IPL as an efficacious modality in the treatment of burn scar dyschromia, with a high level of satisfaction, despite the potential for morbidity. However, we are reluctant to recommend IPL for routine treatment of burn scar dyschromias, given only minimal improvement observed, potential for

  11. Response of overstory and understory vegetation 37 years after prescribed burning in an aspen-dominated forest in northern Minnesota, USA – a case study (United States)

    A. Dhar; C.D. Baker; H.B. Massicotte; Brian J. Palik; C.D.B. Hawkins


    Many studies have examined short-term changes in understory vegetation following prescribed burning. However, knowledge concerning longer term effects on both forest understory and overstory vegetation is lacking. This investigation was initiated to examine changes in understory (herbaceous and shrub) and overstory species composition almost four decades after logging...

  12. Case study to examine the effects of a growing-season burn and annosum root disease on mortality in a longleaf pine stand (United States)

    Michelle M. Cram; Dan Shea; Ken Forbus


    A case study of a growing-season burn in a longleaf pine (Pinus palustris) stand affected by annosum root disease was conducted at Savannah River Site, SC. The project utilized a longleaf pine stand from a 1995 evaluation of a stump applicator system. The Tim-bor® (disodium octaborate tetrahydrate) and no stump treatment blocks (NST) were...

  13. Quantifying the influence of previously burned areas on suppression effectiveness and avoided exposure: A case study of the Las Conchas Fire (United States)

    Matthew P. Thompson; Patrick Freeborn; Jon D. Rieck; Dave Calkin; Julie W. Gilbertson-Day; Mark A. Cochrane; Michael S. Hand


    We present a case study of the Las Conchas Fire (2011) to explore the role of previously burned areas (wildfires and prescribed fires) on suppression effectiveness and avoided exposure. Methodological innovations include characterisation of the joint dynamics of fire growth and suppression activities, development of a fire line effectiveness framework, and...

  14. Evidence for a Very Early Intermediate in Bacterial Photosynthesis. A Photon-Echo and Hole-Burning Study of the Primary Donor Band in Rhodopseudomonas Sphaeroides

    NARCIS (Netherlands)

    Meech, S.R.; Hoff, A.J.


    Two coherent spectroscopic methods, accumulated photon echo and population bottleneck hole-burning, have been employed in a study of the decay rate of the primary donor (P) of Rhodopseudomonas sphaeroides at 1.5 K. The decay rate is instrument-limited in the photon-echo experiment, implying a

  15. Long-term impacts of prescribed burns on soil thermal conductivity and soil heating at a Colorado Rocky Mountain site: a data/model fusion study (United States)

    W. J. Massman; J. M. Frank; N. B. Reisch


    Heating any soil during a sufficiently intense wild fire or prescribed burn can alter that soil irreversibly, resulting in many significant, and well studied, long-term biological, chemical, and hydrological effects. On the other hand, much less is known about how fire affects the thermal properties and the long-term thermal regime of soils. Such knowledge is important...

  16. Robust diffusion imaging framework for clinical studies

    CERN Document Server

    Maximov, Ivan I; Neuner, Irene; Shah, N Jon


    Clinical diffusion imaging requires short acquisition times and good image quality to permit its use in various medical applications. In turn, these demands require the development of a robust and efficient post-processing framework in order to guarantee useful and reliable results. However, multiple artefacts abound in in vivo measurements; from either subject such as cardiac pulsation, bulk head motion, respiratory motion and involuntary tics and tremor, or imaging hardware related problems, such as table vibrations, etc. These artefacts can severely degrade the resulting images and render diffusion analysis difficult or impossible. In order to overcome these problems, we developed a robust and efficient framework enabling the use of initially corrupted images from a clinical study. At the heart of this framework is an improved least trimmed squares diffusion tensor estimation algorithm that works well with severely degraded datasets with low signal-to-noise ratio. This approach has been compared with other...

  17. Psychotropic drugs and risk of burn injury in individuals with mental illness: a 10-year population-based case-control study. (United States)

    Chang, Chia-Ming; Wu, Kuan-Yi; Chiu, Yu-Wen; Wu, Hsiao-Ting; Tsai, Yu-Ting; Chau, Yeuk-Lun; Tsai, Hui-Ju


    We aimed to investigate the association between psychotropic treatment and risk of burn injury in individuals with mental illness. A nested case-control study was conducted by using the National Health Insurance Research Database in Taiwan. A total of 3187 cases with burn injury under International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-949 and 19 122 matched controls were identified from 2003 to 2012. Four kinds of psychotropic agents (antipsychotics (APs), antidepressants (ADs), benzodiazepines, and z-drugs) were examined. Psychotropic exposure status was measured, and a set of potential confounding factors was adjusted in the analyses. Conditional logistic regressions were applied to determine the effect of psychotropic use on burn injury. A significant increased risk of burn injury was observed among psychotropic users compared with non-users (adjusted odds ratio (AOR) = 1.45, 95%CI = 1.31-1.61). When classifying psychotropic users into current, new, continuous, and past users, a significant elevated risk of burn injury was found across all groups (AOR = 1.76, 95%CI = 1.54-2.00 in current users; AOR = 2.02, 95%CI = 1.55-2.65 in new users; AOR = 1.72, 95%CI = 1.50-1.96 in continuous users; and AOR = 1.35, 95%CI = 1.21-1.51 in past users). When assessing each individual kind of examined psychotropic agents, a significant elevated risk of burn injury was found among users of APs, ADs, benzodiazepines, and z-drugs except for current and continuous users of z-drugs. The results demonstrate an elevated risk of burn injury among individuals with current psychotropic use. The findings underscore the need for greater attention to be given to the cognitive performance and psychomotor abilities of individuals taking psychotropic medications in order to prevent the occurrence of burn injury. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Study on Processing Method of Image Shadow

    Directory of Open Access Journals (Sweden)

    Wang Bo


    Full Text Available In order to effectively remove disturbance of shadow and enhance robustness of information processing of computer visual image, this paper makes study on inspection and removal of image shadow. It makes study the continual removal algorithm of shadow based on integration, the illumination surface and texture, it respectively introduces their work principles and realization method, it can effectively carrying processing for shadow by test.

  19. Pediatric Burns in the Bedouin Population in Southern Israel


    Arnon D. Cohen; R. Gurfinkel; R. Glezinger; Y. Kriger; N. Yancolevich; L. Rosenberg


    Burn trauma is an important public health concern, with increased risk for burns in children. A cross-sectional study was performed to describe the epidemiological characteristics and risk factors for burns in hospitalized Bedouin children in Soroka University Medical Center during the years 2001–2002. In a population of 558 hospitalized burn-injured patients, 282 Bedouin children were identified. Two hundred and sixty five patients (94.0%) had burns involving less than 20% of the body surfac...

  20. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study (United States)


    Background The efficacy of Centella asiatica for incision and burn wounds are not fully understood. Here, we report the wound healing activities of sequential hexane, ethyl acetate, methanol, and water extracts of Centella asiatica in incision and partial-thickness burn wound models in rats. Methods Male Sprague–Dawley rats weighing 250–300 g were randomly divided into incision and burn wound groups. Each group was stratified into seven subgroups: (1) untreated; (2) NSS-; (3) Tween 20®- (vehicle control); (4) hexane extract-; (5) ethyl acetate extract-; (6) methanol extract-; and (7) aqueous extract-treated groups. The test substances were applied topically once daily. The tensile strength of the incision wound was measured on the seventh day after wound infliction. The general appearance and degree of wound healing of the burn wound were assessed on Days 3, 7, 10 and 14 after burn injury and prior to histopathological evaluation. Results On the seventh day after wound infliction, the tensile strength of incision wound in all extract-treated groups was significantly higher than that of the vehicle control (Tween 20®), but comparable to the NSS-treated group. The degrees of healing in the burn wound with the four extracts were significantly higher than that of the control on Days 3, 10 and 14. Histopathological findings on Day 14 after burn injury revealed prominent fibrinoid necrosis and incomplete epithelialization in the control and untreated groups, whereas fully developed epithelialization and keratinization were observed in all extract-treated groups. Analysis by thin layer chromatography demonstrated that the phyto-constituents β-sitosterol, asiatic acid, and asiaticoside and madecassocide were present in the hexane, ethyl acetate and methanol extracts, respectively. Conclusions All extracts of Centella asiatica facilitate the wound healing process in both incision and burn wounds. Asiatic acid in the ethyl acetate extract seemed to be the most active

  1. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study

    Directory of Open Access Journals (Sweden)

    Somboonwong Juraiporn


    Full Text Available Abstract Background The efficacy of Centella asiatica for incision and burn wounds are not fully understood. Here, we report the wound healing activities of sequential hexane, ethyl acetate, methanol, and water extracts of Centella asiatica in incision and partial-thickness burn wound models in rats. Methods Male Sprague–Dawley rats weighing 250–300 g were randomly divided into incision and burn wound groups. Each group was stratified into seven subgroups: (1 untreated; (2 NSS-; (3 Tween 20®- (vehicle control; (4 hexane extract-; (5 ethyl acetate extract-; (6 methanol extract-; and (7 aqueous extract-treated groups. The test substances were applied topically once daily. The tensile strength of the incision wound was measured on the seventh day after wound infliction. The general appearance and degree of wound healing of the burn wound were assessed on Days 3, 7, 10 and 14 after burn injury and prior to histopathological evaluation. Results On the seventh day after wound infliction, the tensile strength of incision wound in all extract-treated groups was significantly higher than that of the vehicle control (Tween 20®, but comparable to the NSS-treated group. The degrees of healing in the burn wound with the four extracts were significantly higher than that of the control on Days 3, 10 and 14. Histopathological findings on Day 14 after burn injury revealed prominent fibrinoid necrosis and incomplete epithelialization in the control and untreated groups, whereas fully developed epithelialization and keratinization were observed in all extract-treated groups. Analysis by thin layer chromatography demonstrated that the phyto-constituents β-sitosterol, asiatic acid, and asiaticoside and madecassocide were present in the hexane, ethyl acetate and methanol extracts, respectively. Conclusions All extracts of Centella asiatica facilitate the wound healing process in both incision and burn wounds. Asiatic acid in the ethyl acetate extract seemed to

  2. Antiseptics for burns. (United States)

    Norman, Gill; Christie, Janice; Liu, Zhenmi; Westby, Maggie J; Jefferies, Jayne M; Hudson, Thomas; Edwards, Jacky; Mohapatra, Devi Prasad; Hassan, Ibrahim A; Dumville, Jo C


    Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. To assess the effects and safety of antiseptics for the treatment of burns in any care setting. In September 2016 we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions based on language, date of publication or study setting. We included randomised controlled trials (RCTs) that enrolled people with any burn wound and assessed the use of a topical treatment with antiseptic properties. Two review authors independently performed study selection, risk of bias assessment and data extraction. We included 56 RCTs with 5807 randomised participants. Almost all trials had poorly reported methodology, meaning that it is unclear whether they were at high risk of bias. In many cases the primary review outcomes, wound healing and infection, were not reported, or were reported incompletely.Most trials enrolled people with recent burns, described as second-degree and less than 40% of total body surface area; most participants were adults. Antiseptic agents assessed were: silver-based, honey, Aloe Vera, iodine-based, chlorhexidine or polyhexanide (biguanides), sodium hypochlorite, merbromin, ethacridine lactate, cerium nitrate and Arnebia euchroma. Most studies compared antiseptic with a topical antibiotic, primarily silver sulfadiazine (SSD); others compared antiseptic with a non

  3. Periorbital burns – a 6 year review of management and outcome. (United States)

    Fitzgerald O'Connor, Edmund; Frew, Q; Din, A; Pleat, J; Ashraff, S; Ghazi-Nouri, S; El-Muttardi, N; Philp, B; Dziewulski, P


    Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form. Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases. Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33% total body surface area. The eyelid burn depth varied; 67% superficial partial thickness, 17% deep dermal and 16% full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months. The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  4. Sexual Function Following Burn Injuries: Literature Review. (United States)

    Pandya, Atisha A; Corkill, Helen A; Goutos, Ioannis


    Sexual function is a profound facet of the human personality. Burns due their sudden and devastating nature can have longstanding effects on intimate function by virtue of physical sequelae as well as alterations in body image and perceived desirability. A considerable number of patients encounter problems with intimate function in burns rehabilitation; nevertheless, the topic appears to be poorly addressed in specialist centers worldwide. Review of the literature suggests that a number of parameters can affect the quality of sexual life following burn injuries including age at the time of injury, location, and severity of the burn as well as coping mechanisms employed by the individual survivor. Addressing issues of intimacy relies on awareness, education, and a holistic approach on behalf of the multidisciplinary team members and, to this effect, recommendations are made on managing sexual function concerns in burns rehabilitation.

  5. Mortality and morbidity of fireworks-related burns on the annual last wednesday of the year festival (charshanbeh soori) in iran: an 11-year study. (United States)

    Vaghardoost, Reza; Ghavami, Yaser; Sobouti, Behnam; Mobayen, Mohammad Reza


    Management of firework-related injuries is costly for the patient, society, and government. Evaluating effective factors yielding to such injuries may lead to better management of patients and decreased costs and morbidities. This retrospective cross-sectional study was performed on burn patients referred to Shahid Motahari Burns Hospital on Charshanbeh Soori day festival during the period extending from March 2000 to March 2011 (11 days in an 11-year period). Demographic data, causes of burn injury, severity, and affected body parts were recorded. Data were analyzed using SPSS version 16. There were164 patients in the study with a mean age of 18.34 ± 9.31 years; 87% (145/164) were male. Homemade grenades were the most frequent cause of injury. Hand injury was reported in 56% (92/164) of the cases. Amputation was executed in 7 (4.3%) cases, and 6 (3.7%) patients died due to severe burn injuries and facial damage. Fireworks- related injuries during Charshanbeh Soori ceremony causes significant morbidities and damage to different body parts (especially upper limbs and face), and some of these injuries will lead to life time disabilities, amputations, and even death. As most of the injured patients are young teenagers and children, special consideration must be taken into account to prevent long term morbidities.

  6. A retrospective study of 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. (United States)

    Arifi, Hysni M; Duci, Shkelzen B; Zatriqi, Violeta K; Ahmeti, Hasan R; Haxhiu, Isa I; Mekaj, Agon Y; Gashi, Musli M; Buja, Zejn A; Derguti, Shkelqim H


    Hands participate in everyday human activities and they are the most vulnerable parts of a human body. The objective of this study is to understand the common causes of hand burns, the methods of surgical interventions, duration of hospitalization and distribution of hand burns in 11 year period regarding the age. This is a retrospective study that included 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package InStat 3. From statistical parameters were calculated structural index, arithmetic median and standard deviation. Data testing is done with X (2) test and the difference is significant if P<0.05. The Ministry of Health of our country should make efforts to organize training for health workers about treatment for minor burns in order to reduce the number of referral patients from other primary (Familiar Medicine) and secondary centers (regional Hospitals).

  7. Burns - Multiple Languages (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Burns URL of this page: Other topics A-Z Expand Section ...

  8. Factors affecting the depth of burns occurring in medical institutions. (United States)

    Cho, Young Soon; Choi, Young Hwan; Yoon, Cheonjae; You, Je Sung


    Most cases of burns occurring in medical institutions are associated with activities involving heat. It is very difficult to detect these burns. To date, there are few reports on burns occurring in medical institutions. The purpose of this paper was to analyze the etiology of burns occurring in medical institutions and to elucidate the factors affecting burn depth. We conducted a retrospective analysis of the medical records of patients who visited our center from April 2008 to February 2013. This study enrolled all patients with burns occurring in the medical institution during or related to treatment. We excluded burn patients whose burns were not related to treatment (for example, we excluded patients with scalding burns that occurred in the hospital cafeteria and pediatric patients with hot water burns from the water purifier). However, patients with burns that occurred in the recovery room after general anesthesia were included. A total of 115 patients were enrolled in this study. The average patient age was 41.5 years, with more women than men (M:F=31:84). There were 29 cases (25.3%) of superficial burns (first-degree and superficial second-degree) and 86 cases (74.7%) of deep burns (deep second-degree and third-degree). Hot packs were the most common cause of burns (27 cases, 23.5%), followed by laser therapy, heating pads, and grounding pads, accounting for 15 cases each. There were 89 cases (77.4%) of contact burns and 26 cases (22.6%) of non-contact burns. The most common site of burns was the lower extremities (41 cases, 35.7%). The burn site and contact burns were both factors affecting burn depth. The rate of deep burns was higher in patients with contact burns than in those with non-contact burns (odds ratio 4.26) and was associated with lower body burns (odds ratio 2.85). In burns occurring in medical institutions, there is a high probability of a deep burn if it is a contact burn or occurs in the lower body. Therefore, safety guidelines are needed

  9. HEPBURN - investigating the efficacy and safety of nebulized heparin versus placebo in burn patients with inhalation trauma: study protocol for a multi-center randomized controlled trial. (United States)

    Glas, Gerie J; Muller, Johannes; Binnekade, Jan M; Cleffken, Berry; Colpaert, Kirsten; Dixon, Barry; Juffermans, Nicole P; Knape, Paul; Levi, Marcel M; Loef, Bert G; Mackie, David P; Malbrain, Manu; Schultz, Marcus J; van der Sluijs, Koenraad F


    Pulmonary coagulopathy is a hallmark of lung injury following inhalation trauma. Locally applied heparin attenuates lung injury in animal models of smoke inhalation. Whether local treatment with heparin benefits patients with inhalation trauma is uncertain. The present trial aims at comparing a strategy using frequent nebulizations of heparin with standard care in intubated and ventilated burn patients with bronchoscopically confirmed inhalation trauma. The Randomized Controlled Trial Investigating the Efficacy and Safety of Nebulized HEParin versus Placebo in BURN Patients with Inhalation Trauma (HEPBURN) is an international multi-center, double-blind, placebo-controlled, two-arm study. One hundred and sixteen intubated and ventilated burn patients with confirmed inhalation trauma are randomized to nebulizations of heparin (the nebulized heparin strategy) or nebulizations of normal saline (the control strategy) every four hours for 14 days or until extubation, whichever comes first. The primary endpoint is the number of ventilator-free days, defined as days alive and breathing without assistance during the first 28 days, if the period of unassisted breathing lasts for at least 24 consecutive hours. As far as the authors know, HEPBURN is the first randomized, placebo-controlled trial, powered to investigate whether local treatment with heparin shortens duration of ventilation of intubated and ventilated burn patients with inhalation trauma. NCT01773083 (, registered on 16 January 2013.Recruiting. Randomisation commenced on 1 January 2014.

  10. Extracorporeal shock waves, a new non-surgical method to treat severe burns. (United States)

    Arnó, A; García, O; Hernán, I; Sancho, J; Acosta, A; Barret, J P


    Extracorporeal shock wave treatment (ESWT) increases perfusion in ischaemic tissues, stimulates growth factors, decreases inflammation and accelerates wound healing. It is a safe technique classically used in urology and orthopaedic surgery with success, but there is still limited literature regarding its use in the management of burns. The aim of this study is to analyse the effect of ESWT on deep partial/full thickness burns in patients attended at our emergency burn unit. We performed two ESWT sessions in 15 patients with laser Doppler imaging (LDI). Of all treated burns, 80% healed uneventfully prior to 3 weeks; as many as 15% required surgical debridement and grafting and 5% developed hypertrophic scarring. After one ESW session, burns had a significant increase in perfusion, objectivated by the LDI images. Extracorporeal shock wave therapy emerges as a new non-invasive, feasible, safe and cost-effective method in deep partial/full thickness burns. It may decrease the need of surgery and therefore the morbidity of the patient. There is a strong need for more studies to establish the optimal timing and dosage of treatment. 2009 Elsevier Ltd and ISBI. All rights reserved.

  11. Economics of pediatric burns. (United States)

    Bass, Michael J; Phillips, Linda G


    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  12. Epidemiology of burns

    NARCIS (Netherlands)

    Dokter, Jan


    The aim of this thesis is to understand the epidemiology, treatment and outcomes of specialized burn care in The Netherlands. This thesis is mainly based on historical data of the burn centre in Rotterdam from 1986, combined with historical data from the burn centres in Groningen and Beverwijk from

  13. Self-inflicted burns: a case series. (United States)

    Henderson, Antony; Wijewardena, Aruna; Streimer, Jeff; Vandervord, John


    Self-inflicted burns are regularly admitted to burns units worldwide. Most of these patients are referred to psychiatric services and are successfully treated however some return to hospital with recurrent self-inflicted burns. The aim of this study is to explore the characteristics of the recurrent self-inflicted burn patients admitted to the Royal North Shore Hospital during 2004-2011. Burn patients were drawn from a computerized database and recurrent self-inflicted burn patients were identified. Of the total of 1442 burn patients, 40 (2.8%) were identified as self-inflicted burns. Of these patients, 5 (0.4%) were identified to have sustained previous self-inflicted burns and were interviewed by a psychiatrist. Each patient had been diagnosed with a borderline personality disorder and had suffered other forms of deliberate self-harm. Self-inflicted burns were utilized to relieve or help regulate psychological distress, rather than to commit suicide. Most patients had a history of emotional neglect, physical and/or sexual abuse during their early life experience. Following discharge from hospital, the patients described varying levels of psychiatric follow-up, from a post-discharge review at a local community mental health centre to twice-weekly psychotherapy. The patients who engaged in regular psychotherapy described feeling more in control of their emotions and reported having a longer period of abstinence from self-inflicted burn. Although these patients represent a small proportion of all burns, the repeat nature of their injuries led to a significant use of clinical resources. A coordinated and consistent treatment pathway involving surgical and psychiatric services for recurrent self-inflicted burns may assist in the management of these challenging patients. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  14. Protocol of study and pursuit of the radioinduced burns; Protocolo de estudio y seguimiento de las quemaduras radioinducidas

    Energy Technology Data Exchange (ETDEWEB)

    Portas, Mercedes; Glustein, Daniel; Pomerane, Armando; Peragallo, Mabel; Guzman, Alejandra; Ciordia, Irma [Hospital de Quemados de Buenos Aires (Argentina). Comite de Radiopatologia; Genovese, Jorge [Laboratorio Craveri, Buenos Aires (Argentina). Dept. de Ingenieria de Tejidos; Cymberknoh, Manuel [Centro de Investigaciones Mamarias, Buenos Aires (Argentina). Dept. de Teletermografia; Dubner, Diana; Michelin, Severino; Perez, Maria del Rosario; Trano, Jose Luis Di; Gisone, Pablo [Autoridad Regulatoria Nuclear, Buenos Aires (Argentina). Lab. de Radiopatologia


    A study of localized overexposures based on local experience and international criteria is being carried out within the framework of a cooperation agreement between the Buenos Aires Burned Hospital and the Nuclear Regulatory Authority. This protocol was designed considering separately acute and chronic reactions, including the following aspects: patient reception: clinical findings, laboratory tests, photographic recording, and multidisciplinary evaluation; dose reconstruction: evaluation of the dose distribution by biophysical and biological procedures; extension and depth estimation: telethermography, computed tomography, magnetic resonance, radioisotopic procedures, capillaroscopy and percutaneous oxymetry; therapeutic strategies: pain treatment, prevention of infections, systemic administration of pentoxiphyllin and alpha-tocopherol, local application of trolamine and antioxidants, prevention and treatment of radioinduced fibrosis. When it is indicated, surgical treatment includes partial or total excision followed by covering by graft or flap. The application of tissue-engineering techniques will be considered. Study of individual radiosensitivity: evaluation of apoptosis in peripheral lymphocytes and clonogenic assays in dermal fibroblasts 'in vitro' irradiated. (author)

  15. A qualitative study of teachers' experiences of a school reintegration programme for young children following a burn injury. (United States)

    Wilson, Hannah M N; Gaskell, Sarah L; Murray, Craig D


    School reintegration programmes provide support to both children absent from school as a result of a serious health problem and their teachers, but little is known regarding their efficacy, or the impact of the situation on teachers. This qualitative study explored the experience of primary school teachers who were involved in a school reintegration programme, following a burn injury to a child in their class. Data was collected using semi-structured interviews with four primary school teachers. Transcripts were analysed using interpretative phenomenological analysis. The findings indicated that participants were positive regarding the programme, but detailed aspects which could be improved, for example better communication before the child's return. They discussed their fears and concerns, including a strong need to protect the child from further harm. Implications of this study include the need to provide adequate support to teachers in similar positions, and further develop school reintegration programmes to best facilitate the child's return to school. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  16. Efficacy of a children’s procedural preparation and distraction device on healing in acute burn wound care procedures: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Brown Nadia J


    Full Text Available Abstract Background The intense pain and anxiety triggered by burns and their associated wound care procedures are well established in the literature. Non-pharmacological intervention is a critical component of total pain management protocols and is used as an adjunct to pharmacological analgesia. An example is virtual reality, which has been used effectively to dampen pain intensity and unpleasantness. Possible links or causal relationships between pain/anxiety/stress and burn wound healing have previously not been investigated. The purpose of this study is to investigate these relationships, specifically by determining if a newly developed multi-modal procedural preparation and distraction device (Ditto™ used during acute burn wound care procedures will reduce the pain and anxiety of a child and increase the rate of re-epithelialization. Methods/design Children (4 to 12 years with acute burn injuries presenting for their first dressing change will be randomly assigned to either the (1 Control group (standard distraction or (2 Ditto™ intervention group (receiving Ditto™, procedural preparation and Ditto™ distraction. It is intended that a minimum of 29 participants will be recruited for each treatment group. Repeated measures of pain intensity, anxiety, stress and healing will be taken at every dressing change until complete wound re-epithelialization. Further data collection will aid in determining patient satisfaction and cost effectiveness of the Ditto™ intervention, as well as its effect on speed of wound re-epithelialization. Discussion Results of this study will provide data on whether the disease process can be altered by reducing stress, pain and anxiety in the context of acute burn wounds. Trial registration ACTRN12611000913976

  17. Micronutrients after burn injury: a review. (United States)

    Nordlund, Megan J; Pham, Tam N; Gibran, Nicole S


    Supplementation of micronutrients after burn injury is common practice in order to fight oxidative stress, support the immune system, and optimize wound healing. Assessing micronutrient status after burn injury is difficult because of hemodilution in the resuscitation phase, redistribution of nutrients from the serum to other organs, and decreases in carrier proteins such as albumin. Although there are many preclinical data, there are limited studies in burn patients. Promising research is being conducted on combinations of micronutrients, especially via the intravenous route.

  18. A comparative study of the dressings silver sulfadiazine and Aquacel Ag in the management of superficial partial-thickness burns. (United States)

    Yarboro, Douglas D


    : The purpose of this investigation was to determine the effectiveness of silver sulfadiazine as compared with Aquacel Ag in patients with superficial partial-thickness burns. : Twenty-four subjects who sustained superficial partial-thickness burns who were between the ages of 19 and 53 years with time of injury from 0 to 4 days were randomly assigned into a control group (silver sulfadiazine) and experimental group (Aquacel Ag; ConvaTec, Skillman, New Jersey). Wound measurements were assessed at the time of the initial examination and every 4 days afterward until the area was re-epithelialized 100%. To ensure objectivity, the burn area was measured digitally with the software program by Aspyra (Aspyra LLC; Blue Springs, Missouri) to prevent discrepancies in wound measurements. : Significant differences between the silver sulfadiazine and Aquacel Ag group were noted in pain (silver sulfadiazine: 4.70 ± 2.22, Aquacel Ag: 2.92 ± 1.12) and the number of treatments (silver sulfadiazine: 10.27 ± 7.46, Aquacel Ag: 4.10 ± 1.38). : Utilization of Aquacel Ag in superficial-partial thickness burns could lead to a decrease in the number of treatments required to re-epithelialize burns 100% with less pain as compared with silver sulfadiazine.

  19. A quantitative, cross-sectional study of depression and self-esteem in teenage and young adult burn victims in rehabilitation. (United States)

    Teixeira Nicolosi, Júlia; Fernandes de Carvalho, Viviane; Llonch Sabatés, Ana


    Burns can have a negative physiological and emotional impact, particularly among teenage victims. To assess the presence of depression and level of self-esteem, a cross-sectional study was conducted among 63 teenage and young adult burn victims ages 12 to 20 years undergoing physical and psychological rehabilitation at the Outpatient Unit for Plastic Surgery and Burns at the Central Institute of the Clínicas Hospital of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil. Assessment instruments included Beck's Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). Internal consistency within and between the two scales was established via Cronbach's-α coefficient. All variables were analyzed using descriptive statistics, and the statistical difference between means was compared using Student's t-test. The majority of participants were female (38, 60.3%) and unmarried (59, 93.7%) with a mean total body surface area (TBSA) burn of 23.84%. Most burns (58, 92.10%) were the result of accidents and were located on the trunk (47, 74.6%), head (43, 68%), arms (41, 65%), hands (38, 60%), neck (34, 54%), and forearm (29, 46%). Participants had received physical and psychological rehabilitation for an average of 124.74 months (SD 63.67) from a multidisciplinary team. The majority of participants (33, 52.4%) reported functional and aesthetic after-effects and appraised their scar as visible (51, 81.0%). BDI results showed low levels or absence of depression (mean = 7.63, SD 8.72; scale 0 = no depression to 63 = serious depression); the RSE showed adequate levels of self-esteem (mean = 8.41, SD 4.74; scale 0-30, where higher scores indicate worst levels of self-esteem). Burn location did not affect depression (BDI: P = 0.26) or self-esteem (RSE: P = 0.21). However, depression and self-esteem were more significant in participants who were not able to work and/or go to school than in those who were (BDI: P = 0.04 and self-esteem RSE: P = 0

  20. A Study on the Countermeasures of Arc Burn-out Faults on EHV Overhead Distribution Lines

    Energy Technology Data Exchange (ETDEWEB)

    Nam-Kung, Do; Ha, Bok Nam; Kim, Myong Soo [Korea Electric Power Research Institute, Taejon (Korea, Republic of); Jung, Dong Hak; Lee, Yong Han; Hwang, Chi Woo; Yoon, Jae Young; Kim, Kyoung Woon; Kim, Seok Sou [Korea Electrotechnology Research Institute, Changwon (Korea, Republic of)


    Using covered conductors as the EHV overhead distribution line conductors, will easily cause arc fusions followed by flashover, because arcs will be easily fixed to the starting points of flashover. And methods or equipment to block arcs are needed. Arc fusion mechanisms were studied and application guidances of protection equipment were suggested in this study. Moreover, covered conductors are vulnerable to damages on covers caused by tracking. Pollutions on insulators will easily cause scintillations on conductor covers, hence, will lead to carbonizations on cover surfaces. In this study, some new ties were tested for the examination of the effects. And new schemes to mitigate tracking was also suggested. (author). 21 refs., 43 figs.

  1. Reproductive health and burn-out among female physicians: nationwide, representative study from Hungary


    Győrffy, Zsuzsa; Dweik, Diána; Girasek, Edmond


    Background There is a worldwide rising tendency of women deciding to become physicians; hence, one of the most remarkable fields of investigation is the wellbeing of female doctors. The aim of this study was to describe female physicians’ reproductive health in Hungary and to explore the potential correlation between their reproductive disorders and burnout symptoms. Up to our present knowledge, there have not been any studies investigating the correlation between reproductive disorders and b...

  2. Burn plasma transfer induces burn edema in healthy rats. (United States)

    Kremer, Thomas; Abé, Dorotheé; Weihrauch, Marc; Peters, Christopher; Gebhardt, Martha Maria; Germann, Guenter; Heitmann, Christoph; Walther, Andreas


    Thermal injuries greater than 20% body surface area (BSA) result in systemic shock with generalized edema in addition to local tissue destruction. Burn shock is induced by a variety of mediators, mainly immunomodulative cytokines. This experimental study evaluates if burn shock can be induced in healthy rats by transfer of burn plasma (BP) with mediators. Thermal injury was induced by hot water (100 degrees C water, 12 s, 30% BSA) in male syngenic Wistar rats. Donor rats were killed 4 h posttrauma, and BP was harvested. Burn plasma was transferred to healthy animals by continuous intravenous infusion in three types of dilution (100%, 10%, and 1%). Positive controls were directly examined 4 h after thermal injury, and negative control rats had a continuous infusion done with sham burn (SB) plasma (37 degrees C water, 12 s, 30% BSA). Afterwards, intravital fluorescence microscopy was performed in postcapillary mesenteric venules at 0, 60, and 120 min. Edema formation was assessed by relative changes over time in fluorescence intensity of fluorescein isothiocyanate-albumin in the intravascular versus the extravascular space. The interactions of leucocytes and endothelium were evaluated by quantification of leukocyte sticking. Additionally, microhemodynamic (volumetric blood flow, erythrocyte velocity, venular wall shear rate, venular diameters) and macrohemodynamic parameters (blood pressure, heart frequency, temperature) were assessed online (arterial catheter). For statistics, an ANOVA was performed with Bonferroni adjustment procedure. Differences were considered significant when P edema formation remains uncertain and requires further investigation.

  3. Burning California Chaparral - An Exploratory Study of Some Common Shrubs and Their Combustion Characteristics (United States)

    David R. Weise; Darold E. Ward


    Abstract. Prescribed fire is a tool used to manage vegetation in southern California. The nature and quantity of gaseous and particulate emissions have not been described for California chaparral. A study examining carbon monoxide (CO), carbon dioxide (CO2), and particulate matter emissions from fuel beds constructed from common chaparral shrubs was initiated. Chamise...

  4. Study of {sup 24}Mg resonances relevant for carbon burning nucleosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Tokić, V.; Soić, N.; Blagus, S.; Fazinić, S.; Jelavić-Malenica, D.; Miljanić, D.; Prepolec, L.; Skukan, N.; Szilner, S.; Uroić, M. [Ruđer Bošković Institute, Bijenička cesta 54, 10000 Zagreb (Croatia); Milin, M. [Faculty of Science, University of Zagreb, Bijenička cesta 32, 10000 Zagreb (Croatia); Di Pietro, A.; Figuera, P.; Fisichella, M.; Lattuada, M.; Scuderi, V.; Strano, E.; Torresi, D. [INFN-Laboratori Nazionali del Sud, via S.Sofia 62, 95125 Catania (Italy); Freer, M.; Ziman, V. [School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT (United Kingdom); and others


    We have studied decays of resonances in {sup 24}Mg at excitation energies above the {sup 12}C+{sup 12}C decay threshold, using {sup 12}C({sup 16}O,α){sup 24}Mg* reaction. This experiment has been performed at INFNLNS, using Tandem accelerator beam of 16O at E = 94 MeV. Some preliminary results are presented.

  5. Fenoldopam Use in a Burn Intensive Care Unit: A Retrospective Study (United States)


    with a dose-dependent (up to 0.5 mcg/kg/min) antihypertensive effect and increased RBF [5, 6]. Subsequent studies have attempted to exploit...regarding fenoldopam’s antihypertensive effect. Fenoldopam has been associated with hypotension, tachycardia, congestive heart failure, myocardial


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


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

  7. Exercise behaviors after burn injury. (United States)

    Baldwin, Jennifer; Li, Frank


    The purpose of this study was to investigate exercise behaviors in adult burn survivors and to identify barriers to exercise in this population. A two-page questionnaire developed by the authors was administered on a single occasion to adults attending the ambulatory burns clinic at a metropolitan hospital. Data from 68 adult burn survivors were analyzed. Within this cohort, 59% of subjects reported exercising several times per week or more and the remaining 41% exercised once per week or less. There was no correlation among exercise frequency and age, TBSA, or hospital length of stay. Walking was the most common type of exercise, and subjects reported lower compliance with stretching and strengthening exercises. Physical condition and motivation were identified as the main barriers to exercise. Although this preliminary study reveals that a higher proportion of burn survivors engage in exercise compared with their healthy counterparts, a substantial number are exercising just once per week or less, below the recommended guidelines to improve physical fitness. Physical and occupational therapists play an important role in providing exercise prescription and education, as well as addressing barriers to exercise in burn survivors. The potential for further research into physical activity across all domains of life using a validated questionnaire is identified.

  8. Burning tongue in patients with geographic and grooved tongue: a study on secondary school students.

    Directory of Open Access Journals (Sweden)

    S. Shamsedini


    Full Text Available This study was conducted on the secondary school students by actively patient selection method; it means that patients did not go to see the doctor themselves. The studies were randomly selected among the schools located in areas of average socioeconomic status. Although geographic and fissured tongue disorders with no discomfort and with clinical sign are common phenomena, they are detected and diagnosed in clinical and collective examinations. people recognition and awareness about them and what they should do when they occur with Syndromal signs are important. Patients usually complain of pain and irritation of the tongue specially during eating spicy and sour food, because the bare part of tongue cannot tolerate the direct contact with such foods. This chronic irritation may cause the fear of cancer (Cancerophobia in patients. It should be pointed out that geographic tongue can be caused by known skin diseases like psoriasis or might be manifested as an allergic reaction to medicines like lithium. In this study we evaluated the relationship between grooved and geographic tongue and age, race, skin color, frequency of brushing, gum status, discomfort of tongue irritation and mouth breathing habit.

  9. Comparative Study of Coal and Biomass Co-Combustion With Coal Burning Separately Through Emissions Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad Siddique


    Full Text Available Appropriate eco-friendly methods to mitigate the problem of emissions from combustion of fossil fuel are highly demanded. The current study was focused on the effect of using coal & coal-biomass co-combustion on the gaseous emissions. Different biomass' were used along with coal. The coal used was lignite coal and the biomass' were tree waste, cow dung and banana tree leaves. Various ratios of coal and biomass were used to investigate the combustion behavior of coal-biomass blends and their emissions. The study revealed that the ratio of 80:20 of coal (lignite-cow dung and 100% banana tree leaves emits less emissions of CO, CO2, NOx and SO2 as compared to 100% coal. Maximum amount of CO emissions were 1510.5 ppm for banana tree waste and minimum amount obtained for lakhra coal and cow dung manure (70:30 of 684.667 ppm. Maximum percentage of SO2 (345.33 ppm was released from blend of lakhra coal and tree leaves (90:10 and minimum amount of SO2 present in samples is in lakhra coal-banana tree waste (80:20. The maximum amount of NO obtained for banana tree waste were 68 ppm whereas maximum amount of NOx was liberated from lakhra coal-tree leaves (60:40 and minimum amount from cow dung manure (30.83 ppm. The study concludes that utilization of biomass with coal could make remedial action against environment pollution.

  10. An optimized animal model for partial and total skin thickness burns studies Um modelo animal aperfeiçoado para estudo de queimaduras superficiais e profundas da pele

    Directory of Open Access Journals (Sweden)

    Ana Paula Bomfim Soares Campelo


    Full Text Available PURPOSE: Development of an improved animal model for studying skin burns in rats. METHODS: Twenty-four male Wistar rats were randomly assigned to four groups (n=6: G1-Control, G2- T100°C, G3-T150°C and G4-T200°C. Two 10 x 10 mm squares were outlined with a sterile surgical marker on each side and along the vertebral column using a prepared template positioned between the anterior and posterior limbs. G2-G4 rats were subjected to 100°C, 150°C and 200ºC thermal burns, respectively. G1 rats served as controls. Burns were inflicted by applying a copper plate connected to an electronic temperature controlling device to the dorsal skin of anesthetized rats. Four burns were produced on each animal (total area: 4 cm²/animal leaving about 1 cm of undamaged skin between burn areas. Analgesia was administered during 24 h after burn injury by adding 30 mg codeine phosphate hemihydrate to 500 ml tap water. RESULTS: The application of 100°C and 150ºC resulted in partial thickness skin burns with central reepithelialization of the burned area only at 100°C. In G4 group the whole thickness of the skin was injured without central reepithelialization. However, there was marginal reepithelialization in all groups. CONCLUSION: The model studied is inexpensive and easily reproducible, enabling the achievement of controlled burns with partial or total impairment of the skin in experimental animals.OBJETIVO: Desenvolvimento de um modelo animal aperfeiçoado para estudo de queimaduras cutâneas em ratos. MÉTODOS: Vinte e quatro ratos Wistar, machos, foram distribuídos aleatoriamente em quatro grupos (n=6: G1-Controle, G2-T100°C, G3-T150°C e G4-T200°C. Dois quadrados medindo 10x10 mm foram delineados com um marcador cirúrgico estéril em cada lado e ao longo da coluna vertebral e posicionados entre os membros anteriores e posteriores, utilizando um molde previamente preparado. Os ratos dos grupos G2-G4 foram submetidos a queimaduras térmicas de 100

  11. A study of the application of residue from burned biomass in mortars

    Directory of Open Access Journals (Sweden)

    Enori Gemelli


    Full Text Available The goal of this work was to study the viability of burnt biomass residue from a pulp and paper plant applied as a raw material for mortar used in the construction industry. The waste - bottom ash - was incorporated into the mortar as a mineral addition to the Portland cement. The effect of the waste's grain size on the properties of mortars containing 10% in volume of waste was investigated, as well as the effect of the concentration of waste with grain size under 0.15 mm. The samples were evaluated after 28 days of aging by uniaxial compression, leaching test and scanning electron microscopy. These characterization techniques indicated that the properties of the mortars depend on the concentration, granulation and size distribution of the waste in the mortar's structure. Furthermore, some chemical elements may be present in stabilized and/or encapsulated form in the cement matrix.

  12. Wood-burning stoves worldwide

    DEFF Research Database (Denmark)

    Luis Teles de Carvalho, Ricardo

    More than any time in our history, the wood-burning stove continues to be the most popular technology used for cooking and heating worldwide. According to the World Health Organization and recent scientific studies, the inefficient use of solid-fuels in traditional stoves constitutes the major...... systems, improved efficient retrofits and advanced stove innovations. In chapter 3, four popular wood-burning practices found in five countries were singled-out to be examined closely in four case studies: “cooking in Brazil”, “cooking and heating in Peru”, “heating in Portugal” and “recreational heat...

  13. Lethal triad in severe burns. (United States)

    Sherren, P B; Hussey, J; Martin, R; Kundishora, T; Parker, M; Emerson, B


    Hypothermia, acidaemia and coagulopathy in trauma is associated with significant mortality. This study aimed to identify the incidence of the lethal triad in major burns, and describe demographics and outcomes. Patients admitted during a 71 month period with a total body surface area burn (TBSA)≥30% were identified. A structured review of a prospective database was conducted. The lethal triad was defined as a combination of coagulopathy (International normalised ratio>1.2), hypothermia (temperature≤35.5°C) and acidaemia (pH≤7.25). Fifteen of 117 patients fulfilled the criteria for the lethal triad on admission. Lethal triad patients had a higher median (IQR) abbreviated burn severity index (ABSI) (12 (9-13) vs. 8.5 (6-10), p=0.001), mean (SD) TBSA burn (59.2% (18.7) vs. 47.9% (18.1), p=0.027), mean (SD) age (46 (22.6) vs. 33 (28.3) years, p=0.033), and had a higher incidence of inhalational injury (p0.05). The lethal triad was associated with increased mortality (66.7% vs. 13.7%, plethal triad was not shown to be a predictor of mortality (p>0.05). Burn patients with the lethal triad have a high mortality rate which reflects the severity of the injury sustained. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  14. Factors Affecting Burn Contracture Outcome in Developing Countries: A Review of 2506 Patients. (United States)

    Garcia, Lauren P; Huang, Alice; Corlew, Daniel Scott; Aeron, Kush; Aeron, Yogi; Rai, Shankar Man; Jovic, Goran; Agag, Richard L


    Burn contractures hinder joint mobility, resulting in functional impairment and reduced quality of life. This is of greater significance in developing countries where there are fewer resources for assistance with such impairments. Contracture release reduces deformity, but multiple factors affect the extent of postsurgical improvements and outcomes. Elucidating these factors may enable surgeons to better care for burn patients. This study assesses factors that impact burn contracture resolution in developing nations. A retrospective review of 2506 burn contractures was performed using information extracted from a large nongovernment organization (ReSurge International) database from Nepal, India, and Zambia. Data points included age, type of burn, time elapsed between injury and release, and extent of final release achieved based on preoperative and postoperative images of hand (n = 1960), elbow (n = 371), and knee (n = 176) contractures. Hand improvement was scored based on digit/wrist involvement (severity of dysfunction) and joint extension capability (functionality); elbow and knee improvement were calculated using preoperative and postoperative joint angles. Multivariate analysis was performed. Hands burned by hot liquid had greater functionality after surgery than open-fire burns (P < 0.01). Improvement in severity of dysfunction and functionality were inversely correlated to age (P < 0.01) and time until surgery (P < 0.01). Elbow improvement decreased as age increased (P < 0.01). Postoperative increase of knee extension decreased for each year elapsed between injury and surgery (P < 0.01). Burn type, age when burned, and timing of surgery were significant factors affecting hand outcomes, whereas age affected elbow outcomes, and time elapsed until surgery affected knee results. An algorithm was formulated to enable physicians in developing countries with limited resources to triage patients and optimize patient outcomes.

  15. High-resolution Earth observation data and spatial analysis for burn severity evaluation and post-fire effects assessment in the Island of Chios, Greece (United States)

    Athanasakis, George; Psomiadis, Emmanouil; Chatziantoniou, Andromachi


    Forest fires are regarded as one of the most threatening sources of disturbance for the property, infrastructure as well as ecosystems. The present study aimed at analyzing spectral information products derived from the Landsat-8 OLI sensor together with spectral indices to evaluate their ability to map burn scars and burn severity. In particular the study objectives were: (1) to identify the capability of OLI to burnt area mapping and burn severity, (2) to evaluate the contribution of several spectral indices to the overall accuracy (3) to assess post-fire effects such as flood risk and, (4) to investigate the vegetation re-growth in relation to the burn severity. As a case study, Chios Island was selected due to the recent fire event in the south-western part of the island (25/07/2016). Three multispectral Landsat-8 OLI images, acquired on 13/07/2016 (pre-fire), 15/09/2016 (post-fire) and 27/03/2017 (six months after the fire), were utilized. Several spectral indices were implemented to detect the burnt areas and assess the burn severity (Burn Area Index - BAI, Normalized Burn Ratio - NBR, Normalized Burn Ration + Thermal - NBRT), as well as to evaluate the vegetation conditions and re-growth six months after the fire event (Normalized Difference Vegetation Index - NDVI and the Normalized Difference Water Index - NDWI). Additionally, NBR index of pre- and post-fire images was calculated in a difference change detection procedure which estimates the Differenced Normalized Burn Ratio dNBR. Overall, a total burned area of 45,9 km2 was delineated, and both burned severity map and vegetation recovery map were created and evaluated.

  16. The trends of burns epidemiology in a tropical regional burns centre. (United States)

    Hwee, Jolie; Song, Christopher; Tan, Kok Chai; Tan, Bien Keem; Chong, Si Jack


    Singapore General Hospital (SGH) is a regional burns centre in Southeast Asia and is the only dedicated burns facility providing specialized burns care in Singapore. A cohort study was performed for burns patients admitted to SGH from 2011 to 2013. We compared our data with earlier studies and observed the trends of burns epidemiology in Singapore. Results were analyzed using the SPSS programme. 655 patients were admitted during this study period, a 35.9% increase from 2003 to 2005. Scalding by water and flame injury remain the top causes of burns and the mean extent of burn is 9.5%. TBSA correlates with the incidence of burn infection, bacteremia and mortality. Patients with ≥20% TBSA are at a higher risk of bacteremia, and ≥ 34% TBSA is a predictor of mortality. 4.9% (n=32) of our patients developed bacteremia. Bacteremia was associated with a surgical duration of ≥80min. Patients with bacteremia incurred longer hospitalization, and had higher mortality rates. Overall mortality rate of our burns patients has decreased from 4.5% to 2.7% (n=18). Key factors of mortality include inhalational injury, bacteremia and ≥20% TBSA. This is a large epidemiology study of a tropical region burns centre. A total of 655 burns cases over a 3-year period were analyzed. We analysed the key factors associated with adverse outcomes including burns infection, bacteremia and mortality, factors associated with mortality, and discussed strategies on the optimization of burns care. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  17. Brain tumour presenting with burns: Case report and discussion. (United States)

    Sawyer, Oliver; O'Boyle, Ciaran P


    Descriptions of burns as the presenting features of underlying neurological pathology are very rare, with only two previously published case reports available. Both of these reports featured meningioma as the pre-existing pathology and both described burn excision and wound healing, prior to surgical tumour ablation. The authors describe the case of a 35-year-old female, who presented with 25% total body surface area burns and recent global neurological deterioration. MRI imaging revealed a large intracranial tumour. Multidisciplinary management included rigorous non-surgical burn wound care and early craniotomy and tumour excision. This proceeded without complication. Burn excision and skin grafting was carried out successfully, two weeks later. This case differs from the previous two reported cases, which both described burn excision, as a pre-requisite to neurosurgery. This case establishes that the presence of a burn wound is not a total contra-indication to intracranial surgery. Copyright © 2016. Published by Elsevier Ltd.

  18. Analysis and Assessment of the Spatial and Temporal Distribution of Burned Areas in the Amazon Forest

    Directory of Open Access Journals (Sweden)

    Francielle da Silva Cardozo


    Full Text Available The objective of this study was to analyze the spatial and temporal distribution of burned areas in Rondônia State, Brazil during the years 2000 to 2011 and evaluate the burned area maps. A Linear Spectral Mixture Model (LSMM was applied to MODIS surface reflectance images to originate the burned areas maps, which were validated with TM/Landsat 5 and ETM+/Landsat 7 images and field data acquired in August 2013. The validation presented a correlation ranging from 67% to 96% with an average value of 86%. The lower correlation values are related to the distinct spatial resolutions of the MODIS and TM/ETM+ sensors because small burn scars are not detected in MODIS images and higher spatial correlations are related to the presence of large fires, which are better identified in MODIS, increasing the accuracy of the mapping methodology. In addition, the 12-year burned area maps of Rondônia indicate that fires, as a general pattern, occur in areas that have already been converted to some land use, such as vegetal extraction, large animal livestock areas or diversified permanent crops. Furthermore, during the analyzed period, land use conversion associated with climatic events significantly influenced the occurrence of fire in Rondônia and amplified its impacts.

  19. The implementation and evaluation of therapeutic touch in burn patients: an instructive experience of conducting a scientific study within a non-academic nursing setting. (United States)

    Busch, Martine; Visser, Adriaan; Eybrechts, Maggie; van Komen, Rob; Oen, Irma; Olff, Miranda; Dokter, Jan; Boxma, Han


    Evaluation of therapeutic touch (TT) in the nursing of burn patients; post hoc evaluation of the research process in a non-academic nursing setting. 38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on anxiety for pain, salivary cortisol, and pain medication. Interviews with nurses were held concerning research in a non-academic setting. Anxiety for pain was more reduced on day 10 in the TT-group. The TT-group was prescribed less morphine on day 1 and 2. On day 2 cortisol level before dressing changes was higher in the TT-group. The situational challenges of this study led to inconsistencies in data collection and a high patient attrition rate, weakening its statistical power. Conducting an effect study within daily nursing practice should not be done with a nursing staff inexperienced in research. Analysis of the remaining data justifies further research on TT for burn patients with pain, anxiety for pain, and cortisol levels as outcomes. Administering and evaluating TT during daily care requires nurses experienced both in TT and research, thus leading to less attrition and missing data, increasing the power of future studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Focused feasibility study for surface soil at the main pits and pushout area, J-field toxic burning pits area, Aberdeen Proving Ground, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    Patton, T.; Benioff, P.; Biang, C.; Butler, J. [and others


    The Environmental Management Division of Aberdeen Proving Ground (APG), Maryland, is conducting a remedial investigation and feasibility study of the J-Field area at APG pursuant to the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (CERCLA). J-Field is located within the Edgewood Area of APG in Harford County, Maryland. Since World War II, activities in the Edgewood Area have included the development, manufacture, testing, and destruction of chemical agents and munitions. These materials were destroyed at J-Field by open burning/open detonation. Portions of J-Field continue to be used for the detonation and disposal of unexploded ordnance (UXO) by open burning/open detonation under authority of the Resource Conservation and Recovery Act.

  1. Relations between soil hydraulic properties and burn severity

    NARCIS (Netherlands)

    Moody, J.A.; Ebel, B.A.; Stoof, C.R.; Nyman, P.; Martin, D.A.; McKinley, R.


    Wildfire can affect soil hydraulic properties, often resulting in reduced infiltration. The magnitude of change in infiltration varies depending on the burn severity. Quantitative approaches to link burn severity with changes in infiltration are lacking. This study uses controlled laboratory

  2. Preparation and Characterization of High-Temperature Hole Burning Materials

    National Research Council Canada - National Science Library

    Bommareddi, Rami


    .... Hole burning efficiency depends on the glass composition as well. We investigated persistent spectral hole burning studies in europium doped glasses such as sodium borates, silicates, borosilicates, germinates and tellurites...

  3. EPiderniolo y and bacterial colonization of burn

    African Journals Online (AJOL)

    IKOOl) '. Bacterial isolates. Figure 2 shows the range of bacteria isolated from burn wounds. S. alfl'fl/J', P. mlmlaz'lz's and streptococci were the commonest isolates. The other Gram negatives were. Paeruglnara (4.5%). Salmonella, E. roll and Klebsz'ella app. Discussion. The epidemiology of burns reported from this study is.

  4. Wind erosion of soils burned by wildfire (United States)

    N. S. Wagenbrenner; M. J. Germino; B. K. Lamb; R. B. Foltz; P. R. Robichaud


    Wind erosion and aeolian transport processes are largely unstudied in the post-wildfire environment, but recent studies have shown that wind erosion can play a major role in burned landscapes. A wind erosion monitoring system was installed immediately following a wildfire in southeastern Idaho, USA to measure wind erosion from the burned area (Figure 1). This paper...

  5. Prevention-oriented epidemiology of burns in Ardabil provincial burn centre, Iran. (United States)

    Sadeghi Bazargani, H; Arshi, S; Ekman, R; Mohammadi, R


    In preventing burns, it is essential to know how they occur and which population groups, environments and heating appliances can be targeted for prevention work. The aim of this study was to determine the epidemiological characteristics of burns leading to hospitalisation in the northwest of Iran with a focus on the pre-event phase of injury. Between 2007 and 2008, 237 burn victims hospitalised in Ardabil provincial burn centre were enrolled into a descriptive study. A questionnaire was filled in during hospital stay for all patients, with a focus on obtaining information necessary for prevention purposes. Males constituted 56% of victims. Mean age was 22 years. The most severe burns occurred between the ages of 18 and 32 years, and were mainly flame related. Both in case of flame and non-flame burns, women suffered more severe burns and mortality than men. However, with respect to non-flame burns of which most were scalds, the majority of the severe cases involved children under the age of 5 years. More than 80% of burns occurred at home. The kitchen was the main place of injury in 47% of cases, followed by living rooms in 28%. Nearly 45% of burns were scalds and 47% were flame burns. The main container was the samovar in 37%, followed by kettles in 32% and pots in 22%. The overturning of a container was the major mechanism of contact with hot liquids in 86%. Bumping into a container was the main scenario of a scald injury, constituting nearly 70% of the cases. The difference between flame and non-flame burns in the distribution of burns in extremities was not statistically significant, but head and neck burns were 3.7 times more likely to be caused by flame. The two most important injury patterns, more common among women, were getting burned while using a camping gas stove or while refilling the chamber of kerosene-burning appliances without first extinguishing them. Domestic burns among children and young women are a priority in injury-prevention programmes

  6. Increased admissions for diabetes mellitus after burn. (United States)

    Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; O'Halloran, Emily; Rea, Suzanne; Wood, Fiona M


    Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident admissions for diabetes mellitus during this time. Results would suggest prolonged clinical management after discharge and or wound healing to minimise post-burn admissions for diabetes mellitus is required. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. A comparative study of histopathological effects of aqueous extract of cinnamon and honey with sulfadiazine on skin burn wound healing in rats infected with Pseudomonas aeuroginosa

    Directory of Open Access Journals (Sweden)

    Mohammadreza Valilou


    Full Text Available Pseudomonas aeruginosa, a ubiquitous opportunistic pathogen, is the most common infective agent of burn wounds. The aim of this study was to compare the histopathological effect of a mixture of aqueous extract of cinnamon and honey with silver sulfadiazine on the healing of Pseudomonas aeruginosa infected second grade skin burn wounds in rats. To this end, 60 male rats were randomly assigned to four experimental groups (15 rats in each group. After inducing anesthesia, second grade burn wound with the diameter of 12 mm was created in the dorsal region of rats. Then, 1.5×108 cfu/ml P. aeruginosa PA01was equally bestrewed on the wound of all rats. Every 12 hours, silver sulfadiazine (group 1, honey (group 2 and aqueous extract of cinnamon and honey (group 3 were applied to the wounds and group 4 was kept as control. On days 7, 14, and 21, five rats were selected from each group at each time point and after inducing anesthesia and measuring the diameter of the wound by coliseum, microbial and histopathological samples were taken from the wounds. Microbial studies showed that in all groups except the control group, the growth of the microbe was stopped. Histopathological observations regarding wound healing and diameter showed that there was a significant difference between treatment groups and the control group on days 7, 14 and 21 (p

  8. The responsiveness of the Chelsea Critical Care Physical Assessment tool in measuring functional recovery in the burns critical care population: an observational study. (United States)

    Corner, Evelyn J; Hichens, Louise V; Attrill, Kate M; Vizcaychipi, Marcela P; Brett, Stephen J; Handy, Jonathan M


    Severe burn leads to a state of hypercatabolism, resulting in rapid muscle loss and long-term disability. As survival rates from severe burn are improving, early rehabilitation is essential to facilitate functional recovery. However, there is no way of measuring the degree of disability in the acute stages, and hence, no marker of functional recovery. This hampers both communication and research into interventions to improve functional outcomes. The Chelsea Critical Care Physical Assessment tool (CPAx) is a simple objective measure of function, designed and validated in the general Intensive Care Unit (ICU) cohort. The aim of this study was to test the responsiveness of the CPAx in the burns ICU (BICU) cohort and validate its use. Observational study of 52 BICU patients admitted for over 48h. All patients were assessed on the CPAx retrospectively for pre-admission, and prospectively at ICU admission, ICU discharge (or final ICU assessment for non-survivors) and hospital discharge. Analysis of variance, post hoc between group differences in median CPAx score, and floor and ceiling effect (i.e. the percentage of patients scoring full marks (50), or zero) for the four time points were completed. Minimal clinically important difference (MCID) was estimated as half of the standard deviation of the CPAx score at ICU discharge. A total of 30 patients were included in the final analysis; mean age was 47.1 years (SD 21.2), 63.3% were male, with a median burn total body surface area (TBSA) of 30% (IQR 11.3-48.8). There was a significant difference in the analysis of variance in median CPAx scores at all four time points (pburn. It has a limited floor and ceiling effect in the acute setting and a change in CPAx score of 6 represents clinically important progress. Further work is required in a larger cohort. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  9. Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study (United States)

    Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane


    Background Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. Aim We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. Methods From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. Results We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. Conclusion The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy. PMID:29491717

  10. Stubble Burning and Consciousness Level of Farmers

    Directory of Open Access Journals (Sweden)

    Gülistan Erdal


    Full Text Available This study analyses the consciousness levels, attitudes and behaviours of farmers against stubble burning and the damages of stubble burning which is a part of land misuse. 86 farmers from 9 villages in Zile county of Tokat province were surveyed for the study. These data was used to state farmers' socio-demographical characteristics and their behaviours against stubble burning was analysed. According to the study results, 99% of the farmers says that stubble burning is a wrong application. They states that stubble burning causes natural damages and the most importantly it is harmful by 76% to the living creatures in the nature. 57% of them prefers the method of mixing stubble to the soil.

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

    African Journals Online (AJOL)

    Materials and methods: A prospective hospital based study was carried out from December 2010 to February 2011 at Yekatit 12 hospital burn center. Periodic wound swabs and blood samples were collected on 1st, 7th, and 14th days of hospital stay and processed with conventional culture and biochemical tests. Isolates ...

  12. Pediatric facial burns. (United States)

    Kung, Theodore A; Gosain, Arun K


    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.

  13. Thrombocytopenia in the pediatric burn patient. (United States)

    Warner, Petra; Fields, Amanda L; Braun, Lindsay C; James, Laura E; Bailey, J Kevin; Yakuboff, Kevin P; Kagan, Richard J


    Thrombocytopenia is initially seen in patients with burn injury as a transient occurrence during the first week after injury. Subsequent decreases occur later in the course of treatment and are commonly due to sepsis, dilutional effects, and medication exposure. Although studies have demonstrated that thrombocytopenia in the critically ill patients is associated with a worse prognosis, there is limited literature as to the significance of thrombocytopenia in the pediatric burn patients. In this study, the authors evaluate the prognostic implications of thrombocytopenia in the pediatric burn patients. They performed a 5-year retrospective chart of patients aged 18 years or younger with burns >20% TBSA admitted to their institution. Data collected included patient demographics, burn etiology and %TBSA involvement, length of stay, pertinent laboratory values, and in-hospital morbidity and mortality. Of the 187 patients studied, thrombocytopenia occurred in 112 patients. Eighty-two percent demonstrated thrombocytopenia within the first week of injury and 18% demonstrated additional episodes of thrombocytopenia after this time. A reactive thrombocytosis occurred in 130 (70%) patients. The incidence of thrombocytopenia could not be attributed to age, gender, or burn etiology. However, patients with thrombocytopenia were more likely to have inhalation injury and extensive TBSA involvement than those without (P thrombocytosis in the pediatric burn patient is associated with increased mortality risk and is influenced by the extent of burn, inhalation injury, and the development of sepsis.

  14. Referral patterns in pediatric burn patients. (United States)

    Doud, Andrea N; Swanson, John M; Ladd, Mitchell R; Neff, Lucas P; Carter, Jeff E; Holmes, James H


    Though multiple studies have demonstrated superior outcomes amongst adult burn patients at verified burn centers (VBCs) relative to nondedicated burn centers (NBCs), roughly half of such patients meeting American Burn Association (ABA) referral guidelines are not sent to these centers. We sought examine referral patterns amongst pediatric burn patients. Retrospective review of a statewide patient database identified pediatric burn patients from 2000 to 2007 using International Classification of Disease (ICD-9) discharge codes. These injuries were crossreferenced with ABA referral criteria to determine compliance with the ABA guidelines. 1831 children sustained burns requiring hospitalization during the study period, of which 1274 (70%) met ABA referral criteria. Of 557 treated at NBCs, 306 (55%) met criteria for transfer. Neither age, gender, nor payer status demonstrated significant association with treatment center. VBCs treated more severely injured patients, but there was no difference in survival or rate of discharge home from NBCs versus VBCs. Studies to evaluate differences in functional outcomes between pediatric burn patients treated at VBCs versus NBCs would be beneficial to ensure optimization of outcomes in this population.

  15. Epidemiology of burn injuries in Mekele Town, Northern Ethiopia: A ...

    African Journals Online (AJOL)

    Introduction: Epidemiological study on burn injuries and exploration of the risk factors in different settings is important for effective intervention. Very little is known about burn injuries in Ethiopia. Objectives: The aims of this study were to assess the annual incidence of burn injuries and to describe the local knowledge about ...

  16. A model of ponderosa pine growth response to prescribed burning (United States)

    Elaine Kennedy Sutherland; W. Wallace Covington; Steve Andariese


    Our objective was to model the radial growth response of individual ponderosa pines to prescribed burning in northern Arizona. We sampled 188 trees from two study areas, which were burned in 1976. Within each study area, control and burned trees were of similar age, vigor, height, and competition index. At Chimney Spring, trees were older, less vigorous, and taller and...

  17. Management of chemical burns of the canine cornea


    Christmas, Richard


    Significant clinical signs and general principles of treatment for chemical burns of the canine cornea are presented using three typical case studies for illustration. Alkali burns are more common in dogs than acid burns. The sources of alkali in this study were soap, cement, and mortar dust. Common signs of chemical burns are ocular pain, corneal ulceration, tear film inadequacy, corneal edema, and marked corneal neovascularity. Successful treatment requires thorough ocular lavage, treatment...

  18. Buried Target Imaging: A Comparative Study (United States)

    Ghaderi Aram, Morteza; Dehmollaian, Mojtaba; Khaleghi, Ali


    A wide variety of qualitative methods have been proposed for microwave imaging. It is difficult to select only one of these methods based on a priori information and measurement equipment to achieve a reliable reconstruction. Various arrangements for antennas to be used in, for instance, have been proposed which have direct impacts on the complexity of inverse methods as well as the quality of output images. In this study, four qualitative methods of the linear sampling method (LSM), time reversal (TR), diffraction tomography (DT), and back-projection (BP) have been reviewed in a 2D scenario; the performance of the methods is compared within the same framework of a multi-static configuration. The goal is to compare their resolutions and determine their advantages and drawbacks. It is shown that LSM provides the best azimuth resolution but the worst range resolution. It is almost invariant to dielectric contrast and is appropriate for a wide range of dielectric contrasts and relatively large objects. It is also shown that at relatively low dielectric contrasts, TR images are most similar to the true object, show fewer artifacts, and offer high immunity to noise. While suffering from more artifacts due to the presence of some ghost images, DT offers the best range resolution. The results also show that BP has the worst azimuth resolution when reconstructing deeply-buried targets, although its implementation is straightforward and not computationally complex.

  19. 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). (United States)

    Mahendraraj, Krishnaraj; Durgan, Diane M; Chamberlain, Ronald S


    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

  20. Possible indicators for bio-mass burning in a small Swedish city as studied by energy dispersive fluorescence (EDXRF) spectrometry

    DEFF Research Database (Denmark)

    Selin Lindgren, Eva; Henriksson, Dag; Lundin, Magnus


    to investigate the contribution of biomass incineration to air quality, energy-dispersive x-ray fluorescence (EDXRF) analysis was performed on aerosol particles sampled in the centre of the small city of Växjö. PM2.5 and PM2.5-10 fractions were sampled with the special aim of determining the contribution...... of biomass burning to particulate air pollution. In order to identify typical indicators for biomass burning, principle component analysis was performed on data on elemental contents and black carbon. Analysis suggests that the K/Zn ratio will be useful as an indicator for biomass incineration.......Biomass is increasingly used in energy plants of different size and sophistication in Sweden. Biomass is also available in Sweden owing to its large forest-covered areas. Incineration of biomass in an environmentally friendly manner is one of the key issues in Swedish policy for sustainable...

  1. A Systematic Review of the Evolution of Laser Doppler Techniques in Burn Depth Assessment

    Directory of Open Access Journals (Sweden)

    Manaf Khatib


    Full Text Available Aims. The introduction of laser Doppler (LD techniques to assess burn depth has revolutionized the treatment of burns of indeterminate depth. This paper will systematically review studies related to these two techniques and trace their evolution. At the same time we hope to highlight current controversies and areas where further research is necessary with regard to LD imaging (LDI techniques. Methods. A systematic search for relevant literature was carried out on PubMed, Medline, EMBASE, and Google Scholar. Key search terms included the following: “Laser Doppler imaging,” “laser Doppler flow,” and “burn depth.” Results. A total of 53 studies were identified. Twenty-six studies which met the inclusion/exclusion criteria were included in the review. Conclusions. The numerous advantages of LDI over those of LD flowmetry have resulted in the former technique superseding the latter one. Despite the presence of alternative burn depth assessment techniques, LDI remains the most favoured. Various newer LDI machines with increasingly sophisticated methods of assessing burn depth have been introduced throughout the years. However, factors such as cost effectiveness, scanning of topographically inconsistent areas of the body, and skewing of results due to tattoos, peripheral vascular disease, and anaemia continue to be sighted as obstacles to LDI which require further research.

  2. Pathophysiologic Response to Burns in the Elderly☆ (United States)

    Jeschke, Marc G.; Patsouris, David; Stanojcic, Mile; Abdullahi, Abdikarim; Rehou, Sarah; Pinto, Ruxandra; Chen, Peter; Burnett, Marjorie; Amini-Nik, Saeid


    Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50) burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p elderly, p > 0.05, but a significant increased incidence of multi organ failure, p elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly. PMID:26629550

  3. Imaging biomarker roadmap for cancer studies


    O'Connor, JPB; Aboagye, EO; Adams, JE; Aerts, HJWL; Barrington, SF; Beer, AJ; Boellaard, R.; Bohndiek, SE; Brady, M.; Brown, G.; Buckley, DL; Chenevert, TL; Clarke, LP; Collette, S.; Cook, GJ


    Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthc...

  4. Study of the corrosiveness of gases given off by burning power-cable insulation and sheath materials

    Energy Technology Data Exchange (ETDEWEB)

    Galloy, A.


    While modern insulation materials are designed to be fire-resistant, they do give off highly corrosive hydrohalogenic acids should burning occur. The author describes the two methods used to determine corrosiveness and presents the results on different types of materials; he discusses the effectiveness of the two test methods, though these have helped establish a correlation between the quantity of halogenic acid given off and the level of corrosiveness.

  5. Burns and military clothing. (United States)

    McLean, A D


    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under


    Directory of Open Access Journals (Sweden)

    Habeeb Mohamed


    Full Text Available BACKGROUND Burn injury is a serious preventable health problem. Unlike developed countries, in India, most burns occur in the domestic environment. The mortality is high. The social, psychological (disfigurement and physical trauma in those who survive is high and the quality of life is greatly reduced. The present study was undertaken to study the epidemiology and the outcome of patients admitted with burn injury in a tertiary care hospital in Kerala. MATERIALS AND METHODS A cross-sectional study was done to assess the profile and the proportion of percentage of burns with morbidity and mortality in a tertiary care hospital of north Kerala in the year 2007. RESULTS The commonest cause of burns were found to be accidental accounting for 73%. Among the study subjects, 45% survived while 49% died and 6% were discharged against medical advice. The mortality was high in patients with more than 60% of body surface area affected by burns. The mortality increased with percentage of burns even in a tertiary care center. The mortality also increased with increase in age of the patient. CONCLUSION The mortality increased with age and percentage of burns even in a tertiary care hospital. The management of burns needs well-equipped burn centres and other facilities, which demand a lot of economic commitment. Setting up of a well-equipped referral burn centre with a trained team with good economic support from the government and non-governmental agencies and strengthening of peripheral healthcare facilities can produce promising results in burn management.

  7. A Study of Digital Image Enlargement and Enhancement

    Directory of Open Access Journals (Sweden)

    Hsueh-Yi Lin


    Full Text Available Most image enlargement techniques suffer the problem of zigzagged edges and jagged images following enlargement. Humans are sensitive to the edges of objects; if the edges in the image are sharp, the visual is considered to be high quality. To solve this problem, this paper presents a new and effective method for image enlargement and enhancement based on adaptive inverse hyperbolic tangent (AIHT algorithm. Conventional image enlargement and enhancement methods enlarge the image using interpolation, and subsequently enhance the image without considering image features. However, this study presents the method based on Adaptive Inverse Hyperbolic Tangent algorithm to enhance images according to image features before enlarging the image. Experimental results indicate that the proposed algorithm is capable of adaptively enhancing the image and extruding object details, thereby improving enlargements by smoothing the edge of the objects in the image.

  8. Mouse Model of Burn Wound and Infection

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus


    The immunosuppression induced by thermal injury renders the burned victim susceptible to infection. A mouse model was developed to examine the immunosuppression, which was possible to induce even at a minor thermal insult of 6% total body surface area. After induction of the burn (48 hr) a depres......The immunosuppression induced by thermal injury renders the burned victim susceptible to infection. A mouse model was developed to examine the immunosuppression, which was possible to induce even at a minor thermal insult of 6% total body surface area. After induction of the burn (48 hr......) a depression of leukocytes in the peripheral blood was found of the burned mice. This depression was due to a reduction in the polymorphonuclear cells. The burned mice were not able to clear a Pseudomonas aeruginosa wound infection, since the infection spread to the blood as compared to mice only infected...... with P. aeruginosa subcutaneously. The burn model offers an opportunity to study infections under these conditions. The present model can also be used to examine new antibiotics and immune therapy. Our animal model resembling the clinical situation is useful in developing new treatments of burn wound...

  9. Antimicrobial blue light therapy for Candida albicans burn infection in mice (United States)

    Zhang, Yunsong; Wang, Yucheng; Murray, Clinton K.; Hamblin, Michael R.; Gu, Ying; Dai, Tianhong


    In this preclinical study, we investigated the utility of antimicrobial blue light therapy for Candida albicans infection in acutely burned mice. A bioluminescent strain of C. albicans was used. The susceptibilities to blue light inactivation were compared between C. albicans and human keratinocyte. In vitro serial passaging of C. albicans on blue light exposure was performed to evaluate the potential development of resistance to blue light inactivation. A mouse model of acute thermal burn injury infected with the bioluminescent strain of C. albicans was developed. Blue light (415 nm) was delivered to mouse burns for decolonization of C. albicans. Bioluminescence imaging was used to monitor in real time the extent of fungal infection in mouse burns. Experimental results showed that C. albicans was approximately 42-fold more susceptible to blue light inactivation in vitro than human keratinocyte (P=0.0022). Serial passaging of C. albicans on blue light exposure implied a tendency for the fungal susceptibility to blue light inactivation to decrease with the numbers of passages. Blue light reduced fungal burden by over 4-log10 (99.99%) in acute mouse burns infected with C. albicans in comparison to infected mouse burns without blue light therapy (P=0.015).

  10. Burns and Fire Safety (United States)

    ... Cairns BA, et al. Etiology and outcome of pediatric burns. J Pediatr Surg. 1996; 31(3): 329-33. ... RT, Feldman JA, McMillon M. Tap water scald burns in children. Pediatrics. 1978; 62(1): 1-7. 10 Baptiste MS, ...

  11. Are burns photographs useful? (United States)

    Nelson, L; Boyle, M; Taggart, I; Watson, S


    Routine photography of all patients admitted to the West of Scotland Regional Burns Unit was introduced in 2003. To date, there are few burns units to evaluate the usefulness of photographs taken. To assess the usefulness of photographs of patients admitted to the burns unit to various members of the multidisciplinary team. A questionnaire was completed by hospital staff involved in the management of burns patients over a 3-month period. A total of 43 questionnaires were completed. The majority of questionnaires were completed by nursing staff (55%) followed by medical staff (23%); physiotherapy (5%); anaesthetists (7%); theatre staff (5%); students (2%); dietician (2%). About 98% of respondents agreed that photographs were useful overall, particularly for teaching purposes. About 9% disagreed that photographs were useful for assessment due to difficulty in assessing depth of burn. About 72% agreed that the photographs were useful for patient management and improve patient care. About 88% agreed that all patients should have photographs available in future. Advantages of photographs include; moving and handling of patients; patient positioning in theatre; reviewing wound healing and complications. They are useful for assessing site, size and type of burn. Disadvantages include difficulty in assessing depth of burn, technical factors, and unavailability out of hours. Photographs of burns patients are useful overall to all members of the multidisciplinary team.

  12. Treating and Preventing Burns (United States)

    ... Listen Español Text Size Email Print Share Burn Treatment & Prevention Tips for Families Page Content ​There are many different causes of serious burns in children, including sunburn , hot water or other hot liquids, and those due to ...

  13. Crusted Scabies in the Burned Patient

    DEFF Research Database (Denmark)

    Berg, Jais Oliver; Alsbjørn, Bjarne


    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 (