WorldWideScience

Sample records for high burn severity

  1. Using High Spatial Resolution Satellite Imagery to Map Forest Burn Severity Across Spatial Scales in a Pine Barrens Ecosystem

    Science.gov (United States)

    Meng, Ran; Wu, Jin; Schwager, Kathy L.; Zhao, Feng; Dennison, Philip E.; Cook, Bruce D.; Brewster, Kristen; Green, Timothy M.; Serbin, Shawn P.

    2017-01-01

    As a primary disturbance agent, fire significantly influences local processes and services of forest ecosystems. Although a variety of remote sensing based approaches have been developed and applied to Landsat mission imagery to infer burn severity at 30 m spatial resolution, forest burn severity have still been seldom assessed at fine spatial scales (less than or equal to 5 m) from very-high-resolution (VHR) data. We assessed a 432 ha forest fire that occurred in April 2012 on Long Island, New York, within the Pine Barrens region, a unique but imperiled fire-dependent ecosystem in the northeastern United States. The mapping of forest burn severity was explored here at fine spatial scales, for the first time using remotely sensed spectral indices and a set of Multiple Endmember Spectral Mixture Analysis (MESMA) fraction images from bi-temporal - pre- and post-fire event - WorldView-2 (WV-2) imagery at 2 m spatial resolution. We first evaluated our approach using 1 m by 1 m validation points at the sub-crown scale per severity class (i.e. unburned, low, moderate, and high severity) from the post-fire 0.10 m color aerial ortho-photos; then, we validated the burn severity mapping of geo-referenced dominant tree crowns (crown scale) and 15 m by 15 m fixed-area plots (inter-crown scale) with the post-fire 0.10 m aerial ortho-photos and measured crown information of twenty forest inventory plots. Our approach can accurately assess forest burn severity at the sub-crown (overall accuracy is 84% with a Kappa value of 0.77), crown (overall accuracy is 82% with a Kappa value of 0.76), and inter-crown scales (89% of the variation in estimated burn severity ratings (i.e. Geo-Composite Burn Index (CBI)). This work highlights that forest burn severity mapping from VHR data can capture heterogeneous fire patterns at fine spatial scales over the large spatial extents. This is important since most ecological processes associated with fire effects vary at the less than 30 m scale and

  2. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  3. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review.

    Science.gov (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Resuscitation of burn victims with high-dose ascorbic acid (vitamin C [VC]) was reported in Japan in the year 2000. Benefits of VC include reduction in fluid requirements, resulting in less tissue edema and body weight gain. In turn, these patients suffer less respiratory impairment and reduced requirement for mechanical ventilation. Despite these results, few burn centers resuscitate patients with VC in fear that it may increase the risk of renal failure. A retrospective review of 40 patients with greater than 20% TBSA between 2007 and 2009 was performed. Patients were divided into two groups: one received only lactated Ringer's (LR) solution and another received LR solution plus 66 mg/kg/hr VC. Both groups were resuscitated with the Parkland formula to maintain stable hemodynamics and adequate urine output (>0.5 ml/kg/hr). Patients with >10-hour delay in transfer to the burn center were excluded. Data collected included age, gender, weight, %TBSA, fluid administered in the first 24 hours, urine output in the first 24 hours, and Acute Physiology and Chronic Health Evaluation II score. PaO2 in millimeters mercury:%FIO2 ratio and positive end-expiratory pressure were measured at 12-hour intervals, and hematocrit was measured at 6-hour intervals. Comorbidities, mortality, pneumonia, fasciotomies, and renal failure were also noted. After 7 patients were excluded, 17 patients were included in the VC group and 16 in the LR group. VC and LR were matched for age (42 ± 16 years vs 50 ± 20 years, P = .2), burn size (45 ± 21%TBSA vs 39 ± 15%TBSA, P = .45), Acute Physiology and Chronic Health Evaluation II (17 ± 7 vs 18 ± 8, P = .8), and gender. Fluid requirements in the first 24 hours were 5.3 ± 1 ml/kg/%TBSA for VC and 7.1 ± 1 ml/kg/%TBSA for LR (P < .05). Urine output was 1.5 ± 0.4 ml/kg/hr for VC and 1 ± 0.5 ml/kg/hr for LR (P < .05). Vasopressors were needed in four VC patients and nine LR patients (P = .07). VC patients required vasopressors to maintain mean

  4. BURN SEVERITY MAPPING IN AUSTRALIA 2009

    Directory of Open Access Journals (Sweden)

    R. McKinley

    2012-07-01

    Full Text Available In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR algorithm.

  5. Infection control in severely burned patients

    OpenAIRE

    Coban, Yusuf Kenan

    2012-01-01

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

  6. The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

    Science.gov (United States)

    Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter

    2017-02-01

    Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, pburn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. Severe metabolic acidosis following assault chemical burn

    Directory of Open Access Journals (Sweden)

    Sophie De Roock

    2012-01-01

    Full Text Available Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9 obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure. Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.

  8. Severe metabolic acidosis following assault chemical burn.

    Science.gov (United States)

    Roock, Sophie D; Deleuze, Jean-Paul; Rose, Thomas; Jennes, Serge; Hantson, Philippe

    2012-04-01

    Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9) obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure). Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.

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

    Directory of Open Access Journals (Sweden)

    Sean A. Parks

    2014-02-01

    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.

  10. Does fire severity influence shrub resprouting after spring prescribed burning?

    Science.gov (United States)

    Fernández, Cristina; Vega, José A.; Fonturbel, Teresa

    2013-04-01

    Prescribed burning is commonly used to reduce the risk of severe wildfire. However, further information about the associated environmental effects is required to help forest managers select the most appropriate treatment. To address this question, we evaluated if fire severity during spring prescribed burning significantly affects the resprouting ability of two common shrub species in shrubland under a Mediterranean climate in NW Spain. Fire behaviour and temperatures were recorded in tagged individuals of Erica australis and Pterospartum tridentatum during prescribed burning. The number and length of resprouted shoots were measured three times (6, 12 and 18 months) after the prescribed burning. The influence of a series of fire severity indicators on some plant resprouting vigour parameters was tested by canonical correlation analysis. Six months and one year after prescribed burning, soil burn severity (measured by the absolute reduction in depth of the organic soil layer, maximum temperatures in the organic soil layer and the mineral soil surface during burning and the post-fire depth of the organic soil layer) reduced the resprouting vigour of E. australis and P. tridentatum. In contrast, direct measurements of fire effects on plants (minimum branch diameter, duration of temperatures above 300 °C in the shrub crown and fireline intensity) did not affect the post-fire plant vigour. Soil burn severity during spring prescribed burning significantly affected the short-term resprouting vigour in a mixed heathland in Galicia. The lack of effects eighteen months after prescribed burning indicates the high resilience of these species and illustrates the need to conciliate fire prevention and conservation goals.

  11. [Severe burns related to steam inhalation therapy].

    Science.gov (United States)

    Belmonte, J A; Domínguez-Sampedro, P; Pérez, E; Suelves, J M; Collado, J M

    2015-02-01

    Despite lack of proven effectiveness and its potential to cause severe burns, steam inhalation therapy (SIT) is still used as a treatment for benign respiratory conditions. To characterize cases of burns related to steam inhalation therapy (BRSIT) in order to formulate appropriate preventive criteria. A review was conducted on cases of BRSIT admitted to a Burns Unit between 2006 and 2012, analysing epidemiological data, clinical aspects, severity and course. A total of 530 patients were admitted; 375 (70%) with scalds, and 15 with BRSIT (2.8% of burns; 4% of scalds). SIT was indicated in most cases for mild upper airway infections. The median age of patients was 7 years (2.5m-14 y). The burned area (BA) was ≥10% in 60% of cases (max. BA 22%). Injuries involved trunk, genital area, and extremities; only in one case was the face affected. The mean hospital length-of-stay was 14 days (3-30 d). Five patients (33%) were admitted to the PICU, most of them (60%) younger than 3 years. Eight patients (53%) underwent surgical treatment (skin grafting). In a 12-year-old patient whooping cough was diagnosed in the Burns Unit, and a 2.5-year-old patient developed staphylococcal toxic shock syndrome. No patient died. The final course was satisfactory in all patients. BRSIT can be severe and cause significant use of health resources. Professionals caring for children, particularly paediatricians, should seriously consider their prevention, avoiding treatments with SIT, and educating parents in order not to use it on their own. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  12. Object-based assessment of burn severity in diseased forests using high-spatial and high-spectral resolution MASTER airborne imagery

    Science.gov (United States)

    Chen, Gang; Metz, Margaret R.; Rizzo, David M.; Dillon, Whalen W.; Meentemeyer, Ross K.

    2015-04-01

    Forest ecosystems are subject to a variety of disturbances with increasing intensities and frequencies, which may permanently change the trajectories of forest recovery and disrupt the ecosystem services provided by trees. Fire and invasive species, especially exotic disease-causing pathogens and insects, are examples of disturbances that together could pose major threats to forest health. This study examines the impacts of fire and exotic disease (sudden oak death) on forests, with an emphasis on the assessment of post-fire burn severity in a forest where trees have experienced three stages of disease progression pre-fire: early-stage (trees retaining dried foliage and fine twigs), middle-stage (trees losing fine crown fuels), and late-stage (trees falling down). The research was conducted by applying Geographic Object-Based Image Analysis (GEOBIA) to MASTER airborne images that were acquired immediately following the fire for rapid assessment and contained both high-spatial (4 m) and high-spectral (50 bands) resolutions. Although GEOBIA has gradually become a standard tool for analyzing high-spatial resolution imagery, high-spectral resolution data (dozens to hundreds of bands) can dramatically reduce computation efficiency in the process of segmentation and object-based variable extraction, leading to complicated variable selection for succeeding modeling. Hence, we also assessed two widely used band reduction algorithms, PCA (principal component analysis) and MNF (minimum noise fraction), for the delineation of image objects and the subsequent performance of burn severity models using either PCA or MNF derived variables. To increase computation efficiency, only the top 5 PCA and MNF and top 10 PCA and MNF components were evaluated, which accounted for 10% and 20% of the total number of the original 50 spectral bands, respectively. Results show that if no band reduction was applied the models developed for the three stages of disease progression had relatively

  13. High burn rate solid composite propellants

    Science.gov (United States)

    Manship, Timothy D.

    High burn rate propellants help maintain high levels of thrust without requiring complex, high surface area grain geometries. Utilizing high burn rate propellants allows for simplified grain geometries that not only make production of the grains easier, but the simplified grains tend to have better mechanical strength, which is important in missiles undergoing high-g accelerations. Additionally, high burn rate propellants allow for a higher volumetric loading which reduces the overall missile's size and weight. The purpose of this study is to present methods of achieving a high burn rate propellant and to develop a composite propellant formulation that burns at 1.5 inches per second at 1000 psia. In this study, several means of achieving a high burn rate propellant were presented. In addition, several candidate approaches were evaluated using the Kepner-Tregoe method with hydroxyl terminated polybutadiene (HTPB)-based propellants using burn rate modifiers and dicyclopentadiene (DCPD)-based propellants being selected for further evaluation. Propellants with varying levels of nano-aluminum, nano-iron oxide, FeBTA, and overall solids loading were produced using the HTPB binder and evaluated in order to determine the effect the various ingredients have on the burn rate and to find a formulation that provides the burn rate desired. Experiments were conducted to compare the burn rates of propellants using the binders HTPB and DCPD. The DCPD formulation matched that of the baseline HTPB mix. Finally, GAP-plasticized DCPD gumstock dogbones were attempted to be made for mechanical evaluation. Results from the study show that nano-additives have a substantial effect on propellant burn rate with nano-iron oxide having the largest influence. Of the formulations tested, the highest burn rate was a 84% solids loading mix using nano-aluminum nano-iron oxide, and ammonium perchlorate in a 3:1(20 micron: 200 micron) ratio which achieved a burn rate of 1.2 inches per second at 1000

  14. [Analysis of respiratory complications in 922 severely burned patients].

    Science.gov (United States)

    Zhang, Tao; Li, Xiaojian; Deng, Zhongyuan; Zhang, Zhi; Tang, Wenbin; Chen, Bin; Bao, Qiang; He, Menglong

    2014-06-01

    To discuss the distribution of the respiratory complications in severely burned patients and the prevention and treatment experience against them. Medical records of 922 adult patients with severe or extremely severe burn hospitalized in our burn ICU from January 2005 to December 2012 were screened and retrospectively analyzed, including patients transferred from other hospitals, patients with total burn area above 50% TBSA, the distribution and treatment of respiratory complications, and the mortality. Data were processed with chi-square test. The constituent ratio of patients transferred to our hospital was 71.1% in 2007 and 40.2% in 2010, while it remained about 50.0% in the other years. The ratios of patients with total burn area larger than 50% TBSA and that of patients with respiratory complications (χ(2) = 2.637, P > 0.05) showed no significant changes each year. Among these 922 burn patients, 523 patients suffered respiratory complications, among which laryngeal edema (50.9%, 266 cases), pulmonary infection (21.6%, 113 cases), and ARDS (11.9%, 62 cases) were the main components, with no significant change each year (with χ(2) values respectively 6.132, 6.319, 0.016, P values above 0.05). Among the patients with respiratory complications, except for 36 were not treated actively, 487 were treated by ventilator among which 228 had undergone tracheostomy, and the constituent ratios in the 8 years were close. Fifteen patients died, with 2 died of laryngeal edema, 3 of ARDS, and 10 of sepsis or MODS as a result of sepsis. Patients with severe burns were at high risk of respiratory complications, among which laryngeal edema was common, followed by pulmonary infection and ARDS. Prophylactic tracheostomy, mechanical ventilation, wound therapy, and anti-infection were all effective measures of prevention and treatment against these complications.

  15. Burn severity and areas of daily fire growth for 42 forest fires in Idaho and Montana, 2005 - 2011

    Science.gov (United States)

    Birch, Donovan Shayne

    This work consisted of two studies of burn severity using infrared perimeter maps and satellite-inferred burn severity data, differenced Normalized Burn Ratio, from 42 wildland fires from central Idaho and western Montana from 2005 to 2007, and 2011. Study 1 examined the proportion of burn severity categories for individual daily areas burned. We defined 2,697 areas, from which we calculated the proportion of three burn severity classes. The proportion of high severity was weakly correlated with size of area burned. Large areas burned do not consistently produced larger proportions of high severity. Study 2 analyzed burn severity relative to 20 environmental variables using the Random Forest machine learning algorithm. We used ten daily weather observations, eight 34-yr climate percentiles, seven topographical index measurements, and four vegetation characteristics from 10,819 randomly located points. We found that higher percentage existing vegetation cover had larger influences on changes in burn severity.

  16. Psychosocial care of persons with severe burns.

    Science.gov (United States)

    Blakeney, Patricia E; Rosenberg, Laura; Rosenberg, Marta; Faber, A W

    2008-06-01

    Treatment of people with burn injuries includes recovery of optimal function for survivors to fully participate in society, psychologically and physically. Increased likelihood of physical survival has led to greater concern for potential psychological morbidity for the burn survivor. Based on research and on many years of clinical experience in providing psychosocial care to burned children and adults, the authors outline their approach to assisting burn survivors and their families through the arduous process of recovery from admission through critical care, inpatient recuperation and reintegration upon hospital discharge. A philosophy of rehabilitation, a process that may occur for many months or years after patients' discharge from their acute hospitalization, is presented in the form of seven guidelines for working with burn survivors.

  17. Do burns increase the severity of terror injuries?

    Science.gov (United States)

    Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef

    2008-01-01

    The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score

  18. 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.

    2016-01-01

    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 measure

  19. Coping with severe burns in the early stage after burn injury.

    Science.gov (United States)

    Bras, Marijana; Loncar, Zoran; Brajković, Lovorka; Gregurek, Rudolf; Micković, Vlatko

    2007-03-01

    This study examined the relationship between coping strategies, anxiety and depression levels and burn injury characteristics in the early phase of the treatment in burn-injured patients. Seventy patients with severe burns were interviewed within two weeks of their burn trauma. Coping strategies were measured by the coping with burns questionnaire (CBQ). Anxiety and depression levels were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. There were no statistically significant gender differences in various coping strategies. Avoidance was associated with higher levels of anxiety, depression and hopelessness. The percentage of total body surface area (TBSA) and localization of burns were not associated with coping patterns. Implications for the assessment and management of burn injured patients were discussed.

  20. US Forest Service Monitoring Trends in Burn Severity

    Data.gov (United States)

    US Forest Service, Department of Agriculture — The Monitoring Trends in Burn Severity (MTBS) project maps the location, extent, and severity of all large fires in the conterminous United States (CONUS), Alaska,...

  1. Mapping burned areas and burn severity patterns across the Mediterranean region

    Science.gov (United States)

    Kalogeropoulos, Christos; Amatulli, Giuseppe; Kempeneers, Pieter; Sedano, Fernando; San Miguel-Ayanz, Jesus; Camia, Andrea

    2010-05-01

    The Mediterranean region is highly susceptible to wildfires. On average, about 60,000 fires take place in this region every year, burning on average half a million hectares of forests and natural vegetation. Wildfires cause environmental degradation and affect the lives of thousands of people in the region. In order to minimize the consequences of these catastrophic events, fire managers and national authorities need to have in their disposal accurate and updated spatial information concerning the size of the burned area as well as the burn severity patterns. Mapping burned areas and burn severity patterns is necessary to effectively support the decision-making process in what concerns strategic (long-term) planning with the definition of post-fire actions at European and national scales. Although a comprehensive archive of burnt areas exists at the European Forest Fire Information System, the analysis of the severity of the areas affected by forest fires in the region is not yet available. Fire severity is influenced by many variables, including fuel type, topography and meteorological conditions before and during the fire. The analysis of fire severity is essential to determine the socio-economic impact of forest fires, to assess fire impacts, and to determine the need of post-fire rehabilitation measures. Moreover, fire severity is linked to forest fire emissions and determines the rate of recovery of the vegetation after the fire. Satellite imagery can give important insights about the conditions of the live fuel moisture content and can be used to assess changes on vegetation structure and vitality after forest fires. Fire events occurred in Greece, Portugal and Spain during the fire season of 2009 were recorded and analyzed in a GIS environment. The Normalized Difference Vegetation Index (NDVI), the Enhanced Vegetation Index (EVI) and the Normalized Burn Ratio (NBR) were calculated from 8-days composites MODIS/TERRA imagery from March to October 2009. In

  2. Quantifying soil burn severity for hydrologic modeling to assess post-fire effects on sediment delivery

    Science.gov (United States)

    Dobre, Mariana; Brooks, Erin; Lew, Roger; Kolden, Crystal; Quinn, Dylan; Elliot, William; Robichaud, Pete

    2017-04-01

    Soil erosion is a secondary fire effect with great implications for many ecosystem resources. Depending on the burn severity, topography, and the weather immediately after the fire, soil erosion can impact municipal water supplies, degrade water quality, and reduce reservoirs' storage capacity. Scientists and managers use field and remotely sensed data to quickly assess post-fire burn severity in ecologically-sensitive areas. From these assessments, mitigation activities are implemented to minimize post-fire flood and soil erosion and to facilitate post-fire vegetation recovery. Alternatively, land managers can use fire behavior and spread models (e.g. FlamMap, FARSITE, FOFEM, or CONSUME) to identify sensitive areas a priori, and apply strategies such as fuel reduction treatments to proactively minimize the risk of wildfire spread and increased burn severity. There is a growing interest in linking fire behavior and spread models with hydrology-based soil erosion models to provide site-specific assessment of mitigation treatments on post-fire runoff and erosion. The challenge remains, however, that many burn severity mapping and modeling products quantify vegetation loss rather than measuring soil burn severity. Wildfire burn severity is spatially heterogeneous and depends on the pre-fire vegetation cover, fuel load, topography, and weather. Severities also differ depending on the variable of interest (e.g. soil, vegetation). In the United States, Burned Area Reflectance Classification (BARC) maps, derived from Landsat satellite images, are used as an initial burn severity assessment. BARC maps are classified from either a Normalized Burn Ratio (NBR) or differenced Normalized Burned Ratio (dNBR) scene into four classes (Unburned, Low, Moderate, and High severity). The development of soil burn severity maps requires further manual field validation efforts to transform the BARC maps into a product more applicable for post-fire soil rehabilitation activities

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

    Science.gov (United States)

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

    2016-09-01

    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.

  4. Update on the critical care management of severe burns.

    Science.gov (United States)

    Kasten, Kevin R; Makley, Amy T; Kagan, Richard J

    2011-01-01

    Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population.

  5. Live Skin Allograft in the Management of Severe Burns

    African Journals Online (AJOL)

    disease, the eventual rejection by the host and its handling ... Methods. Patients with severe burns of more than 40% surface area admitted at the Nyeri Provincial General Hospital .... of donors and patients it can have a wide acceptance.

  6. Burn Severity Estimation Using MERIS Full Resolution Imagery

    Science.gov (United States)

    Oliva, Patricia; De Santis, Angela

    2010-12-01

    This paper presents the first results of Fire Effects Modelling and Mapping (FEMM) project carried out in the framemark of the Changing Earth Science Network. The objective of this study is to test the performance of the inversion of Radiative Transfer Models (RTMs) in ENVISA T-MERIS Full Resolution data to estimate burn severity levels in terms of Composite Burn Index (CBI) levels. Nevertheless, as the RTM model was calibrated in Landsat-TM images, evaluation of its performance in MERIS imagery was needed. We tested the performance of the RTM model in several study sites located in two large fires occurred in Spain during 2009 fire season. The results were validated by comparison with burn severity maps computed from Landsat-TM imagery. The results obtained showed values of the coefficient of determination of 0.92 and 0.95 thus, the estimation of burn severity was accurate and consistent, in spite of the different spatial and spectral resolutions.

  7. Enzymatic debridement for the treatment of severely burned upper extremities – early single center experiences

    OpenAIRE

    Cordts, Tomke; Horter, Johannes; Vogelpohl, Julian; Kremer, Thomas; Kneser, Ulrich; Hernekamp, Jochen-Frederick

    2016-01-01

    Background Severe burns of hands and arms are complex and challenging injuries. The Standard of care (SOC) – necrosectomy with skin grafting – is often associated with poor functional or aesthetic outcome. Enzymatic debridement (ED) is considered one promising alternative but, until recently, results proved to be highly variable. Methods Between 04/2014 and 04/2015, 16 patients with deep partial- to full-thickness burns of the upper extremities underwent enzymatic debridement (ED) in our Burn...

  8. Determining relative contributions of vegetation and topography to burn severity from LANDSAT imagery.

    Science.gov (United States)

    Wu, Zhiwei; He, Hong S; Liang, Yu; Cai, Longyan; Lewis, Bernard J

    2013-10-01

    Fire is a dominant process in boreal forest landscapes and creates a spatial patch mosaic with different burn severities and age classes. Quantifying effects of vegetation and topography on burn severity provides a scientific basis on which forest fire management plans are developed to reduce catastrophic fires. However, the relative contribution of vegetation and topography to burn severity is highly debated especially under extreme weather conditions. In this study, we hypothesized that relationships of vegetation and topography to burn severity vary with fire size. We examined this hypothesis in a boreal forest landscape of northeastern China by computing the burn severity of 24 fire patches as the difference between the pre- and post-fire Normalized Difference Vegetation Index obtained from two Landsat TM images. The vegetation and topography to burn severity relationships were evaluated at three fire-size levels of small (1,000 ha, n = 3). Our results showed that vegetation and topography to burn severity relationships were fire-size-dependent. The burn severity of small fires was primary controlled by vegetation conditions (e.g., understory cover), and the burn severity of large fires was strongly influenced by topographic conditions (e.g., elevation). For moderate fires, the relationships were complex and indistinguishable. Our results also indicated that the pattern trends of relative importance for both vegetation and topography factors were not dependent on fire size. Our study can help managers to design fire management plans according to vegetation characteristics that are found important in controlling burn severity and prioritize management locations based on the relative importance of vegetation and topography.

  9. Endogenous endophthalmitis after severe burn: A case report

    Directory of Open Access Journals (Sweden)

    Seyedeh Maryam Hosseini

    2017-01-01

    Conclusion: Burn patients treated with broad-spectrum antibiotics are at risk of candidemia and its complications, including endogenous endophthalmitis. Early diagnosis of endogenous endophthalmitis in high risk patients could prevent visual loss.

  10. Burn Severity Dominates Understory Plant Community Response to Fire in Xeric Jack Pine Forests

    Directory of Open Access Journals (Sweden)

    Bradley D. Pinno

    2016-04-01

    Full Text Available Fire is the most common disturbance in northern boreal forests, and large fires are often associated with highly variable burn severities across the burnt area. We studied the understory plant community response to a range of burn severities and pre-fire stand age four growing seasons after the 2011 Richardson Fire in xeric jack pine forests of northern Alberta, Canada. Burn severity had the greatest impact on post-fire plant communities, while pre-fire stand age did not have a significant impact. Total plant species richness and cover decreased with disturbance severity, such that the greatest richness was in low severity burns (average 28 species per 1-m2 quadrat and plant cover was lowest in the high severity burns (average 16%. However, the response of individual plant groups differed. Lichens and bryophytes were most common in low severity burns and were effectively eliminated from the regenerating plant community at higher burn severities. In contrast, graminoid cover and richness were positively related to burn severity, while forbs did not respond significantly to burn severity, but were impacted by changes in soil chemistry with increased cover at pH >4.9. Our results indicate the importance of non-vascular plants to the overall plant community in this harsh environment and that the plant community is environmentally limited rather than recruitment or competition limited, as is often the case in more mesic forest types. If fire frequency and severity increase as predicted, we may see a shift in plant communities from stress-tolerant species, such as lichens and ericaceous shrubs, to more colonizing species, such as certain graminoids.

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

    Directory of Open Access Journals (Sweden)

    Peeyush Dahal

    2016-01-01

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

  12. Burn Severity Dominates Understory Plant Community Response to Fire in Xeric Jack Pine Forests

    OpenAIRE

    Pinno, Bradley D.; Ruth C. Errington

    2016-01-01

    Fire is the most common disturbance in northern boreal forests, and large fires are often associated with highly variable burn severities across the burnt area. We studied the understory plant community response to a range of burn severities and pre-fire stand age four growing seasons after the 2011 Richardson Fire in xeric jack pine forests of northern Alberta, Canada. Burn severity had the greatest impact on post-fire plant communities, while pre-fire stand age did not have a significant im...

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Changes in Fat Distribution in Children Following Severe Burn Injury

    OpenAIRE

    Patel, Pavankumar; Sallam, Hanaa S.; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N.; Abate, Nicola

    2014-01-01

    Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution.

  15. Sodium butyrate protects against severe burn-induced remote acute lung injury in rats.

    Directory of Open Access Journals (Sweden)

    Xun Liang

    Full Text Available High-mobility group box 1 protein (HMGB1, a ubiquitous nuclear protein, drives proinflammatory responses when released extracellularly. It plays a key role as a distal mediator in the development of acute lung injury (ALI. Sodium butyrate, an inhibitor of histone deacetylase, has been demonstrated to inhibit HMGB1 expression. This study investigates the effect of sodium butyrate on burn-induced lung injury. Sprague-Dawley rats were divided into three groups: 1 sham group, sham burn treatment; 2 burn group, third-degree burns over 30% total body surface area (TBSA with lactated Ringer's solution for resuscitation; 3 burn plus sodium butyrate group, third-degree burns over 30% TBSA with lactated Ringer's solution containing sodium butyrate for resuscitation. The burned animals were sacrificed at 12, 24, and 48 h after burn injury. Lung injury was assessed in terms of histologic changes and wet weight to dry weight (W/D ratio. Tumor necrosis factor (TNF-α and interleukin (IL-8 protein concentrations in bronchoalveolar lavage fluid (BALF and serum were measured by enzyme-linked immunosorbent assay, and HMGB1 expression in the lung was determined by Western blot analysis. Pulmonary myeloperoxidase (MPO activity and malondialdehyde (MDA concentration were measured to reflect neutrophil infiltration and oxidative stress in the lung, respectively. As a result, sodium butyrate significantly inhibited the HMGB1 expressions in the lungs, reduced the lung W/D ratio, and improved the pulmonary histologic changes induced by burn trauma. Furthermore, sodium butyrate administration decreased the TNF-α and IL-8 concentrations in BALF and serum, suppressed MPO activity, and reduced the MDA content in the lungs after severe burn. These results suggest that sodium butyrate attenuates inflammatory responses, neutrophil infiltration, and oxidative stress in the lungs, and protects against remote ALI induced by severe burn, which is associated with inhibiting HMGB1

  16. 1984–2010 trends in fire burn severity and area for the conterminous US

    Science.gov (United States)

    Picotte, Joshua J.; Peterson, Birgit E.; Meier, Gretchen; Howard, Stephen M.

    2016-01-01

    Burn severity products created by the Monitoring Trends in Burn Severity (MTBS) project were used to analyse historical trends in burn severity. Using a severity metric calculated by modelling the cumulative distribution of differenced Normalized Burn Ratio (dNBR) and Relativized dNBR (RdNBR) data, we examined burn area and burn severity of 4893 historical fires (1984–2010) distributed across the conterminous US (CONUS) and mapped by MTBS. Yearly mean burn severity values (weighted by area), maximum burn severity metric values, mean area of burn, maximum burn area and total burn area were evaluated within 27 US National Vegetation Classification macrogroups. Time series assessments of burned area and severity were performed using Mann–Kendall tests. Burned area and severity varied by vegetation classification, but most vegetation groups showed no detectable change during the 1984–2010 period. Of the 27 analysed vegetation groups, trend analysis revealed burned area increased in eight, and burn severity has increased in seven. This study suggests that burned area and severity, as measured by the severity metric based on dNBR or RdNBR, have not changed substantially for most vegetation groups evaluated within CONUS.

  17. Vegetation burn severity mapping using Landsat-8 and WorldView-2

    Science.gov (United States)

    Wu, Zhuoting; Middleton, Barry R.; Hetzler, Robert; Vogel, John M.; Dye, Dennis G.

    2015-01-01

    We used remotely sensed data from the Landsat-8 and WorldView-2 satellites to estimate vegetation burn severity of the Creek Fire on the San Carlos Apache Reservation, where wildfire occurrences affect the Tribe's crucial livestock and logging industries. Accurate pre- and post-fire canopy maps at high (0.5-meter) resolution were created from World- View-2 data to generate canopy loss maps, and multiple indices from pre- and post-fire Landsat-8 images were used to evaluate vegetation burn severity. Normalized difference vegetation index based vegetation burn severity map had the highest correlation coefficients with canopy loss map from WorldView-2. Two distinct approaches - canopy loss mapping from WorldView-2 and spectral index differencing from Landsat-8 - agreed well with the field-based burn severity estimates and are both effective for vegetation burn severity mapping. Canopy loss maps created with WorldView-2 imagery add to a short list of accurate vegetation burn severity mapping techniques that can help guide effective management of forest resources on the San Carlos Apache Reservation, and the broader fire-prone regions of the Southwest.

  18. High-tension Electrical Burns: Report of Two Cases

    OpenAIRE

    Abbas, A.D.; Dabkana, T.M.; Tahir, C.; Naaya, H.U.

    2009-01-01

    High-tension electrical burns are a rare but devastating form of injury. The objective of this case report is to bring to the fore the severity of this rare form of injury and highlight the benefits of active surgical management of such a condition. We report the cases of two patients who were managed for high-tension electrical burns and highlight the main features of their presentation and management. Both patients needed urgent resuscitation and subsequent multiple amputations and disartic...

  19. Treatment of severe burn injury of 98% TBSA with 95% full-thickness burn and severe inhalation injury: a case report

    Institute of Scientific and Technical Information of China (English)

    杨磊; 王甲汉; 周一平

    2003-01-01

    @@ The treatment of extensive severe burn injury is very difficult, especially when some complications are involved. A burned patient sustained 98% total body surface area (TBSA) with 95% full thickness burn and severe inhalation injury was admitted to our hospital in 08- 2000. After aggressive treatment, the patient recovered fully. This paper reports the treatment of the patient.

  20. Detection of Burn Area and Severity with MODIS Satellite Images and Spatial Autocorrelation Techniques

    Science.gov (United States)

    Kaya, S.; Kavzoglu, T.; Tonbul, H.

    2014-12-01

    Effects of forest fires and implications are one of the most important natural disasters all over the world. Statistical data observed that forest fires had a variable structure in the last century in Turkey, but correspondingly the population growth amount of forest fires and burn area increase widely in recent years. Depending on this, erosion, landslides, desertification and mass loss come into existence. In addition; after forest fires, renewal of forests and vegetation are very important for land management. Classic methods used for detection of burn area and severity requires a long and challenging process due to time and cost factors. Thanks to advanced techniques used in the field of Remote Sensing, burn area and severity can be determined with high detail and precision. The purpose of this study based on blending MODIS (Moderate Resolution Imaging Spectradiometer) satellite images and spatial autocorrelation techniques together, thus detect burn area and severity absolutely. In this context, spatial autocorrelation statistics like Moran's I and Get is-Ord Local Gi indexes were used to measure and analyze to burned area characteristics. Prefire and postfire satellite images were used to determine fire severity depending on spectral indexes corresponding to biomass loss and carbon emissivity intensities. Satellite images have used for identification of fire damages and risks in terms of fire management for a long time. This study was performed using prefire and postfire satellite images and spatial autocorrelation techniques to determining and analyzing forest fires in Antalya, Turkey region which serious fires occurred. In this context, this approach enables the characterization of distinctive texture of burned area and helps forecasting more precisely. Finally, it is observed that mapping of burned area and severity could be performed from local scale to national scale. Key Words: Spatial autocorrelation, MODIS, Fire, Burn Severity

  1. Disruption of bone and skeletal muscle in severe burns

    Institute of Scientific and Technical Information of China (English)

    Gordon L Klein

    2015-01-01

    Severe burn injury triggers the body’s nonspecific adaptive responses to acute insult, including the systemic inflammatory and stress responses, as well as the sympathetic response to immobilization. These responses trigger inflammatory bone resorption followed by glucocorticoid-induced apoptosis of osteoblasts and probably osteocytes. Because these patients are catabolic, they suffer concomitant muscle wasting and negative nitrogen balance. The use of anabolic agents such as recombinant human growth hormone and oxandrolone results in improved bone mineral content and muscle strength after approximately 1 year. Use of bisphosphonates within the first 10 days of a severe burn completely blocks the resorptive bone loss and has the added advantage of appearing to preserve muscle protein from excessive breakdown. The mechanism for the protective effect on muscle is not currently known. However, if the effect of bisphosphonates on muscle can be confirmed, it raises the possibility that bone communicates with muscle.

  2. Microvascular regeneration in meshed skin transplants after severe burns.

    Science.gov (United States)

    Meier, T O; Guggenheim, M; Vetter, S T; Husmann, M; Haile, S R; Amann-Vesti, B R

    2011-09-01

    Function of the skin lymphatics as well as blood perfusion of a meshed transplant is crucial for the healing. The lymphatic regeneration and arterial perfusion of skin transplants after severe burns of the extremities had been studied in eight patients by microlymphography, laser doppler perfusion imaging and transcutaneous oxygen pressure measurements 1, 6 and 18 months after transplantation. One month after transplantation, only fragmented as well as many giant lymphatic skin vessels were present in the transplant. After 6 months a normal lymphatic network had developed in all grafts. The extension of the dye in the lymphatics decreased from 4.5 (0-16) at 1 month to 3.0 (1-6) mm after 18 months, indicating improved lymph drainage capacity. The permeability of the lymphatics in the graft was normal. After 1 month, median laser flux in the transplant was 155.6% (105-246%) of the normal skin but it normalised within 18 months. By contrast, transcutaneous oxygen measurement (TcPO(2)) increased from 44 (21-47) to 55 (50-76) mmHg. In meshed transplants used to cover severely burned skin morphological and functional normal lymphatics develop within 6 months and the initially increased laser flux due to inflammatory reaction normalises. Our results provide important insights into the healing process of skin transplants after burn. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  3. Relation between proteinuria and acute kidney injury in patients with severe burns

    Science.gov (United States)

    2012-01-01

    Introduction Proteinuria in burn patients is common, and may be associated with acute kidney injury (AKI) and adverse outcomes. We evaluated the incidences, outcomes, characteristics and determinants of proteinuria and its influence on AKI and outcomes in burn patients. Methods This retrospective study was carried out in a hospital's burn department. The study population consisted of patients with burn injuries admitted during a five-year period. Positive urine dipstick readings were defined as mild (± or 1+) or heavy (≥ 2+) proteinuria, and AKI was diagnosed and staged according to the Risk, Injury, Failure, Loss, End Stage (RIFLE) classification system. Patient characteristics, management and outcomes were evaluated for associations with proteinuria using nonparametric tests, chi-square (χ2) tests and binary logistic regression. Results Of the patients admitted to the burn unit during the study period (n = 2,497), 865 (34.64%) were classified as having proteinuria. In the patients whose total burn surface areas (TBSA) were > 30% (n = 396), 271 patients (68.43%) had proteinuria and 152 of these patients (56.09%) met AKI criteria. No patients without proteinuria developed AKI. Intensive care unit (ICU) mortality rates were 0.8%, 16.67% and 30.77% (P proteinuria, respectively. Logistic regression analysis identified proteinuria (OR 4.48; 95% CI, 2.824 to 7.108; P proteinuria in patients with severe burns (> 30% TBSA). Severely burned patients with proteinuria had a high risk of developing AKI and a poor prognosis for survival. This suggests that proteinuria should be used for identifying burn patients at risk of developing AKI. PMID:23021407

  4. [Multicenter epidemiological investigation of hospitalized children with severe burn].

    Science.gov (United States)

    Tang, Y; Wang, L X; Chen, J J; Liu, J Q; Ren, L C; Liu, X S; Yin, M F; Zhang, D X; Huang, Y S; Zhang, J P

    2016-10-20

    Objective: To analyze the epidemiological characteristics of hospitalized children with severe burn from several regions in China during 3 years, so as to provide evidence for prevention of burns in children. Methods: Relying on the entry system of epidemiology data and biological sample of severe burn from multicenter in clinic, medical records of children with severe burn, aged 18 and under, hospitalized in 6 burn wards from February 2012 to February 2015 were collected. The children were divided into 5 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 6 years old, more than 6 years old and less than or equal to 12 years old, more than 12 years old and less than or equal to 18 years old. Meanwhile the children were divided into rural and urban children according to their residences. Data of gender and residence of children in the 5 age brackets, cause of injury, location of injury, total burn area, wound site, inhalation injury and combined injury, and source of hospitalization expenses of children in the 5 age brackets and two types of residence, and outcome and length of hospital stay of the children were analyzed. The cause of injury of children in different location of injury was analyzed. In addition, they were divided into 2 age brackets: less than or equal to 6 years old and more than 6 years old and less than or equal to 18 years old, and then incidences of hand and foot burn injury were compared. Data were processed with chi-square test, and the correlation between age and total burn area was processed with Spearman correlation analysis. Results: Four hundred and forty out of 1 106 inpatients with severe burn were children, accounting for 39.8% who were included in the system. (1) The majority of children were male (270, 61.4%). The number of children more than 1 year old and less than or equal to 3 years old ranked the first (222, 50.5%) in the 5

  5. Early and Late Acute Kidney Injury in Severely Burned Patients

    Science.gov (United States)

    Witkowski, Wojciech; Kawecki, Marek; Surowiecka-Pastewka, Agnieszka; Klimm, Wojciech; Szamotulska, Katarzyna; Niemczyk, Stanisław

    2016-01-01

    Background This study evaluated factors influencing early and late occurrence of AKI in severely burned patients and assessed the relationship between time of occurrence of AKI and mortality of AKI patients. Material/Methods Renal function was evaluated at 3 time points: at admission, at the critical point or middle point of hospitalization, and at the endpoint for which death or a discharge from the center was considered. AKI criteria were: decrease in GFR of less than 60 ml/min at admission, decrease in GFR of more than 75% compared to baseline, and decrease in the daily diuresis of less than 500 ml/24 h. Results At admission, 15.1% of the patients had eGFR burns, respiratory failure, low protein concentration (for all ppatients. Mortality was 100% with the initial GFR ≥60, 100% with the initial GFR patients and mortality in this group was 79.2%. Mortality in the entire group with AKI was 88.0% versus 24.5%. Conclusions The frequent occurrence of AKI, especially early, worsens the prognosis for survival. Assessment of renal function should be included in the prognostic scales for burned patients. PMID:27746455

  6. Characteristics of and strategies for patients with severe burn-blast combined injury

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHEN Chuan-an; TUO Xiao-ye; LIANG Li-ming; WANG Shu-jun; SHENG Zhi-yong; LU Jiang-yang; WEN Zhong-guang; YANG Hong-ming; JIA Xiao-ming; LI Li-gen; CAO Wei-hong; HAO Dai-feng

    2007-01-01

    Background Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.Methods Five patients with severe burn-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% (89.6%±7.2%) of TBSA (full-thickness burns 75%-92%(83.4%±7.3%)). All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.Results One patient died of septic shock 23 hours after admission (four days after injury), the others survived.Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.Conclusions Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients' condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.

  7. A clinical observation of early short-term use of potent antibiotics in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    RONG Xin-zhou; ZHANG Wen-zhen; REN Jia-liang; ZHOU Wei-ming

    2001-01-01

    Objective: To evaluate the effect of early and short-term use of potent antibiotics following extensive severe burn injury. Methods: Seventeen severely burned patients hospitalized in the same period (Nov.,1998 to Oct., 2000) wer esame treatment in Group 2 (n=8) was discontinued until day 15 postburn. The survival rate, blood bacterial culture, body temperature and white blood cell and platelet counts were compared between the 2 groups. Results: All the 17 patients survived and all blood bacterial cultures were negative. No significant difference of body temperature and white blood cell and platelet counts between the 2 groups was observed (P>0.05). Conclusion: Early use of high-potency antibiotics at short treatment course after extensive severe burn is effective to prevent infection and reduce the cost.

  8. Effects of Burn Severity and Environmental Conditions on Post-Fire Regeneration in Siberian Larch Forest

    Directory of Open Access Journals (Sweden)

    Thuan Chu

    2017-03-01

    Full Text Available Post-fire forest regeneration is strongly influenced by abiotic and biotic heterogeneity in the pre- and post-fire environments, including fire regimes, species characteristics, landforms, hydrology, regional climate, and soil properties. Assessing these drivers is key to understanding the long-term effects of fire disturbances on forest succession. We evaluated multiple factors influencing patterns of variability in a post-fire boreal Larch (Larix sibirica forest in Siberia. A time-series of remote sensing images was analyzed to estimate post-fire recovery as a response variable across the burned area in 1996. Our results suggested that burn severity and water content were primary controllers of both Larch forest recruitment and green vegetation cover as defined by the forest recovery index (FRI and the fractional vegetation cover (FVC, respectively. We found a high rate of Larch forest recruitment in sites of moderate burn severity, while a more severe burn was the preferable condition for quick occupation by vegetation that included early seral communities of shrubs, grasses, conifers and broadleaf trees. Sites close to water and that received higher solar energy during the summer months showed a higher rate of both recovery types, defined by the FRI and FVC, dependent on burn severity. In addition to these factors, topographic variables and pre-fire condition were important predictors of post-fire forest patterns. These results have direct implications for the post-fire forest management in the Siberian boreal Larch region.

  9. 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

    Science.gov (United States)

    Chen, X.; Vogelmann, J.E.; Rollins, M.; Ohlen, D.; Key, C.H.; Yang, L.; Huang, C.; Shi, H.

    2011-01-01

    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. ?? 2011 Taylor & Francis.

  10. Contamination of burn wounds by Achromobacter Xylosoxidans followed by severe infection: 10-year analysis of a burn unit population

    Science.gov (United States)

    Schulz, A.; Perbix, W.; Fuchs, P.C.; Seyhan, H.; Schiefer, J.L.

    2016-01-01

    Summary Gram-negative infections predominate in burn surgery. Until recently, Achromobacter species were described as sepsis-causing bacteria in immunocompromised patients only. Severe infections associated with Achromobacter species in burn patients have been rarely reported. We retrospectively analyzed all burn patients in our database, who were treated at the Intensive Care Burn Unit (ICBU) of the Cologne Merheim Burn Centre from January 2006 to December 2015, focusing on contamination and infection by Achromobacter species.We identified 20 patients with burns contaminated by Achromobacter species within the 10-year study period. Four of these patients showed signs of infection concomitant with detection of Achromobacter species. Despite receiving complex antibiotic therapy based on antibiogram and resistogram typing, 3 of these patients, who had extensive burns, developed severe sepsis. Two patients ultimately died of multiple organ failure. In 1 case, Achromobacter xylosoxidans was the only isolate detected from the swabs and blood samples taken during the last stage of sepsis. Achromobacter xylosoxidans contamination of wounds of severely burned immunocompromised patients can lead to systemic lethal infection. Close monitoring of burn wounds for contamination by Achromobacter xylosoxidans is essential, and appropriate therapy must be administered as soon as possible. PMID:28149253

  11. Severity of burn and its related factors: A study from the developing country Pakistan.

    Science.gov (United States)

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

    2016-06-01

    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.

  12. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction

    OpenAIRE

    2016-01-01

    This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group), or burn injury combined with seawater immersion (BI group), or only immersion in seawater (I group), or control animals with no injury or immersion (C group). The circulating endothelial cell (CEC) count and coagulation-fibrinolysis paramet...

  13. Live sibling skin allografts for severe burns in a paediatric patient: A viable option in developing countries

    Directory of Open Access Journals (Sweden)

    Basil Leodoro

    2014-11-01

    Full Text Available Severe burns in the paediatric population are associated with high mortality and morbidity in any developing countries. Children with more than 40% total body surface area burns in Fiji will succumb from complications and as a direct result of inadequate treatment and lack of resources. The surgical treatment of any severely burnt patient is not only laborious but very costly to the Fiji health system and depletes existing resources with few options for skin coverage. This is the first case report of live sibling skin allograft for severe paediatric burns and one of only few patients to have survived more than 50% burns in Fiji. We describe the technique and the role of using live sibling skin allograft as an option to improve survival in patients with severe burns in a developing country.

  14. Vegetation, topography and daily weather influenced burn severity in central Idaho and western Montana forests

    Science.gov (United States)

    Donovan S. Birch; Penelope Morgan; Crystal A. Kolden; John T. Abatzoglou; Gregory K. Dillon; Andrew T. Hudak; Alistair M. S. Smith

    2015-01-01

    Burn severity as inferred from satellite-derived differenced Normalized Burn Ratio (dNBR) is useful for evaluating fire impacts on ecosystems but the environmental controls on burn severity across large forest fires are both poorly understood and likely to be different than those influencing fire extent. We related dNBR to environmental variables including vegetation,...

  15. [Severe ocular burns by calcium carbide in a speleologist: a case report].

    Science.gov (United States)

    Testud, F; Voegtlé, R; Nordmann, J P; Descotes, J

    2002-03-01

    A case of severe ocular burns in an amateur speleologist is reported. The explosion of his acetylene lamp caused the projection of calcium carbide particles, which induced burning of the cornea and conjunctiva in both eyes. He slowly recovered in several months. The pathophysiology of the burns, linked to the in situ production of lime, and their management are discussed.

  16. Treatment of patients with severe burns-costs and health-related quality of life outcome.

    Science.gov (United States)

    Koljonen, Virve; Laitila, Markku; Rissanen, Anne M; Sintonen, Harri; Roine, Risto P

    2013-01-01

    To study the effectiveness of the treatment of patients with severe burns, the authors collected health-related quality of life (HRQoL) data with the 15D instrument, 17 to 29 months after treatment had commenced at the national burns unit. The costs of each patient's secondary care treatment were followed for a mean of 66 months. During the 1-year study period, 107 patients were treated at the burns unit, eight for scar surgery, the remainder for primary treatment of a burn injury; 19 had died or could not be located during the time of the HRQoL survey. Of the remaining 88 patients, 43 (49%; mean [SD] age 45.7 [14.8] years; 70% men) returned the questionnaire. Their mean (SD) HRQoL score (0.909[0.113]) was only slightly, and not significantly, lower than that of the age- and sex- standardized general population (0.928[0.080]). The mean (SD) secondary care cost of burn treatment of for all the 107 patients, over the 60- to 72-month observation time, was 42,838 USD (73,569 USD; range 1319-34,8741 USD). The largest portion of the total cost was because of inpatient treatment (61%) followed by operations (22%), and outpatient visits. In addition to the costs of burns treatment, the patients consumed other secondary care services to a value of nearly 12,229 USD. The HRQoL in patients treated for severe burns is good, thus the observed high-treatment costs can be considered acceptable.

  17. Developing a burn injury severity score (BISS): adding age and total body surface area burned to the injury severity score (ISS) improves mortality concordance.

    Science.gov (United States)

    Cassidy, J Tristan; Phillips, Michael; Fatovich, Daniel; Duke, Janine; Edgar, Dale; Wood, Fiona

    2014-08-01

    There is limited research validating the injury severity score (ISS) in burns. We examined the concordance of ISS with burn mortality. We hypothesized that combining age and total body surface area (TBSA) burned to the ISS gives a more accurate mortality risk estimate. Data from the Royal Perth Hospital Trauma Registry and the Royal Perth Hospital Burns Minimum Data Set were linked. Area under the receiver operating characteristic curve (AUC) measured concordance of ISS with mortality. Using logistic regression models with death as the dependent variable we developed a burn-specific injury severity score (BISS). There were 1344 burns with 24 (1.8%) deaths, median TBSA 5% (IQR 2-10), and median age 36 years (IQR 23-50). The results show ISS is a good predictor of death for burns when ISS≤15 (OR 1.29, p=0.02), but not for ISS>15 (ISS 16-24: OR 1.09, p=0.81; ISS 25-49: OR 0.81, p=0.19). Comparing the AUCs adjusted for age, gender and cause, ISS of 84% (95% CI 82-85%) and BISS of 95% (95% CI 92-98%), demonstrated superior performance of BISS as a mortality predictor for burns. ISS is a poor predictor of death in severe burns. The BISS combines ISS with age and TBSA and performs significantly better than the ISS. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  18. The role of exercise in the rehabilitation of patients with severe burns.

    Science.gov (United States)

    Porter, Craig; Hardee, Justin P; Herndon, David N; Suman, Oscar E

    2015-01-01

    Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and efficacious strategy to restore lean body mass and physical function in burn victims. Here, we review the evidence for the utility of rehabilitative exercise training in restoring physiological function in burn survivors.

  19. Human umbilical cord mesenchymal stem cells transplantation promotes cutaneous wound healing of severe burned rats.

    Directory of Open Access Journals (Sweden)

    Lingying Liu

    Full Text Available BACKGROUND: Severe burns are a common and highly lethal trauma. The key step for severe burn therapy is to promote the wound healing as early as possible, and reports indicate that mesenchymal stem cell (MSC therapy contributes to facilitate wound healing. In this study, we investigated effect of human umbilical cord MSCs (hUC-MSCs could on wound healing in a rat model of severe burn and its potential mechanism. METHODS: Adult male Wistar rats were randomly divided into sham, burn, and burn transplanted hUC-MSCs. GFP labeled hUC-MSCs or PBS was intravenous injected into respective groups. The rate of wound closure was evaluated by Image Pro Plus. GFP-labeled hUC-MSCs were tracked by in vivo bioluminescence imaging (BLI, and human-specific DNA expression in wounds was detected by PCR. Inflammatory cells, neutrophils, macrophages, capillaries and collagen types I/III in wounds were evaluated by histochemical staining. Wound blood flow was evaluated by laser Doppler blood flow meter. The levels of proinflammatory and anti-inflammatory factors, VEGF, collagen types I/III in wounds were analyzed using an ELISA. RESULTS: We found that wound healing was significantly accelerated in the hUC-MSC therapy group. The hUC-MSCs migrated into wound and remarkably decreased the quantity of infiltrated inflammatory cells and levels of IL-1, IL-6, TNF-α and increased levels of IL-10 and TSG-6 in wounds. Additionally, the neovascularization and levels of VEGF in wounds in the hUC-MSC therapy group were markedly higher than those in other control groups. The ratio of collagen types I and III in the hUC-MSC therapy group were markedly higher than that in the burn group at indicated time after transplantation. CONCLUSION: The study suggests that hUC-MSCs transplantation can effectively improve wound healing in severe burned rat model. Moreover, these data might provide the theoretical foundation for the further clinical application of hUC-MSC in burn areas.

  20. Toddlers at High Risk of Chemical Eye Burns

    Science.gov (United States)

    ... fullstory_160258.html Toddlers at High Risk of Chemical Eye Burns: Study Access to household cleaning products to blame, ... and 2 years have relatively high rates of chemical eye burns, with everyday cleaners a common cause, researchers say. ...

  1. Predictors of muscle protein synthesis after severe pediatric burns

    Science.gov (United States)

    Objectives: Following a major burn, muscle protein synthesis rate increases but in most patients, this response is not sufficient to compensate the also elevated protein breakdown. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that skeletal muscle prot...

  2. The Combustion of HMX. [burning rate at high pressures

    Science.gov (United States)

    Boggs, T. L.; Price, C. F.; Atwood, A. I.; Zurn, D. E.; Eisel, J. L.

    1980-01-01

    The burn rate of HMX was measured at high pressures (p more than 1000 psi). The self deflagration rate of HMX was determined from 1 atmosphere to 50,000 psi. The burning rate shows no significant slope breaks.

  3. Performance of Burn-Severity Metrics and Classification in Oak Woodlands and Grasslands

    Directory of Open Access Journals (Sweden)

    Michael C. Stambaugh

    2015-08-01

    Full Text Available Burn severity metrics and classification have yet to be tested for many eastern U.S. deciduous vegetation types, but, if suitable, would be valuable for documenting and monitoring landscape-scale restoration projects that employ prescribed fire treatments. Here we present a performance analysis of the Composite Burn Index (CBI and its relationship to spectral data (differenced Normalized Burn Ratio (dNBR and its relative form (RdNBR across an oak woodland - grassland landscape in southwestern Oklahoma, USA. Correlation and regression analyses were used to compare CBI strata, assess models describing burn severity, and determine thresholds for burn severity classes. Confusion matrices were used to assess burn severity classification accuracy. Our findings suggest that dNBR and RdNBR, thresholded using total CBI, can produce an accurate burn severity map in oak woodlands, particularly from an initial assessment period. Lower accuracies occurred for burn severity classifications of grasslands and raises questions related to definitions and detection of burn severity for grasslands, particularly in transition to more densely treed structures such as savannas and woodlands.

  4. Autoextraction of Permanent Incisors and Self-Inflicted Orodental Trauma in a Severely Burned Child

    Directory of Open Access Journals (Sweden)

    Sultan Keles

    2015-01-01

    Full Text Available Autoextraction is one type of self-injurious behaviour. In the literature, self-injurious behaviours are observed in syndromes and genetic conditions. However, to the best of our knowledge, SIB and autoextraction in a severely burned patient have not been reported to date. This report describes the self-inflicted trauma and autoextraction in a severely burned child, and the management of the child during and after burn treatment.

  5. Long-term persistance of the pathophysiologic response to severe burn injury.

    Directory of Open Access Journals (Sweden)

    Marc G Jeschke

    Full Text Available BACKGROUND: Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. METHODOLOGY/PRINCIPAL FINDINGS: PATIENTS: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. CONCLUSIONS: Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified

  6. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction

    Directory of Open Access Journals (Sweden)

    Hong Yan

    2016-01-01

    Full Text Available This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group, or burn injury combined with seawater immersion (BI group, or only immersion in seawater (I group, or control animals with no injury or immersion (C group. The circulating endothelial cell (CEC count and coagulation-fibrinolysis parameters were measured. The CEC count in B group increased at 4 h, 7 h, and 10 h after injury and then reduced, whereas it continuously increased to a greater extent in BI group (P<0.05. The von Willebrand factor (vWF activity, plasminogen activator inhibitor (PAI-1, and the ratio of thromboxane B2 (TXB2 to 6-keto-prostaglandin F1α (6-K-PGF1α in BI group had a marked increase after injury, and the tissue-type plasminogen activator (tPA in the BI group decreased. Microscope observations revealed thrombus formation in lungs of the animals in BI group, but not in C, I, or B groups. Burn injury causes endothelial dysfunction, and seawater immersion lastingly aggravates this injury, leading to a higher risk of developing thrombosis.

  7. Absence of exertional hyperthermia in a 17-year-old boy with severe burns.

    Science.gov (United States)

    McEntire, Serina J; Lee, Jong O; Herndon, David N; Suman, Oscar E

    2009-01-01

    An important safety concern when exercising burned patients is the potential for an excessive increase in core body temperature (hyperthermia=body core temperature>39 degrees C) during exercise. We examined the thermoregulatory response to exercise in the heat (31 degrees C, relative humidity 40%) in a 17-year-old boy with a 99% TBSA burn. A 30-minute exercise test was performed at an intensity of 75% of his peak aerobic capacity. Intestinal temperature was assessed via telemetry with an ingestible capsule. Intestinal temperature was measured before, during, and postexercise. The patient completed 12 minutes of the 30-minute exercise test. Starting core temperature was 36.98 degrees C and increased 0.69 degrees C during exercise. After exercise, intestinal temperature continued to increase, but no hyperthermia was noted. It has been reported that burned children can safely exercise at room temperature; however, the response in the heat is unknown. This patient did not develop exertional hyperthermia, which we propose is due to his low-fitness level and heat intolerance. However, the potential for hyperthermia would be increased if he was forced to maintain a high relative workload in the heat. We propose that severely burned individuals should be able to safely participate in physical activities. However, the decision to stop exercising should be accepted to avoid development of exertional hyperthermia.

  8. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at pPatient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), pPatients in the high group required significantly longer ventilation compared to low patients (ppneumonia confirming the previous studies in critically ill patients. PMID:24074819

  9. Calibrating Satellite-Based Indices of Burn Severity from UAV-Derived Metrics of a Burned Boreal Forest in NWT, Canada

    Directory of Open Access Journals (Sweden)

    Robert H. Fraser

    2017-03-01

    Full Text Available Wildfires are a dominant disturbance to boreal forests, and in North America, they typically cause widespread tree mortality. Forest fire burn severity is often measured at a plot scale using the Composite Burn Index (CBI, which was originally developed as a means of assigning severity levels to the Normalized Burn Ratio (NBR computed from Landsat satellite imagery. Our study investigated the potential to map biophysical indicators of burn severity (residual green vegetation and charred organic surface at very high (3 cm resolution, using color orthomosaics and vegetation height models derived from UAV-based photographic surveys and Structure from Motion methods. These indicators were scaled to 30 m resolution Landsat pixel footprints and compared to the post-burn NBR (post-NBR and differenced NBR (dNBR ratios computed from pre- and post-fire Landsat imagery. The post-NBR showed the strongest relationship to both the fraction of charred surface (exponential R2 = 0.79 and the fraction of green crown vegetation above 5 m (exponential R2 = 0.81, while the dNBR was more closely related to the total green vegetation fraction (exponential R2 = 0.69. Additionally, the UAV green fraction and Landsat indices could individually explain more than 50% of the variance in the overall CBI measured in 39 plots. These results provide a proof-of-concept for using low-cost UAV photogrammetric mapping to quantify key measures of boreal burn severity at landscape scales, which could be used to calibrate and assign a biophysical meaning to Landsat spectral indices for mapping severity at regional scales.

  10. TNF-α/IL-10 ratio correlates with burn severity and may serve as a risk predictor of increased susceptibility to infections

    Directory of Open Access Journals (Sweden)

    Amy Tsurumi

    2016-10-01

    Full Text Available Severe burn injury renders patients susceptible to multiple infection episodes, however identifying specific patient groups at high risk remains challenging. Burn-induced inflammatory response dramatically modifies the levels of various cytokines. Whether these changes could predict susceptibility to infections remains unknown. The aim of this study was to determine the early changes in the pro- to anti-inflammatory cytokine ratio and investigate its ability to predict susceptibility to repeated infections after severe burn trauma. The patient population consisted of 34 adult patients having early (≤48 hours since injury blood draws following severe (≥20% total burn surface area (TBSA burn injury, and suffering from a first infection episode at least one day after blood collection. Plasma TNF-α and IL-10 levels were measured to explore the association between the TNF-α/IL-10 ratio, hypersusceptibility to infections, burn size (TBSA, and common severity scores (Acute Physiology and Chronic Health Evaluation (APACHEII, Baux, modified Baux (R-Baux, Ryan Score, Abbreviated Burn Severity Index (ABSI. TNF-α/IL10 plasma ratio measured shortly after burn trauma was inversely correlated with burn size and the injury severity scores investigated, and was predictive of repeated infections (≥3 infection episodes outcome (AUROC [95%CI] of 0.80 [0.63–0.93]. Early measures of circulating TNF-α/IL10 ratio may be a previously unidentified biomarker associated with burn injury severity and predictive of the risk of hypersusceptibility to repeated infections.

  11. Psychological impact of burns on children treated in a severe burns unit.

    Science.gov (United States)

    Delgado Pardo, Gracia; Moreno García, Inmaculada; Marrero, Francisca Del Rosario Miralles; Gómez Cía, Tomás

    2008-11-01

    The aims of this study were to analyse the types of incident which cause children's burns, to investigate emotional reactions and associated behaviour afterward and to ascertain post-admission sequelae. A total of 83 young people took part, aged 1-17 years, with a mean 12% (range 1.5-47%, S.D. 8.0) total body surface area burned. According to the results from the psychometric scales and questionnaire used, most burns were the result of domestic incidents. Older children scored higher in anxiety. The most common behavioural reactions observed (attachment, wish to go back home) reflect the particularity of these patients compared with other samples of children in hospital. With respect to post-admission sequelae, no relevant results were obtained.

  12. Pressure ulcers and risk assessment in severe burns.

    Science.gov (United States)

    Lewis, Giavonni M; Pham, Tam N; Robinson, Ellen; Otto, Andrew; Honari, Shari; Heimbach, David M; Klein, Matthew B; Gibran, Nicole S

    2012-01-01

    Risk and incidence of pressure ulcers (PUs) in the burn population remain poorly understood. The purpose of this study was to determine the timing and incidence of PUs at our regional burn center and to identify early risk factors for PU development in burn patients. A retrospective review of 40 charts was performed from among the 1489 patients admitted to our regional burn center between January 2008 and December 2009. Twenty patients acquired PUs during their admission and were identified on the basis of International Classification of Diseases, ninth revision, designation, hospital stay >7 days, and thermal injury (excluding toxic epidermal necrolysis and purpura fulminans). The remaining 20 patients were matched controls based on ±5 years in age and ±8% TBSA. Patient, injury, and outcome characteristics were compared among patient groups using χ for categorical variables and Mann-Whitney for continuous variables. The incidence of PU was 1.3% of all admissions. PU most commonly occurred at the sacrum/coccyx (eight), lower extremity (seven), and occiput (six). A majority of PU presented at stage 2 (33%), stage 3 (26%), and unstageable (30%). Thirteen were splint or device related and reportable. Ninety percent of patients with PUs presented with a Braden score of 16 or less (P = .03), although 60% of controls also had admission Braden scores less than 16. On an average, PUs were acquired within 17 days of admission. Data suggest burn patients are particularly at risk of developing PU based on admission Braden scores. However, low Braden scores do not necessarily correlate with eventual development of PU. Therefore, early and aggressive PU prevention and risk assessment tools must be used to diagnose PUs at an early and reversible stage.

  13. [Plasma gelsolin level and its relationship with the prognosis of patients with severe burns].

    Science.gov (United States)

    Huang, Li-feng; Yao, Yong-ming; Dong, Ning; He, Li-xin; Zhang, Qing-hong; Yu, Yan; Sheng, Zhi-yong

    2013-04-01

    To observe the changes in plasma gelsolin (pGSN) level of patients with severe burn and to explore its relationship with sepsis and death of patients. One hundred and two patients with total burn area equal to or larger than 30% TBSA hospitalized from May 2010 to May 2012 were included as burn group. Twenty-five healthy volunteers were recruited as healthy control group. Peripheral venous blood of patients was harvested on post burn day (PBD) 1, 3, 7, 14, and 21 to determine the pGSN level with double antibody sandwich ELISA kits, and the same maneuver was carried out in healthy volunteers. (1) Patients in burn group were divided into three groups by burn size: small burn area group (30% - 49% TBSA, n = 39), medium burn area group (larger than 49% and smaller than or equal to 69% TBSA, n = 33), and large burn area group (larger than 69% and smaller than or equal to 99% TBSA, n = 30). (2) According to diagnostic criteria of burn sepsis, patients in burn group were divided into sepsis group (n = 43) and non-sepsis group (n = 59). (3) According to the prognosis of patients with sepsis, patients in sepsis group were further divided into non-survival sepsis group (n = 14) and survival sepsis group (n = 29). The levels of pGSN in above groups were compared, and their relationship with sepsis and death of patients was analyzed. Data were analyzed with analysis of variance, LSD test and one-way Logistic regressions. (1) Levels of pGSN in burn group were obviously lower than those of healthy control group on PBD 1, 3, 7, 14, and 21 (with F values respectively 140.01, 369.52, 702.15, 360.14, 84.16, P values all below 0.01). (2) The mean levels of pGSN in large, medium, and small burn area groups at five time points were (43 ± 11), (85 ± 23), (124 ± 38) mg/L, showing statistically significant differences among them (F = 367.76, P burn patients. Severe burn injury could down-regulate the pGSN level of patients, and it decreases along with the increase in the area and

  14. Normalized burn ratios link fire severity with patterns of avian occurrence

    Science.gov (United States)

    Rose, Eli T.; Simons, Theodore R.; Klein, Rob; McKerrow, Alexa

    2016-01-01

    ContextRemotely sensed differenced normalized burn ratios (DNBR) provide an index of fire severity across the footprint of a fire. We asked whether this index was useful for explaining patterns of bird occurrence within fire adapted xeric pine-oak forests of the southern Appalachian Mountains.ObjectivesWe evaluated the use of DNBR indices for linking ecosystem process with patterns of bird occurrence. We compared field-based and remotely sensed fire severity indices and used each to develop occupancy models for six bird species to identify patterns of bird occurrence following fire.MethodsWe identified and sampled 228 points within fires that recently burned within Great Smoky Mountains National Park. We performed avian point counts and field-assessed fire severity at each bird census point. We also used Landsat™ imagery acquired before and after each fire to quantify fire severity using DNBR. We used non-parametric methods to quantify agreement between fire severity indices, and evaluated single season occupancy models incorporating fire severity summarized at different spatial scales.ResultsAgreement between field-derived and remotely sensed measures of fire severity was influenced by vegetation type. Although occurrence models using field-derived indices of fire severity outperformed those using DNBR, summarizing DNBR at multiple spatial scales provided additional insights into patterns of occurrence associated with different sized patches of high severity fire.ConclusionsDNBR is useful for linking the effects of fire severity to patterns of bird occurrence, and informing how high severity fire shapes patterns of bird species occurrence on the landscape.

  15. Burns

    Science.gov (United States)

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

  16. Two new risk factors for heterotopic ossification development after severe burns

    OpenAIRE

    Thefenne, Laurent; de Brier, Gratiane; Leclerc, Thomas; Jourdan, Claire; Nicolas, Claire; Truffaut, Stéphanie; Lapeyre, Eric; Genet, Francois

    2017-01-01

    Objectives Life after severe burns is conditioned by the remaining sequelae. The pathophysiology and risk factors of Heterotopic Ossification (HO) after burns are still poorly understood. The aim of this study was to determine: 1) the incidence of HO after burns and 2) the risk factors associated with HO development, in a large retrospective study. Methods A case-control study of patients admitted to the burns intensive care unit of Percy Hospital, Paris, from the 1st January 2009 to the 31st...

  17. Gut microbiota trajectory in patients with severe burn: A time series study.

    Science.gov (United States)

    Wang, Xinying; Yang, Jianbo; Tian, Feng; Zhang, Li; Lei, Qiucheng; Jiang, Tingting; Zhou, Jihong; Yuan, Siming; Wang, Jun; Feng, Zhijian; Li, Jieshou

    2017-08-12

    This time series experiments aimed to investigate the dynamic change of gut microbiomes after severe burn and its association with enteral nutrition (EN). Seven severely burned patients who suffered from a severe metal dust explosion injury were recruited in this study. The dynamic changes of gut microbiome of fecal samples at six time points (1-3days, 2, 3, 4, 5 and 6weeks after severe burn) were detected using 16S ribosomal RNA pyrosequencing technology. Following the post-burn temporal order, gut microbiota dysbiosis was detected in the gut microbiome after severe burn, then it was gradually resolved. The bio-diversity of gut bacteria was initially decreased, and then returned to normal level. In addition, at the early stage (from 2 to 4weeks), the majority of those patients' gut microbiome were opportunistic pathogen genus, Enterococcus and Escherichia; while at the end of this study, the majority was a beneficial genus, Bacteroides. EN can promote the recovery of gut microbiota, especially in EN well-tolerated patients. Severe burn injury can cause a dramatic dysbiosis of gut microbiota. A trend of enriched beneficial bacteria and diminished opportunistic pathogen bacteria may serve as prognosis microbiome biomarkers of severe burn patients. Copyright © 2017. Published by Elsevier Inc.

  18. Prehospital cooling of severe burns: Experience of the Emergency Department at Edendale Hospital, KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Fiandeiro, D; Govindsamy, J; Maharaj, R C

    2015-06-01

    Early cooling with 10 - 20 minutes of cool running water up to 3 hours after a burn has a direct impact on the depth of the burn and therefore on the clinical outcome of the injury. An assessment of the early cooling of burns is essential to improve this aspect of burns management. To assess the rates and adequacy of prehospital cooling received by patients with severe burns before presentation to the Emergency Department (ED) at Edendale Hospital, Pietermaritzburg, South Africa. Patients with inadequate prehospital cooling who presented to the ED within 3 hours were also identified. A retrospective reviewof the burns database for all the patients with severe burns admitted from the ED at Edendale Hospital from September 2012 to August 2013 was undertaken. Demographic details, characteristics and timing of the burns, and presentation were correlated with burn cooling. Ninety patients were admitted with severe burns. None received sufficient cooling of their burns, 25.6% received cooling of inadequate duration, and 32.3% arrived at the ED within 3 hours after the burn with either inadequate or no cooling. The median time to presentation to the ED after the burn was 260 minutes. Appropriate cooling of severe burns presenting to Edendale Hospital is inadequate. Education of the community and prehospital healthcare workers about the iiportance of early appropriate cooling of severe burns is required. Many patients would benefit from cooling of their burns in the ED, and facilities should be provided for this vital function.

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

    Science.gov (United States)

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

    2016-07-01

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

  20. Comparative observation with MRI and pathology of brain edema at the early stage of severe burn

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the correlation between MRI features and pathology in brain edema at the early stage of severe burn (50% TBSA Ⅲ degree) in dogs.Methods: Fifty-two dogs were randomized into control, simple burn (SB), burn plus sodium lactate (BSL), and burn plus glucose solution groups (BGS). The manifestation of the brain of control group was compared with that of burn groups at 6, 12, 18 and 24 hours postburn with MRI and pathological examination (gross appearance, electron microscopy and light microscopy).Results: The earliest findings of brain edema were seen at 12 hours after burn in BGS group, in which brain swelling was the main feature of MRI. The decrease of SIR on T1WI was not observed until it was exceeded 10%.Signal of T2WI increased by 8.29% at 24 hours after burn.It was difficult to distinguish the gray matter from the white matter at the boundary line, which became blurred later. Histological changes of brain edema were observed as early as 6 hours after burn, being accompanied by swelling of endothelial cells and peri-vescular astrocytes, and vacuolation took place in neurons at 12 hours after burn, with different degrees of necrosis of capillary endothelimn,neurons, and axons. These changes became more marked with elapse of time. The BGS group showed the most obvious changes mentioned above at 24 hours after burn.Conclusions: The model of the brain edema after severe burn has the feature of both vasogenic edema and cytotoxic edema on the MRI and pathology. Positive MRI findings lagged behind that of the pathomorphological changes.ed

  1. The effects and mechanisms of insulin on systemic inflammatory response and immune cells in severe trauma, burn injury, and sepsis.

    Science.gov (United States)

    Deng, Hu-Ping; Chai, Jia-Ke

    2009-10-01

    Insulin resistance, hyperglycemia, inflammatory disorders and immune dysfunction cause high morbidity and mortality in patients with severe trauma, burn injuries, or sepsis. Many studies have shown that intensive insulin therapy can combat insulin resistance, decrease blood glucose levels, and induce anabolic processes, thus, decreasing morbidity and mortality. Moreover, in recent years, it has been proven that insulin can attenuate systemic inflammatory responses and modulate the proliferation, apoptosis, differentiation and immune functions of certain immune cells, especially monocytes/macrophages, neutrophils, and T cells associated with severe trauma, burn injury, or sepsis. This effect of insulin may expand our understanding of intensive insulin therapy in critically ill patients. This review attempts to summarize studies on the modulatory effects and mechanisms of insulin therapy on systemic inflammation and immune cells in severe trauma, burn injury and sepsis, and further propose some questions for future studies.

  2. Nurse Understanding on 1 Case of Severe Burn Complicated with Diabetes

    Institute of Scientific and Technical Information of China (English)

    LAI Lihong

    2002-01-01

    @@ There was one diabetic with severe burn complicated with diabetes received satified effect after treated and nursed timely from December, 1997to April, 1998 in our hospital. Now the nurse work is following.

  3. LandCarbon Conterminous United States Burned Area and Severity Mosaics 2001-2050 Metadata

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The burn area and severity data were stochastically generated using a probabilistic ignition model and mechanistic fire-spread model. The ignition model consisted of...

  4. Structural Equation Modeling on Life-world Integration in People with Severe Burns

    Directory of Open Access Journals (Sweden)

    Gyeong Suk Lee, PhD, RN

    2013-09-01

    Conclusion: Physical function should be directly improved to adjust to life-world integration. A comprehensive integration approach is also necessary to help people with severe burns successfully return to society.

  5. Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury

    Directory of Open Access Journals (Sweden)

    George Kuo

    2016-12-01

    Conclusion: Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury.

  6. Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2012-01-01

    Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

  7. Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2014-07-01

    Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

  8. Analysis of Climate and Topographic Controls on Burn Severity in the Western United States (1984-2005)

    Science.gov (United States)

    Holden, Z. A.; Crimmins, M.; Luce, C.; Heyerdahl, E. K.; Morgan, P.

    2008-12-01

    Fire activity in the western US is likely to increase with climate warming. However, relationships between climate and the magnitude of vegetation change (severity) associated with recent fires have not been quantified. The magnitude of change associated with fires is a critical component of understanding fire- induced emissions carbon loss and ecosystem change. We present statistical analyses of 22-year climate- burn severity relationships for more than 1200 major wildfires in the Pacific Northwest region of the western U.S. Using stream gage, soil moisture, temperature, precipitation data and North American Regional Reanalysis data, we examine the relative influences of climate (precipitation and temperature) and fire weather (wind, relative humidity) on burn severity of individual fires, and regional analyses of area burned severely. Our results show statistically significant relationships between temperature, precipitation and the proportion of each fire classified as high-severity. Using Fragstats metrics for each fire, we show increasingly large patch sizes and homogenous patch distributions associated with warmer, drier conditions. Using topographic variables and the random forest machine learning algorithm, we analyze the occurrence of severely burned areas relative to 12 topographic variables. Classification accuracy results are high (greater than 70 percent) suggesting that there is some predictability in where fires are likely to occur.

  9. Multispectral imaging burn wound tissue classification system: a comparison of test accuracies between several common machine learning algorithms

    Science.gov (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.

    2016-03-01

    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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  11. SENTINEL-2A red-edge spectral indices suitability for discriminating burn severity

    Science.gov (United States)

    Fernández-Manso, Alfonso; Fernández-Manso, Oscar; Quintano, Carmen

    2016-08-01

    Fires are a problematic and recurrent issue in Mediterranean ecosystems. Accurate discrimination between burn severity levels is essential for the rehabilitation planning of burned areas. Sentinel-2A MultiSpectral Instrument (MSI) record data in three red-edge wavelengths, spectral domain especially useful on agriculture and vegetation applications. Our objective is to find out whether Sentinel-2A MSI red-edge wavelengths are suitable for burn severity discrimination. As study area, we used the 2015 Sierra Gata wildfire (Spain) that burned approximately 80 km2. A Copernicus Emergency Management Service (EMS)-grading map with four burn severity levels was considered as reference truth. Cox and Snell, Nagelkerke and McFadde pseudo-R2 statistics obtained by Multinomial Logistic Regression showed the superiority of red-edge spectral indices (particularly, Modified Simple Ratio Red-edge, Chlorophyll Index Red-edge, Normalized Difference Vegetation Index Red-edge) over conventional spectral indices. Fisher's Least Significant Difference test confirmed that Sentinel-2A MSI red-edge spectral indices are adequate to discriminate four burn severity levels.

  12. Integrating satellite imagery with simulation modeling to improve burn severity mapping.

    Science.gov (United States)

    Karau, Eva C; Sikkink, Pamela G; Keane, Robert E; Dillon, Gregory K

    2014-07-01

    Both satellite imagery and spatial fire effects models are valuable tools for generating burn severity maps that are useful to fire scientists and resource managers. The purpose of this study was to test a new mapping approach that integrates imagery and modeling to create more accurate burn severity maps. We developed and assessed a statistical model that combines the Relative differenced Normalized Burn Ratio, a satellite image-based change detection procedure commonly used to map burn severity, with output from the Fire Hazard and Risk Model, a simulation model that estimates fire effects at a landscape scale. Using 285 Composite Burn Index (CBI) plots in Washington and Montana as ground reference, we found that an integrated model explained more variability in CBI (R (2) = 0.47) and had lower mean squared error (MSE = 0.28) than image (R (2) = 0.42 and MSE = 0.30) or simulation-based models (R (2) = 0.07 and MSE = 0.49) alone. Overall map accuracy was also highest for maps created with the Integrated Model (63 %). We suspect that Simulation Model performance would greatly improve with higher quality and more accurate spatial input data. Results of this study indicate the potential benefit of combining satellite image-based methods with a fire effects simulation model to create improved burn severity maps.

  13. [Preclinical treatment of severe burn trauma due to an electric arc on an overhead railway cable].

    Science.gov (United States)

    Spelten, O; Wetsch, W A; Hinkelbein, J

    2013-09-01

    Severe burns due to electrical accidents occur rarely in Germany but represent a challenge for emergency physicians and their team. Apart from extensive burns cardiac arrhythmia, neurological damage caused by electric current and osseous injury corresponding to the trauma mechanism are also common. It is important to perform a survey of the pattern of injuries and treat acute life-threatening conditions immediately in the field. Furthermore, specific conditions related to burns must be considered, e.g. fluid resuscitation, thermal management and analgesia. In addition, a correct strategy for further medical care in an appropriate hospital is essential. Exemplified by this case guidelines for the treatment of severe burns and typical pitfalls are presented.

  14. Burn Severities, Fire Intensities, and Impacts to Major Vegetation Types from the Cerro Grande Fire

    Energy Technology Data Exchange (ETDEWEB)

    Balice, Randy G. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bennett, Kathryn D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wright, Marjorie A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2004-12-15

    The Cerro Grande Fire resulted in major impacts and changes to the ecosystems that were burned. To partially document these effects, we estimated the acreage of major vegetation types that were burned at selected burn severity levels and fire intensity levels. To accomplish this, we adopted independently developed burn severity and fire intensity maps, in combination with a land cover map developed for habitat management purposes, as a basis for the analysis. To provide a measure of confidence in the acreage estimates, the accuracies of these maps were also assessed. In addition, two other maps of comparable quality were assessed for accuracy: one that was developed for mapping fuel risk and a second map that resulted from a preliminary application of an evolutionary computation software system, called GENIE.

  15. Macrophage migration inhibitory factor-A potential diagnostic tool in severe burn injuries?

    Science.gov (United States)

    Grieb, Gerrit; Simons, David; Piatkowski, Andrzej; Bernhagen, Jürgen; Steffens, Guy; Pallua, Norbert

    2010-05-01

    Serum macrophage migration inhibitory factor (MIF) and procalcitonin (PCT) concentrations as well as leucocyte numbers were evaluated in a retrospective study with 23 patients with severe burn injuries. The MIF and PCT concentrations as well as the number of leucocytes (LEU) were monitored over a period of 5 days. The total body surface area (TBSA) and sepsis-related organ failure assessment (SOFA) scores were also evaluated. The MIF, PCT concentrations and leucocyte counts were profoundly increased in all patients with severe burn wounds. At the time of admission into the intensive care unit, no significant differences were observed for the MIF and PCT levels between patients with a TBSApatients with a TBSA>60% (Group 2). After 48 h, however, the MIF and PCT levels reached very high levels in a subgroup of the patients, whereas these levels became normal again in other subgroups. The group of patients with a TBSA>60% was, therefore, subdivided in three groups (subgroups 2a-c). The MIF and PCT data pairs in these subgroups appeared to correlate in an inhomogeneous manner. These levels in the subgroup 2a (i.e., lethal within 5 days) were strongly elevated over those observed in Group 1 (TBSAburn inflammation and systemic inflammatory response syndrome (SIRS) or sepsis with lethal outcome.

  16. Circulating Microvesicles Are Elevated Acutely following Major Burns Injury and Associated with Clinical Severity.

    Science.gov (United States)

    O'Dea, Kieran P; Porter, John R; Tirlapur, Nikhil; Katbeh, Umar; Singh, Suveer; Handy, Jonathan M; Takata, Masao

    2016-01-01

    Microvesicles are cell-derived signaling particles emerging as important mediators and biomarkers of systemic inflammation, but their production in severe burn injury patients has not been described. In this pilot investigation, we measured circulating microvesicle levels following severe burns, with severe sepsis patients as a comparator group. We hypothesized that levels of circulating vascular cell-derived microvesicles are elevated acutely following burns injury, mirroring clinical severity due to the early onset and prevalence of systemic inflammatory response syndrome (SIRS) in these patients. Blood samples were obtained from patients with moderate to severe thermal injury burns, with severe sepsis, and from healthy volunteers. Circulating microvesicles derived from total leukocytes, granulocytes, monocytes, and endothelial cells were quantified in plasma by flow cytometry. All circulating microvesicle subpopulations were elevated in burns patients on day of admission (day 0) compared to healthy volunteers (leukocyte-microvesicles: 3.5-fold, p = 0.005; granulocyte-microvesicles: 12.8-fold, pmicrovesicles: 20.4-fold, pmicrovesicles: 9.6-fold, p = 0.01), but decreased significantly by day 2. Microvesicle levels were increased with severe sepsis, but less consistently between patients. Leukocyte- and granulocyte-derived microvesicles on day 0 correlated with clinical assessment scores and were higher in burns ICU non-survivors compared to survivors (leukocyte MVs 4.6 fold, p = 0.002; granulocyte MVs 4.8 fold, p = 0.003). Mortality prediction analysis of area under receiver operating characteristic curve was 0.92 (p = 0.01) for total leukocyte microvesicles and 0.85 (p = 0.04) for granulocyte microvesicles. These findings demonstrate, for the first time, acute increases in circulating microvesicles following burns injury in patients and point to their potential role in propagation of sterile SIRS-related pathophysiology.

  17. Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

    OpenAIRE

    Ali, Arham; Herndon, David N.; Mamachen, Ashish; Hasan, Samir; Andersen, Clark R; Grogans, Ro-Jon; Brewer, Jordan L.; Lee, Jong O.; Heffernan, Jamie; Suman, Oscar E.; Finnerty, Celeste C

    2015-01-01

    Introduction Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults. Methods Sixty-nine...

  18. Use of a radiative transfer model to simulate the postfire spectral response to burn severity

    Science.gov (United States)

    Chuvieco, E.; RiañO, D.; Danson, F. M.; Martin, P.

    2006-12-01

    Burn severity is related to fire intensity and fire duration and provides a quantitative measure related to fire impact and biomass consumption. Traditional field-based methods to estimate burn severity are time consuming, labor intensive, and normally limited in spatial extent. Remotely sensed data may provide a means to estimate severity levels across large areas, but it is critical to understand the causes of variability in spectral response with variations in burn severity. To address this issue, a combined leaf (Prospect) and canopy (Kuusk) reflectance model was used to simulate the spectral response of a range of vegetation canopies with different burn severity levels. The key aspects examined in the simulations were change in soil color, change in foliage color from green to brown (burned), and change in leaf area index (LAI). For each simulation the composite burn index (CBI) was determined using the same rules used in the field to estimate burn severity levels. Statistical analyses examined the strength of the correlations between CBI and reflectance in individual wave bands in the 400-2500 nm range and CBI and a range of spectral indices combining pairs of wave bands. The results showed that wave bands in the near infrared (NIR) were most strongly related to the CBI of the simulated canopies because of their sensitivity to reduction in LAI. Spectral indices combining reflectance in wave bands in the NIR and shortwave infrared and red edge region showed stronger correlations with CBI. Forward stepwise regression with two to six terms selected wave bands in these regions and accounted for more than 90% of the variation in CBI.

  19. Burns

    Science.gov (United States)

    To help prevent burns: Install smoke alarms in your home. Check and change batteries regularly. Teach children about fire safety and the danger of matches and fireworks. Keep children from climbing on top of a stove ...

  20. An evaluation of Emergency Management of Severe Burn (EMSB) course in Bangladesh: a strategic direction.

    Science.gov (United States)

    Biswas, Animesh; Rahman, Fazlur; Maitz, Peter; Baset, Kamran Ul; Hossain, Jahangir; Mashreky, Saidur Rahman

    2017-01-01

    Burn is one of the major public health problems in Bangladesh. Specialized personnel and technologies are required, however, in many cases they are not readily available. Taking the situation into account, Interplast Australia and New Zealand, Australia & New Zealand Burn Association (ANZBA), and Centre for Injury Prevention and Research, Bangladesh (CIPRB) initiated Emergency Management of Severe Burn (EMSB) training programme for Bangladeshi physicians in 2008 to help improving their burn management skill. The study was designed to evaluate the effect of EMSB programme in Bangladesh. Both qualitative and quantitative methods were adopted. A cross-sectional survey was conducted to obtain quantitative information from 38 randomly selected EMSB-trained doctors among 380 trained physicians based on a five year database of EMSB (2008-2012). In-depth interviews (IDIs) and focus group discussion (FGD) were used as data collection techniques to get information. A total of 32 participants completed the interview. It was found that 87.5% (n=28) doctors were using their skill in burn management that they learnt from the EMSB course. About 43.8% (n=14) doctors felt that the course largely helped improve their confidence. Majority (56.2%, n=18) of doctors stated EMSB is essential for the Bangladeshi doctors to learn better management of burns. Qualitative findings show that the courses were organized successfully with an excellent coordination, maintaining same quality and standard as running anywhere in the world. For its effectiveness, the course has been recommended to train graduate nurses and junior doctors from the periphery of the country. EMSB has already created a large doctor community who are able to effectively manage burn patients. It also has proven its indispensability for learning burn management skill. The EMSB established a platform to serve the burn victims and reduce the burden of injuries in Bangladesh.

  1. Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires

    Directory of Open Access Journals (Sweden)

    G. M. Davies

    2015-09-01

    Full Text Available Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the Composite Burn Index (pCBI to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids and ground (litter, moss, duff fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a Generalised Linear Mixed Model (GLMM. Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System, and pre-fire fuel structure. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m−2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.

  2. Burning high-level TRU waste in fusion fission reactors

    National Research Council Canada - National Science Library

    Shen, Yaosong

    2016-01-01

    .... A new method of burning high-level transuranic (TRU) waste combined with Thorium–Uranium (Th–U) fuel in the subcritical reactors driven by external fusion neutron sources is proposed in this paper...

  3. High Burn Rate Hybrid Fuel for Improved Grain Design Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A novel type of fuel providing high burning rate for hybrid rocket applications is proposed. This fuel maintains a hydrodynamically rough surface to...

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

    Science.gov (United States)

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

    2013-04-01

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

  5. High Pressure Burn Rate Measurements on an Ammonium Perchlorate Propellant

    Energy Technology Data Exchange (ETDEWEB)

    Glascoe, E A; Tan, N

    2010-04-21

    High pressure deflagration rate measurements of a unique ammonium perchlorate (AP) based propellant are required to design the base burn motor for a Raytheon weapon system. The results of these deflagration rate measurements will be key in assessing safety and performance of the system. In particular, the system may experience transient pressures on the order of 100's of MPa (10's kPSI). Previous studies on similar AP based materials demonstrate that low pressure (e.g. P < 10 MPa or 1500 PSI) burn rates can be quite different than the elevated pressure deflagration rate measurements (see References and HPP results discussed herein), hence elevated pressure measurements are necessary in order understand the deflagration behavior under relevant conditions. Previous work on explosives have shown that at 100's of MPa some explosives will transition from a laminar burn mechanism to a convective burn mechanism in a process termed deconsolidative burning. The resulting burn rates that are orders-of-magnitude faster than the laminar burn rates. Materials that transition to the deconsolidative-convective burn mechanism at elevated pressures have been shown to be considerably more violent in confined heating experiments (i.e. cook-off scenarios). The mechanisms of propellant and explosive deflagration are extremely complex and include both chemical, and mechanical processes, hence predicting the behavior and rate of a novel material or formulation is difficult if not impossible. In this work, the AP/HTPB based material, TAL-1503 (B-2049), was burned in a constant volume apparatus in argon up to 300 MPa (ca. 44 kPSI). The burn rate and pressure were measured in-situ and used to calculate a pressure dependent burn rate. In general, the material appears to burn in a laminar fashion at these elevated pressures. The experiment was reproduced multiple times and the burn rate law using the best data is B = (0.6 {+-} 0.1) x P{sup (1.05{+-}0.02)} where B is the burn

  6. [Effect of severe burn on growth and development and the level of growth hormone in mice].

    Science.gov (United States)

    Wang, Fei; Qiu, Lin; Liu, Cuiping; Tian, Xiaofei; Xiao, Jun

    2014-02-01

    To analyze the changes in body growth, learning and memory capabilities, exercise capacity, and the level of growth hormone (GH) in mice suffering from severe burn. One hundred and four healthy BALB/c mice aged from 3 to 4 weeks were divided into normal control group (NC, without treatment) , 7 s burn group (inflicted with 20%TBSA deep partial-thickness burn on the back), 10 s burn group (inflicted with 20%TBSA full-thickness burn on the back), and negative control group (simulating the treatment of two burn groups without injury) according to the random number table, with 26 mice in each group. The body weight, body length, and tail length of 8 mice in each group were measured before burn. Respectively 6 mice of two burn groups were sacrificed on post burn day (PBD) 1, 3, and 7 for determination of serum level of GH with enzyme-linked immunosorbent assay kit. The remaining 8 mice in each of the two burn groups were raised to adulthood. The body weight, body length, and tail length were measured on PBD 62, and the increased percentages of body weight, body length, and tail length were calculated. Morris water maze tests, including escape latency on PBD 66, 67, and 68, frequency of stepping over the platform location and proportion of staying time in the target quadrant on PBD 69, were used to examine the learning and memory capabilities. The time of loaded swimming and the time of pole-climbing on PBD 70 were used to assess the exercise capacity. Above-mentioned indexes were also determined in the two control groups at the same time points. Data were processed with one-way analysis of variance; Welch test was applied when equal variance was not assumed; independent samples t test was applied for paired comparison. (1) The level of GH of mice in 7 s burn group on PBD 1 [(3 021 ± 506) pg/mL] was lower than that of group NC [(3 728 ± 412) pg/mL, t = 2.656, P 0.05), while the increased percentages of other indexes of mice in the two burn groups were lower than those

  7. Effects of glycine supplementation on myocardial damage and cardiac function after severe burn.

    Science.gov (United States)

    Zhang, Yong; Lv, Shang-jun; Yan, Hong; Wang, Lin; Liang, Guang-ping; Wan, Qian-xue; Peng, Xi

    2013-06-01

    Glycine has been shown to participate in protection from hypoxia/reoxygenation injury. However, the cardioprotective effect of glycine after burn remains unclear. This study aimed to explore the protective effect of glycine on myocardial damage in severely burned rats. Seventy-two Wistar rats were randomly divided into three groups: normal controls (C), burned controls (B), and glycine-treated (G). Groups B and G were given a 30% total body surface area full-thickness burn. Group G was administered 1.5 g/(kg d) glycine and group B was given the same dose of alanine via intragastric administration for 3d. Serum creatine kinase (CK), lactate dehydrogenase (LDH), aspartate transaminase (AST), and blood lactate, as well as myocardial ATP and glutathione (GSH) content, were measured. Cardiac contractile function and histopathological changes were analyzed at 12, 24, 48, and 72 hours. Serum CK, LDH, AST, and blood lactate increased, while myocardial ATP and GSH content decreased in both burned groups. Compared with group B, the levels of CK, LDH, and AST significantly decreased, whereas blood lactate as well as myocardial ATP and GSH content increased in group G. Moreover, cardiac contractile function inhibition and myocardial histopathological damage in group G significantly decreased compared with group B. Myocardial histological structure and function were damaged significantly after burn. Glycine is beneficial to myocardial preservation by improving cardiomyocyte energy metabolism and increasing ATP and GSH abundance. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  8. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

    Science.gov (United States)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

    2014-01-01

    This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. 严重烧伤患者外周血高迁移率族蛋白B-1水平的检测及其临床意义%Detection of plasma high mobility group box-1 protein in severely burned patients and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    肖锦华; 王亚萍; 朱华燕; 潘宇红; 黄璇

    2012-01-01

    目的 检测严重烧伤后患者血浆高迁移率族蛋白B-1 (HMGB1)水平的变化并探讨其临床意义.方法 用酶联免疫吸附试验法检测77例严重烧伤患者血浆HMGB1水平,同步检测肿瘤坏死因子-α(TNF-α)含量,并与30名健康对照组进行比较.结果 77例严重烧伤患者按烧伤面积分为3组,A组31例,烧伤总面积30%~49%,B组25例,烧伤总面积50%~69%,C组21例,烧伤总面积70%~95%;烧伤患者血浆HMGB1及TNF-α水平在A组为(22.15±6.34) ng/ml、(89.26±21.41)pg/ml,B组为(26.24±9.71)ng/ml、( 132.45±76.32)pg/ml,C组为(36.45±11.63)ng/ml、(213.61±87.45) pg/ml,对照组为(2.17±1.13)ng/ml、(45.32±13.84)pg/m1,烧伤各组HMGB1及TNF-α水平明显高于对照组(P<0.01);24例特大面积烧伤患者根据预后情况分为生存组和死亡组进行动态观察,两组患者血浆HMGB1水平在伤后第1天即显著升高(P<0.01),在伤后3~21 d,死亡组明显高于生存组(P<0.05),而TNF-α含量在伤后第3~7 d达高峰,以后逐渐下降,到21d时生存组与死亡组相比已差异无统计学意义.结论 严重烧伤后HMGB1的表达异常升高,HMGB1作为重要的晚期炎症介质和TNF-α相互诱生相互作用,参与严重烧伤后全身炎症反应综合征的病理生理过程,动态观察其水平变化有助于烧伤患者病程监测及预后判断.%OBJECTIVE To investigate the changes of plasma high mobility group box-1 protein ( HMGB1) in severely burned patients and its clinical significance. METHODS The plasma HMGB1 and TNF-α levels were measured by enzyme linked immunosorbent assay(ELISA) simultaneously in all patients and were compared with 30 healthy control subjects. RESULTS Totally 77 burned patients were involved in this study, and they were divided into three burn size groups: 30%-49% total body surface area(TBSA) burn(group A, n = 31), 50% - 69% TBSA burn (group B, n = 25) and 70%-95% TBSA burn(group C, n = 21). The levels of HMGB2 and TNF

  10. [Improving myocardial mechanics parameters of severe burn rabbits with oral fluid resuscitation].

    Science.gov (United States)

    Ruan, Jing; Zhang, Bing-qian; Wang, Guang; Luo, Zhong-hua; Zheng, Qing-yi; Zheng, Jian-sheng; Huang, Yue-sheng; Xiao, Rong

    2008-08-01

    To investigate the protective effect of oral fluid resuscitation on cardiac function in severe burn rabbits. One hundred and fifty rabbits were randomly divided into normal control group (NC group, n = 6, without treatment), burn group (B group, n = 42, without fluid therapy), immediate oral fluid resuscitation group (C group, n = 42), delayed oral fluid resuscitation group (D group, n = 30) and delayed and rapid oral fluid resuscitation group (E group, n = 30). The rabbits in B, C, D, E groups were subjected to 40% TBSA full-thickness burn, then were treated with fluid therapy immediately after burn (C group), at 6 hour after burn (D, E groups). The myocardial mechanics parameters including mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV +/- dp/dt max were observed at 2, 6, 8, 12, 24, 36 and 48 post burn hour (PBH). Urine output was also examined. The level of LVSP, LV +/- dp/dt max in B roup were significantly lower than those in NC group. The level of LVSP, LV +/- dp/dt max in the C and E group were singnificantly increased during 24 hour after burn. The level of LV + dp/dt max and LV-dp/dt max in C group peaked at 8 PBH (892 +/- 116 kPa/s) and at 6PBH (724 +/- 149 kPa/s) respectively. The levels of LV +/- dp/dt max, LVSP in D group at each time point were similar to B group (P > 0.05). Both the levels of LV +/- dp/dt max in E group peaked at 8 PBH. The level of LVEDP was no obvious difference between B and other groups at each time point (P > 0.05). The changes of MAP and urine output on 24 PBH in each group were similar to above indices. Effective oral fluid therapy in severe burn rabbits during 24 hours after burn can ameliorate myocardial mechanics parameters. The amount of fluid resuscitation can be estimated according to relevant formula for delayed fluid resuscitation in burn rabbits.

  11. Continuous Venovenous Hemofiltration in Severely Burned Patients with Acute Kidney Injury: A Cohort Study

    Science.gov (United States)

    2009-05-01

    tailed , with P < 0.05 considered significant. Kaplan-Meier esti- mate of survival was constructed to compare one-year survival between the CVVH group...Jeschke MG, Dziewulski P, Barrow RE, Herndon DN: Acute renal dysfunction in severely burned adults. J Trauma 1999, 46:141-144. 2. Coca SG, Bauling P

  12. A systematic review on intra-abdominal pressure in severely burned patients

    NARCIS (Netherlands)

    K.D. Strang; E.M.M. van Lieshout (Esther); R.S. Breederveld (Roelf S.); O.J.F. van Waes (Oscar)

    2014-01-01

    textabstractObjective Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are complications that may occur in severely burned patients. Evidenced based medicine for these patients is in its early development. The aim of this study was to provide an overview of literature rega

  13. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with faci

  14. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  15. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with faci

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

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

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

  17. Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

    Directory of Open Access Journals (Sweden)

    Agarwal Pawan

    2004-01-01

    Full Text Available Severe post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

  18. [Decrease of the incidence of sepsis syndrome after early enteral nutrition of patients with severe burns].

    Science.gov (United States)

    Pereira, J L; Gómez-Cia, T; Garrido, M; Parejo, J; Jódar, E; Serrano, P; Romero, H; Fraile, J; Franco, A; García-Luna, P P

    1996-01-01

    The objective of this study was to evaluate the effect of early enteral nutrition on the incidence of the septic syndrome as well as its tolerance, in patients with severe burns. We retrospectively studied 64 patients older than 15 years of age, with a greater than 20% burned body surface area. They were divided into 2 groups as a function of the time elapsed between the beginning of Enteral Nutrition and the time of the burning: 23 patients were given Enteral Nutrition within 24 hours after the burn, and in 41 patients the enteral nutrition was started later than 24 hours after sustaining the thermal injury. Both groups were similar with respect to age, sex, percentage of 2nd and 3rd degree burns, incidence of inhalation, and deaths. All patients received the Enteral Nutrition through a nasogastric tube, with administration of a polymeric, hyperprotein and hypocaloric formula through a continuous infusion pump. In our study we saw a reduction of the incidence of the septic syndrome in the patients who received early enteral Nutrition (26%; 6 patients of a total of 23), with respect to those who did non receive early Enteral Nutrition (54%; 22 patients of a total of 41), with a statistical significance of p > 0.05. There were no differences between both groups with respect to the digestive tolerance to Enteral Nutrition. From our study we can deduce that early Enteral Nutrition reduces the incidence of septic complications, without this increasing the digestive intolerance to the same.

  19. Association between PAI-1 polymorphisms and plasma PAI-1 level with sepsis in severely burned patients.

    Science.gov (United States)

    Chi, Y F; Chai, J K; Yu, Y M; Luo, H M; Zhang, Q X; Feng, R

    2015-08-21

    We investigated the association between plasminogen activator inhibitor-1 (PAI-1) polymorphisms and plasma PAI-1 level with sepsis in severely burned patients. A total of 182 patients with burn areas lager than 30% of the body surface area were enrolled in this study. Peripheral blood samples were obtained from 103 patients with sepsis (sepsis group) and 79 patients without sepsis (control group). An allele-specific polymerase chain reaction assay was used to determine PAI-1 polymorphism 4G/5G distribution. Plasma PAI-1 levels were detected using an enzyme-linked immunosorbent assay. The frequency of the 4G/4G genotype and the 4G allele frequency in the sepsis group were 42.7 and 62.1% respectively, which were significantly higher than those in the control group (P PAI-1 level than the control group (P PAI-1 concentrations were significantly higher in the 4G/4G genotype (P PAI-1 gene may be related to the susceptibility to burn sepsis and that the 4G/4G genotype may be an important genetic risk factor of burn sepsis. Additionally, PAI-1 concentrations in the serum are increased in patients with burn sepsis.

  20. Severe Burn Injury Induces Thermogenically Functional Mitochondria in Murine White Adipose Tissue.

    Science.gov (United States)

    Porter, Craig; Herndon, David N; Bhattarai, Nisha; Ogunbileje, John O; Szczesny, Bartosz; Szabo, Csaba; Toliver-Kinsky, Tracy; Sidossis, Labros S

    2015-09-01

    Chronic cold exposure induces functionally thermogenic mitochondria in the inguinal white adipose tissue (iWAT) of mice. Whether this response occurs in pathophysiological states remains unclear. The purpose of this study was to determine the impact of severe burn trauma on iWAT mitochondrial function in mice. Male BALB/c mice (10-12 weeks) received full-thickness scald burns to ∼30% of the body surface area. Inguinal white adipose tissue was harvested from mice at 1, 4, 10, 20, and 40 days postinjury. Total and uncoupling protein 1 (UCP1)-dependent mitochondrial thermogenesis were determined in iWAT. Citrate synthase activity was determined as a proxy of mitochondrial abundance. Immunohistochemistry was performed to assess iWAT morphology and UCP1 expression. Uncoupling protein 1-dependent respiration was significantly greater at 4 and 10 days after burn compared with sham, peaking at 20 days after burn (P white adipose tissue in vivo and may offer a mechanistic explanation for the chronic hypermetabolism observed in burn victims.

  1. Acute insulin resistance mediated by advanced glycation endproducts in severely burned rats.

    Science.gov (United States)

    Zhang, Xing; Xu, Jie; Cai, Xiaoqing; Ji, Lele; Li, Jia; Cao, Bing; Li, Jun; Hu, Dahai; Li, Yan; Wang, Haichang; Xiong, Lize; Xiao, Ruiping; Gao, Feng

    2014-06-01

    Hyperglycemia often occurs in severe burns; however, the underlying mechanisms and importance of managing postburn hyperglycemia are not well recognized. This study was designed to investigate the dynamic changes of postburn hyperglycemia and the underlying mechanisms and to evaluate whether early glycemic control is beneficial in severe burns. Prospective, randomized experimental study. Animal research laboratory. Sprague-Dawley rats. Anesthetized rats were subjected to a full-thickness burn injury comprising 40% of the total body surface area and were randomized to receive vehicle, insulin, and a soluble form of receptor for advanced glycation endproducts treatments. An in vitro study was performed on cultured H9C2 cells subjected to vehicle or carboxymethyllysine treatment. We found that blood glucose change presented a distinct pattern with two occurrences of hyperglycemia at 0.5- and 3-hour postburn, respectively. Acute insulin resistance evidenced by impaired insulin signaling and glucose uptake occurred at 3-hour postburn, which was associated with the second hyperglycemia and positively correlated with mortality. Mechanistically, we found that serum carboxymethyllysine, a dominant species of advanced glycation endproducts, increased within 1-hour postburn, preceding the occurrence of insulin resistance. More importantly, treatment of animals with soluble form of receptor for advanced glycation endproducts, blockade of advanced glycation endproducts signaling, alleviated severe burn-induced insulin resistance. In addition, early hyperglycemic control with insulin not only reduced serum carboxymethyllysine but also blunted postburn insulin resistance and reduced mortality. These findings suggest that severe burn-induced insulin resistance is partly at least mediated by serum advanced glycation endproducts and positively correlated with mortality. Early glycemic control with insulin or inhibition of advanced glycation endproducts with soluble form of receptor

  2. [Surgical therapy and critical care medicine in severely burned patients - Part 2: the basics in definite care].

    Science.gov (United States)

    Deisz, Robert; Kauczok, Jens; Dembinski, Rolf; Pallua, Norbert; Marx, Gernot

    2013-01-01

    Critical care medicine in severely burned patients should be adapted to the different pathophysiological phases. Accordingly, surgical and non-surgical therapy must be coordinated adequately. Initial stabilization of the burn victim during the first 24 hours (Surgical therapy and critical care medicine in severely burned patients - Part 1: the first 24 ours, AINS 9/12) is followed by a long lasting reconstructive period. During this time calculated fluid replacement to compensate evaporative losses by large bourn wounds is as essential as reconstruction of the integrity of the skin and the modulation of metabolic consequences following severe burn injury. Special attention has to be paid to local and systemic infections.

  3. [Effects of lappaconitine on pain and inflammatory response of severely burned rats and the mechanism].

    Science.gov (United States)

    Yang, C L; Wei, Z R; Zhang, T H; Zeng, X Q; Wu, B H

    2017-06-20

    Objective: To explore the effects of lappaconitine (LA) on pain and inflammatory response of severely burned rats and the mechanism. Methods: Forty SD rats were divided into healthy+ normal saline group, sham injury+ normal saline group, pure burn group, burn+ LA group, and healthy+ LA group according to the random number table (the same dividing method below), with 8 rats in each group. Rats in pure burn and burn+ LA groups were inflicted with about 32% total body surface area deep partial-thickness scald (hereinafter referred to as burn) on the back and right hind. Rats in sham injury+ normal saline group were sham injured. Rats in burn+ LA group were intraperitoneally injected with 1 g/L LA solution in the dosage of 4 mL/kg at 2.0 h before injury and post injury hour (PIH) 0 (immediately), 24.0, 48.0, and 72.0. Rats in healthy+ LA group were intraperitoneally injected with LA solution in the same dose at the same time points as above, and rats in healthy+ normal saline and sham injury+ normal saline groups were intraperitoneally injected with normal saline in the dose of 4 mL/kg at the same time points as above. At 1.5 h before injury and PIH 12.5, 24.5, 36.5, 48.5, and 72.5, the paw withdrawal mechanical threshold (PWMT) of injured rats was detected, and their pain behaviors were observed. The same observation and detection were conducted in rats without injury in the two groups at the same time points as above. Another 32 SD rats were divided into normal saline group, trinitrophenyl (TNP)-ATP group, minocyline group, pyridoxal-phosphate-6-azophenyl-2', 4'-disulfonic acid (PPADS) group, with 8 rats in each group, and all the rats were inflicted with the same burn injury as above. At PIH 48.0, rats in normal saline group were intrathecally injected with 10 μL normal saline; rats in TNP-ATP group were intrathecally injected with 10 μL TNP-ATP in the concentration of 30 nmol/μL; rats in minocyline group were intrathecally injected with 10 μL minocyline in the

  4. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  5. Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury.

    Science.gov (United States)

    Kuo, George; Yang, Shih-Yi; Chuang, Shiow-Shuh; Fan, Pei-Chun; Chang, Chih-Hsiang; Hsiao, Yen-Chang; Chen, Yung-Chang

    2016-12-01

    Acute kidney injury (AKI) is a frequent complication of severe burn injury and is associated with mortality. The definition of AKI was modified by the Kidney Disease Improving Global Outcomes Group in 2012. So far, no study has compared the outcome accuracy of the new AKI staging guidelines with that of the complex score system. Hence, we compared the accuracy of these approaches in predicting mortality. This was a post hoc analysis of prospectively collected data from an intensive care burn unit in a tertiary care university hospital. Patients admitted to this unit from July 2004 to December 2006 were enrolled. Demographic, clinical, and laboratory data and prognostic risk scores were used as predictors of mortality. A total of 145 adult patients with a mean age of 41.9 years were studied. Thirty-five patients (24.1%) died during the hospital course. Among the prognostic risk models, the Acute Physiology and Chronic Health Evaluation III system exhibited the strongest discriminative power and the AKI staging system also predicted mortality well (areas under the receiver operating characteristic curve: 0.889 vs. 0.835). Multivariate logistic regression analysis identified total burn surface area, ventilator use, AKI, and toxic epidermal necrolysis as independent risk factors for mortality. Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury. Copyright © 2016. Published by Elsevier B.V.

  6. [Surgical therapy and critical care medicine in severely burned patients - Part 1: the first 24 ours].

    Science.gov (United States)

    Dembinski, Rolf; Kauczok, Jens; Deisz, Robert; Pallua, Norbert; Marx, Gernot

    2012-09-01

    Critical care medicine in severely burned patients should be adapted to the different pathophysiological phases. Accordingly, surgical and non-surgical therapy must be coordinated adequately. Initial wound care comprises topical treatment of less severely injured skin and surgical debridement of severely burned areas. The first 24 hours of intensive care are focused on calculated fluid delivery to provide stable hemodynamics and avoid progression of local edema formation. In the further course wound treatment with split-thickness skin grafts is the major aim of surgical therapy. Critical care is focused on the avoidance of complications like infections and ventilator associated lung injury. Therefore, lung-protective ventilation strategies, weaning and sedation protocols, and early enteral nutrition are important cornerstones of the treatment.

  7. 77 FR 70389 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Science.gov (United States)

    2012-11-26

    ... Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile or Other Conveyance and... INFORMATION CONTACT: Nancy Copeland, Consultant, Regulations Staff (211D), Compensation Service, Veterans... adding ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as...

  8. 77 FR 66419 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Science.gov (United States)

    2012-11-05

    ...'' as severe burn injuries. We believe that VA's definition of severe burn injury for purposes of... consistent with congressional intent. This definition generally reflects the purpose found at 38 U.S.C. 3901... affect in a material way the economy, a sector of the economy, productivity, competition, jobs,...

  9. Non-severe burn injury leads to depletion of bone volume that can be ameliorated by inhibiting TNF-α.

    Science.gov (United States)

    O'Halloran, Emily; Kular, Jasreen; Xu, Jiake; Wood, Fiona; Fear, Mark

    2015-05-01

    Bone loss after severe burn injury is well established, and is thought to be a consequence of the severe hyper-metabolic response as well as changes in cytokine and glucocorticoid levels that decrease bone synthesis and increase rate of loss. However, 90% of presentations are for non-severe burns which do not elicit this response. Little is known about whether these non-severe injuries may also affect bone tissue, and whether other mechanisms may be involved. To investigate whether bone loss occurs after a non-severe burn injury we used a mouse model of an approximately 8% total body surface area (TBSA) full-thickness burn and micro-CT. We also assessed whether blocking TNF-α after a burn injury by administration of an antibody could modulate the impacts of the burn on bone tissue. There was a significant loss of trabecular bone volume of (3.27% compared to 5.27%, p=0.0051) after non-severe burn injury. Trabecular number was significantly decreased (0.57/mm after injury compared to 1.02/mm controls, p=0.0051) and spacing increased after burn injury (0.40 compared to 0.28, p=0.0083). Anti-TNF-α antibodies significantly improved trabecular bone volume (8.53%, p=0.0034) and number after burn injury (1.28/mm, p=0.0034). There was no significant change observed in cortical bone after burn injury or administration of anti-TNF-α antibodies. These findings show that non-severe burn injury can lead to changes in bone metabolism. Monitoring bone density in patients with non-severe injuries and interventions to limit the impacts of the inflammatory storm may benefit patient recovery and outcomes.

  10. Emphasize the diagnosis and treatment of infective endocarditis in patients with severe burn%重视严重烧伤患者感染性心内膜炎的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    郇京宁

    2016-01-01

    The incidence and mortality of infective endocarditis (IE) in patients with severe burn remain high,which are attributed to invasive procedures,bacteremia,and wound infection after burns.Clinical clues for IE in burns are usually masked by burn-related manifestations,so the diagnosis of IE may be delayed or missed.For burned patients with persistent bacteremia of unknown source,especially Staphylococcus aureus -induced bacteremia,the diagnosis of IE should be considered according to the Duke criteria,and early echocardiography performance is particularly important.Antibiotic therapy is the mainstay initial management,and early surgical intervention is strongly recommended once IE is clearly diagnosed in patients with burns.In order to lower the incidence and mortality of IE in burns,it is very important to take prophylactic procedures along with the whole course of burn management.

  11. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  12. Severe burns as a consequence of seizures in patients with epilepsy.

    Science.gov (United States)

    Spitz, M C

    1992-01-01

    We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of striving for optimal seizure control. Two burns each occurred from an electric iron, a hand-held hair dryer, and stove-top cooking. Minimizing these activities, especially in patients with frequent consciousness-altering seizures, may be useful. Three burns occurred while showering; these resulted in the most severe injuries, with hospital stays of 29, 30, and 41 days. Simple plumbing devices may have prevented these injuries.

  13. A soil burn severity index for understanding soil-fire relations in tropical forests

    Science.gov (United States)

    Jain, T.B.; Gould, W.A.; Graham, R.T.; Pilliod, D.S.; Lentile, L.B.; Gonzalez, G.

    2008-01-01

    Methods for evaluating the impact of fires within tropical forests are needed as fires become more frequent and human populations and demands on forests increase. Short- and long-term fire effects on soils are determined by the prefire, fire, and postfire environments. We placed these components within a fire-disturbance continuum to guide our literature synthesis and develop an integrated soil burn severity index. The soil burn severity index provides a set of indicators that reflect the range of conditions present after a fire. The index consists of seven levels, an unburned level and six other levels that describe a range of postfire soil conditions. We view this index as a tool for understanding the effects of fires on the forest floor, with the realization that as new information is gained, the index may be modified as warranted. ?? Royal Swedish Academy of Sciences 2008.

  14. Resistance of the boreal forest to high burn rates.

    Science.gov (United States)

    Héon, Jessie; Arseneault, Dominique; Parisien, Marc-André

    2014-09-23

    Boreal ecosystems and their large carbon stocks are strongly shaped by extensive wildfires. Coupling climate projections with records of area burned during the last 3 decades across the North American boreal zone suggests that area burned will increase by 30-500% by the end of the 21st century, with a cascading effect on ecosystem dynamics and on the boreal carbon balance. Fire size and the frequency of large-fire years are both expected to increase. However, how fire size and time since previous fire will influence future burn rates is poorly understood, mostly because of incomplete records of past fire overlaps. Here, we reconstruct the length of overlapping fires along a 190-km-long transect during the last 200 y in one of the most fire-prone boreal regions of North America to document how fire size and time since previous fire will influence future fire recurrence. We provide direct field evidence that extreme burn rates can be sustained by a few occasional droughts triggering immense fires. However, we also show that the most fire-prone areas of the North American boreal forest are resistant to high burn rates because of overabundant young forest stands, thereby creating a fuel-mediated negative feedback on fire activity. These findings will help refine projections of fire effect on boreal ecosystems and their large carbon stocks.

  15. Oxandrolone Coadministration Does Not Alter Plasma Propranolol Concentrations in Severely Burned Pediatric Patients

    OpenAIRE

    Guillory, Ashley N.; Herndon, David N.; Silva, Michael B.; Andersen, Clark R; Suman, Oscar E.; Finnerty, Celeste C

    2017-01-01

    The systemic impact of severe burn injury results in a variety of disorders that require therapeutic intervention. Propranolol, a nonselective β1, β2-adrenergic receptor antagonist, reduces resting heart rate and cardiac work caused by elevated circulating catecholamines. Oxandrolone, a testosterone mimetic, promotes protein synthesis and anabolism to counter muscle wasting. Coadministration of these drugs is expected to synergistically improve patient outcomes. Testosterone administration is...

  16. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

    Science.gov (United States)

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  17. [Consequent use of the Aachen therapy concept after severe chemical burns of both eyes].

    Science.gov (United States)

    Herboth, T; Geerling, G; Duncker, G; Bastian, G O; Seiler, T

    1998-03-01

    Severe chemical burn and its complications still are a serious threat to the afflicted eye, particularly in case of insufficient treatment. Rehabilitation of visual acuity can be achieved only in the minority of cases. We present a 49-year-old female patient, who suffered a severe chemical burn in both eyes by alcaline detergent. Visual acuity was OD 20/50, OS light perception. After directly started acute treatment as well as peritomy, peridectomy, tenon plasty and application of a PMMA contact lens a stabilization was achieved. Complete rehabilitation of visual acuity was gained by EDTA abrasion, excimer treatment, penetrating keratoplasty and cataract surgery. Last examination showed a visual acuity of 25/20 in both eyes. Even in severe chemical burn an optimal result can be achieved by using an adequate treatment conception. Immediate beginning of therapy is important as well as persistent and persevering application of the treatment. Repeated, if necessary daily, excisions of necrotic tissue associated with tenon plasty and application of a PMMA contact lens have special importance.

  18. Prevalence and resistance of Pseudomonas aeruginosa in severely burned patients: a 10-year retrospective study.

    Science.gov (United States)

    Lipový, B; Rihová, H; Hanslianová, M; Gregorová, N; Suchánek, I; Brychta, P

    2010-01-01

    Infection complications caused by gram-negative bacteria nowadays constitute the dominant mortality cause in severely burned patients. Pseudomonas aeruginosa is the most feared nosocomial pathogen among burn centers worldwide, with the highest mortality. The study involved adult patients hospitalized at the Intensive Care Unit at the Department of Burns and Reconstructive Surgery, University Hospital Brno, between the years 2000 and 2009. These patients were hospitalized for thermal injuries. Retrospectively we have evaluated the extent of the burned areas, ages, depth of injury at admission and at discharge or in dissection (histology) and length of hospitalization on the Intensive Care Unit. By completing regular swabs we monitored and evaluated the microbiological situation not only at the burned areas but also in the lower respiratory system, in the urinary tract and in the blood stream. The study involved a total of 640 adults hospitalized at the Intensive Care Unit at the Department of Burns and Reconstructive Surgery, University Hospital Brno, for burn trauma between the years 2000 and 2009. The average extent of the burned area in patients was 36.2% TBSA (2-97% TBSA), average age was 36.7% years (18-92 years), average length of hospitalization at the Intensive Care Unit was 27.1 days (1-151 days). We isolated a total of 2,958 strains of Pseudomonas aeruginosa (including repeated isolation of pseudomonas strains in the same patients) in these patients. The most frequently found of these was Pseudomonas aeruginosa isolated from the burned area (1,301 strains), from the lower respiratory system (651) and from the urinary tract (592 strains). During the monitored period the number of strains isolated in our patients increased (146 strains in 2000, 521 strains in 2009). Furthermore, we noticed increased resistance to all available antibiotics except Polymyxins. All of the Pseudomonas aeruginosa strains in the monitored years maintained 100% sensitivity to

  19. Application of a Four-dimensional Mathematical Model in the Establishment of an Early Post-burn Cerebral Oedema Model in Severely Burned Dogs.

    Science.gov (United States)

    Haitao, L; Dajun, Y; Kaifa, W; Xiuwu, B; Jiansen, S; Zongchen, Y

    2005-06-30

    The aim of this study was to explore the spatiotemporal development of cerebral oedema in the early stage of severe burn (50% TBSA, third degree), using a four-dimensional (4D) mathematical model. Twenty-six male mongrel dogs were randomly divided into control and 6, 12, 18, and 24 post-burn hour (PBH) groups. The manifestation of magnetic resonance imaging (MRI) and histopathology, changes of brain water content, and intracranial pressure were observed in each group respectively. A 4D mathematical model was established on the basis of the results of MRI scanning. Two turning points (6 and 18 PBH) and three phases of pathological change were displayed by the 4D mathematical model of cerebral oedema in the early stage of severe burn. The first phase was in the subclinical period, and effective treatment should therefore be performed as quickly as possible in order to prevent deterioration of post-burn cerebral oedema. The second phase (6-18 PBH), with pathological characteristics of cytotoxic cerebral oedema, was in the apoptosis period. The third stage (18-24 PBH) was the danger period of cerebral oedema. Intracranial pressure increased rapidly owing to the limitation of the cranial cavity. As a result, cerebral hernia could easily occur. An S-shape curve in the pathological process of cerebral oedema occurred in the early post-burn stage following severe burn.

  20. Maggot therapy for repairing serious infective wound in a severely burned patient

    Directory of Open Access Journals (Sweden)

    WU Jun-cheng

    2012-04-01

    Full Text Available 【Abstract】The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain. Key words: Biological therapy; Wound infection; Burns; Wound healing; Debridement

  1. The effects of exercise programming vs traditional outpatient therapy in the rehabilitation of severely burned children.

    Science.gov (United States)

    Cucuzzo, N A; Ferrando, A; Herndon, D N

    2001-01-01

    The purpose of this study was to compare the efficacy and effects of exercise programming (Study group, n = 11) vs traditional outpatient therapy (Home group, n = 10) in burned children (> 40% body surface area). This was a prospective, randomized, controlled trial in a hospital-based children's wellness center. Twenty-one patients (13 boys and 8 girls) averaging 10.6 +/- 0.9 years and TBSA = 59.7 +/- 3.1% were evaluated 6 and 9 months postburn. Moderate intensity, progressive resistance and aerobic exercise conducted 3 times weekly for 1 hour were a supplement to standard therapy over 12 weeks. Muscular strength and functional outcome significantly increased in both groups (P exercise programming may be safely included in rehabilitation programs for severely burned children and can be effective in increasing muscular strength and functional outcome.

  2. Transfer of patients with severe burn injury%严重烧伤伤员的转运

    Institute of Scientific and Technical Information of China (English)

    彭毅志

    2015-01-01

    Transfer of patients with severe burn injury is an important issue during the rescue of mass casualties,as it may give rise to great influence on the prognosis of patients.Timing of transfer,preparation before transfer,and details for attention are elaborated in this article,aiming to further specify the procedures of transfer of patients with burn injury.

  3. Burning high-level TRU waste in fusion fission reactors

    Science.gov (United States)

    Shen, Yaosong

    2016-09-01

    Recently, the concept of actinide burning instead of a once-through fuel cycle for disposing spent nuclear fuel seems to get much more attention. A new method of burning high-level transuranic (TRU) waste combined with Thorium-Uranium (Th-U) fuel in the subcritical reactors driven by external fusion neutron sources is proposed in this paper. The thorium-based TRU fuel burns all of the long-lived actinides via a hard neutron spectrum while outputting power. A one-dimensional model of the reactor concept was built by means of the ONESN_BURN code with new data libraries. The numerical results included actinide radioactivity, biological hazard potential, and much higher burnup rate of high-level transuranic waste. The comparison of the fusion-fission reactor with the thermal reactor shows that the harder neutron spectrum is more efficient than the soft. The Th-U cycle produces less TRU, less radiotoxicity and fewer long-lived actinides. The Th-U cycle provides breeding of 233U with a long operation time (>20 years), hence significantly reducing the reactivity swing while improving safety and burnup.

  4. High Impetus Cool Burning Gun Propellants

    Directory of Open Access Journals (Sweden)

    R.S. Dames

    2000-07-01

    Full Text Available This study explores the possibility of reducing the flame temperature (Tf without decrease in impetus of RDX-NC matrix-based high energy gun propellants by partial replacement of RDX with triaminoguanidine nitrate (TAGN. Compositions containing TAGN as an energetic oxidiser with varying percentage of RDX have been formulated. Glycidyl azide polymer was incorporated as an energetic plasticiser to achieve the higher level of impetus. Performance in terms of ballistic parameters (theoretical/experimental sensitivity, thermal characteristics, stability and mechanical properties was evaluated and compared with the basic composition containing RDX as a single oxidiser. Experimental data indicates that the partial replacement of RDX by TAGN in gun propellant compositions decreases Tf significantly with only marginal decrease in impetus. "

  5. Effect of artificial colloids on blood coagulation during shock stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-jun; XING Nan; CHEN Jiong; SHI Jian-wu; SU Guo-liang

    2013-01-01

    Background There are controversies about the use of artificial colloids.This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury.Methods Totally,18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia.Resuscitation therapy was applied 2 hours after the injury,using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns.The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group):succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection),hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)),and allogeneic plasma group (the colloid used was allogeneic plasma).Blood samples were collected from the animals prior to the burn injury and again at intervals of 4,8,24 and 48 hours post-injury.The platelet count (PLT),prothrombin time (PT),international normalized ratio (INR),activated partial thromboplastin time (APTT),and fibrinogen (Fib) were measured,followed by a statistical analysis of all results.Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3±52.7),(78.8±16.4)×109/L and (159.0±62.8),(87.3±32.0)×109/L respectively.But in the allogeneic plasma group at intervals of 8,24,and 48 hours were (234.3±52.6),(136.0±47.4),(75.8±31.0)×109/L.The decrease were all statistically significant (P <0.05,P <0.01) when compared to pre-burn ((383.3±77.9),(382.7±65.7),(381.0±49.4)×109/L).The PLT among the three groups,at all the time points,had no statistical difference (P >0.05).Compared to pre-burn ((10.8±0.9),(11.4±0.8),(10.6±0.7) seconds),the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5±1.5) and (16.2±1.3) seconds,whereas in the allogeneic plasma group at 8 and 24 hours the PT were

  6. Changes in burn scar contracture: utilization of a severity scale and predictor of return to duty for service members.

    Science.gov (United States)

    Niedzielski, Lt Stephanie; Chapman, Maj Ted

    2015-01-01

    A medical records review of Operation Iraqi Freedom and Operation Enduring Freedom burn injury survivors admitted to the U.S. Army Institute of Surgical Research Burn Center from April 2003 to August 2005 was conducted. The study proposed the use of a newly developed scale, the Burn Scar Contracture Severity Scale, to potentially provide standardization in quantifying burn scar contracture severity. Changes in the active range of motion from in-patient discharge to out-patient follow-up of individuals with upper extremity burn injuries were compared. Changes in the impairment via American Medical Association impairment scores and perceived disability using the disabilities of the arm, shoulder, and hand questionnaire scores from the in-patient discharge to the out-patient follow-up were also compared. A weak, yet positive correlation (r = .417, .451, P ≤ .001) between the proposed scale and the disabilities of the arm, shoulder, and hand questionnaire and the American Medical Association impairment scores was found, respectively. A receiver operating characteristic curve analysis revealed a cut-off score of 6.5 for the burn scar contracture severity scale, indicating that individuals scoring below a 6.5 returned to duty and those scoring above 6.5 did not return to duty. Results suggest that the burn scar contracture severity scale is able to discriminate between the individuals who returned to duty and those who did not return to duty.

  7. 重度烧伤病人的睡眠管理%Sleep management of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    刘志宣

    2013-01-01

    Based on the observation and analysis of the factors of severe burn patients sleep effect, summed up the effective management method of sleep quality of severe burn patients. To improve the sleep quality of patients with severe burn, promote early recovery of patients with severe burn, and decrease the rate of disability, and even death, has a very important significance.%本文通过对重度烧伤病人睡眠影响因素的观察与分析,总结出对重度烧伤病人睡眠质量的有效管理方法。对提高重度烧伤病人的睡眠质量,促进重度重度烧伤病人早日康复,并降低其致残率,甚至死亡率,具有非常重要的意义。

  8. Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol.

    Science.gov (United States)

    Guo, Z G; Jia, X P; Wang, X Y; Li, P; Su, X J; Hao, J H

    2015-07-13

    This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.

  9. Effect of burn-up and high burn-up structure on spent nuclear fuel alteration

    Energy Technology Data Exchange (ETDEWEB)

    Clarens, F.; Gonzalez-Robles, E.; Gimenez, F. J.; Casas, I.; Pablo, J. de; Serrano, D.; Wegen, D.; Glatz, J. P.; Martinez-Esparza, A.

    2009-07-01

    In this report the results of the experimental work carried out within the collaboration project between ITU-ENRESA-UPC/CTM on spent fuel (SF) covering the period 2005-2007 were presented. Studies on both RN release (Fast Release Fraction and matrix dissolution rate) and secondary phase formation were carried out by static and flow through experiments. Experiments were focussed on the study of the effect of BU with two PWR SF irradiated in commercial reactors with mean burn-ups of 48 and 60 MWd/KgU and; the effect of High Burn-up Structure (HBS) using powdered samples prepared from different radial positions. Additionally, two synthetic leaching solutions, bicarbonate and granitic bentonite ground wa ter were used. Higher releases were determined for RN from SF samples prepared from the center in comparison with the fuel from the periphery. However, within the studied range, no BU effect was observed. After one year of contact time, secondary phases were observed in batch experiments, covering the SF surface. Part of the work was performed for the Project NF-PRO of the European Commission 6th Framework Programme under contract no 2389. (Author)

  10. Application of a Four-dimensional Mathematical Model in the Establishment of an Early Post-burn Cerebral Oedema Model in Severely Burned Dogs

    OpenAIRE

    Haitao, L.; Dajun, Y.; Kaifa, W.; Xiuwu, B.; Jiansen, S.; Zongchen, Y.

    2005-01-01

    The aim of this study was to explore the spatiotemporal development of cerebral oedema in the early stage of severe burn (50% TBSA, third degree), using a four-dimensional (4D) mathematical model. Twenty-six male mongrel dogs were randomly divided into control and 6, 12, 18, and 24 post-burn hour (PBH) groups. The manifestation of magnetic resonance imaging (MRI) and histopathology, changes of brain water content, and intracranial pressure were observed in each group respectively. A 4D mathem...

  11. Increased expression of atrogenes and TWEAK family members after severe burn injury in nonburned human skeletal muscle.

    Science.gov (United States)

    Merritt, Edward K; Thalacker-Mercer, Anna; Cross, James M; Windham, Samuel T; Thomas, Steven J; Bamman, Marcas M

    2013-01-01

    Severe burn induces rapid skeletal muscle proteolysis after the injury, which persists for up to 1 year and results in skeletal muscle atrophy despite dietary and rehabilitative interventions. The purpose of this research was to determine acute changes in gene expression of skeletal muscle mass regulators postburn injury. Specimens were obtained for biopsy from the vastus lateralis of a nonburned leg of eight burned subjects (6M, 2F: 34.8 ± 2.7 years: 29.9 ± 3.1% TBSA burn) at 5.1 ± 1.1 days postburn injury and from matched controls. mRNA expression of cytokines and receptors in the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) families, and the ubiquitin proteasome E3 ligases, atrogin-1 and MuRF-1, was determined. TNF receptor 1A was over 3.5-fold higher in burn. Expression of TNF-like weak inducer of apoptosis and its receptor were over 1.6 and 6.0-fold higher in burn. IL-6, IL-6 receptor, and glycoprotein 130 were elevated in burned subjects with IL-6 receptor over 13-fold higher. The level of suppressor of cytokine signaling-3 was also increased nearly 6-fold in burn. Atrogin-1 and MuRF-1 were more than 4- and 3-fold higher in burn. These results demonstrate for the first time that severe burn in humans has a remarkable impact on gene expression in skeletal muscle of a nonburned limb of genes that promote inflammation and proteolysis. Because these changes likely contribute to the acute skeletal muscle atrophy in areas not directly affected by the burn, in the future it will be important to determine the responsible systemic cues.

  12. Simulating Local and Intercontinental Pollutant Effects of Biomass Burning: Integration of Several Remotely Sensed Datasets

    Science.gov (United States)

    Chatfield, Robert B.; Vastano, John A.; Guild, Liane; Hlavka, Christine; Brass, James A.; Russell, Philip B. (Technical Monitor)

    1994-01-01

    Burning to clear land for crops and to destroy pests is an integral and largely unavoidable part of tropical agriculture. It is easy to note but difficult to quantify using remote sensing. This report describes our efforts to integrate remotely sensed data into our computer model of tropical chemical trace-gas emissions, weather, and reaction chemistry (using the MM5 mesoscale model and our own Global-Regional Atmospheric Chemistry Simulator). The effects of burning over the continents of Africa and South America have been noticed in observations from several satellites. Smoke plumes hundreds of kilometers long may be seen individually, or may merge into a large smoke pall over thousands of kilometers of these continents. These features are related to intense pollution in the much more confined regions with heavy burning. These emissions also translocate nitrogen thousands of kilometers in the tropical ecosystems, with large fixed-nitrogen losses balanced partially by locally intense fertilization downwind, where nitric acid is rained out. At a much larger scale, various satellite measurements have indicated the escape of carbon monoxide and ozone into large filaments which extend across the Tropical and Southern Atlantic Ocean. Our work relates the source emissions, estimated in part from remote sensing, in part from conventional surface reports, to the concentrations of these gases over these intercontinental regions. We will mention work in progress to use meteorological satellite data (AVHRR, GOES, and Meteosat) to estimate the surface temperature and extent and height of clouds, and explain why these uses are so important in our computer simulations of global biogeochemistry. We will compare our simulations and interpretation of remote observations to the international cooperation involving Brazil, South Africa, and the USA in the TRACE-A (Transport and Atmospheric Chemistry near the Equator - Atlantic) and SAFARI (Southern Africa Fire Atmosphere Research

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

    Science.gov (United States)

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

    2015-06-01

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

  14. LONG-TERM ASSESSMENT OF ECCENTRIC, ISOMETRIC, CONCENTRIC MUSCLE STRENGTH AND FUNCTIONAL CAPACITY AFTER SEVERELY BURNED ADULT

    Directory of Open Access Journals (Sweden)

    Anwar Abdelgayed Ebid

    2015-06-01

    Full Text Available Background: Severe burn leads to marked and prolonged skeletal muscle catabolism and weakness. Objective: The aim of this study was to investigate the long term effect of severe burn injury on eccentric, concentric, isometric muscle torque, average power, lean body mass, six minute walk and 8-foot walk. Design: Eccentric, isometric and concentric muscle torque and average power were assessed at 24 months in burned adult with 40%-50% total body surface area (TBSA at 150 o/s by using isokinetic dynamometry, Total lean body mass (TLBM and lower limb mass (LLM measurements were assessed for both groups using dual energy X-ray absorptiometry. Functional capacity was assessed using six minute walk test (6MWT and 8-Feet walk test. Lean body mass (LBM was determined via dual energy X-ray absorptiometry. Nonburned adult was assessed similarly, and served as controls. Results: severely burned adult (n=35, relative to nonburned adult (n=42 had significantly lower peak torque of eccentric, isometric, concentric muscle strength, average power and functional capacity. The most affected type of muscle strength after burn was concentric, isometric then eccentric. Conclusions: Our results serve as an objective data for assessing the three modes of muscle strength and functional capacity in severely burned adult population.

  15. High explosive programmed burn in the FLAG code

    Energy Technology Data Exchange (ETDEWEB)

    Mandell, D.; Burton, D.; Lund, C.

    1998-02-01

    The models used to calculate the programmed burn high-explosive lighting times for two- and three-dimensions in the FLAG code are described. FLAG uses an unstructured polyhedra grid. The calculations were compared to exact solutions for a square in two dimensions and for a cube in three dimensions. The maximum error was 3.95 percent in two dimensions and 4.84 percent in three dimensions. The high explosive lighting time model described has the advantage that only one cell at a time needs to be considered.

  16. Systematic approach to verification and validation: High explosive burn models

    Energy Technology Data Exchange (ETDEWEB)

    Menikoff, Ralph [Los Alamos National Laboratory; Scovel, Christina A. [Los Alamos National Laboratory

    2012-04-16

    , run a simulation, and generate a comparison plot showing simulated and experimental velocity gauge data. These scripts are then applied to several series of experiments and to several HE burn models. The same systematic approach is applicable to other types of material models; for example, equations of state models and material strength models.

  17. Learn from the burn: The High Park Fire 5 years later

    Science.gov (United States)

    Sue Miller; Charles Rhodes; Pete Robichaud; Sandra Ryan; Jen Kovecses; Carl Chambers; Sara Rathburn; Jared Heath; Stephanie Kampf; Codie Wilson; Dan Brogan; Brad Piehl; Mary Ellen Miller; John Giordanengo; Erin Berryman; Monique Rocca

    2017-01-01

    It has been 5 years since the High Park Fire burned over 85,000 acres in Northern Colorado, causing extensive property damage, loss of life, and severe impacts to the water quality of the Poudre River. In the fall of 2016, a conference was organized by the USFS Rocky Mountain Research Station and the Coalition for the Poudre River Watershed to discuss what has been...

  18. Effects of glycyl-glutamine dipeptide supplementation on myocardial damage and cardiac function in rats after severe burn injury.

    Science.gov (United States)

    Zhang, Yong; Yan, Hong; Lv, Shang-Gun; Wang, Lin; Liang, Guang-Ping; Wan, Qian-Xue; Peng, Xi

    2013-01-01

    Glutamine decreases myocardial damage in ischemia/reperfusion injury. However, the cardioprotective effect of glutamine after burn injury remains unclear. Present study was to explore the protective effect of glycyl-glutamine dipeptide on myocardial damage in severe burn rats. Seventy-two Wistar rats were randomly divided into three groups: normal control (C), burned control (B) and glycyl-glutamine dipeptide-treated (GG) groups. B and GG groups were inflicted with 30% total body surface area of full thickness burn. The GG group was given 1.5 g/kg glycyl-glutamine dipeptide per day and the B group was given the same dose of alanine via intraperitoneal injection for 3 days. The serum CK, LDH, AST, and, blood lactic acid levels, as well as the myocardium ATP and GSH contents, were measured. The indices of cardiac contractile function and histopathological change were analyzed at 12, 24, 48, and 72 post-burn hours (PBH). The serum CK, LDH, AST and blood lactic acid levels increased, and the myocardium ATP and GSH content decreased in both burned groups. Compared with B group, the CK, LDH, AST and blood lactic acid levels reduced, myocardium ATP and GSH content increased in GG group. Moreover, the inhibition of cardiac contractile function and myocardial histopathological damage were reduced significantly in GG group. We conclude that myocardial histological structure and function were damaged significantly after burn injury, glycyl-glutamine dipeptide supplementation is beneficial to myocardial preservation by improving cardiocyte energy metabolism, increasing ATP and glutathione synthesis.

  19. Characterizing demographics, injury severity, and intubation status for patients transported by air or ground ambulance to a rural burn center.

    Science.gov (United States)

    Ahmed, Azeemuddin; Van Heukelom, Paul; Harland, Karisa; Denning, Gerene; Liao, Junlin; Born, Janelle; Latenser, Barbara

    2014-01-01

    Our study was designed to characterize intubation status among patients transported by air or ground ambulance to a rural burn center. A retrospective chart review of patients arriving at our burn center from January 1, 2005 to December 31, 2009 was completed. Descriptive and multivariate analyses were performed. During the study period, 259 air and 590 ground ambulance patients met inclusion criteria. Air ambulance patients were older and had higher total body surface area burned, lower Glasgow Coma scores, longer lengths of stay, and more frequent inhalation injuries. Approximately 10% of patients arriving by air were intubated after burn center admission, and 49% of intubated patients were extubated within 24 hours of admission. These values were 2% and 40%, respectively, for patients transported by ground. Increasing age and air ambulance transport increased the overall likelihood of change in intubation status. The likelihood of intubation by burn center providers increased with age, with suspicion of inhalation injury, and for patients transported by air. The likelihood of extubation within 24 hours of burn center admission increased with age, decreased with suspected inhalation injury, and was independent of transport mode. Among our patient population, more severely injured patients were being transported by air ambulance. However, age, suspicion of inhalation injury, and mode of transport showed a complex pattern of associations with changes in intubation status, and illustrate the need to develop better prehospital guidelines for intubation in burn patients.

  20. Oxandrolone induced lean mass gain during recovery from severe burns is maintained after discontinuation of the anabolic steroid.

    Science.gov (United States)

    Demling, Robert H; DeSanti, Leslie

    2003-12-01

    Weight loss and lean mass loss from burn induced catabolism can be more rapidly restored when the anabolic steroid oxandrolone is added to optimum nutrition compared to nutrition alone. Our purpose in this study was to determine whether the regained lean body mass (LBM) is retained 6 months after stopping oxandrolone. Forty-five severe burn patients, entering the recovery phase were randomized into a nutrition group alone or with the addition of oxandrolone, 20mg per day upon admission to the acute burn rehabilitation (RH) unit. Oxandrolone was discontinued after at least 80% of the involuntary weight loss occurring in the acute burn period, was restored. Body composition was measured using bioelectric impedence analysis (BIA). We found that patients receiving oxandrolone, in the rehabilitation unit, regained weight and lean mass two to three times faster than with nutrition alone. The difference was statistically significant (Ppatients were discharged from RH on a nutrition and exercise program and monitored in the outpatient burn center. After 6 months, body weight and body composition were again measured. We found that the body weight and lean mass which was restored during RH, was maintained 6 months after discontinuation of oxandrolone. Lost lean mass was not yet restored in the nutrition alone group. We can conclude that body weight and lean mass which is lost, due to burn induced catabolism, can be effectively restored in the post-burn recovery period with oxandrolone. The body weight and lost lean mass which is regained, is maintained 6 months after stopping the drug.

  1. [Standardisation of the Initial Treatment of Severely Burned Patients: The Necessary Transfer of Concepts from Trauma Care].

    Science.gov (United States)

    Münzberg, M; Harbers, T; Kneser, U; Grützner, P A; Reichert, B; Kremer, T; Wölfl, C G; Horter, J; Hirche, C

    2016-12-01

    The initial treatment of severely burned patients remains a huge challenge for first responders in emergency services as well as emergency doctors who do not work in a centre for severe burn injuries. The reason for this is the low number of cases in developed countries and a lack of training concepts for the specific aspects of the initial treatment of severe burn injuries. Because of guidelines with limited evidence (S1, S2k) and a lack of structured treatment approaches, uncertainties with respect to initial treatment are still visible. Even within the professional societies and on international comparison, controversial aspects remain. In contrast, optimised and standardised procedures are available for the treatment of severely injured (trauma) patients, based on PHTLS® (Pre Hospital Trauma Life Support) for preclinical and ATLS® (Advanced Trauma Life Support) for in-hospital first aid. This article takes stock of the current structure of care and the relevant evidence for the initial treatment of severe burns. Also it discusses a possible transfer and further development of concepts for primary trauma care by all disciplines involved. Nine essential steps in the primary care of burned patients are identified and evaluated. The need for the introduction of a uniform treatment algorithm is illustrated. The treatment algorithm presented in this article addresses all first responders who are faced with initial treatment in the first 24 hours outside of burn centres. As an essential, new aspect, it offers a transfer and adaptation of concepts from trauma care to standardise the care of severely burned patients.

  2. High-voltage electrical burns due to copper theft - Case series.

    Science.gov (United States)

    Braga, M J; Oliveira, I; Egipto, P; Silva, A

    2016-03-31

    Electrical burns are among the most devastating trauma inflicted on the human body. These burns have a higher morbidity, length of stay and a much higher risk of amputation than any other type of burn. Electrical burns affect mostly young, working males because they are more frequently the result of a work accident. However, possibly due to the worldwide economic crisis, we are experiencing a new phenomenon: the theft of high-voltage copper wiring.

  3. High-voltage electrical burns due to copper theft – Case series

    Science.gov (United States)

    Braga, M.J.; Oliveira, I.; Egipto, P.; Silva, A.

    2016-01-01

    Summary Electrical burns are among the most devastating trauma inflicted on the human body. These burns have a higher morbidity, length of stay and a much higher risk of amputation than any other type of burn. Electrical burns affect mostly young, working males because they are more frequently the result of a work accident. However, possibly due to the worldwide economic crisis, we are experiencing a new phenomenon: the theft of high-voltage copper wiring. PMID:27857650

  4. Thermodynamic analysis for high burn-up fuel internal chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Fuji, Kensho; Kyoh, Bunkei [Kinki Univ., Higashi-Osaka, Osaka (Japan). Faculty of Science and Technology

    1997-09-01

    Chemical states of fission products and actinide elements in high burn-up LWR fuel pellets have been analyzed thermodynamically using the computer program SOLGASMIX-PV. Calculations with this computer code have been performed for a complex multi-component system, which comprises 54 chemical species. The analysis shows that neither alkali nor alkaline-earth uranates are formed, but alkali and alkaline-earth molybdates exist in irradiated LWR fuel pellets in contrast with their post irradiation examinations. These molybdates tend to increase with increasing oxygen potential in the fuel under operating conditions, whereas the zirconates decrease. (author)

  5. Maggot therapy for repairing serious infective wound in a severely burned patient

    Institute of Scientific and Technical Information of China (English)

    WU Jun-cheng; LU Ren-rong; HUO Ran; FU Hong-bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn.A total of 50 000 aseptic maggots were put onto the infective wound surface,and aseptic dressings overlaid the surface.Three days later,another 20 000 maggots were put onto the wound for the second therapy.After twice maggot debridement,most necrotic muscle tissues of the wound were cleaned up,and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting.The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

  6. Severe Burns and Amputation of Both Arms in the First Psychotic Episode of a Schizophrenic Patient

    Directory of Open Access Journals (Sweden)

    Lizardo Cruzado

    2015-01-01

    Full Text Available An alleged reduction of sensitivity to pain in people with schizophrenia has been reported, but the nature of this complex phenomenon has not been elucidated yet. Reports of insensitivity to burns from people with schizophrenia are extremely rare. We report the case of a 24-year-old man who set both of his arms on fire during the first break of paranoid schizophrenia. As a result of severe tissue damage, both of his limbs had to be amputated. Today, at the age of 59, the patient is physically and mentally rehabilitated and is adherent to treatment. Additionally, given the uncertainty about the true nature of the alleged hypoalgesia in schizophrenia, we postulate the need for a comprehensive phenomenological approach in the study of embodiment in people with this condition.

  7. Upper gastrointestinal bleeding in severely burned patients: a case-control study to assess risk factors, causes, and outcome.

    Science.gov (United States)

    Kim, Young Jin; Koh, Dong Hee; Park, Se Woo; Park, Sun Man; Choi, Min Ho; Jang, Hyun Joo; Kae, Sea Hyub; Lee, Jin; Byun, Hyun Woo

    2014-01-01

    To determine the risk factors, causes, and outcome of clinically important upper gastrointestinal bleeding that occurs in severely burned patients. The charts of all patients admitted to the burn intensive care unit were analyzed retrospectively over a 4-year period (from January 2006 to December 2009). Cases consisted of burned patients who developed upper gastrointestinal bleeding more than 24 hours after admission to the burn intensive care unit. Controls were a set of patients, in the burn intensive care unit, without upper gastrointestinal bleeding matched with cases for age and gender. Cases and controls were compared with respect to the risk factors of upper gastrointestinal bleeding and outcomes. During the study period, clinically important upper gastrointestinal bleeding occurred in 20 patients out of all 964 patients. The most common cause of upper gastrointestinal bleeding was duodenal ulcer (11 of 20 cases, 55%). In the multivariate analysis, mechanical ventilation (p = 0.044) and coagulopathy (p = 0.035) were found to be the independent predictors of upper gastrointestinal bleeding in severely burned patients. Upper gastrointestinal hemorrhage tends to occur more frequently after having prolonged mechanical ventilation and coagulopathy.

  8. Plasma proteome response to severe burn injury revealed by 18O-labeled "universal" reference-based quantitative proteomics.

    Science.gov (United States)

    Qian, Wei-Jun; Petritis, Brianne O; Kaushal, Amit; Finnerty, Celeste C; Jeschke, Marc G; Monroe, Matthew E; Moore, Ronald J; Schepmoes, Athena A; Xiao, Wenzhong; Moldawer, Lyle L; Davis, Ronald W; Tompkins, Ronald G; Herndon, David N; Camp, David G; Smith, Richard D

    2010-09-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the 12 most abundant plasma proteins with cysteinyl-peptide enrichment-based fractionation prior to LC-MS analyses of individual patient samples. Incorporation of an 18O-labeled "universal" reference among the sample sets enabled precise relative quantification across samples. In total, 313 plasma proteins confidently identified with two or more unique peptides were quantified. Following statistical analysis, 110 proteins exhibited significant abundance changes in response to the burn injury. The observed changes in protein concentrations suggest significant inflammatory and hypermetabolic response to the injury, which is supported by the fact that many of the identified proteins are associated with acute phase response signaling, the complement system, and coagulation system pathways. The regulation of approximately 35 proteins observed in this study is in agreement with previous results reported for inflammatory or burn response, but approximately 50 potentially novel proteins previously not known to be associated with burn response or inflammation are also found. Elucidating proteins involved in the response to severe burn injury may reveal novel targets for therapeutic interventions as well as potential predictive biomarkers for patient outcomes such as multiple organ failure.

  9. High pressure droplet burning experiments in reduced gravity

    Science.gov (United States)

    Chauveau, Christian; Goekalp, Iskender

    1995-01-01

    A parametric investigation of single droplet gasification regimes is helpful in providing the necessary physical ideas for sub-grid models used in spray combustion numerical prediction codes. A research program has been initiated at the LCSR to explore the vaporization regimes of single and interacting hydrocarbon and liquid oxygen droplets under high pressure conditions. This paper summarizes the status of the LCSR program on the high pressure burning of single fuel droplets; recent results obtained under normal and reduced gravity conditions with suspended droplets are presented. In the work described here, parabolic flights of the CNES Caravelle is used to create a reduced gravity environment of the order of 10(exp -2) g(sub O). For all the droplet burning experiments reported here, the suspended droplet initial diameters are scattered around 1.5 mm; and the ambient air temperature is 300 K. The ambient pressure is varied between 0.1 MPa and 12 MPa. Four fuels are investigated: methanol (Pc = 7.9 MPa), n-heptane (Pc = 2.74 MPa), n-hexane (Pc = 3.01 MPa) and n-octane (Pc = 2.48 MPa).

  10. Computerized Decision Support System Improves Fluid Resuscitation Outcomes Following Severe Burns: An Original Study

    Science.gov (United States)

    2011-01-01

    stantial plasma volume deficit during the initial 48 hrs post burn, which engenders hypovolemic shock and generalized edema formation (4). These include a...3). Burn manage- ment requires specialized expertise and treatment options that may not normally be available at nonburn centers. In addi- tion...principal fluid shift into the surrounding interstitial space (i.e., third-spacing) that has to be treated to avoid burn shock conditions (5–6). *See

  11. Role of Central American biomass burning smoke in increasing tornado severity in the US

    Science.gov (United States)

    Saide, P. E.; Spak, S.; Pierce, R.; Otkin, J.; Rabin, R.; Schaack, T.; Heidinger, A. K.; da Silva, A.; Kacenelenbogen, M. S.; Redemann, J.; Carmichael, G. R.

    2013-12-01

    Violent tornadoes in the Southeast and Central US during spring are often accompanied by smoke from biomass burning in Central America. We analyzed the effect of smoke on a historic severe weather outbreak that occurred 27 April 2011 using a coupled aerosol, chemistry and weather model (WRF-Chem) and a suite of satellite and ground-based observations. Smoke from Central American biomass burning was present in the boundary layer and lower free troposphere before and during the storm outbreak. Simulations show that adding smoke to the environment already conducive to severe thunderstorm development increases the likelihood of significant tornado occurrence, which is assessed by analyzing effects of smoke on meteorological conditions (tornado parameters) used by prediction centers to forecast tornado occurrence and severity. Smoke effects generate slightly lower rain rates and cloud top heights, indicating no evidence of storm invigoration for these storms and instead pointing towards convection inhibition. Further analysis shows that there are two mechanisms responsible for the parameter intensification: First, through indirect effects, stratiform clouds present during and before the outbreak became optically thicker, which reduced the amount of solar radiation reaching the ground and produced more stable conditions and higher low-level shear in the mixed layer. Second, through semi-direct effects, soot contained in the smoke heated the aerosol layer stabilizing the atmosphere and enhancing cloud cover below the aerosol layer, producing a more stable boundary layer and conditions leading to higher probability of violent tornadoes. The inclusion of aerosol-cloud-radiation interactions in weather forecasts may help improve the predictability of these extreme events, which can improve the timeliness and accuracy of severe weather alerts within future operational forecast systems. Left panel: Back trajectories from the beginning of violent tornado tracks, with circles

  12. High-fidelity plasma codes for burn physics

    Energy Technology Data Exchange (ETDEWEB)

    Cooley, James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Graziani, Frank [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Marinak, Marty [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Murillo, Michael [Michigan State Univ., East Lansing, MI (United States)

    2016-10-19

    Accurate predictions of equation of state (EOS), ionic and electronic transport properties are of critical importance for high-energy-density plasma science. Transport coefficients inform radiation-hydrodynamic codes and impact diagnostic interpretation, which in turn impacts our understanding of the development of instabilities, the overall energy balance of burning plasmas, and the efficacy of self-heating from charged-particle stopping. Important processes include thermal and electrical conduction, electron-ion coupling, inter-diffusion, ion viscosity, and charged particle stopping. However, uncertainties in these coefficients are not well established. Fundamental plasma science codes, also called high-fidelity plasma codes, are a relatively recent computational tool that augments both experimental data and theoretical foundations of transport coefficients. This paper addresses the current status of HFPC codes and their future development, and the potential impact they play in improving the predictive capability of the multi-physics hydrodynamic codes used in HED design.

  13. High-fidelity plasma codes for burn physics

    Energy Technology Data Exchange (ETDEWEB)

    Cooley, James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Graziani, Frank [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Marinak, Marty [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Murillo, Michael [Michigan State Univ., East Lansing, MI (United States)

    2016-10-19

    Accurate predictions of equation of state (EOS), ionic and electronic transport properties are of critical importance for high-energy-density plasma science. Transport coefficients inform radiationhydrodynamic codes and impact diagnostic interpretation, which in turn impacts our understanding of the development of instabilities, the overall energy balance of burning plasmas, and the efficacy of selfheating from charged-particle stopping. Important processes include thermal and electrical conduction, electron-ion coupling, inter-diffusion, ion viscosity, and charged particle stopping. However, uncertainties in these coefficients are not well established. Fundamental plasma science codes, also called high-fidelity plasma codes are a relatively recent computational tool that augments both experimental data and theoretical foundations of transport coefficients. This paper addresses the current status of HFPC codes and their future development, and the potential impact they play in improving the predictive capability of the multi-physics hydrodynamic codes used in HED design.

  14. Long-term skeletal muscle mitochondrial dysfunction is associated with hypermetabolism in severely burned children

    Science.gov (United States)

    The long-term impact of burn trauma on skeletal muscle bioenergetics remains unknown. Here, we determined respiratory capacity and function of skeletal muscle mitochondria in healthy individuals and in burn victims for up to two years post-injury. Biopsies were collected from the m. vastus lateralis...

  15. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Directory of Open Access Journals (Sweden)

    Ravi F Sood

    Full Text Available Hypertrophic scarring (HTS is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs in MAPK-pathway genes would be associated with severity of post-burn HTS.We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing.Our study population consisted of 538 adults (median age 40 years who were predominantly White (76% males (71% admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area. Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5% was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6. In gene-based analysis, PTPN5 (P = 1.2×10-5 showed a significant association and BDNF (P = 9.5×10-4 a borderline-significant association with HTS severity.We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  16. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Science.gov (United States)

    Sood, Ravi F; Arbabi, Saman; Honari, Shari; Gibran, Nicole S

    2016-01-01

    Hypertrophic scarring (HTS) is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK) pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs) in MAPK-pathway genes would be associated with severity of post-burn HTS. We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS) assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing. Our study population consisted of 538 adults (median age 40 years) who were predominantly White (76%) males (71%) admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area). Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5%) was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6). In gene-based analysis, PTPN5 (P = 1.2×10-5) showed a significant association and BDNF (P = 9.5×10-4) a borderline-significant association with HTS severity. We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  17. 高频超声组织谐波技术及多普勒血流成像技术在四肢深度电烧伤诊断中的应用%The Application of High-frequency Ultrasound Tissue Harmonic Imaging and Doppler Vascular Imaging Techniques in the Diagnosis of Severe Electrical Burns in Extremities

    Institute of Scientific and Technical Information of China (English)

    郭瑜峰; 陈浩杰; 于新国; 朱维平; 陈国华; 王意达; 王怡

    2013-01-01

      目的:探讨高频超声组织谐波技术及多普勒血流成像技术在四肢深度电烧伤诊疗中的应用价值。方法:2008年12月-2010年8月笔者对本科收治的15例四肢深度电烧伤患者手术前后使用超声组织谐波成像技术及多普勒血流成像技术进行全面检查,观察软组织损伤情况及范围,测量血流相关参数,判断血管损伤程度。结果:共检测患肢28条,上肢19条,下肢 9条。组织谐波技术所得到的声像图能准确显示软组织受损程度及范围,判断肌组织坏死情况。彩色多普勒及频谱多普勒技术能对血管受损情况做出准确判断,检测出7例血栓形成病例。术前超声检查结果与手术中所见一致。术后超声检查可以动态追踪软组织恢复情况并检测血管内血流动力学参数,并据此评估疗效。结论:高频超声组织谐波技术及多普勒血流成像技术应用于重度电烧伤患肢可在手术前后实时、形象、直观地显示组织、血管损伤的形态学及功能学变化,具有很高的临床应用价值。%Objective:To evaluate the diagnosis value of high-frequency ultrasound tissue harmonic imaging and Doppler vascular imaging techniques in the treatment of severe electrical burns in limbs.Method:From December 2008 to August 2010,fifteen patients with severe electrical burns in limbs were admitted to author’s hospital. Ultrasound tissue harmonic imaging and Doppler vascular imaging techniques were applied in the thorough ultrasonogarphy examination of their limbs pre- and post-operatively,with the special attention to the extension and damage level of suffered soft tissue and vasculars.Result:Altogether,twenty-eight limbs,nineteen upper extremities and nine lower extremities,were examined.Sonograms acquired by tissue harmonic imaging technique could precisely show the extension and damage level of suffered soft and muscular tissues. Doppler vascular imaging

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

    Directory of Open Access Journals (Sweden)

    Talita de Oliveira Melo

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

  19. Using "The Burns Suite" as a Novel High Fidelity Simulation Tool for Interprofessional and Teamwork Training.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2016-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. The authors recently published the concept of "The Burns Suite" (TBS) as a novel tool to advance the delivery of burns education for residents/clinicians. Effectively, TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. Recently, simulation-based team training (SBTT) has been advocated as a means to improve interprofessional practice. The authors aimed to explore the role of TBS in SBTT. A realistic pediatric burn resuscitation scenario was designed based on "advanced trauma and life support" and "emergency management of severe burns" principles, refined utilizing expert opinion through cognitive task analysis. The focus of this analysis was on nontechnical and interpersonal skills of clinicians and nurses within the scenario, mirroring what happens in real life. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's alpha was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twenty-two participants completed TBS resuscitation scenario. Mean face and content validity ratings were high (4.4 and 4.7 respectively; range 4-5). The internal consistency of questions was high. Qualitative data analysis revealed two new themes. Participants reported that the experience felt particularly authentic because the simulation had high psychological and social fidelity, and there was a demand for such a facility to be made available to improve nontechnical skills and interprofessional relations. TBS provides a realistic, novel tool for SBTT, addressing both nontechnical and interprofessional team skills. Recreating clinical challenge is crucial to optimize SBTT. With a better understanding of the theories underpinning simulation and interprofessional education, future simulation scenarios can be designed to provide

  20. Comparison Between Surf and Multi-Shock Forest Fire High Explosive Burn Models

    Energy Technology Data Exchange (ETDEWEB)

    Greenfield, Nicholas Alexander [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-07-18

    PAGOSA1 has several different burn models used to model high explosive detonation. Two of these, Multi-Shock Forest Fire and Surf, are capable of modeling shock initiation. Accurately calculating shock initiation of a high explosive is important because it is a mechanism for detonation in many accident scenarios (i.e. fragment impact). Comparing the models to pop-plot data give confidence that the models are accurately calculating detonation or lack thereof. To compare the performance of these models, pop-plots2 were created from simulations where one two cm block of PBX 9502 collides with another block of PBX 9502.

  1. 高原烧伤大鼠脑损伤与丙二醛、超氧化物歧化酶含量变化%Early changes of injured brain tissues and superoxide dismutase and malondialdehyde in severely burned rats after delayed fluid resuscitation at high altitude

    Institute of Scientific and Technical Information of China (English)

    蔡黔; 刘毅; 张斌; 张鲜英; 郑荣梁

    2008-01-01

    Objective To explore the early changes of the superoxide dismutase (SOD) and malondialdehyde (MDA) in rata' brain in earlier period after severe burn with delayed fluid resuscitation at high altitude and the relation with cerebral injury. Methods At 3800 m, the experimental bum animal model ( TBSA 30% , Ⅲ° ) of high altitude was designed. One hundred and thirty male Wistar rats were randomly divided into 4 groups:group A (immediate fluid resuscitation group), group B (delayed fluid resuscitation group) ,group C (normal control group at high altitude) and group D (normal control group at Lanzhou region,1517 m). At different time points (post-burn 1,6,12,24,72 h and 7 day) after bum,the levels of SOD and MDA in rats' brain were measured by spectrophotography, brain water was determined by drying eleetrothermostat and the apoptosis ceils in pallium were detected by terminal deoxynucleotidyl transferase[ TdT] -mediated deoxyuridinetriphate [ dUTP] nick end-labeling (TUNEL) staining. Results The activity of SOD in rats' brain in group A was obviously decreased at 24 h post burn. Apart from at 12 h post bum,the aetivity of SOD in group B was reduced as compared with group A at above time points (P<0.05). The contents of MDA in rats' brain in group A were increased obviously, and reached the peak at 12 h post burn. The change tendency of contents of MDA in group B was same as that in group A, but the contents of MDA at 7 day post bum in group B were higher than in group C and group D. Brain water and the apoptosis cells in pallium were increased. Condusion After severe burn with delayed fluid resuseitation at high altitude,contents of MDA were increased and SOD exhausted in rata' brain,indicating that these may be involved in the mechanisms of pathophysiology of brain injury.%目的 观察高原严重烧伤延迟复苏后早期大鼠脑组织中丙二醛及超氧化物歧化酶含量变化及其与脑损伤的关系.方法 130只

  2. A pilot evaluation study of high resolution digital thermal imaging in the assessment of burn depth.

    Science.gov (United States)

    Hardwicke, Joseph; Thomson, Richard; Bamford, Amy; Moiemen, Naiem

    2013-02-01

    Thermal imaging is a tool that can be used to determine burn depth. We have revisited the use of this technology in the assessment of burns and aim to establish if high resolution, real-time technology can be practically used in conjunction with clinical examination to determine burn depth. 11 patients with burns affecting upper and lower limbs and the anterior and posterior trunk were included in this study. Digital and thermal images were recorded at between 42 h and 5 days post burn. When compared to skin temperature, full thickness burns were significantly cooler (pburns (pburns were not significantly different in temperature than non-burnt skin (p>0.05). Typically, full thickness burns were 2.3°C cooler than non-burnt skin; deep partial thickness burns were 1.2°C cooler than non-burnt skin; whilst superficial burns were only 0.1°C cooler. Thermal imaging can correctly determine difference in burn depth. The thermal camera produces images of high resolution and is quick and easy to use. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  3. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part II)*.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-09-30

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society. Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  4. Nutritional and pharmacological modulation of the metabolic response of severely burned patients: review of the literature (part 1).

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-06-30

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society. Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  5. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part III)*.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-12-31

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society.Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  6. Quantitative assessments of burn degree by high-frequency ultrasonic backscattering and statistical model

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yi-Hsun; Wang, Shyh-Hau [Department of Computer Science and Information Engineering, and Institute of Medical Informatics, National Cheng Kung University, No 1, University Road, Tainan City 70101, Taiwan (China); Huang, Chih-Chung, E-mail: shyhhau@mail.ncku.edu.tw [Department of Electrical Engineering, Fu Jen Catholic University, 510, Chung Cheng Rd, Hsin Chuang, Taipei County 24205, Taiwan (China)

    2011-02-07

    An accurate and quantitative modality to assess the burn degree is crucial for determining further treatments to be properly applied to burn injury patients. Ultrasounds with frequencies higher than 20 MHz have been applied to dermatological diagnosis due to its high resolution and noninvasive capability. Yet, it is still lacking a substantial means to sensitively correlate the burn degree and ultrasonic measurements quantitatively. Thus, a 50 MHz ultrasound system was developed and implemented to measure ultrasonic signals backscattered from the burned skin tissues. Various burn degrees were achieved by placing a 100 deg. C brass plate onto the dorsal skins of anesthetized rats for various durations ranged from 5 to 20 s. The burn degrees were correlated with ultrasonic parameters, including integrated backscatter (IB) and Nakagami parameter (m) calculated from ultrasonic signals acquired from the burned tissues of a 5 x 1.4 mm (width x depth) area. Results demonstrated that both IB and m decreased exponentially with the increase of burn degree. Specifically, an IB of -79.0 {+-} 2.4 (mean {+-} standard deviation) dB for normal skin tissues tended to decrease to -94.0 {+-} 1.3 dB for those burned for 20 s, while the corresponding Nakagami parameters tended to decrease from 0.76 {+-} 0.08 to 0.45 {+-} 0.04. The variation of both IB and m was partially associated with the change of properties of collagen fibers from the burned tissues verified by samples of tissue histological sections. Particularly, the m parameter may be more sensitive to differentiate burned skin due to the fact that it has a greater rate of change with respect to different burn durations. These ultrasonic parameters in conjunction with high-frequency B-mode and Nakagami images could have the potential to assess the burn degree quantitatively.

  7. 重度烧伤22例临床分析%Clinical Analysis of 22 Patients with Severe Burn

    Institute of Scientific and Technical Information of China (English)

    杨宏伟

    2013-01-01

    目的:总结重度烧伤及特重度烧伤的救治经验,寻找存在的问题,为进一步实施救治提供依据.方法:对通辽市科尔沁区第一人民医院自2010年10月-2012年10月收治的22例重度及特重度烧伤患者的临床资料进行回顾性分析.结果:22例中除2例死于多器官衰竭外,其余均治愈,治愈率90.90%.结论:如何减少或避免烧伤早期损害及并发症的防治仍是烧伤救治的关键.%Objective:To provide a basis for clinical treatment through summarizing the experience in treatment of se-vere burn and extraordinarily severe burn patients, finding out the existing problems. Methods: The general clinical data of 22 patients with severe burn and extraordinarily severe burn who were treated in the First People’s Hospital of Korqin District from October 2010 to October 2012 were retrospectively analyzed. Results: In 22 cases, 2 died of multi-organ failure, the others were cured, the cure rate was 90.90%. Conclusion:How to reduce or avoid early dam-age, prevent complications is the key to treat burn.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fatemi

    2013-01-01

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

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

    Science.gov (United States)

    Fatemi, Mohammad Javad; Salehi, Hamid; Akbari, Hossein; Alinejad, Faranak; Saberi, Mohsen; Mousavi, Seyed Jaber; Soltani, Majid; Taghavi, Shahrzad; Payandan, Hossein

    2013-01-01

    Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8). Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption. PMID:24381625

  10. 特重度烧伤患儿一体化救治与康复%Integration of burn treatment and rehabilitation for a child with extremely severe burn

    Institute of Scientific and Technical Information of China (English)

    李鸿明; 张家平; 陈建; 宋华培; 刘秋石; 范鑫; 彭毅志; 吴军

    2015-01-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury,30% TBSA deep partial-thickness injury,and 1% TBSA superficial partial-thickness injury),severe inhalation injury,severe burn shock,stress ulcer,gastrointestinal bleeding and atelectasis of the right upper lung.The patient was given effective fluid infusion against shock,treatment for gastrointestinal bleeding,and other effective supportive treatment for functions of various organs after being admitted to our burn ward.When vital signs became stable at 30 hours post injury,bedside rehabilitation was begun.On post injury day (PID) 4,escharectomy was performed for both lower limbs,followed by microskin grafting and allogeneic skin covering.On PID 10,invasive infection of multi-drug resistant bacteria was found with accompanied high fever,and at the same time allograft began to disintegrate,with dissolution of large area of eschar,leading to a raw surface reaching 86% TBSA.Following debridement,dressing,application of compound polymyxin B ointment,temporary covering of wounds with porcine acellular dermal matrix,adjustment of antibiotics,patient's condition was finally stabilized.From PID 28 on,split-thickness skin grafting was conducted 7times,and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered.At the same time,our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise,occupational therapy,prevention of scar formation,organ function training and psychological intervention.Finally,the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury.Oriented forwards functional rehabilitation,strong cooperation between team members,and synchronous effective implementation of burn treatment and rehabilitation in the whole process

  11. Surgical treatment and management of the severely burn patient: Review and update.

    Science.gov (United States)

    Gacto-Sanchez, P

    Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. Clinical application and viability of cryopreserved cadaveric skin allografts in severe burn: a retrospective analysis.

    Science.gov (United States)

    Cleland, Heather; Wasiak, Jason; Dobson, Hannah; Paul, Michelle; Pratt, George; Paul, Eldho; Herson, Marisa; Akbarzadeh, Shiva

    2014-02-01

    Cadaveric cutaneous allografts are used in burns surgery both as a temporary bio-dressing and occasionally as definitive management of partial thickness burns. Nonetheless, limitations in the understanding of the biology of these grafts have meant that their role in burns surgery continues to be controversial. A review of all patients suffering 20% or greater total body surface area (TBSA) burns over an eight year period that received cadaveric allografts were identified. To investigate whether tissue viability plays a role in engraftment success, five samples of cryopreserved cadaveric cutaneous allograft processed at the Donor Tissue Bank of Victoria (DTBV) were submitted to our laboratory for viability analysis using two methods of Trypan Blue Exclusion and tetrazolium salt (MTT) assays. During the study period, 36 patients received cadaveric allograft at our institution. The average total burn surface area (TBSA) for this group of patients was 40% and all patients received cadaveric skin as a temporizing measure prior to definitive grafting. Cadaveric allograft was used in complicated cases such as wound contamination, where synthetic dressings had failed. Viability tests showed fewer than 30% viability in processed allografts when compared to fresh skin following the thawing process. However, the skin structure in the frozen allografts was histologically well preserved. Cryopreserved cutaneous cadaveric allograft has a positive and definite role as an adjunct to conventional dressing and grafting where available, particularly in patients with large TBSA burns. The low viability of cryopreserved specimens processed at DTBV suggests that cell viability in cadaveric allograft may not be essential for its clinical function as a wound dressing or even as permanent dermal substitute. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  13. Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Joelle W Boeve

    2011-03-01

    Full Text Available Patrick K Boyle, John J Badal, Joelle W BoeveDepartment of Anesthesiology, Arizona Health Sciences Center, Tucson, AZ, USAAbstract: Although regional anesthesia offers advantages for intraoperative and postoperative pain relief, it is not possible without complications. A case of a significant burn injury after splint placement is described after a peripheral nerve block was performed for postoperative pain management. It is our hope that this case alerts physicians and others involved in the management of postoperative patients to the challenges of managing a blocked extremity after thermal cast placement and offers solutions that can be standardized.Keywords: Peripheral nerve block, cast burn, postoperative complication

  14. [Effects of activating silent information regulator 1 on early kidney damage in rats with severe burn].

    Science.gov (United States)

    Bai, X Z; He, T; Liu, Y; Zhang, W; Han, F; Yang, C; Cai, W X; Jia, Y H; Shi, J H; Han, J T; Su, L L; Hu, D H

    2017-06-20

    Objective: To investigate the effects of activating silent information regulator 1 (SIRT1) on the early kidney damage in rats with severe burn. Methods: Thirty healthy male SD rats were divided into sham injury group (SI), pure burn group (PB), and SIRT1 activator group (SA) according to the random number table, with 10 rats in each group. Rats in groups PB and SA were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burn) on the back. Immediately after injury, rats in group PB were intraperitoneally injected with normal saline in the dosage of 50 mL/kg, and those in group SA with 1 mg/mL (final mass concentration) resveratrol in the dosage of 50 mL/kg. Rats in group SI were sham injured and intraperitoneally injected with normal saline in the dosage of 50 mL/kg immediately after injury. Kidney tissue and abdominal aorta blood of rats in the three groups were collected at 24 hours after injury. The morphology of kidney tissue was observed after HE staining. The serum content of creatinine and urea nitrogen was determined with enzyme-linked immunosorbent assay. Protein expressions of SIRT1, Bax, and Bcl-2 in kidney tissue were determined with Western blotting. mRNA expressions of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and IL-10 in kidney tissue were determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with one-way analysis of variance and LSD-t test. Results: (1) In rats of group SI, structures of kidney tubules and glomeruli were intact. In rats of group PB, structures of kidney tubules were not clear with casts in them, and glomeruli showed pyknosis. In rats of group SA, structures of kidney tubules were relatively intact, and the pyknosis of glomeruli were slighter as compared with that of group PB with fewer glomeruli showing pyknosis. (2) The serum content of creatinine and urea nitrogen in rats of group PB was (67±14)

  15. Fatty infiltration of the liver in severely burned pediatric patients : Autopsy findings and clinical implications

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Background. Trauma induces hypermetabolic responses that are characterized by the mobilization of all available substrates. The marked increase of peripheral lipolysis after a burn can lead to the development of fatty liver, which has been associated with immunodepression and increased mortality. Me

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

    NARCIS (Netherlands)

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

    1992-01-01

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

  17. FOETAL MUMMIFICATION OWING TO SEVERE THERMAL BURN IN AN INDIGENOUS COW

    Directory of Open Access Journals (Sweden)

    Debasis Jana

    2014-06-01

    Full Text Available A very rare incidence of bovine foetal mummification owing to thermal burn injury and its successful obstetrical treatment and management with the extraction of an inert mummified foetus diagnosed to be an atypical amorphous globocephalus foetal monster at its 2nd trimester of development is reported.

  18. Signals from Fat After Injury: Plasma Adipokines and Ghrelin Concentrations in the Severely Burned

    Science.gov (United States)

    2012-09-26

    hor- mones , beta blockers and intensive insulin therapy. Furthermore, Table 1 Demographics of control and burn subjects. Values in the table are mean...possibilities to assess the status of the patient through the use of these hor- mones as biomarkers. This work also provides the basis on which to

  19. Incidence of non-candidal fungal infections in severe burn injury: an Australian perspective.

    Science.gov (United States)

    Katz, T; Wasiak, J; Cleland, H; Padiglione, A

    2014-08-01

    Infection remains the primary cause of morbidity and mortality in the burns patient population. While candidal infection in burns patients is well described, there is dearth of information regarding non-candidal fungal infections in this setting. All adult burns patients who developed non-candidal fungal infections over a period of 10 years (between January 2001 and June 2011) were included. Retrospective data analyzed included patient demographics, organisms cultured, antibiotic susceptibility patterns, treatment, length of stay and overall mortality. The incidence of non-candidal fungal infections at our centre over the time period studied was 0.04%. A total of 12 patients had a fungus other than Candida isolated. Of these 12 patients, seven were thought to have clinically significant fungal infections and were treated with targeted anti-fungal therapy. Between them, seven species of fungus were isolated: Aspergillus fumigatus (n=7), Scedosporium prolificans (n=2), Fusarium solani (n=2), Mucor spp. (n=2), Absydia corymbifera (n=1), Penicillium (n=1) and Alternaria spp. (n=1). Of those definitively treated, two died, although fungal infection was not believed to be a contributing factor to these deaths. We demonstrate a low incidence and attributable mortality of non-candidal fungal infections in the setting of early antifungal therapy and extensive surgical debridement at our state-wide Burns Service. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  20. EXPERIENCE IN TREATING SECONDARY SYSTEMIC MYCOTIC INFECTION AFTER SEVERE BURNS ASSOCIATED WITH ELECTRIC INJURY

    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝

    1995-01-01

    One patient with wound surface sepsis caused by secondary pyocyanic infection after extensive burns associated with visceral injuries (peptic ulcer hemorrhage, renal insufficiency and hepatic dysfunction) and generalized candidiasis albicans was cured after anti-infection treatment with proper antibiotics, removal of the infected focus, and effective anti-fungal drugs.

  1. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    Science.gov (United States)

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems.

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

    Directory of Open Access Journals (Sweden)

    Ssentongo Robert

    2011-06-01

    Full Text Available Abstract Background HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting and to compare the outcome of these patients who are HIV positive with those who are HIV negative. Methods This was a prospective cohort study involving burn injury patients admitted to Mulago Hospital between November 2005 and February 2006. Patients were stratified into HIV positive (exposed group and HIV-negative (unexposed group. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 11.5. Results Of the 130 patients included in the study, 17 (13.1% patients tested HIV positive and this formed the study (exposed group. The remaining 113 patients (86.9% formed the control (unexposed group. In the HIV positive group, females outnumbered males by a ratio of 1.4:1 and the mean age was 28.4 ± 21.5 years (range 3 months-34 years. 64.7% of HIV positive patients reported to have risk factors for HIV infection. Of these, multiple sexual partners [Odds Ratio 8.44, 95% C.I. (3.87-143.23, P = 0.011] and alcoholism [Odds Ratio 8.34, 95% C.I. (5.76-17.82, P = 0.002] were found to be independently and significantly associated with increased risk to HIV infection. The mean CD4 count for HIV positive and HIV negative patients were 394 ± 328 cells/μL and 912 ± 234 cells/μL respectively which is statistically significant (P = 0.001. There was no difference in the bacteria cultured from the wounds of HIV positive and negative patients (P = 0.322. Patients with clinical signs of sepsis had lower CD4+ counts compared to patients without sepsis (P Conclusion HIV infection is prevalent among burn injury patients in our setting and thus presents an occupational hazard to health care workers who care for these patients. All burn health care workers in this region need to

  3. Self-perceptions of young adults who survived severe childhood burn injury.

    Science.gov (United States)

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the

  4. Scald Burns

    Science.gov (United States)

    Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

  5. Do fentanyl and morphine influence body temperature after severe burn injury?

    Science.gov (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Fentanyl lacks the antiinflammatory properties of morphine. Morphine attenuates the inflammatory response through differential stimulation of μ-receptor subtypes. Patients who receive morphine during coronary artery bypass graft have been shown to experience less postoperative fever than those who receive fentanyl. Patients who receive continuous fentanyl infusions in increased room temperatures after thermal injury may be at increased risk to experience higher body temperature than those who receive morphine. The records of 28 patients with >20%TBSA burn in 30 intensive care unit rooms (13 received fentanyl and 15 received morphine or hydromorphone) and 12 trauma patients who received fentanyl in 22°C intensive care unit rooms were reviewed. Mean maximum core temperature and percentage of temperature recordings > 39°C in the first 48 hours of admission were compared between burn patients who received fentanyl, those who did not, and with trauma patients. Burn patients exposed to fentanyl experienced significantly higher temperatures (40.1 ± 0.9°C) compared with those given morphine (38.7 ± 0.8°C) and compared with trauma patients (37.5 ± 2.4°C), P Burn patients on fentanyl had temperatures > 39°C for a higher percentage of time (33 ± 27%) than those without fentanyl (7.2 ± 13%) and trauma patients (1 ± 2.8%), P Burn patients who receive fentanyl in 30°C rooms experience higher body temperatures and are febrile for a higher percentage of time than those receiving morphine only. Morphine has well-established antiinflammatory properties and likely attenuates the postburn inflammatory response more than fentanyl, resulting in lower body temperatures. This phenomenon needs to be further investigated in additional studies.

  6. A comprehensive biomass burning emission inventory with high spatial and temporal resolution in China

    Science.gov (United States)

    Zhou, Ying; Xing, Xiaofan; Lang, Jianlei; Chen, Dongsheng; Cheng, Shuiyuan; Wei, Lin; Wei, Xiao; Liu, Chao

    2017-02-01

    . As for the straw burning emission of various crops, corn straw burning has the largest contribution to all of the pollutants considered, except for CH4; rice straw burning has highest contribution to CH4 and the second largest contribution to other pollutants, except for SO2, OC, and Hg; wheat straw burning is the second largest contributor to SO2, OC, and Hg and the third largest contributor to other pollutants. Heilongjiang, Shandong, and Henan provinces located in the north-eastern and central-southern regions of China have higher emissions compared to other provinces in China. Gridded emissions, which were obtained through spatial allocation based on the gridded rural population and fire point data from emission inventories at county resolution, could better represent the actual situation. High biomass burning emissions are concentrated in the areas with more agricultural and rural activity. The months of April, May, June, and October account for 65 % of emissions from in-field crop residue burning, while, regarding EC, the emissions in January, February, October, November, and December are relatively higher than other months due to biomass domestic burning in heating season. There are regional differences in the monthly variations of emissions due to the diversity of main planted crops and climatic conditions. Furthermore, PM2.5 component results showed that OC, Cl-, EC, K+, NH4+, elemental K, and SO42- are the main PM2.5 species, accounting for 80 % of the total emissions. The species with relatively high contribution to NMVOC emission include ethylene, propylene, toluene, mp-xylene, and ethyl benzene, which are key species for the formation of secondary air pollution. The detailed biomass burning emission inventory developed by this study could provide useful information for air-quality modelling and could support the development of appropriate pollution-control strategies.

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

    Science.gov (United States)

    Melo, Talita de Oliveira; Lima, Antônio Fernandes Costa

    2017-01-01

    to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. a MDC of US$ 0.65 (SD=0.36) was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23) for "intravenous drug administration"; US$ 5.90 (SD=2.75) for "measurement of diuresis"; US$ 0.93 (SD=0.42) for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55) for "bandaging". the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care. identificar o custo direto médio (CDM) dos procedimentos realizados, com maior frequência, por profissionais de enfermagem, em uma Unidade de Terapia Intensiva, aos pacientes grandes queimados. pesquisa quantitativa, exploratório-descritiva, do tipo estudo de caso único. O CDM foi calculado multiplicando-se o tempo (cronometrado) despendido por profissionais de enfermagem na execução dos procedimentos, objeto de estudo, pelo custo unitário da mão de obra direta, somando-se ao custo dos materiais e soluções/medicamentos. obteve-se o CDM de US$ 0.65 (SD=0.36) para "controle dos sinais vitais"; US$ 10.00 (SD=24.23) para "administração de medicamentos via intravenosa"; US$ 5.90 (SD=2.75) para "mensuração de diurese"; US$ 0.93 (SD=0.42) para "verificação de glicemia capilar"; e US$ 99.75 (SD=129.55) para "curativo". o conhecimento desenvolvido pode fundamentar as tomadas de decisão gerenciais subsidiando a eficiência alocativa dos recursos envolvidos e, quando possível, indicar estratégias de conten

  8. Targeted Prevention or Treatment of Bacterial Biofilm Infections of Severe Burns and Wounds

    Science.gov (United States)

    2011-04-01

    for P. aeruginosa and accelerates the formation of biofilms. neutrophil accumulation Normal epidermis Burn Biofilm neutrophil necrosis NMHC-II F...actin + DNA dermis 4 Body: Over the 18 months of this proposal, we have completed all of the stated Aims within the approved Statement of Work. Results...methods. Associated with decreased neutrophil accumu- lation to the dermis was a decrease in burden of P. aeru- ginosa. This effect was greatest at the

  9. Contributions of Severe Burn and Disuse to Bone Structure and Strength in Rats

    Science.gov (United States)

    2013-01-01

    injuries of≥40% total body surface area (TBSA) has markedly reduced bone formation in both adults and children [1]. Burn induces a systemic catabolic...injury can also be a significant contributing factor to loss of bone density and strength [8]. Bed rest causes an uncoupling of resorption and...the reduction in bone formation [3,5,15] and thusmay be associated with a higher incidence of fractures and osteoporosis [3,16,17]. Using two and

  10. Genetically Modified Porcine Skin Grafts for Treatment of Severe Burn Injuries

    Science.gov (United States)

    2010-07-01

    artif act of m igration of peripheral s kin cells into the wound area durin g healing. In addition, full-th ickness wounds bette r represent the...and Rutan RL, Early burn wound excision significantly reduces blood loss. Ann Surg 211: 753-759, 1990. 3. Nakazawa H and Nozaki M, [Experience of...immunosuppressant. By the time of this skin experiment, the baboon was healthy, and its blood cell counts and phenotypes had returned to baseline. On

  11. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

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

  12. [Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage].

    Science.gov (United States)

    Zhang, Hong-hui; Li, Yue-jun; Li, Xue-yong; Chen, Shao-zong; Lü, Xiao-xing; Feng, Jian; Li, Jing; Jiang, Li

    2010-10-01

    To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients. Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software. Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0. The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.

  13. Pain in burn patients.

    Science.gov (United States)

    Latarjet, J; Choinère, M

    1995-08-01

    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.

  14. Observation of anesthesia depth in severe burn patients with target controlled infusion of propofol and remifentanil by bispectral index

    Directory of Open Access Journals (Sweden)

    Zheng-gang GUO

    2012-04-01

    Full Text Available Objective To evaluate the feasibility and efficiency of bispectral index (BIS for monitoring the anesthesia depth of severe burn patients with target controlled infusion (TCI of propofol and remifentanil. Methods A total of 80 severe burns patients undergoing eschar excision ( < 1week were randomly divided into BIS group (group A and control group (group B, with 40 cases assigned in each group. These patients were 18 years to 65 years old, ASAⅡ-Ⅲ. Their total burn surface areas (TBSA were from 31% to 50%, or 11% to 20% with three-degree burns. All patients received remifentanil and propofol for TCI intravenous anesthesia. The mean arterial pressure (MAP and heart rate (HR were determined at following time points, namely, entrance to the operation room, loss of consciousness, 2min after intubation, before surgery, 2, 15, and 30min after the start of surgery, end of surgery, eye opening, and period when Aldrete score reaching 9 points, as well as the target concentrations of remifentanil and propofol. The time frames from stoppage of drug infusion to eye opening and the period when Aldrete score reaching 9 points were also recorded. Results Compared with group B, the target concentrations of remifentanil (2.12±0.35ng/ml vs. 2.50±0.21ng/ml and propofol (2.54±0.22μg/ml vs. 2.86±0.31μg/ml were significantly lower in group A during anesthetic maintenance (P < 0.01. The time interval from stoppage of drug infusion to eye opening (7.90±0.58min vs. 8.35±0.66min and period when Aldrete score reaching 9 points (9.15±0.69min vs. 11.13±0.96min were significantly reduced in group A. The MAP of both groups from loss of consciousness at all time points, except 2min after intubation, was significantly lower than the basic values upon entrance into the operation room (P < 0.05. The HR at all time points were significantly lower compared with the basic data (P < 0.05. Conclusion BIS for monitoring the anesthetic depth of severe burns patients

  15. Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest.

    Science.gov (United States)

    Schlossmacher, Pascal; Martinet, Olivier; Testud, Richard; Agesilas, Fabrice; Benhamou, Léon; Gauzëre, Bernard Alex

    2006-02-01

    We report the life-saving use of Griggs percutaneous tracheostomy in an arrested patient with complex upper airway obstruction, as a result of burns, smoke injuries and iterative tracheal intubation attempts. The technique was performed blindly at bedside to treat an acute episode of failed ventilation and intubation and cardiac arrest in a patient with altered neck anatomy. The intervention salvaged the situation, leaving a definitive airway. The feasibility of using an emergency Griggs percutaneous tracheostomy versus cricothyroidotomy is suggested in selected cases.

  16. Curbing Inflammation in Burn Patients

    Directory of Open Access Journals (Sweden)

    Jayme A. Farina

    2013-01-01

    Full Text Available Patients who suffer from severe burns develop metabolic imbalances and systemic inflammatory response syndrome (SIRS which can result in multiple organ failure and death. Research aimed at reducing the inflammatory process has yielded new insight into burn injury therapies. In this review, we discuss strategies used to curb inflammation in burn injuries and note that further studies with high quality evidence are necessary.

  17. Prevention and treatment of gastrointestinal dysfunction following severe burns:A summary of recent 30-year clinical experience

    Institute of Scientific and Technical Information of China (English)

    Shi-Chu Xiao; Shi-Hui Zhu; Zhao-Fan Xia; Wei Lu; Guang-Qing Wang; Dao-Feng Ben; Guang-Yi Wang; Da-Sheng Cheng

    2008-01-01

    AIM:To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients,and propose practicable guidelines for the prevention and treatment of gastrointestinal (GI) dysfunction.METHODS= From 1980 to 2007,a total of 219 patients with large area and extraordinarily large area burns (LAB) were admitted,who were classified into three stages according the therapeutic protocols used at the time:Stage 1 from 1980 to 1989,stage 2 from 1990 to 1995,and stage 3 from 1996 to 2007.The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed.RESULTS:The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1,which was significantly lower than that in stage 1 (P < 0.05).No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3.The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%,21.4% and 28.5%,respectively,which were significantly lower than those in stage 1 patients (P < 0.05 or P < 0.01),and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients (P < 0.05).CONCLUSION:Comprehensive fluid resuscitation,early excision of necrotic tissue,staged food ingestion,and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients.

  18. High-resolution mapping of biomass burning emissions in tropical regions across three continents

    Science.gov (United States)

    Shi, Yusheng; Matsunaga, Tsuneo; Saito, Makoto

    2015-04-01

    Biomass burning emissions from open vegetation fires (forest fires, savanna fires, agricultural waste burning), human waste and biofuel combustion contain large amounts of trace gases (e.g., CO2, CH4, and N2O) and aerosols (BC and OC), which significantly impact ecosystem productivity, global atmospheric chemistry, and climate . With the help of recently released satellite products, biomass density based on satellite and ground-based observation data, and spatial variable combustion factors, this study developed a new high-resolution emissions inventory for biomass burning in tropical regions across three continents in 2010. Emissions of trace gases and aerosols from open vegetation burning are estimated from burned areas, fuel loads, combustion factors, and emission factors. Burned areas were derived from MODIS MCD64A1 burned area product, fuel loads were mapped from biomass density data sets for herbaceous and tree-covered land based on satellite and ground-based observation data. To account for spatial heterogeneity in combustion factors, global fractional tree cover (MOD44B) and vegetation cover maps (MCD12Q1) were introduced to estimate the combustion factors in different regions by using their relationship with tree cover under less than 40%, between 40-60% and above 60% conditions. For emission factors, the average values for each fuel type from field measurements are used. In addition to biomass burning from open vegetation fires, the emissions from human waste (residential and dump) burning and biofuel burning in 2010 were also estimated for 76 countries in tropical regions across the three continents and then allocated into each pixel with 1 km grid based on the population density (Gridded Population of the World v3). Our total estimates for the tropical regions across the three continents in 2010 were 17744.5 Tg CO2, 730.3 Tg CO, 32.0 Tg CH4, 31.6 Tg NOx, 119.2 Tg NMOC, 6.3 Tg SO2, 9.8 NH3 Tg, 81.8 Tg PM2.5, 48.0 Tg OC, and 5.7 Tg BC, respectively. Open

  19. Traveling Charge Gun Firings Using Very High Burning Rate Propellants

    Science.gov (United States)

    1988-12-01

    21.5 grams. This gave a charge-to-mass ratio of approximately 1.6. Data acquisition is done on analog tape, which is later digitized and reduced by...fashion. Pressure historias indica e a decreasing mass generation rate as a function of burn time. As a consequence of these two observations and in order...Station, Indian Head, MD, December 1980. 11. Gough, P.S., "Extensions of BRLTC. A Code for the Digital Simulation of the Traveling Charge," Contract Report

  20. Levoglucosan indicates high levels of biomass burning aerosols over oceans from the Arctic to Antarctic

    Science.gov (United States)

    Hu, Q.; Xie, Z.; Wang, X.; Kang, H.; Zhang, P.

    2015-12-01

    Biomass burning discharges numerous kinds of gases and aerosols, such as carbon dioxide (CO2), carbon monoxide (CO), methane (CH4), black carbon (BC), alcohols, organic acids and persistent organic pollutants (POPs), and is known to affect air quality, global carbon cycle, and climate. However, the extent to which biomass burning gases/aerosols are present on a global scale, especially in the marine atmosphere, is poorly understood. Here we measure levoglucosan, a superior molecular tracer of biomass burning aerosols because of its single source, in marine air from the Arctic Ocean through the North and South Pacific Ocean to coastal Antarctica during burning season. Levoglucosan was found to be present in all regions at ng/m3 levels. As a whole, levoglucosan concentrations in the Southern Hemisphere were comparable to those in the Northern Hemisphere. Marine air in the mid-latitudes (30°-60° N and S) has the highest levoglucosan loading due to the emission from adjacent lands. Air over the Arctic Ocean which affected by biomass burning in the east Siberia has intermediate loading. Equatorial latitudes is the main source of biomass burning emissions, however, levoglucosan is in relatively low level. Large amount of precipitation and high hydroxyl radical concentration in this region cause more deposition and degradation of levoglucosan during transport. Previous studies were debatable on the influence of biomass burning on the Antarctic because of uncertain source of BC. Here via levoglucosan, it is proved that although far away from emission sources, the Antarctic is still affected by biomass burning aerosols which may be derived from South America. Biomass burning has a significant impact on mercury (Hg) and water-soluble organic carbon (WSOC) in marine aerosols from pole to pole, with more contribution to WSOC in the Northern Hemisphere than in the Southern Hemisphere.

  1. The early enteral feeding and rehabilitation of severely burned patients%严重烧伤患者的早期肠道营养与康复

    Institute of Scientific and Technical Information of China (English)

    邢德荣

    2002-01-01

    Objective To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients .Method A total of 22 patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF). The levels of serum endotoxin were detected in the members of both groups in 1, 3, and 5 days .Result The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P< 0.01) . The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P< 0.01). Conclusion Early enteral feeding may decrease enterogenic infection and it helps the nutrition support, improve the patient resistance, facilitate the repair of damaged tissue , so it contributes to the rehabilitation of burned patients.

  2. Nutrition Support in Burn Patients

    Directory of Open Access Journals (Sweden)

    Cem Aydoğan

    2012-08-01

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

  3. Probability and volume of potential postwildfire debris flows in the 2012 High Park Burn Area near Fort Collins, Colorado

    Science.gov (United States)

    Verdin, Kristine L.; Dupree, Jean A.; Elliott, John G.

    2012-01-01

    This report presents a preliminary emergency assessment of the debris-flow hazards from drainage basins burned by the 2012 High Park fire near Fort Collins in Larimer County, Colorado. Empirical models derived from statistical evaluation of data collected from recently burned basins throughout the intermountain western United States were used to estimate the probability of debris-flow occurrence and volume of debris flows along the burned area drainage network and to estimate the same for 44 selected drainage basins along State Highway 14 and the perimeter of the burned area. Input data for the models included topographic parameters, soil characteristics, burn severity, and rainfall totals and intensities for a (1) 2-year-recurrence, 1-hour-duration rainfall (25 millimeters); (2) 10-year-recurrence, 1-hour-duration rainfall (43 millimeters); and (3) 25-year-recurrence, 1-hour-duration rainfall (51 millimeters). Estimated debris-flow probabilities along the drainage network and throughout the drainage basins of interest ranged from 1 to 84 percent in response to the 2-year-recurrence, 1-hour-duration rainfall; from 2 to 95 percent in response to the 10-year-recurrence, 1-hour-duration rainfall; and from 3 to 97 in response to the 25-year-recurrence, 1-hour-duration rainfall. Basins and drainage networks with the highest probabilities tended to be those on the eastern edge of the burn area where soils have relatively high clay contents and gradients are steep. Estimated debris-flow volumes range from a low of 1,600 cubic meters to a high of greater than 100,000 cubic meters. Estimated debris-flow volumes increase with basin size and distance along the drainage network, but some smaller drainages were also predicted to produce substantial volumes of material. The predicted probabilities and some of the volumes predicted for the modeled storms indicate a potential for substantial debris-flow impacts on structures, roads, bridges, and culverts located both within and

  4. Yellow pine regeneration as a function of fire severity and post-burn stand structure in the southern Appalachian Mountains

    Science.gov (United States)

    Michael A. Jenkins; Robert N. Klein; Virginia L. McDaniel

    2011-01-01

    We used pre- and post-burn fire effects data from six prescribed burns to examine post-burn threshold effects of stand structure (understory density, overstory density, shrub cover, duff depth, and total fuel load) on the regeneration of yellow pine (Pinus subgenus Diploxylon) seedlings and cover of herbaceous vegetation in six prescribed-fire management units located...

  5. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment.

    Science.gov (United States)

    Oláh, Gábor; Finnerty, Celeste C; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David N; Szabó, Csaba

    2011-07-01

    Activation of the nuclear enzyme poly(ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibition. The aims of the current study were to measure the activation of PARP in human skeletal muscle biopsies at various stages of severe pediatric burn injury and to identify the cell types where this activation may occur. Another aim of the study was to test the effect of propranolol (an effective treatment of patients with burns) on the activation of PARP in skeletal muscle biopsies. Poly(ADP-ribose) polymerase activation was measured by Western blotting for its product, poly(ADP-ribose) (PAR). The localization of PARP activation was determined by PAR immunohistochemistry. The results showed that PARP becomes activated in the skeletal muscle tissue after burns, with the peak of the activation occurring in the middle stage of the disease (13-18 days after burns). Even at the late stage of the disease (69-369 days after burn), an elevated degree of PARP activation persisted in some of the patients. Immunohistochemical studies localized the staining of PAR primarily to vascular endothelial cells and occasionally to resident mononuclear cells. There was a marked suppression of PARP activation in the skeletal muscle biopsies of patients who received propranolol treatment. We conclude that human burn injury is associated with the activation of PARP. We hypothesize that this response may contribute to the inflammatory responses and cell dysfunction in burns. Some of the clinical benefit of propranolol in burns may be related to its inhibitory effect on PARP activation.

  6. Biomass burning in eastern Europe during spring 2006 caused high deposition of ammonium in northern Fennoscandia

    DEFF Research Database (Denmark)

    Karlsson, Per Erik; Ferm, Martin; Pihl Karlsson, Gunilla

    2013-01-01

    High air concentrations of ammonium were detected at low and high altitude sites in Sweden, Finland and Norway during the spring 2006, coinciding with polluted air from biomass burning in eastern Europe passing over central and northern Fennoscandia. Unusually high values for throughfall deposition...

  7. [The relationship between rhGH and blood sugar on different ages of severe degree burned patients].

    Science.gov (United States)

    Chen, Jiong; Xia, Shi-chun; Xie, Bing; Tang, Zhi-jian; Su, Guo-liang; Shi, Jian-wu; Lu, Xue-mian

    2009-08-01

    Probe the effects of rhGH on severe degree burned patients' blood sugar in different age of years. Elected 210 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2008, who were burned in 48 h, older than 18 years, ever had no diabetes and tumor history and placidly pull through shock stage. Among the patients there were 132 males and 78 females. The age was from 18 to 65 years old, average (40.7 +/- 7.2) years old. The extent of burn were form TBSA 25% to TBSA 86%, average TBSA (40.4 +/- 12.5)%. The depths of burn were from superficial second degree to third degree. All of the total divided into A (18 - 44 years old) and B (> 45 years old)groups. Each group had 105 patients. Two groups were randomly divided into A(1), A(2), A(0) and B(1), B(2), B(0) groups. Each group had 35 patients. The A(1) and B(1) groups were used 0.15 U/(kg.d) growth hormone (Somatropin, S19990021), A(2) and B(2) groups were used 0.2 U/(kg.d) growth hormone, A(0) and B(0) groups were used NS as control. Observed and analyzed the change of blood sugar and insulin amount used in 210 patients. Of all the patients in 6 groups, there were 190 patients finished the experimentation in four weeks. The insulin amount of A(1), A(2), A(0) groups used were (2123.3 +/- 152.3), (2885.6 +/- 148.5), (724.1 +/- 31.1) U, B(1), B(2), B(0) group were (2715.1 +/- 95.3), (3652.2 +/- 198.1), (801.8 +/- 22.2) U. The consequence showed that the number need insulin to control blood sugar in B group was more than A group, as well as using 0.2 U/(kg.d) does to 0.15 U/(kg.d) does, and using growth hormone to no using(P 0.05). The blood sugar's alteration has positive correlation with the age of years and the does of rhGH. As long as normative using rhGH it doesn't induce diabetes.

  8. Effects of nutritional support route on intestinal structure and function in the early stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhong-yong; WANG Shi-liang; YU Bin; LI Ao

    2001-01-01

    To assess the clinical effects ofenteral nutrition on intestinal structure and function in the early stage of severe burns. Methods: Nineteen cases of severe burn injury were divided randomly into enteral nutrition group (EN) and parenteral nutrition group (PN). Gastrin, motilin, malondialdehyde (MDA), superoxide dismutase (SOD), endotoxin, rumor necrosis (TNF), diamine oxidase (DAO) and lactulose/mannitol (L/M) were determined on postburn day 1, 4, 8, 14 (PBD) respectively. Results: Serum gastrin and motilin on PBD 4 and 8 were significantly higher in EN group than in PN group (P<0.05-0.01). Plasma MDA on PBD4 and PBD8 was obviously lower in EN group than in PN group (P<0.01). Plasma SOD on PBD4 and PBD8 was significantly higher in EN group than in PN group (P<0.01). At the most time points, endotoxin and TNF were significantly lower in EN group than in PN group (P<0.01). Serum DAO tended to decrease in EN group, and on PBD4 it was obviously lower in EN group than in PN group (P<0.01). Gut permeability L/M on PBD4, PBD8 was obviously in EN group lower than in PN group (P<0.05-0.01). There was positive correlation between L/M and DAO, and between MDA and TNF (P<0.05-0.01), and negative correlation between L/M and SOD (P<0.01). Conclusion: On the basis of the findings, it is considered that the early enteral nutrition is more effective to preserve the secretion and motility of gastrointestinal tract, decrease intestinal ischemia and reperfusion injury, reduce intestinal permeability, decrease plasma endotoxin and mediators,and maintain mucosa barrier function. Enteral nutrition is superior to parenteral nutrition in the early stage of severe bum injury.

  9. Control of Thermoregulatory Sweating during Exercise in Patients with Severe Burns

    OpenAIRE

    秦, 祐子; 林, 隆宏; 宮本, 隆志; 辛島, 修二; 山口, 昌夫; 花山, 耕三; 永坂, 鉄夫; 桜田, 惣太郎; 田辺, 実

    1995-01-01

    全身の広範囲な皮膚汗腺破壊をともなう重症熱傷患者の, 運動時の発汗能に着目し, 体温調節能力と運動耐久性について検討した。Burn Index 70以上で日常生活動作の自立した2症例を対象に, 自転車エルゴメーターによる運動負荷試験をおこない, 呼気ガス分析・発汗量・深部体温・皮膚温・皮膚血流量・心拍数を経時的に測定した。その結果, 両者とも予想最大酸素摂取量に対する実測の酸素摂取量のピーク値の割合は低く, 運動耐久性は低下していると推察された。一方, III度熱傷値皮部からの発汗は認められなかったが, 運動中の体温の恒常性はかなり保たれたものであった。したがって, 熱傷により広範囲に皮膚汗腺破壊が生じても, 運動中の体温調節能力は比較的維持されると言え, この汗腺破壊が, 運動遂行能力の制限因子となるとは考え難いことが示唆された。 Thermoregulatory capacity and exercise endurance during exercise were studied in patients with impaired sweating capacity ...

  10. 重度烧伤液体复苏的研究进展%Advances in the Research of Fluid Resuscitation Following Severe Burn

    Institute of Scientific and Technical Information of China (English)

    王碧莹(综述); 葛茂星(审校)

    2015-01-01

    Burn shock is the first hurdle in patients with severe burn injury.Fluid resuscitation is an important treatment of burn shock.Reasonable fluid resuscitation can not only avoid burn shock,but also reduce the death risk and complications incidence.Here is to make a review of the research of severe burn fluid infusion volume,infusion method,inhalation injury,wound depth,delayed resuscitation and etc.,for the sake of providing some thoughts for fluid resuscitation of severe burn patients .%烧伤休克是重度烧伤患者伤后面临的第一道难关。液体复苏是休克期救治的重要措施,合理的补液不仅能避免烧伤休克的发生,也将降低后续并发症的发生率及死亡的风险。该文就目前国内外对重度烧伤液体复苏的补液量、补液途径、吸入性损伤、创面深度及延迟复苏等方面的相关研究进行综述,以期为临床重度烧伤的液体复苏提供一个简要的总结和一些思考。

  11. Topical application of docosanol- or stearic acid-containing creams reduces severity of phenol burn wounds in mice.

    Science.gov (United States)

    Khalil, M H; Marcelletti, J F; Katz, L R; Katz, D H; Pope, L E

    2000-08-01

    Because of their reported antiviral and anti-inflammatory activities, cream formulations containing n-docosanol (docosanol) or stearic acid were tested for effects on chemically-induced burns in mice. In this model, injury was induced by painting the abdomens of mice with a chloroform solution of phenol. This was followed by the topical application of test substances 0.5, 3, and 6 h later. Progression of the wounds was assessed by a single evaluator after 8 h, using a numerical score of gross morphology. Docosanol- and stearic acid-containing creams substantially and reproducibly lessened the severity and progression of skin lesions compared to untreated sites with a 76% and 57% reduction in mean lesion scores, respectively. Untreated wounds appeared red and ulcerated; docosanol cream-treated wounds showed only slight erythema.

  12. Management of burn wounds.

    Science.gov (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  13. Interactive effects of burn severity and canopy cover on ecophysiology of tree seedlings in boreal forests

    Science.gov (United States)

    Wildfires are an important disturbance because they improve habitat conditions for establishing plants. Fires of differing severity can have dramatically different impacts on habitat, particularly when coupled with canopy-level disturbances. In a boreal forest, we outplanted seedlings of four specie...

  14. Soil water repellency within a burned pinon-juniper woodland: spatial distribution, severity, and ecohydrologic implications

    Science.gov (United States)

    Post-fire recovery of juniper-dominated ecosystems is dependent on the extent that ecological processes have been altered. Soil water repellency is a common condition in these ecosystems that may limit site recovery. In this study we examined the extent, severity, and ecohydrologic implications of p...

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

    Energy Technology Data Exchange (ETDEWEB)

    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: kyungjin.suh@gmail.com; Choi, Min Ho (Dept. of Internal Medicine, Hallym Univ. College of Medicine, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of))

    2011-02-15

    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

  16. X-ray analysis of 80 patients with severe endemic fluorosis caused by coal burning

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Z.P.; Yuan, M.B.; Liu, G.F. [Luzhou Medical College, Luzhou (China)

    1996-05-01

    Radiographs of 80 patients with severe endemic fluorosis of coalburning type (CBFF) - 49 males and 31 females aged 30 to 70 years - were analysed to examine the changes to the bone substance, peripheral structure of bone, and joints. The changes to bone substance were: (1) osteosclerosis type, 62 cases (77.5%); (2) mixed type, 16 cases (21.25%); (3) osteoporosis type, one case (1.25%); (4) osteomalacia type, one case (1.25%). The changes to the joints were found in the hips and elbows in 79 cases (98.75%), and in the knees in 75 cases (93.75%). When combinations of the above three changes occur, the classification of the disease is according to the most severe one of the three. Our findings can increase the accuracy of X-ray diagnosis, making it more consistent with clinical diagnosis, thus improving prevention and treatment of CBEF.

  17. Increased B-type natriuretic peptide and decreased proteinuria might reflect decreased capillary leakage and is associated with a better outcome in patients with severe burns

    NARCIS (Netherlands)

    de Leeuw, Karina; Nieuwenhuis, Marianne K; Niemeijer, Anuschka S; Eshuis, Hans; Beerthuizen, Gerard I J M; Janssen, Wilbert M

    2011-01-01

    INTRODUCTION: It is difficult to adjust fluid balance adequately in patients with severe burns due to various physical changes. B-type natriuretic peptide (BNP) is emerging as a potential marker of hydration state. Proteinuria is used as a predictor of outcome in severe illness and might correlate t

  18. A randomized controlled trial to compare the effects of liquid versus powdered recombinant human growth hormone in treating patients with severe burns

    Science.gov (United States)

    CHEN, GUOXIAN; SHAO, HUAWEI; PAN, XUANLIANG

    2016-01-01

    Recombinant human growth hormone (rhGH) promotes protein utilization and synthesis, and is widely used as a therapy to treat severe burns. The present randomized controlled trial evaluated the effects of different forms of rhGH on patients with severe burns. A total of 29 adult severe burns patients were enrolled between February 2009 and November 2011, and randomly assigned to either treatment group (T, liquid rhGH) or control group (C, powder rhGH). From days 5 to 7 following the infliction of burns, both patient groups received rhGH at 0.067 mg/kg/d, once for 10 days. Median serum pre-albumin levels increased in both groups following treatment, the elevation from baseline was significantly higher in the T group on day 10 compared to the C group (88 mg/l vs. 65 mg/l, P=0.046). C-reactive protein, fasting plasma glucose and body weight decreased in both groups. Body weight was significantly lower in the T compared to the C group at baseline, Day 5 and Day 10 (P=0.046, P=0.018 and P=0.006, respectively), however the decrease from baseline levels were not significantly different. Wound healing time was similar between groups (P=0.270). In conclusion the early use of liquid rather than powder rhGH may be more beneficial for treating adult patients with severe burns. PMID:27123246

  19. Differences in resuscitation in morbidly obese burn patients may contribute to high mortality.

    Science.gov (United States)

    Rae, Lisa; Pham, Tam N; Carrougher, Gretchen; Honari, Shari; Gibran, Nicole S; Arnoldo, Brett D; Gamelli, Richard L; Tompkins, Ronald G; Herndon, David N

    2013-01-01

    extent of their lower BMI counterparts (P values .04 and .03). Complications and morbidities across BMI groups were similar, although examination of organ failure scores indicated more severe organ dysfunction in the morbidly obese group. Compared with being normal weight, being morbidly obese was an independent risk factor for death (odds ratio = 10.1; confidence interval, 1.94-52.5; P = .006). Morbidly obese patients with severe burns tend to receive closer to predicted fluid resuscitation volumes for their actual weight. However, this patient group has persistent metabolic acidosis during the resuscitation phase and is at risk of developing more severe multiple organ failure. These factors may contribute to higher mortality risk in the morbidly obese burn patient.

  20. Childhood burns in Israel: a 7-year epidemiological review.

    Science.gov (United States)

    Goldman, Sharon; Aharonson-Daniel, Limor; Peleg, Kobi

    2006-06-01

    Understanding the etiology of severe burns injuries and identifying high risk groups are essential for allotting resources for prevention and treatment. The objective of this study was to develop a profile of severe childhood burns in Israel. A retrospective study of children (ages 0-14) hospitalized with a burn, between 1998 and 2004. Data from all five burn units in Israel was retrieved from the National Trauma Registry. Two thousand seven hundred and five children were hospitalized with burns (51% of all burn admissions). Infants (ages 0-1) had the highest prevalence (45%). Scalds caused 68% of burns. Burn extent in 83% of the patients was less than 20% TBSA, 3% suffered 40%TBSA burns. Surgical intervention increased from 6% in 1998 to 21% in 2002. Non-Jewish children sustained proportionally more burn injuries (48%). Among Jewish children an increase in burn injuries was noted on Thursdays and Fridays. Infants, boys and non-Jewish children were found to be at greatest risk for a burn injury, while older children were at higher risk for severe burns. Prevention programs should target these high risk groups, with an emphasis on the unique characteristics of each group. Policy makers should reassess the benefits of a pediatric burn unit in Israel. The increase in rates of surgical intervention should be further investigated.

  1. 也谈严重烧伤感染治疗%To intensify our understanding about management of severe burn infection

    Institute of Scientific and Technical Information of China (English)

    张勤; 廖镇江

    2009-01-01

    Nowadays, it is necessary to emphasize the three basic inseparable elements in the treatment of severe burn infection, which are systemic care, burn wound care, and ra-tional use of antimicrobia/s topically or systematically. Systemic care has been shifted from simple nutritional support to maintai-ning the systemic homeostasis, including balancing immune-in-flammatory response, and protecting organs from dysfunction.Some work focused on regulating systemic immune response in the initial phase and the balance of inflammatory response after occurrence of severe burn infection have been reported. These results at least broaden our thinking to recognize that treatment should not only destroy microbes, but also balance the response of the body. Escharectomy in earlier phase has been a consen-sus. Currently, we turn our vision into how to use "damage con-trol surgery (DCS)" concept in management of severe burn.DCS in burn care includes the evaluation of perioperative situa-tion more accurate to make a more appropriate surgical decision. Meanwhile, an overall strategy should be established to confront the rapidly increasing drug resistance of the pathogens. The re-lease of endotoxin after use of antimicrobials, which has been studied widely, should be explored further.

  2. Particulate matter contamination in the corneal stroma of severe eye burns in humans

    Energy Technology Data Exchange (ETDEWEB)

    Schrage, N.F.; Reim, M.; Burchard, W.G. (Department of Ophthalmology, RWTH-Aachen (Germany))

    1990-01-01

    Corneal buttons obtained from keratoplasty were examined by energy dispersive x-ray analysis (EDXA) combined with scanning electron microscopy (SEM). This method enables to assay the mineral composition of minute parts of tissue samples identified in SEM images. Samples were cut from paraffin embedded corneae, deparaffinized in xylol, dried in aceton, critical-point desiccated, covered by evaporating with a thin layer of carbon and examined by SEM. In healthy human donor eyes, only some iron particles had been found. In the 22 patients samples high amounts of different particles were identified, materials from rubber stoppers, chromesteel, titanium pigments, talcum, barium and glass. Furthermore a lot of different metal particles containing varying amounts of Na, Mg, Al, Si, P, S, Cl, K, Ca, Fe, Cu, Cr, Zn, La and Ce were detected. Some particles may be caused by the initial trauma, others by therapy. Such contaminations might have supported leucocyte and fibrocyte invasion increasing the inflammatory reaction in the burnt cornea.

  3. Vegetation response to a short interval between high-severity wildfires in a mixed-evergreen forest

    Science.gov (United States)

    Daniel C. Donato; Joseph B. Fontaine; W. Douglas Robinson; J. Boone Kauffman; Beverly E. Law

    2009-01-01

    Variations in disturbance regime strongly influence ecosystem structure and function. A prominent form of such variation is when multiple high-severity wildfires occur in rapid succession (i.e. short-interval (SI) severe fires, or ‘re-burns’). These events have been proposed as key mechanisms altering successional rates and pathways....

  4. Laminar burn rates of gun propellants measured in the high-pressure strand burner

    Energy Technology Data Exchange (ETDEWEB)

    Reaugh, J. E., LLNL

    1997-10-01

    The pressure dependence of the laminar burn rate of gun propellants plays a role in the design and behavior of high-performance guns. We have begun a program to investigate the effects of processing variables on the laminar burn rates, using our high-pressure strand burner to measure these rates at pressures exceeding 700 MPa. We have burned JA2 and M43 propellant samples, provided by Dr. Arpad Juhasz, ARL, from propellant lots previously used in round-robin tests. Our results at room temperature are in accord with other measurements. In addition, we present results measured for propellant that has been preheated to 50 C before burning. We used our thermochemical equilibrium code, CHEETAH, to help interpret the simultaneous pressure and temperature measurements taken during the testing, and show examples of its use. It has been modified to provide performance measures and equations of state for the products that are familiar to the gun-propellant community users of BLAKE.

  5. Severity of symptoms of depression among burned patients one week after injury, using Beck Depression Inventory-II (BDI-II).

    Science.gov (United States)

    Ahrari, Farideh; Salehi, Seyyed Hamid; Fatemi, Mohammad Javad; Soltani, Madjid; Taghavi, Shahrzad; Samimi, Roghayeh

    2013-03-01

    This study was done to determine the severity of symptoms of depression in burned patients and to assess the effect of burn related factors on depression. This is a descriptive cross-sectional survey, performed in Burn center, Motahhari hospital, Tehran University of Medical Sciences, Iran. The population of the study included 300 hospitalized patients from April 2010 to May 2011 who were assessed for symptoms of depression one week after burn injury by Beck Depression Inventory-II. Three hundred subjects (50% female and 50% male) participated in the study. Age ranged from 13 to 75 with the mean of 35.06±12.79 years. 184 (61.3%) had symptoms of depression, 58 (19.3%) of them mild, 52 (17.3%) moderate and 74 (24.7%) severe depression symptoms. There was a significant relationship between symptoms of depression and age, gender, educational level, TBSA%, number of burn sites and amputation (p valueburned patients suggests that depression should be screened in such patients and treat if indicated. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  6. [Effects of different doses of L-arginine on the serum levels of helper T lymphocyte 1 (Th1)/Th2 cytokines in severely burned patients].

    Science.gov (United States)

    Yan, Hong; Peng, Xi; Wang, Pei; Huang, Yue-sheng; Wang, Shi-liang

    2009-10-01

    To investigate the effects of L-arginine in different doses on the serum levels of helper T lymphocyte1 (Th1)/Th2 cytokines in severely burned patients. Twenty-nine severely burned patients, with total burn surface area from 50% to 80%TBSA, hospitalized within 20 hours after burn, were randomly divided into control group (10 cases, fed with 5% glucose saline 500 mL), L-arginine 200 mg group (10 cases, fed with 5% glucose saline 500 mL + 200 mg/kg L-arginine), L-arginine 400 mg group (9 cases, fed with 5% glucose saline 500 mL + 400 mg/kg L-arginine). All patients received enteral feeding through nasointestinal tube, started within 22 hours after burn. Fasting venous blood of all patients was harvested on post burn day (PBD) 1 (before enteral feeding), 3, 5, and 7 to determine serum contents of TNF-alpha, IL-1beta, TGF-beta(1) and IL-4 by radio-immunity method and enzyme-linked immunosorbent assay. Serum contents of TNF-alpha and IL-1beta of patients in all groups increased rapidly after burn, and although contents of TNF-alpha (318 +/- 57) ng/mL and IL-1beta (218 +/- 47) pg/mL of patients in L-arginine 200 mg group peaked on PBD 5, they were still significantly lower than those of patients in control group [(389 +/- 34) ng/mL, (272 +/- 40) pg/mL, P 0.05). Serum contents of TGF-beta(1) and IL-4 of patients in each group increased slowly after burn, and content of TGF-beta(1) (110 +/- 16) pg/mL of patients in L-arginine 200 mg group was significantly higher than that of patients in control group [(83 +/- 20) pg/mL, P 0.05). Compared with the dosage of 400 mg/kg L-arginine, the 200 mg/kg dose is more effective in reducing the release of Th1 cytokines and increasing Th2 cytokines production, hence maintaining Th1/Th2 cytokine ratio to produce better immune opsonization during the infection phase of severe burn.

  7. 成批重度烧伤患者相关感染的个体化治疗%Individualized treatment of infection on mass severe burn casualties

    Institute of Scientific and Technical Information of China (English)

    巴特

    2016-01-01

    Successful treatment of mass severe burn casualties is one of the important criteria to test the emergency response ability of department. Burn sepsis, pulmonary infection, local wound infection, enterogenous infection, and a series of infections in the process of mass burn casualties are seriously threatening the life of the patients. In addition to the routine treatment of patients with severe burn, this article focuses on the individual treatment programs for patients with different infections, and achieved good results. Mass burn casualties with severe burn treatment, need to adjust the specific circumstances, in order to maximize the success rate of treatment.%成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。

  8. Intentional burns in Nepal: a comparative study.

    Science.gov (United States)

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

    2015-09-01

    psychosocial risk factors were identified in most cases. Intentional burns resulted in severe burns with high mortality. Intentional burns are not only a serious medical issue; they represent significant public health and gender issues in Nepal. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  9. Predicting severity of pathological scarring due to burn injuries: a clinical decision making tool using Bayesian networks.

    Science.gov (United States)

    Berchialla, Paola; Gangemi, Ezio Nicola; Foltran, Francesca; Haxhiaj, Arber; Buja, Alessandra; Lazzarato, Fulvio; Stella, Maurizio; Gregori, Dario

    2014-06-01

    It is important for clinicians to understand which are the clinical signs, the patient characteristics and the procedures that are related with the occurrence of hypertrophic burn scars in order to carry out a possible prognostic assessment. Providing clinicians with an easy-to- use tool for predicting the risk of pathological scars. A total of 703 patients with 2440 anatomical burn sites who were admitted to the Department of Plastic and Reconstructive Surgery, Burn Center of the Traumatological Hospital in Torino between January 1994 and May 2006 were included in the analysis. A Bayesian network (BN) model was implemented. The probability of developing a hypertrophic scar was evaluated on a number of scenarios. The error rate of the BN model was assessed internally and it was equal to 24·83%. While classical statistical method as logistic models can infer only which variables are related to the final outcome, the BN approach displays a set of relationships between the final outcome (scar type) and the explanatory covariates (patient's age and gender, burn surface area, full-thickness burn surface area, burn anatomical area and wound-healing time; burn treatment options such as advanced dressings, type of surgical approach, number of surgical procedures, type of skin graft, excision and coverage timing). A web-based interface to handle the BN model was developed on the website www.pubchild.org (burns header). Clinicians who registered at the website could submit their data in order to get from the BN model the predicted probability of observing a pathological scar type. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  10. Organic functional groups in aerosol particles from burning and non-burning forest emissions at a high-elevation mountain site

    Directory of Open Access Journals (Sweden)

    S. Takahama

    2011-07-01

    Full Text Available Ambient particles collected on teflon filters at the Peak of Whistler Mountain, British Columbia (2182 m a.s.l. during spring and summer 2009 were measured by Fourier transform infrared (FTIR spectroscopy for organic functional groups (OFG. The project mean and standard deviation of organic aerosol mass concentrations (OM for all samples was 3.2±3.3 (μg m−3. Measurements of aerosol mass fragments, size, and number concentrations were used to separate fossil-fuel combustion and burning and non-burning forest sources of the measured organic aerosol. The OM was composed of the same anthropogenic and non-burning forest components observed at Whistler mid-valley in the spring of 2008; during the 2009 campaign, biomass burning aerosol was additionally observed from fire episodes occurring between June and September. On average, organic hydroxyl, alkane, carboxylic acid, ketone, and primary amine groups represented 31 %±11 %, 34 %±9 %, 23 %±6 %, 6 %±7 %, and 6 %±3 % of OM, respectively. Ketones in aerosols were associated with burning and non-burning forest origins, and represented up to 27 % of the OM. The organic aerosol fraction resided almost entirely in the submicron fraction without significant diurnal variations. OM/OC mass ratios ranged mostly between 2.0 and 2.2 and O/C atomic ratios between 0.57 and 0.76, indicating that the organic aerosol reaching the site was highly aged and possibly formed through secondary formation processes.

  11. High Burn-Up Spent Nuclear Fuel Vibration Integrity Study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jy-An John [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Hong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Jiang, Hao [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Bevard, Bruce Balkcom [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Howard, Rob L [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Scaglione, John M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-01-01

    The Oak Ridge National Laboratory (ORNL) has developed the cyclic integrated reversible-bending fatigue tester (CIRFT) approach to successfully demonstrate the controllable fatigue fracture on high burnup (HBU) spent nuclear fuel (SNF) in a normal vibration mode. CIRFT enables examination of the underlying mechanisms of SNF system dynamic performance. Due to the inhomogeneous composite structure of the SNF system, the detailed mechanisms of the pellet-pellet and pellet-clad interactions and the stress concentration effects at the pellet-pellet interface cannot be readily obtained from a CIRFT system measurement. Therefore, finite element analyses (FEAs) are used to translate the global moment-curvature measurement into local stress-strain profiles for further investigation. The major findings of CIRFT on the HBU SNF are as follows: SNF system interface bonding plays an important role in SNF vibration performance. Fuel structure contributes to SNF system stiffness. There are significant variations in stress and curvature of SNF systems during vibration cycles resulting from segment pellets and clad interactions. SNF failure initiates at the pellet-pellet interface region and appears to be spontaneous.

  12. Development and in vivo evaluation of silver sulfadiazine loaded hydrogel consisting polyvinyl alcohol and chitosan for severe burns

    Directory of Open Access Journals (Sweden)

    S R Chakavala

    2012-01-01

    Full Text Available A new Hydrogel containing silver Sulfadiazine (SSD was developed for enhanced burns wound healing. The hydrogel was prepared by cross-linking of PVA and Chitosan by freeze thawing method. Their gel properties, moisture retaining capacity, fluid uptake capacity, in vitro release study, in vivo burn healing effect were evaluated. Chitosan and PVA cross linking decreased gel fraction upto 70% determined the good gel properties. This cross linked hydrogel increased the Swelling ratio and Water vapour transmission rate (WVTR which provides the sustained release of drug and moist environment for healing respectively. The hydrogel containing 7.5% of PVA, 0.75% of chitosan found to have increased gel strength, higher water vapour transmission rate and fluid uptake capacity suitable for faster healing of burns. This hydrogel also sustained the release of 1% SSD required for longer antimicrobial activity and found better in vivo burn healing capacity as compared to marketed preparation. Thus hydrogel containing 7.5% of PVA, 0.75% of chitosan and 1% SSD is a potential burns dressing with better gel properties and excellent burns healing capacity.

  13. Use of the Beck Depression Inventory for assessing depression in patients hospitalized with severe burn. Disentangling symptoms of depression from injury and treatment factors.

    Science.gov (United States)

    Thombs, Brett D

    2007-08-01

    The objective of this study was to assess whether scores on the Beck Depression Inventory (BDI) are biased by injury severity among hospitalized survivors of burn (N=262). A confirmatory factor analysis (CFA) model was developed with a general depression factor that loaded on all items and somatic and cognitive factors that were orthogonal to the general factor and to each other. The model fit the data well and substantially better than an alternative three-factor model with correlated factors. Percent total body surface area burned (TBSA) was significantly associated with the general depression factor (p=.04), but also with the orthogonal somatic factor (pburn injury. Analysis of item communalities, however, suggested that only approximately 2% of total predicted item variance was associated with bias related to injury severity. It was concluded that, despite a small amount of bias, the BDI is a reasonably accurate clinical tool even in the context of severe burn. Appropriate adjustments for bias, however, should be made in research with the BDI among patients with acute burn.

  14. Acute pain management in burn patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units. METHOD: The study had...... patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn......OBJECTIVE: Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain...

  15. The Application of Gastrocnemius Flap in Severe Electrical Burns of the Knees%腓肠肌肌瓣在修复严重膝部电烧伤中的应用

    Institute of Scientific and Technical Information of China (English)

    朱维平; 陈国华; 赵琳

    2003-01-01

    Objective To investigate the repairing methods of severe electrical burns of the knees. Methods 10pateints with severe electrical burns of the knees were enrolled in this study. After local debridement, gastrocnemius flap and netskin graft immediately. Results The entire flap survived very well with satisfactory results. Conclusion Early debridementfollowed by gastrocnemius flap and net skin graft could be simple, safe and reliable treatment strategies in the patients withsevere electrical burns of the knees.

  16. The Complete Burning of Weapons Grade Plutonium and Highly Enriched Uranium with (Laser Inertial Fusion-Fission Energy) LIFE Engine

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J C; Diaz de la Rubia, T; Moses, E

    2008-12-23

    blanket in a fusion-fission hybrid system is subcritical, a LIFE engine can burn any fertile or fissile nuclear material, including unenriched natural or depleted U and SNF, and can extract a very high percentage of the energy content of its fuel resulting in greatly enhanced energy generation per metric ton of nuclear fuel, as well as nuclear waste forms with vastly reduced concentrations of long-lived actinides. LIFE engines could thus provide the ability to generate vast amounts of electricity while greatly reducing the actinide content of any existing or future nuclear waste and extending the availability of low cost nuclear fuels for several thousand years. LIFE also provides an attractive pathway for burning excess weapons Pu to over 99% FIMA (fission of initial metal atoms) without the need for fabricating or reprocessing mixed oxide fuels (MOX). Because of all of these advantages, LIFE engines offer a pathway toward sustainable and safe nuclear power that significantly mitigates nuclear proliferation concerns and minimizes nuclear waste. An important aspect of a LIFE engine is the fact that there is no need to extract the fission fuel from the fission blanket before it is burned to the desired final level. Except for fuel inspection and maintenance process times, the nuclear fuel is always within the core of the reactor and no weapons-attractive materials are available outside at any point in time. However, an important consideration when discussing proliferation concerns associated with any nuclear fuel cycle is the ease with which reactor fuel can be converted to weapons usable materials, not just when it is extracted as waste, but at any point in the fuel cycle. Although the nuclear fuel remains in the core of the engine until ultra deep actinide burn up is achieved, soon after start up of the engine, once the system breeds up to full power, several tons of fissile material is present in the fission blanket. However, this fissile material is widely dispersed in

  17. RELATION BETWEEN PORE MODEL AND CENTER-LINE TEMPERATURE IN HIGH BURN-UP UO2 PELLET

    Directory of Open Access Journals (Sweden)

    Suwardi Suwardi

    2010-06-01

    Full Text Available Relation between pore model and center-line temperature of high burn up UO2 Pellet. Temperature distribution has been evaluated by using different model of pore distribution. Typical data of power distribution and coolant data have been chosen in this study. Different core model and core distribution model have been studied for related temperature, in correlation with high burn up thermal properties. Finite element combined finite different adapted from Saturn-1 has been used for calculating the temperature distribution. The center-line temperature for different pore model and related discussion is presented.   Keywords: pore model, high burn up, UO2 pellet, centerline temperature.

  18. Analysis of xRAGE and flag high explosive burn models with PBX 9404 cylinder tests

    Energy Technology Data Exchange (ETDEWEB)

    Harrier, Danielle [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Andersen, Kyle Richard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-05

    High explosives are energetic materials that release their chemical energy in a short interval of time. They are able to generate extreme heat and pressure by a shock driven chemical decomposition reaction, which makes them valuable tools that must be understood. This study investigated the accuracy and performance of two Los Alamos National Laboratory hydrodynamic codes, which are used to determine the behavior of explosives within a variety of systems: xRAGE which utilizes an Eulerian mesh, and FLAG with utilizes a Lagrangian mesh. Various programmed and reactive burn models within both codes were tested using a copper cylinder expansion test. The test was based on a recent experimental setup which contained the plastic bonded explosive PBX 9404. Detonation velocity versus time curves for this explosive were obtained using Photon Doppler Velocimetry (PDV). The modeled results from each of the burn models tested were then compared to one another and to the experimental results. This study validate

  19. Analysis of Xrage and Flag High Explosive Burn Models with PBX 9404 Cylinder Tests

    Science.gov (United States)

    Harrier, Danielle; Fessenden, Julianna; Ramsey, Scott

    2016-11-01

    High explosives are energetic materials that release their chemical energy in a short interval of time. They are able to generate extreme heat and pressure by a shock driven chemical decomposition reaction, which makes them valuable tools that must be understood. This study investigated the accuracy and performance of two Los Alamos National Laboratory hydrodynamic codes, which are used to determine the behavior of explosives within a variety of systems: xRAGE which utilizes an Eulerian mesh, and FLAG with utilizes a Lagrangian mesh. Various programmed and reactive burn models within both codes were tested, using a copper cylinder expansion test. The test was based off of a recent experimental setup which contained the plastic bonded explosive PBX 9404. Detonation velocity versus time curves for this explosive were obtained from the experimental velocity data collected using Photon Doppler Velocimetry (PDV). The modeled results from each of the burn models tested were then compared to one another and to the experimental results using the Jones-Wilkins-Lee (JWL) equation of state parameters that were determined and adjusted from the experimental tests. This study is important to validate the accuracy of our high explosive burn models and the calibrated EOS parameters, which are important for many research topics in physical sciences.

  20. 重度烧伤患者烧伤初期内环境改变及输血治疗的探讨%Investigation of internal environment changes and transfusion therapy at early burn stage of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    陈妙婵; 蔡葵

    2015-01-01

    Objective To explore the clinical significance of internal environment changes and transfusion therapy at early burn stage of severe burn patients.Methods From January 2010 to May 2014,forty-three early extensive severe burn patients who hospitalized in Foshan First People's Hospital of Guangdong Province were enrolled into this study,as study group.Detect the internal environment changes at different time during treatment,such as routine blood test,blood coagulation function,blood gas analysis,blood biochemical indicators and so on.Except of conventional burn treatment,appropriate component transfusion therapy was conducted on patients at the same time,according to its burn surface area and burn degree,volume of surgical hemorrhage,blood oozing from the wound surface and the progression of disease.Analyze the blood transfusion and internal environment changes of early severe burn patients.Forty-three cases of healthy who took health examination in the same hospital during the same period were chose as control group.Statistical analysis was performed on two groups of routine blood test,blood coagulation function,arterial blood gas analysis,blood biochemical indicator and so on.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Foshan First People's Hospital of Guangdong Province.Informed consent was obtained from all participants.There were no significant differences about age and gender between two groups (P>0.05).Results ① At the early stage of burn,sever burn patients had different degree of coagulation dysfunction.Within one day after burning,the prothrombin time (PT),international normalized ratio (INR) and activated partial thromboplastin time (APTT) of study group were higher than t.hose of control group,and the differences were statistically significant (P<0.05) ; At the time of admission,thrombin time (TT) of study group was higher than that of control group,and the difference was statistically significant

  1. Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

    Directory of Open Access Journals (Sweden)

    Liu Hongqi

    2014-01-01

    Full Text Available The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS in the treatment of deep-burns in hands of severely burned patients.We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group; 30 were treated with autologous medium-thickness skin (AMTS (control group. The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22±3.34 days were longer than that of the control group (13.42±3.36 days and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14±1.63 vs. 14.28±2.37 days and statistically significant (P<0.05. The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

  2. Ingesta de antioxidantes y poliaminas en pacientes con quemaduras graves Ingestion of antioxidants and polyamines in patients with severe burns

    Directory of Open Access Journals (Sweden)

    M. Farriol

    2004-10-01

    Full Text Available El objetivo del estudio fue valorar el aporte energético, de antioxidantes y de poliaminas de la ingesta, iniciándose desde las primeras 24 horas inmediatas a la quemadura. La valoración nutricional se realizó a los 7, 15 y 21 días y se comparó con el grupo control (n = 30. La edad de los pacientes (n = 25; 20 hombres y 5 mujeres fue de 45,6 ± 20,4 años. Veintiún pacientes presentaron una superficie corporal quemada (SQC entre el 20-50% y en 4 casos fue superior al 50%. Se observó un descenso del aporte energético medio de ~40% vs el teórico calculado en los 3 períodos: 1.186 ± 32, 1.117 ± 589 y 1.331 ± 578 kcal. En los primeros 15 días la ingesta de antioxidantes fue ligeramente inferior a las RDA para la vitamina C: 60 mg vs 57 ± 32, 57 ± 53 y 75 ± 53 mg, e inferior durante todo el período para la vitamina E: 10 mg vs 5,0 ± 2,9; 4,5 ± 3,0 y 5,3 ± 3,4 mg, selenio: 40 µg vs 22,8 ± 13,7, 22,5 ± 9,8 y 25,7 ± 11,2 µg y zinc: 12 mg vs 7.3 ± 3.0; 6,8 ± 4,8 y 8.4 ± 5,3 mg. La ingesta de taurina descendió en el día 15 y se incrementó significativamente en el día 21: 65,7 ± 30 mg, 50,9 ± 25 y 72,0 ± 29 mg (p Starting the first 24 hours after burn injury, energy supply, antioxidants and polyamines were assessed in 25 severe burn patients (20 men and 5 women with a mean age of 45.6 ± 20.4 years. Nutritional assessment was performed at 7, 15 and 21 days and was compared with a control group (n = 30. In 21 patients the burned body surface area was 20%-50% and in four patients it was greater than 50%. A mean decrease in energy supply of ~40% versus the calculated theoretical value was found in the three periods: 1,186 ± 32; 1,117 ± 589 and 1,331 ± 578 kcal. In the first 15 days antioxidant ingestion was slightly lower than the recommended daily allowance for vitamin C: 60 mg versus 57 ± 32, 57 ± 53 and 75 ± 53 mg, and was lower during the entire period for vita-min E: 10 mg versus 5.0 ± 2.9; 4.5 ± 3.0 and 5.3

  3. Optimization of burn referrals

    DEFF Research Database (Denmark)

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

    2014-01-01

    INTRODUCTION: Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmar...

  4. Extension and validation of the TRANSURANUS burn-up model for helium production in high burn-up LWR fuels

    Science.gov (United States)

    Botazzoli, Pietro; Luzzi, Lelio; Brémier, Stephane; Schubert, Arndt; Van Uffelen, Paul; Walker, Clive T.; Haeck, Wim; Goll, Wolfgang

    2011-12-01

    The TRANSURANUS burn-up model (TUBRNP) calculates the local concentration of the actinides, the main fission products, and 4He as a function of the radial position across a fuel rod. In this paper, the improvements in the helium production model as well as the extensions in the simulation of 238-242Pu, 241Am, 243Am and 242-245Cm isotopes are described. Experimental data used for the extended validation include new EPMA measurements of the local concentrations of Nd and Pu and recent SIMS measurements of the radial distributions of Pu, Am and Cm isotopes, both in a 3.5% enriched commercial PWR UO 2 fuel with a burn-up of 80 and 65 MWd/kgHM, respectively. Good agreement has been found between TUBRNP and the experimental data. The analysis has been complemented by detailed neutron transport calculations (VESTA code), and also revealed the need to update the branching ratio for the 241Am(n,γ) 242mAm reaction in typical PWR conditions.

  5. Burns, hypertrophic scar and galactorrhea.

    Science.gov (United States)

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro

    2013-07-01

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

  6. Burns, hypertrophic scar and galactorrhea

    Directory of Open Access Journals (Sweden)

    Hamid Karimi

    2013-07-01

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

  7. Use of a pediatric oxygenator integrated in a veno-venous hemofiltration circuit to remove CO2: a case report in a severe burn patient with refractory hypercapnia.

    Science.gov (United States)

    Rousseau, Anne-Françoise; Damas, Pierre; Renwart, Ludovic; Amand, Théo; Erpicum, Marie; Morimont, Philippe; Dubois, Bernard; Massion, Paul B

    2014-11-01

    Acute respiratory distress syndrome management is currently based on lung protective ventilation. Such strategy may lead to hypercapnic acidosis. We report a case of refractory hypercapnia in a severe burn adult, treated with simplified veno-venous extracorporeal carbon dioxide removal technique. We integrated a pediatric oxygenator in a continuous veno-venous hemofiltration circuit. This technique, used during at least 96h, was feasible, sure and efficient with carbon dioxide removal rate up to 32%.

  8. Burn Pits

    Science.gov (United States)

    ... Enter ZIP code here Enter ZIP code here Burn Pits Burn Pits Registry Studies Photo: U.S. Department ... the health of deployed Veterans. Health effects from burn pit smoke Toxins in burn pit smoke may ...

  9. Burn Institute

    Science.gov (United States)

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  10. [Hydrofluoric acid burns].

    Science.gov (United States)

    Holla, Robin; Gorter, Ramon R; Tenhagen, Mark; Vloemans, A F P M Jos; Breederveld, Roelf S

    2016-01-01

    Hydrofluoric acid is increasingly used as a rust remover and detergent. Dermal contact with hydrofluoric acid results in a chemical burn characterized by severe pain and deep tissue necrosis. It may cause electrolyte imbalances with lethal consequences. It is important to identify high-risk patients. 'High risk' is defined as a total affected body area > 3% or exposure to hydrofluoric acid in a concentration > 50%. We present the cases of three male patients (26, 31, and 39 years old) with hydrofluoric acid burns of varying severity and describe the subsequent treatments. The application of calcium gluconate 2.5% gel to the skin is the cornerstone of the treatment, reducing pain as well as improving wound healing. Nails should be thoroughly inspected and possibly removed if the nail is involved, to ensure proper healing. In high-risk patients, plasma calcium levels should be evaluated and cardiac monitoring is indicated.

  11. Effects of a 12-week rehabilitation program with music & exercise groups on range of motion in young children with severe burns.

    Science.gov (United States)

    Neugebauer, Christine Tuden; Serghiou, Michael; Herndon, David N; Suman, Oscar E

    2008-01-01

    Previous studies indicate that rehabilitation programs supplemented with a strength and endurance-based exercise program improve lean body mass, pulmonary function, endurance, strength, and functional outcomes in severely burned children over the age of 7-years when compared with standard of care (SOC). To date, supplemental exercise programming for severely burned children under the age of 7-years has not yet been explored. The purpose of this study was to determine if a 12-week rehabilitation program supplemented with music & exercise, was more effective in improving functional outcomes than the SOC alone. This is a descriptive study that measured elbow and knee range of motion (ROM) in 24 severely burned children between ages 2 and 6 years. Groups were compared for demographics as well as active and passive ROM to bilateral elbows and knees. A total of 15 patients completed the rehabilitation with supplemental music and exercise, and data was compared with 9 patients who received SOC. Patients receiving the 12-week program significantly improved ROM in all joints assessed except for one. Patients receiving SOC showed a significant improvement in only one of the joints assessed. Providing a structured supplemental music and exercise program in conjunction with occupational and physical therapy seems to improve both passive and active ROM to a greater extent than the SOC alone.

  12. Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates.

    Science.gov (United States)

    Friedman, Bruce C; Mian, Mohammad A H; Mullins, Robert F; Hassan, Zaheed; Shaver, Joseph R; Johnston, Krystal K

    2015-01-01

    The objective of this study is to determine the catheter-related bloodstream infection (CRBSI) rate in a severely burned patient population, many of whom required prolonged use of central venous catheters (CVCs). Between January 2008 and June 2012, 151 patients underwent placement of 455 five-lumen minocycline/rifampin-impregnated CVCs. CRBSI was defined as at least one blood culture (>100,000 colonies) and one simultaneous roll-plate CVC tip culture (>15 colony forming units) positive for the same organism. Most patients had accidental burns (81.5%) with a mean TBSA of 50%. A mean of three catheters were inserted per patient (range, 1-25). CVCs were inserted in the femoral vein (91.2%), subclavian vein (5.3%), and internal jugular vein (3.3%). Mean overall catheter indwell time was 8 days (range, 0-39 days). The overall rate of CRBSI per 1000 catheter days was 11.2; patients with a TBSA >60% experienced significantly higher rates of CRBSI than patients with a TBSA ≤60% (16.2 vs 7.3, P = .01). CVCs placed through burned skin were four times more likely to be associated with CRBSI than CVCs placed through intact skin. The most common infectious organism was Acinetobacter baumannii. Deep venous thrombosis developed in eleven patients (7%). The overall rate of CRBSI was 11.2, consistent with published rates of CRBSI in burn patients. Thus, femoral placement of 5-lumen CVCs did not result in increased CRBSI rates. These data support the safety of femoral CVC placement in burn patients, contrary to the Centers for Disease Control recommendation to avoid femoral CVC insertion.

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

    Directory of Open Access Journals (Sweden)

    Guillermo García Álvarez

    2015-09-01

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

  14. The Correlation Between the Burning Features, the Burning Agent and Motivation in Burn Victims Attending Shahid Motahari Hospital in Tehran During 2009: letter to Editor

    Directory of Open Access Journals (Sweden)

    Kamran Aghakhani M.D.

    2011-06-01

    Full Text Available Burning is one of the commonest causes of death. Due to the high rate of death among burn victims epidemiological investigation of burning, burning agents and the relevant motivations can be of great preventive value.1 In this cross-sectional study all the hospitalized patients in Shahid Motahari Burn Hospital at Tehran city in the year 2009 were included in the study. The collected data were analyzed by SPSS (ver. 17 software. Out of the 1548 hospitalized patients for burn, 1134 (73.3% left hospital in good conditions, 47 (3% left in relatively good conditions, 289 (18.7% died and 78 (5% persons left the Hospital satisfactorily on their own volition. About two-thirds of the patients were men. The mean age of the burn victims was 27.9±18.3 years, 16% of them being 5 years old or younger. The highest percentage of burn area was 30% of the total body surface which was seen in 20 to 30-year old patients. 58.7% of burns had been caused by fire. 94% of the burns had happened accidentally, 5% by suicidal and 1% by homicidal acts. The highest percentage of burn was observed in patients in whom the burn agent was fire. Six (4% persons had first degree, 820 (53% persons had second degree and 722 (46.6% had third degree burns. In patients who had committed suicide third degree burns were higher than second degree burns (7.7% vs. 2%. 24.4% of women and 16.6% of men died due to the burns. The rate of death in patients less than 50 years of age was 18% but the figure increased to 24% in those above 50. A burn area less than or more than 10% was, respectively correlated with 2.1% and 22.1% of deaths. 34.8% of the patients with third degree burns and 4.6% of those with second and first degree burns died. 58.3% of the suicidal patient died due to the severity of the burns relative to 16.7% due to other causes. 89 (5.7% patients had respiratory tract burns and the death rate was 58.4% among these patients while the death rate was 16.2% in patients without

  15. Thermodynamic analysis for high burn-up fuel internal chemistry. 2

    Energy Technology Data Exchange (ETDEWEB)

    Fuji, Kensho; Kyoh, Bunkei [Kinki Univ., Higashi-Osaka, Osaka (Japan)

    1998-09-01

    Thermodynamic calculations with the computer program SOLGASMIX-PV have been performed for the chemical states expected in irradiated fast breeder reactor (FBR) fuels containing transuranium (TRU) elements. The analysis shows that A (alkali and alkaline-earth)-molybdates exist, but neither A-uranates nor A-zirconates are formed in FBR fuel pellets irradiated to high burn-up. And increase of oxygen potential in irradiated FBR fuel is ascribed to growing amount of rare earth, noble metal and TRU elements. (author)

  16. High temperature corrosion by combustion gases produced by burning liquid fuels containing sulphur, sodium and vanadium.

    OpenAIRE

    Khan, Fazlur Rahman

    1980-01-01

    High temperature corrosion, at 730° C, by combustion gases produced by burning liquid fuels in a laboratory combustor has been investigated. A selected range of steels and alloys (mild steel, stainless steel type 347, Nimonic N90, N105, and IN657) have been tested in the combustion gases using fuels containing varying amounts of impurities in the range of 0 - 6% sulphur, 0 - 60 ppm sodium, and 0 - 300 ppm vanadium. On the basis of the comprehensive results a computer programme was written t...

  17. EBSD and TEM characterization of high burn-up mixed oxide fuel

    Science.gov (United States)

    Teague, Melissa; Gorman, Brian; Miller, Brandon; King, Jeffrey

    2014-01-01

    Understanding and studying the irradiation behavior of high burn-up oxide fuel is critical to licensing of future fast breeder reactors. Advancements in experimental techniques and equipment are allowing for new insights into previously irradiated samples. In this work dual column focused ion beam (FIB)/scanning electron microscope (SEM) was utilized to prepared transmission electron microscope samples from mixed oxide fuel with a burn-up of 6.7% FIMA. Utilizing the FIB/SEM for preparation resulted in samples with a dose rate of <0.5 mRem/h compared to ∼1.1 R/h for a traditionally prepared TEM sample. The TEM analysis showed that the sample taken from the cooler rim region of the fuel pellet had ∼2.5× higher dislocation density than that of the sample taken from the mid-radius due to the lower irradiation temperature of the rim. The dual column FIB/SEM was additionally used to prepared and serially slice ∼25 μm cubes. High quality electron back scatter diffraction (EBSD) were collected from the face at each step, showing, for the first time, the ability to obtain EBSD data from high activity irradiated fuel.

  18. Chronic arsenic poisoning from burning high-arsenic-containing coal in Guizhou, China

    Energy Technology Data Exchange (ETDEWEB)

    Liu, J.; Zheng, B.S.; Aposhian, H.V.; Zhou, Y.S.; Chen, M.L.; Zhang, A.H.; Waalkes, M.P. [NIEHS, Research Triangle Park, NC (USA)

    2002-07-01

    Arsenic is an environmental hazard and the reduction of drinking water arsenic levels is under consideration. People are exposed to arsenic not only through drinking water but also through arsenic-contaminated air and food. Here the health effects of arsenic exposure from burning high arsenic-containing coal in Guizhou, China was investigated. Coal is burned inside the home in open pits for daily cooking and crop drying, producing a high concentration of arsenic in indoor air. Arsenic in the air coats and permeates food being dried producing high concentrations in food; however, arsenic concentrations in the drinking water are in the normal range. The estimated sources of total arsenic exposure in this area are from arsenic-contaminated food (50-80%), air (10-20%), water (1-5%), and direct contact in coal-mining workers (1%). At least 3,000 patients with arsenic poisoning were found in the Southwest Prefecture of Guizhou, and approximately 200,000 people are at risk for such over exposures. Skin lesions are common, including keratosis of the hands and feet, pigmentation on the trunk, skin ulceration, and skin cancers. Toxicities to internal organs, including lung dysfunction, neuropathy, and nephrotoxicity, are clinically evident. The prevalence of hepatomegaly was 20%, and cirrhosis, ascites, and liver cancer are the most serious outcomes of arsenic poisoning. The Chinese government and international organizations are attempting to improve the house conditions and the coal source, and thereby protect human health in this area.

  19. Behaviour of fission gas in the rim region of high burn-up UO 2 fuel pellets with particular reference to results from an XRF investigation

    Science.gov (United States)

    Mogensen, M.; Pearce, J. H.; Walker, C. T.

    1999-01-01

    XRF and EPMA results for retained xenon from Battelle's high burn-up effects program are re-evaluated. The data reviewed are from commercial low enriched BWR fuel with burn-ups of 44.8-54.9 GWd/tU and high enriched PWR fuel with burn-ups from 62.5 to 83.1 GWd/tU. It is found that the high burn-up structure penetrated much deeper than initially reported. The local burn-up threshold for the formation of the high burn-up structure in those fuels with grain sizes in the normal range lay between 60 and 75 GWd/tU. The high burn-up structure was not detected by EPMA in a fuel that had a grain size of 78 μm although the local burn-up at the pellet rim had exceeded 80 GWd/tU. It is concluded that fission gas had been released from the high burn-up structure in three PWR fuel sections with burn-ups of 70.4, 72.2 and 83.1 GWd/tU. In the rim region of the last two sections at the locations where XRF indicated gas release the local burn-up was higher than 75 GWd/tU.

  20. Burn-back Equations for High Volumetric Loading Single-grain Dual-thrust Rocket Propellant Configuration (Review Paper

    Directory of Open Access Journals (Sweden)

    Himanshu Shekhar

    2011-02-01

    Full Text Available Dual-thrust mode is adopted in solid propellant rocket propulsion through tailoring of burning area, nozzle, rocket motor chamber, propellant type, multiple propellant blocks. In the present study, mathematical formulation has been evolved for generation of burning surface area with web burnt for a simple central blind hole in a solid cylindrical propellant geometry with proper partial inhibition on external and lateral surfaces. The burn-back equation has been validated by static firing and parametric study was conducted to understand effect of various control geometrical parameters. The system is utilised for high volumetric loading, single propellant, single composition, single-chamber, single nozzle dual-thrust mode of burning profiles in rocket application.Defence Science Journal, 2011, 61(2, pp.165-170, DOI:http://dx.doi.org/10.14429/dsj.61.41

  1. Characterization of high-resolution aerosol mass spectra of primary organic aerosol emissions from Chinese cooking and biomass burning

    Directory of Open Access Journals (Sweden)

    L.-Y. He

    2010-09-01

    Full Text Available Aerosol Mass Spectrometer (AMS has proved to be a powerful tool to measure submicron particulate composition with high time resolution. Factor analysis of mass spectra (MS collected worldwide by AMS demonstrates that submicron organic aerosol (OA is usually composed of several major components, such as oxygenated (OOA, hydrocarbon-like (HOA, biomass burning (BBOA, and other primary OA. In order to help interpretation of component MS from factor analysis of ambient OA datasets, AMS measurement of different primary sources is required for comparison. Such work, however, has been very scarce in the literature, especially for high resolution MS (HR-MS measurement, which performs improved characterization by separating the ions of different elemental compositions at each m/z in comparison with unit mass resolution MS (UMR-MS measurement. In this study, primary emissions from four types of Chinese cooking (CC and six types of biomass burning (BB were simulated systemically and measured using an Aerodyne High-Resolution Time-of-Flight AMS (HR-ToF-AMS. The MS of the CC emissions show high similarity with m/z 41 and m/z 55 being the highest signals; the MS of the BB emissions also show high similarity with m/z 29 and m/z 43 being the highest signals. The MS difference between the CC and BB emissions is much bigger than that between different CC (or BB types, especially for the HR-MS. The O/C ratio of OA ranges from 0.08 to 0.13 for the CC emissions while from 0.18 to 0.26 for the BB emissions. The ions of m/z 43, m/z 44, m/z 57, and m/z 60, usually used as tracer ions in AMS measurement, were examined for their HR-MS characteristics in the CC and BB emissions. Moreover, the MS of the CC and BB emissions are also used to compare with component MS from factor analysis of ambient OA datasets observed in China, as well as with other AMS measurements of primary sources in the literature. The MS

  2. Instant release fraction and matrix release of high burn-up UO2 spent nuclear fuel: Effect of high burn-up structure and leaching solution composition

    Science.gov (United States)

    Serrano-Purroy, D.; Clarens, F.; González-Robles, E.; Glatz, J. P.; Wegen, D. H.; de Pablo, J.; Casas, I.; Giménez, J.; Martínez-Esparza, A.

    2012-08-01

    Two weak points in Performance Assessment (PA) exercises regarding the alteration of Spent Nuclear Fuel (SNF) are the contribution of the so-called Instant Release Fraction (IRF) and the effect of High Burn-Up Structure (HBS). This manuscript focuses on the effect of HBS in matrix (long term) and instant release of a Pressurised Water Reactor (PWR) SNF irradiated in a commercial reactor with a mean Burn-Up (BU) of 60 GWd/tU. In order to study the HBS contribution, two samples from different radial positions have been prepared. One from the centre of the SNF, labelled CORE, and one from the periphery, enriched with HBS and labelled OUT. Static leaching experiments have been carried out with two synthetic leaching solutions: bicarbonate (BIC) and Bentonitic Granitic Groundwater (BGW), and in all cases under oxidising conditions. IRF values have been calculated from the determined Fraction of Inventory in Aqueous Phase (FIAP). In all studied cases, some radionuclides (RN): Rb, Sr and Cs, have shown higher release rates than uranium, especially at the beginning of the experiment, and have been considered as IRF. Redox sensitive RN like Mo and Tc have been found to dissolve slightly faster than uranium and further studies might be needed to confirm if they can also be considered part of the IRF. Most of the remaining studied RN, mainly actinides and lanthanides, have been found to dissolve congruently with the uranium matrix. Finally, Zr, Ru and Rh presented lower release rates than the matrix. Higher matrix release has been determined for CORE than for OUT samples showing that the formation of HBS might have a protective effect against the oxidative corrosion of the SNF. On the contrary, no significant differences have been observed between the two studied leaching solutions (BIC and BGW). Two different IRF contributions have been determined. One corresponding to the fraction of inventory segregated in the external open grain boundaries, directly available to water and

  3. Historic records of organic aerosols from a high Alpine glacier: implications of biomass burning, anthropogenic emissions, and dust transport

    Directory of Open Access Journals (Sweden)

    C. Müller-Tautges

    2015-05-01

    Full Text Available Historic records of α-dicarbonyls (glyoxal, methylglyoxal, carboxylic acids (C6–C12 dicarboxylic acids, pinic acid, p-hydroxybenzoic acid, phthalic acid, 4-methylphthalic acid, and major ions (oxalate, formate, calcium were determined with annual resolution in an ice core from Grenzgletscher in the southern Swiss Alps, covering the time period from 1942 to 1993. Measurements were conducted using ultra-high performance liquid chromatography (UHPLC coupled to electrospray ionization high resolution mass spectrometry (ESI-HRMS. For the first time, long-term records of the carboxylic acids and dicarbonyls as well as their source apportionment are reported for Western Europe. Source assignment of the organic species present in the ice core was performed using principal component analysis. Our results suggest biomass burning, anthropogenic emissions, and transport of mineral dust to be the main parameters influencing the concentration of organic compounds. Ice core records of several highly correlated compounds (e.g. p-hydroxybenzoic acid, pinic acid, C7 and C8 dicarboxylic acids can be related to the forest fire history in southern Switzerland. P-hydroxybenzoic acid was found to be the best organic fire tracer in the study area, revealing the highest correlation with the burned area from fires. Historical records of methylglyoxal, phthalic acid, and dicarboxylic acids C6, C10, and C12 are comparable with that of anthropogenic emissions of volatile organic compounds (VOCs. The small organic acids oxalic acid and formic acid are both highly correlated with calcium, suggesting their records to be affected by changing mineral dust transport to the drilling site.

  4. Historic records of organic compounds from a high Alpine glacier: influences of biomass burning, anthropogenic emissions, and dust transport

    Science.gov (United States)

    Müller-Tautges, C.; Eichler, A.; Schwikowski, M.; Pezzatti, G. B.; Conedera, M.; Hoffmann, T.

    2016-01-01

    Historic records of α-dicarbonyls (glyoxal, methylglyoxal), carboxylic acids (C6-C12 dicarboxylic acids, pinic acid, p-hydroxybenzoic acid, phthalic acid, 4-methylphthalic acid), and ions (oxalate, formate, calcium) were determined with annual resolution in an ice core from Grenzgletscher in the southern Swiss Alps, covering the time period from 1942 to 1993. Chemical analysis of the organic compounds was conducted using ultra-high-performance liquid chromatography (UHPLC) coupled to electrospray ionization high-resolution mass spectrometry (ESI-HRMS) for dicarbonyls and long-chain carboxylic acids and ion chromatography for short-chain carboxylates. Long-term records of the carboxylic acids and dicarbonyls, as well as their source apportionment, are reported for western Europe. This is the first study comprising long-term trends of dicarbonyls and long-chain dicarboxylic acids (C6-C12) in Alpine precipitation. Source assignment of the organic species present in the ice core was performed using principal component analysis. Our results suggest biomass burning, anthropogenic emissions, and transport of mineral dust to be the main parameters influencing the concentration of organic compounds. Ice core records of several highly correlated compounds (e.g., p-hydroxybenzoic acid, pinic acid, pimelic, and suberic acids) can be related to the forest fire history in southern Switzerland. P-hydroxybenzoic acid was found to be the best organic fire tracer in the study area, revealing the highest correlation with the burned area from fires. Historical records of methylglyoxal, phthalic acid, and dicarboxylic acids adipic acid, sebacic acid, and dodecanedioic acid are comparable with that of anthropogenic emissions of volatile organic compounds (VOCs). The small organic acids, oxalic acid and formic acid, are both highly correlated with calcium, suggesting their records to be affected by changing mineral dust transport to the drilling site.

  5. Effects of a Hospital Based Wellness and Exercise Program on Quality of Life of Children with Severe Burns

    Science.gov (United States)

    Rosenberg, Marta; Celis, Mario M; Meyer, Walter; Tropez-Arceneaux, Lisa; McEntire, Serina J.; Fuchs, Helen; Richardson, Lisa; Holzer, Charles; Herndon, David N.; Suman, Oscar E.

    2012-01-01

    Objective To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥ 40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes. Methods Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28. Results The mean age of children in the W&E group was 14.07y±3.5 and mean TBSA was 58%±11.8. The mean age of children in the SOC group was 13.9y±3.1 and mean TBSA was 49%±7.8. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children’s physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning post-exercise. Conclusions These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes. PMID:22985974

  6. Burning vasculitis.

    Science.gov (United States)

    Chadha, Priyanka; Hobday, Dorian; O'Connor, Edmund Fitzgerald; D'Cruz, David

    2016-04-26

    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn.

  7. Effect of vitamin D supplementation and isokinetic training on muscle strength, explosive strength, lean body mass and gait in severely burned children: A randomized controlled trial.

    Science.gov (United States)

    Ebid, Anwar Abdelgayed; El-Shamy, Shamekh Mohamed; Amer, Maysa Abbas

    2017-03-01

    To determine the effects of vitamin D (VD) supplementation and isokinetic training on muscle strength, explosive strength (counter movement jump) (ES), lean body mass (LBM) and gait parameters in severe pediatric burn. Forty-eight burned children with circumferential lower extremity burns covering 40-55% of the total body surface area (TBSA), aged 10-16 years (Mean±SD 13.01±1.75), were randomized into the standard of care (n=16), isokinetic (n=17) and VD (n=15) groups. Unburned children (n=20) served as matched controls. All burned children received 12 weeks of routine physical therapy program (RPTP). In addition, the isokinetic group received isokinetic training for the quadriceps dominant limb 3 times per week at angular velocity 150°/s, and the VD group received the isokinetic training plus an oral daily dose of vitamin D3 1000 IU (Cholecalciferol). The primary measures, assessed at baseline and 12 weeks, included quadriceps strength by isokinetic dynamometer, ES, LBM by dual-energy X-ray absorptiometry (DEXA) and gait parameters by GAITRite system. The VD and isokinetic groups showed significant improvement in quadriceps strength, ES, LBM and gait parameters compared with the standard of care, and VD group show significant improvement in the VD level as compared with the other groups. The outcome measures (and percent of improvement where applicable) for the VD, isokinetic and standard of care are as follows: quadriceps strength, 85.25±0.93Nm (85%), 64.25±0.93 (36%) and 51.88±1.31Nm (12%); stride length, 94.00±2.69 (7%), 110.60±2.87 (25%) and 139.56±2.57 (60%); step length, 67.26±2.45 (72%), 55.25±2.49 (43%) and 43.76±1.34 (18%); velocity, 133.94±1.65 (82%), 99.94±1.65 (35%) and 80.11±1.91 (9%); and cadence, 140.63±1.36 (68%), 132.63±1.36 (58%) and 90.35±1.32 (9%), VD level 43.33±7.48 (75%), 24.77±7.38 (5%) and 25.63±8.39 (4%) respectively. VD supplementation combined with exercise training significantly increased muscle strength, ES, LBM

  8. esearch and Application of Burned Microporous High Alumian—Graphite(Al/C) Brick in Blast Furnace

    Institute of Scientific and Technical Information of China (English)

    ZHANXiaoming; SONGMusen

    1999-01-01

    This paper inroduces the research background,technology,product property and application of burned microporous high alumina-graphite brick (Al2O3-C brick) used in blast furnace,The difference of property between Al2O3-C brick and other blast furnace refractories is discussed .The results of simulative tests show that ,Al2O3-C brick has good alkali resistance,slag resistance,thermal shock resistance,oxidation resistance,high thermal conductivity,low permeability and low solubility in molten iron,The brick with micropores of average radius less than 1μm has been successively applied to fourteen blast furnaces, the lining life of the brick is almost as long as that of Si3N4 bonded SiC brick Al2O3-C brick will be widely used in lower stack ,belly,bosh and hearth in the future.

  9. Assessment of post-fire changes in land surface temperature and surface albedo, and their relation with fire-burn severity using multitemporal MODIS imagery

    OpenAIRE

    Veraverbeke, Sander; Verstraeten, Willem W.; Lhermitte, Stefaan; Van De Kerchove, Ruben; Goossens, Rudi

    2012-01-01

    This study evaluates the effects of the large 2007 Peloponnese (Greece) wildfires on changes in broadband surface albedo (a), daytime land surface temperature (LSTd) and night-time LST (LSTn) using a 2-year post-fire time series of Moderate Resolution Imaging Spectroradiometer satellite data. In addition, it assesses the potential of remotely sensed a and LST as indicators for fire-burn severity. Immediately after the fire event, mean a dropped up to 0.039 (standard deviation = 0.012) (P < 0....

  10. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie [Dept. of Radiology, Hangang Scared Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Lee, Eil Seong [Dept.of Radiology, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju (Korea, Republic of)

    2011-04-15

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  11. [The pain from burns].

    Science.gov (United States)

    Latarjet, J

    2002-03-01

    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.

  12. Implications of high altitude desert dust transport from Western Sahara to Nile Delta during biomass burning season.

    Science.gov (United States)

    Prasad, Anup K; El-Askary, Hesham; Kafatos, Menas

    2010-11-01

    The air over major cities and rural regions of the Nile Delta is highly polluted during autumn which is the biomass burning season, locally known as black cloud. Previous studies have attributed the increased pollution levels during the black cloud season to the biomass or open burning of agricultural waste, vehicular, industrial emissions, and secondary aerosols. However, new multi-sensor observations (column and vertical profiles) from satellites, dust transport models and associated meteorology present a different picture of the autumn pollution. Here we show, for the first time, the evidence of long range transport of dust at high altitude (2.5-6 km) from Western Sahara and its deposition over the Nile Delta region unlike current Models. The desert dust is found to be a major contributor to the local air quality which was previously considered to be due to pollution from biomass burning enhanced by the dominant northerly winds coming from Europe.

  13. Record high peaks in PCB concentrations in the Arctic atmosphere due to long-range transport of biomass burning emissions

    Directory of Open Access Journals (Sweden)

    S. Eckhardt

    2007-05-01

    Full Text Available Soils and forests in the boreal region of the northern hemisphere are recognised as having a large capacity for storing air-borne Persistent Organic Pollutants (POPs, such as the polychlorinated biphenyls (PCBs. Following reductions of primary emissions of various legacy POPs, there is an increasing interest and debate about the relative importance of secondary re-emissions on the atmospheric levels of POPs. In spring of 2006, biomass burning emissions from agricultural fires in Eastern Europe were transported to the Zeppelin station on Svalbard, where record-high levels of many air pollutants were recorded (Stohl et al., 2007. Here we report on the extremely high concentrations of PCBs that were also measured during this period. 21 out of 32 PCB congeners were enhanced by more than two standard deviations above the long-term mean concentrations. In July 2004, about 5.8 million hectare of boreal forest burned in North America, emitting a pollution plume which reached the Zeppelin station after a travel time of 3–4 weeks (Stohl et al., 2006. Again, 12 PCB congeners were elevated above the long-term mean by more than two standard deviations, with the less chlorinated congeners being most strongly affected. We propose that these abnormally high concentrations were caused by biomass burning emissions. Based on enhancement ratios with carbon monoxide and known emissions factors for this species, we estimate that 130 and 66 μg PCBs were released per kilogram dry matter burned, respectively. To our knowledge, this is the first study relating atmospheric PCB enhancements with biomass burning. The strong effects on observed concentrations far away from the sources, suggest that biomass burning is an important source of PCBs for the atmosphere.

  14. Transmutation Analysis of Enriched Uranium and Deep Burn High Temperature Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Michael A. Pope

    2012-07-01

    High temperature reactors (HTRs) have been under consideration for production of electricity, process heat, and for destruction of transuranics for decades. As part of the transmutation analysis efforts within the Fuel Cycle Research and Development (FCR&D) campaign, a need was identified for detailed discharge isotopics from HTRs for use in the VISION code. A conventional HTR using enriched uranium in UCO fuel was modeled having discharge burnup of 120 GWd/MTiHM. Also, a deep burn HTR (DB-HTR) was modeled burning transuranic (TRU)-only TRU-O2 fuel to a discharge burnup of 648 GWd/MTiHM. For each of these cases, unit cell depletion calculations were performed with SCALE/TRITON. Unit cells were used to perform this analysis using SCALE 6.1. Because of the long mean free paths (and migration lengths) of neutrons in HTRs, using a unit cell to represent a whole core can be non-trivial. The sizes of these cells were first set by using Serpent calculations to match a spectral index between unit cell and whole core domains. In the case of the DB-HTR, the unit cell which was arrived at in this way conserved the ratio of fuel to moderator found in a single block of fuel. In the conventional HTR case, a larger moderator-to-fuel ratio than that of a single block was needed to simulate the whole core spectrum. Discharge isotopics (for 500 nuclides) and one-group cross-sections (for 1022 nuclides) were delivered to the transmutation analysis team. This report provides documentation for these calculations. In addition to the discharge isotopics, one-group cross-sections were provided for the full list of 1022 nuclides tracked in the transmutation library.

  15. Management of Outpatient Burns

    OpenAIRE

    Waslen, G. D.

    1986-01-01

    The severity of burns depends on the depth and extent of body surface involved. The total body surface area (TBSA) involved can be estimated by the ‘rule of nines’; body locations are 9% of body surface or multiples of nine. Depth and TBSA can be used to classify burns as minor, moderate, or critical. Diagnosis depends on history and physical examination. Most burns can be treated in an outpatient setting. Treatment should include debriding necrotic tissue, preventing infection and encouragin...

  16. Mechanisms of skeletal muscle wasting after severe burn and its treatment%严重烧伤后骨骼肌消耗的机制与治疗前景思考

    Institute of Scientific and Technical Information of China (English)

    柴家科

    2009-01-01

    Most of the major advances in burn treatment were made within the last five decades. However, hyperrnetabol-ic response after severe burn remains a problem in the treatment of patients with massive burn. As skeletal muscle accounts for o-ver 50% of body cell dry weight, its catabolism exerts profound effect on body metabolism as a whole. Main mechanisms under-lying skeletal muscle wasting induced by severe burn include ac-tivation of ubiquitin-proteasome pathway, bringing about break-down of muscle protein, and myonuclear apoptosis. Therapeutic strategies for skeletal muscle wasting after burn mainly include maintenance of room temperature at (31.5±0.7)℃, early ac-tive and passive exercise of skeletal muscles, administration of β adrenergic receptor blocker such as Prnpranolol, recombinant growth hormone, androgen, and insulin, which has lately been proven to possess the effect of suppressing myonuclear apoptosis after burn. Combination of multiple therapeutic strategies is ben-eficial in reducing complications of burn patients, particularly wide ranged skeletal muscle atrophy, to achieve a better clinical outcome.

  17. 烧伤脓毒症发病机制与防治对策%The pathogenesis and management of severe sepsis after burns

    Institute of Scientific and Technical Information of China (English)

    姚咏明; 盛志勇; 柴家科

    2008-01-01

    Sepsis and septic shock as a result of an invasire infection are challenging problems in extensively burned patients, and frequently end in multiple organ dysfunction syndrome (MODS).It is of great significance to further elucidate the pathogenetic mechanisms, and to seek novel intervention strategies to prevent and treat sepsis/MODS secondary to severe bums. A more complete understanding of the pathogenetic mechanisms of postburn sepsis would certainly elicit a number of potential therapeutic strategies for it. It is our belief that compre hensive clinical measures for management of severe sepsis should include rapid, adequate fluid resuscitation for bum shock, early feeding, effective control of infection, early escharectomy, and reinforcement of organ support. Once bum wound sepsis occurs, prompt removal of infected necrotic tissue is the key procedure to ensure a successful result. Further study is necessary to determine the precise mechanisms of these protective effects and the clinical advantages for postburn sepsis using evidence-based methodology system.

  18. Do Large Fire Runs Result in More Severe Fires?

    Science.gov (United States)

    Morgan, P.; Birch, D.; Kolden, C.; Smith, A. M.

    2013-12-01

    Do large fire runs consistently result in high severity fires, and how do climate, weather topography and fuels influence where they burn severely? We analyzed burn severity on 11,938 polygons representing daily area growth (0.09 - 5559 ha, median 0.75 ha) from 410 days of fire progression totaling more than 141,363 ha from 43 large forest fires from Idaho and Montana that burned 2007-2011. We used burn severity classes interpreted using differenced Normalized Burn Ratio from 30-m Landsat satellite imagery by the Monitoring Trends in Burn Severity project, along with infrared perimeter maps provided by the USDA Forest Service National Infrared Operations. Proportion burned with high severity, likely indicating tree mortality >70%, was not correlated with the daily area growth (Kendall Tau=0.288, p=Forest Machine Learning algorithm to analyze burn severity relative to 31 fuel, topography, and weather factors, with weather factors such as temperature and relative humidity based on the 24-hour burn period, all at randomly located points within polygons. Results support our hypothesis that local, bottom-up fuels and topography influences where fires burn severely, while top-down climate and weather more strongly influence area burned, even when large areas burn within a single 24-hour period.

  19. The Complete Burning of Weapons Grade Plutonium and Highly Enriched Uranium with (Laser Inertial Fusion-Fission Energy) LIFE Engine

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J C; Diaz de la Rubia, T; Moses, E

    2008-12-23

    blanket in a fusion-fission hybrid system is subcritical, a LIFE engine can burn any fertile or fissile nuclear material, including unenriched natural or depleted U and SNF, and can extract a very high percentage of the energy content of its fuel resulting in greatly enhanced energy generation per metric ton of nuclear fuel, as well as nuclear waste forms with vastly reduced concentrations of long-lived actinides. LIFE engines could thus provide the ability to generate vast amounts of electricity while greatly reducing the actinide content of any existing or future nuclear waste and extending the availability of low cost nuclear fuels for several thousand years. LIFE also provides an attractive pathway for burning excess weapons Pu to over 99% FIMA (fission of initial metal atoms) without the need for fabricating or reprocessing mixed oxide fuels (MOX). Because of all of these advantages, LIFE engines offer a pathway toward sustainable and safe nuclear power that significantly mitigates nuclear proliferation concerns and minimizes nuclear waste. An important aspect of a LIFE engine is the fact that there is no need to extract the fission fuel from the fission blanket before it is burned to the desired final level. Except for fuel inspection and maintenance process times, the nuclear fuel is always within the core of the reactor and no weapons-attractive materials are available outside at any point in time. However, an important consideration when discussing proliferation concerns associated with any nuclear fuel cycle is the ease with which reactor fuel can be converted to weapons usable materials, not just when it is extracted as waste, but at any point in the fuel cycle. Although the nuclear fuel remains in the core of the engine until ultra deep actinide burn up is achieved, soon after start up of the engine, once the system breeds up to full power, several tons of fissile material is present in the fission blanket. However, this fissile material is widely dispersed in

  20. The Protective Effects of Epigallocatechin Gallate Against Distant Organ Damage After Severe Skin Burns--Experimental Study Using a Rat Model of Thermal Trauma.

    Science.gov (United States)

    Hosnuter, Mubin; Melikoglu, Cenk; Aslan, Cem; Saglam, Gulcan; Sutcu, Recep

    2015-01-01

    Epigallocatechin gallate (EGCG), a green tea polyphenol, has potent antioxidant properties. The purpose of the present study was to examine the possible preventative effects of EGCG against internal organ injury due to large-surface skin burns in a rat model. The study design involved three groups of rats: a sham group and two groups with 25-30% full-thickness burns: (a) the sham group without burns or treatment (n=18); (b) the control burn group (burns+sterile saline, n=18); and (c) the burn treatment group (burns+treatment with EGCG, n=18). EGCG was administered intraperitoneally immediately after the thermal injury, and daily in 100 μmol/kg doses. Kidney and lung tissue samples were taken to determine the levels of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), and glutathione peroxidase (GPX) after the first, third and seventh post-burn days. In the EGCG-treated burn group, SOD and GPX activity were significantly higher than in the burn control group. Additionally, MDA and TNF-α levels were significantly lower in the EGCG-treated burn group. Based on this study, it might be anticipated that EGCG treatment may be beneficial in burn injury cases.

  1. Epidemiology of hospitalized burns patients in Taiwan.

    Science.gov (United States)

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang

    2003-09-01

    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children.

  2. Fatigue crack growth behaviors of a new burn-resistant highly-stabilized beta titanium alloy

    Institute of Scientific and Technical Information of China (English)

    WU Huan; ZHAO Yongqing; ZENG Weidong; QIAN Li

    2009-01-01

    This article presents the fatigue crack growth (FCG) behaviors of a new burn-resistant highly-stabilized beta Ti40 alloy. The FCG rotes were analyzed. The fracture surfaces and the side surfaces of the test samples were explored. The results show that frequency affects the cracking behaviors of Ti40 alloy. Temperature also plays an important role in Ti40 alloy cracking. At room temperature (25℃), when the frequency increases, the cracking rate changes a little in the range of low stress intensity factor (ΔK), while it changes significantly when ΔK is high. At 500℃, the cracking rate of Ti40 alloy changes significantly during all the course of clacking. The frequency also affects the microstructure patterns of Ti40 alloy. A number of secondary cracks appear in the area more than 200 μm from the main crack at a high ΔK when the fre-quency is 1 Hz, but only a few secondary cracks exist when the frequency is 10 Hz. Facet image is the main image of the fracture surfaces when the frequency is 1 Hz. While, ductile striation occupies most of the area of fracture surfaces when the frequency is 10 Hz.

  3. Investigations on high speed directly modulated microdisk lasers accounting for radial carrier hole burning

    Science.gov (United States)

    Huang, Yong-Zhen; Lv, Xiao-Meng; Zou, Ling-Xiu; Long, Heng; Xiao, Jin-Long; Yang, Yue-De; Du, Yun

    2014-04-01

    High-speed modulation characteristics are investigated for microdisk lasers theoretically and experimentally. In rate equation analysis, the microdisk resonator is radially divided into two regions under uniform carrier density approximation in each region. The injection current profile, carrier spatial hole burning, and diffusion are accounted for in the evaluation of small-signal modulation curves and the simulation of large-signal responses. The numerical results indicate that a wide mode field pattern in radial direction has merit for high-speed modulation, which is expected for coupled modes in the microdisk lasers connected with an output waveguide. For a 15-μm-radius microdisk laser connected with a 2-μm-wide output waveguide, the measured small-signal response curves with a low-frequency roll-off are well in agreement with the simulated result at a 2-μm radial width for the mode intensity distribution. The resonant frequencies of 7.2, 5.9, and 3.9 GHz are obtained at the temperatures of 287, 298, and 312 K from the small-signal response curves, and clear eye diagrams at 12.5 Gb/s with an extinction ratio of 6.1 dB are observed for the microdisk laser at the biasing current of 38 mA and 287 K.

  4. TEM Characterization of High Burn-up Microstructure of U-7Mo Alloy

    Energy Technology Data Exchange (ETDEWEB)

    Jian Gan; Brandon Miller; Dennis Keiser; Adam Robinson; James Madden; Pavel Medvedev; Daniel Wachs

    2014-04-01

    As an essential part of global nuclear non-proliferation effort, the RERTR program is developing low enriched U-Mo fuels (< 20% U-235) for use in research and test reactors that currently employ highly enriched uranium fuels. One type of fuel being developed is a dispersion fuel plate comprised of U-7Mo particles dispersed in Al alloy matrix. Recent TEM characterizations of the ATR irradiated U-7Mo dispersion fuel plates include the samples with a local fission densities of 4.5, 5.2, 5.6 and 6.3 E+21 fissions/cm3 and irradiation temperatures of 101-136?C. The development of the irradiated microstructure of the U-7Mo fuel particles consists of fission gas bubble superlattice, large gas bubbles, solid fission product precipitates and their association to the large gas bubbles, grain subdivision to tens or hundreds of nanometer size, collapse of bubble superlattice, and amorphisation. This presentation will describe the observed microstructures specifically focusing on the U-7Mo fuel particles. The impact of the observed microstructure on the fuel performance and the comparison of the relevant features with that of the high burn-up UO2 fuels will be discussed.

  5. 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

    1997-01-01

    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.

  6. A high-resolution and multi-year emissions inventory for biomass burning in Southeast Asia during 2001-2010

    Science.gov (United States)

    Shi, Yusheng; Yamaguchi, Yasushi

    2014-12-01

    Biomass burning (BB) emissions from forest fires, agricultural waste burning, and peatland combustion contain large amounts of greenhouse gases (e.g., CO2, CH4, and N2O), which significantly impact ecosystem productivity, global atmospheric chemistry, and climate change. With the help of recently released satellite products, biomass density based on satellite and observation data, and spatiotemporal variable combustion factors, this study developed a new high-resolution and multi-year emissions inventory for BB in Southeast Asia (SEA) during 2001-2010. The 1-km grid was effective for quantifying emissions from small-sized fires that were frequently misinterpreted by coarse grid data due to their large smoothed pixels. The average annual BB emissions in SEA during 2001-2010 were 277 Gg SO2, 1125 Gg NOx, 55,388 Gg CO, 3831 Gg NMVOC, 553 Gg NH3, 324 Gg BC, 2406 Gg OC, 3832 Gg CH4, 817,809 Gg CO2, and 99 Gg N2O. Emissions were high in western Myanmar, Northern Thailand, eastern Cambodia, northern Laos, and South Sumatra and South Kalimantan of Indonesia. Emissions from forest burning were the dominant contributor to the total emissions among all land types. The spatial pattern of BB emissions was consistent with that of the burned areas. In addition, BB emissions exhibited similar temporal trends from 2001 to 2010, with strong interannual and intraannual variability. Interannual and intraannual emission peaks were seen during 2004, 2007, 2010, and January-March and August-October, respectively.

  7. Transplantation of reconstructed corneal layer composed of corneal epithelium and fibroblasts on a lyophilized amniotic membrane to severely alkali-burned cornea.

    Science.gov (United States)

    Jang, In-Keun; Ahn, Jae-Il; Shin, Jun-Seop; Kwon, Young-Sam; Ryu, Yang-Hwan; Lee, Jeong-Kyu; Park, Jung-Keug; Song, Kye-Yong; Yang, Eun-Kyung; Kim, Jae-Chan

    2006-06-01

    The purpose of this article was to evaluate the graft efficacy of reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on a lyophilized amniotic membrane (LAM), in a severely alkali-burned corneal model. After biopsy specimens were obtained from the left eyes of 24 rabbits, the corneal epithelial cells and fibroblasts were expanded in vitro and the corneal layer was reconstructed on LAM. Thirty-six eyes of rabbits underwent alkali burn (1 N NaOH, 30 s) to create a limbal deficiency and a deeply damaged corneal stroma. Four weeks later, group 1 underwent a graft of the reconstructed corneal layer composed of autologous corneal epithelium and fibroblasts on LAM. Group 2 was transplanted with a graft of the reconstructed autologous corneal epithelium, and group 3 served as a control without surgery. Wound healing and stabilization of the ocular surfaces occurred much faster in group 1 than in groups 2 and 3. The eyes in group 3 revealed typical limbal deficiencies with conjuctivalization and persistent corneal epithelial defects. However, the corneas in group 1 developed only mild peripheral neovascularization. Immunohistochemical staining in group 1 demonstrated that p63, cytokeratin 3, E-cadherin, transforming growth factor (TGF)-beta1, and collagen IV were expressed strongly in the corneal epithelium and basement membrane. On the basis of these results, transplantation of the reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on LAM, partially accelerated the recovery of the alkali-injured rabbit ocular surface, and might be useful therapeutically for the treatment of patients with severely damaged cornea.

  8. The Burning Saints

    DEFF Research Database (Denmark)

    Xygalatas, Dimitris

    . Carrying the sacred icons of the saints, participants dance over hot coals as the saint moves them. The Burning Saints presents an analysis of these rituals and the psychology behind them. Based on long-term fieldwork, The Burning Saints traces the historical development and sociocultural context......, The Burning Saints presents a highly original analysis of how mental processes can shape social and religious behaviour....

  9. Irradiation characteristics examination technology development of irradiated nuclear material and high burn-up fuels

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Kwon Pyo; Choo, Y. S.; Oh, Y. W. [and others

    2002-12-01

    The research and development for the first year of the project are performed through specialization of researchers, information from aborad and international cooperation, securement of advanced nuclear technology, development and installation of test equipment, application of external man-power, establishment of advanced test techniques, and certified test method. 1. Absolute efficiency measurement examination technology development of gamma scanning system 2. Sample preparation technology development of SEM and EPMA for micro-structural observation and chemical composition analysis 3. Irradiated high burn-up nuclear fuel transportation and test for PWR 4. Development of hot cell examination techniques and equipment 5. Acquirement of KOLAS system. In addition to the project, the following activities are carried out as follows; - PIE of Hanaro fuel(KH99H-001) - PIE of U-Mo advanced nuclear fuel irradiated at Hanaro - PIE of Hi-MET advanced nuclear fuel irradiated at Hanaro - PIE of DUPIC project - Hot cell examination of Hanaro irradiated capsule - Leaching test of PWR fuels - Surveillance test of PWR vessels - Mechanical test of CANDU pressure tubes.

  10. CLINICAL TREATMENT OF 183 CASES OF SEVERE AND EXTREMELY SEVERE BURN CHILDREN%183例小儿重度、特重度烧伤的临床治疗方法分析

    Institute of Scientific and Technical Information of China (English)

    康群军; 余群洪; 胡安根; 林冬梅; 黄卫虎; 李勇铁

    2012-01-01

      Objective: To study the clinical treatment of the children with severe and extremely severe burn. Methods: Treating processes and clinical data of 183 patients with severe and extremely severe burn, from January 2006 to December 2011 were analyzed retrospectively in the hospital. Results: 167 patients among 183 ones were healed, the recovery rate was 91.26%. Conclusion: Valid anti-shock treat timely in early stage are important assurance for successful treatment, reasonably applying antibiotics all over the body was important measure for prevent wound infection, positively preventing side effects, maintaining airway patency and correct wound management, sealing wound surface with cutting scab and skin grafting in early stage were the key steps of successful treatment.%  目的研究小儿重度、特重度烧伤的临床救治.方法对我院2006年1月至2011年12月收治的183例重度、特重度小儿烧伤临床资料进行回顾总结及分析.结果183例患儿中治愈167例,治愈率为91.26%.结论早期及时有效的抗休克治疗是成功救治的重要保证,全身合理使用抗生素是防治烧伤感染的重要措施,积极预防烧伤并发症、维持气道通畅及合理创面外用药物、早期切削痂植皮封闭创面,是成功救治的重要环节

  11. Epidemiology of burns in Taiwan: a nationwide report including inpatients and outpatients.

    Science.gov (United States)

    Chen, Shih-Han; Chen, Yi-Chun; Chen, Tzeng-Ji; Ma, Hsu

    2014-11-01

    The aim of the study is to understand the incidence of burns among outpatients and inpatients of Taiwan in 2010. Characteristics of the burned patients were also studied in terms of gender, age, burn sites, burn degree, reconstructive surgical treatment, as well as which specialty and medical facility they are treated in. Burned patients were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. Ones who had been hospitalized with discharge diagnoses related to burns were categorized as inpatients and others who had only ambulatory visits and emergency room visits were classified as outpatients. 7630 burn-injury patients were found, presenting an annual incidence of burns as 670.8/10(5) in males (n=3303) and 852.5/10(5) in females (n=4327). Only 3.4% (156 males and 107 females) of them were hospitalized. Higher incidence of burns were found in females and young children, while males and the elderly tended to have more severe burns, based on high-degree burns, admission rate, and incidence of hospitalizations for burns. This is a population-based study demonstrating the epidemiology of burns among outpatients and inpatients in Taiwan, leading us closer to the reality of burns treated in different settings of medical facilities. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. Influence of biomass burning from South Asia at a high-altitude mountain receptor site in China

    Directory of Open Access Journals (Sweden)

    J. Zheng

    2017-06-01

    Full Text Available Highly time-resolved in situ measurements of airborne particles were conducted at Mt. Yulong (3410 m above sea level on the southeastern edge of the Tibetan Plateau in China from 22 March to 14 April 2015. The detailed chemical composition was measured by a high-resolution time-of-flight aerosol mass spectrometer together with other online instruments. The average mass concentration of the submicron particles (PM1 was 5.7 ± 5.4 µg m−3 during the field campaign, ranging from 0.1 up to 33.3 µg m−3. Organic aerosol (OA was the dominant component in PM1, with a fraction of 68 %. Three OA factors, i.e., biomass burning organic aerosol (BBOA, biomass-burning-influenced oxygenated organic aerosol (OOA-BB and oxygenated organic aerosol (OOA, were resolved using positive matrix factorization analysis. The two oxygenated OA factors accounted for 87 % of the total OA mass. Three biomass burning events were identified by examining the enhancement of black carbon concentrations and the f60 (the ratio of the signal at m∕z 60 from the mass spectrum to the total signal of OA. Back trajectories of air masses and satellite fire map data were integrated to identify the biomass burning locations and pollutant transport. The western air masses from South Asia with active biomass burning activities transported large amounts of air pollutants, resulting in elevated organic concentrations up to 4-fold higher than those of the background conditions. This study at Mt. Yulong characterizes the tropospheric background aerosols of the Tibetan Plateau during pre-monsoon season and provides clear evidence that the southeastern edge of the Tibetan Plateau was affected by the transport of anthropogenic aerosols from South Asia.

  13. Influence of biomass burning from South Asia at a high-altitude mountain receptor site in China

    Science.gov (United States)

    Zheng, Jing; Hu, Min; Du, Zhuofei; Shang, Dongjie; Gong, Zhaoheng; Qin, Yanhong; Fang, Jingyao; Gu, Fangting; Li, Mengren; Peng, Jianfei; Li, Jie; Zhang, Yuqia; Huang, Xiaofeng; He, Lingyan; Wu, Yusheng; Guo, Song

    2017-06-01

    Highly time-resolved in situ measurements of airborne particles were conducted at Mt. Yulong (3410 m above sea level) on the southeastern edge of the Tibetan Plateau in China from 22 March to 14 April 2015. The detailed chemical composition was measured by a high-resolution time-of-flight aerosol mass spectrometer together with other online instruments. The average mass concentration of the submicron particles (PM1) was 5.7 ± 5.4 µg m-3 during the field campaign, ranging from 0.1 up to 33.3 µg m-3. Organic aerosol (OA) was the dominant component in PM1, with a fraction of 68 %. Three OA factors, i.e., biomass burning organic aerosol (BBOA), biomass-burning-influenced oxygenated organic aerosol (OOA-BB) and oxygenated organic aerosol (OOA), were resolved using positive matrix factorization analysis. The two oxygenated OA factors accounted for 87 % of the total OA mass. Three biomass burning events were identified by examining the enhancement of black carbon concentrations and the f60 (the ratio of the signal at m/z 60 from the mass spectrum to the total signal of OA). Back trajectories of air masses and satellite fire map data were integrated to identify the biomass burning locations and pollutant transport. The western air masses from South Asia with active biomass burning activities transported large amounts of air pollutants, resulting in elevated organic concentrations up to 4-fold higher than those of the background conditions. This study at Mt. Yulong characterizes the tropospheric background aerosols of the Tibetan Plateau during pre-monsoon season and provides clear evidence that the southeastern edge of the Tibetan Plateau was affected by the transport of anthropogenic aerosols from South Asia.

  14. High dose corticosteroids in severe leptospirosis: a systematic review.

    Science.gov (United States)

    Rodrigo, Chaturaka; Lakshitha de Silva, Nipun; Goonaratne, Ravindi; Samarasekara, Keshinie; Wijesinghe, Indika; Parththipan, B; Rajapakse, Senaka

    2014-12-01

    The role of corticosteroids in the treatment of severe leptospirosis is unclear. The rationale for their use is that, in severe leptospirosis, there is a severe immunological response that is harmful to the host resulting in multi-organ dysfunction, which is potentially offset by the nonspecific immunosuppression of high dose steroids. We conducted a systematic review of studies that have assessed the use of high dose corticosteroids in patients with severe leptospirosis by searching MEDLINE and Scopus SciVerse without any language or time restrictions. We identified five studies, including one open randomized clinical trial, which had assessed the use of high dose steroids in severe leptospirosis. Four studies demonstrated a benefit of corticosteroids in treating severe disease with pulmonary involvement when administered early in the course of the disease, but these studies had several methodological constraints as highlighted in the text. Only the randomized controlled trial study showed that corticosteroids are ineffective and may increase the risk of nosocomial infections. There is no robust evidence to suggest that high dose corticosteroids are effective in severe leptospirosis, and a well-designed randomized clinical trial is needed to resolve this.

  15. Deep sole burns in several participants in a traditional festival of the firewalking ceremony in Kee-lung, Taiwan--clinical experiences and prevention strategies.

    Science.gov (United States)

    Chang, Shun-Cheng; Hsu, Chih-Kang; Tzeng, Yuan-Sheng; Teng, Shou-Cheng; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chen, Tim-Mo; Feng, Chun-Che

    2012-11-01

    Firewalking is a common Taoist cleansing ceremony in Taiwan, but burns associated with the practice have rarely been reported. We analyzed the patients with plantar burns from one firewalking ceremony. In one firewalking ceremony, 12 Taoist disciples suffered from contact burns to the soles of their feet while walking over burning coals. Eight of them had at least second-degree burns over areas larger than 1% of their total body surface areas (TBSAs). The age, sex, medical history, date of injury, time taken to traverse the fire pit, depth and TBSA of the burns, treatment, length of stay, and outcome were recorded and analyzed. Deep, disseminated second- to third-degree burns were noted and healing took as long as three weeks in some patients. Because disseminated hypertrophic scars form after burns, the soles involved regain much of their tensile strength while walking. The patients experienced only a few difficulties in their daily lives three months after injury. From our experience treating patients with deep disseminated second- to third-degree plantar burns caused by firewalking, we conclude that they should be treated conservatively, with secondary healing rather than a skin graft. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  16. Family aggregation in a population of chronic arsenic poisoning associated with high arsenic coal burning

    Institute of Scientific and Technical Information of China (English)

    LinGF; ChenJG

    2002-01-01

    About 2600 cases of chronic arsenic poisoning (CAP) in Southwest China-Guizhou Povince represent a unique case of CAP in the world associated with indoor high As coal burning.An epidemiological investigation in 4 clans (694 subjects,male 299,female 395) was launched in one Cun(village) in JL area(21000 residents,about 2000 CAP cases).(1)Clan G(possible Hanized Yi origin).The ancestors,a couple settled here in Qing dynasty.CAP prevalence was 43.3%(93/215).It was found that in 9 of 25 brotherhood groups all the members suffered with CAP.(2) An non-consanguinous branch of family G.The ancestor,a boy was adopted by family G in 1890s.The incidence rate was 20.8%(11/53) which was lower than that in clan G(consanguineous)(P=0.00261,r=0.344),though both clans have been living in the same family for 4 generations.(3)Clan B(Han origin).The ancestor moved the family from Nanjing in Ming dynasty.The CAP prevalence is 45.5%(75/165).(4)Clan P(ethnic Miao).The CAP prevalence is 3.9(9/232),far less than other ethnic clans,for example,less than clan G (consanguineous)(P=3.706E=23,r=0.052944).The observation suggests possible family aggregation of CAP in high As coal using area.further work is required.

  17. Use of LiDAR and multispectral imagery to determine conifer mortality and burn severity following the lockheed fire

    Science.gov (United States)

    Russell A. White; Brian C. Dietterick

    2012-01-01

    The effects of wildfire on tree mortality, stand structure, and regeneration are major concerns in many California ecosystems. These effects are often highly variable across the landscape and can be difficult to assess at broad scales. There are few datasets that provide a detailed description of stand conditions, both before and after wildland fire, particularly in...

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

    Science.gov (United States)

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

    2004-01-01

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

  19. Abnormal strong burn-in degradation of highly efficient polymer solar cells caused by spinodal donor-acceptor demixing

    Science.gov (United States)

    Li, Ning; Perea, José Darío; Kassar, Thaer; Richter, Moses; Heumueller, Thomas; Matt, Gebhard J.; Hou, Yi; Güldal, Nusret S.; Chen, Haiwei; Chen, Shi; Langner, Stefan; Berlinghof, Marvin; Unruh, Tobias; Brabec, Christoph J.

    2017-02-01

    The performance of organic solar cells is determined by the delicate, meticulously optimized bulk-heterojunction microstructure, which consists of finely mixed and relatively separated donor/acceptor regions. Here we demonstrate an abnormal strong burn-in degradation in highly efficient polymer solar cells caused by spinodal demixing of the donor and acceptor phases, which dramatically reduces charge generation and can be attributed to the inherently low miscibility of both materials. Even though the microstructure can be kinetically tuned for achieving high-performance, the inherently low miscibility of donor and acceptor leads to spontaneous phase separation in the solid state, even at room temperature and in the dark. A theoretical calculation of the molecular parameters and construction of the spinodal phase diagrams highlight molecular incompatibilities between the donor and acceptor as a dominant mechanism for burn-in degradation, which is to date the major short-time loss reducing the performance and stability of organic solar cells.

  20. Abnormal strong burn-in degradation of highly efficient polymer solar cells caused by spinodal donor-acceptor demixing

    Science.gov (United States)

    Li, Ning; Perea, José Darío; Kassar, Thaer; Richter, Moses; Heumueller, Thomas; Matt, Gebhard J.; Hou, Yi; Güldal, Nusret S.; Chen, Haiwei; Chen, Shi; Langner, Stefan; Berlinghof, Marvin; Unruh, Tobias; Brabec, Christoph J.

    2017-01-01

    The performance of organic solar cells is determined by the delicate, meticulously optimized bulk-heterojunction microstructure, which consists of finely mixed and relatively separated donor/acceptor regions. Here we demonstrate an abnormal strong burn-in degradation in highly efficient polymer solar cells caused by spinodal demixing of the donor and acceptor phases, which dramatically reduces charge generation and can be attributed to the inherently low miscibility of both materials. Even though the microstructure can be kinetically tuned for achieving high-performance, the inherently low miscibility of donor and acceptor leads to spontaneous phase separation in the solid state, even at room temperature and in the dark. A theoretical calculation of the molecular parameters and construction of the spinodal phase diagrams highlight molecular incompatibilities between the donor and acceptor as a dominant mechanism for burn-in degradation, which is to date the major short-time loss reducing the performance and stability of organic solar cells. PMID:28224984

  1. Fission Gas Release in LWR Fuel Rods Exhibiting Very High Burn-Up

    DEFF Research Database (Denmark)

    Carlsen, H.

    1980-01-01

    Two UO2Zr BWR type test fuel rods were irradiated to a burn-up of about 38000 MWd/tUO2. After non-destructive characterization, the fission gas released to the internal free volume was extracted and analysed. The irradiation was simulated by means of the Danish fuel performance code WAFER-2, which...... uses an empirical gas release model combined with a strongly burn-up dependent correction term, developed by the US Nuclear Regulatory Commission. The paper presents the experimental results and the code calculations. It is concluded that the model predictions are in reasonable agreement (within 15...

  2. Association between depression, patient scar assessment and burn-specific health in hospitalized burn patients.

    Science.gov (United States)

    Roh, Young Sook; Chung, Hyun Soo; Kwon, Boeun; Kim, Giyon

    2012-06-01

    Depression is one of the most common psychological problems arising after a burn, but its relationship with patient scar assessment and burn-specific health are poorly understood. The aim of this study was to identify the incidence of in-hospital symptoms of depression, compare level of patient scar assessment, and burn-specific health by depression cutoff point, and identify the relationship between depression and these variables. In a cross-sectional descriptive study, 113 burn patients from two inpatient burn centers were divided into two groups based on the cutoff point of the Korean Center for Epidemiologic Studies Depression Scale (Korean CES-D): ≥25 or Patient Scar Assessment Scale and Korean Burn-Specific Health Scale-Brief (BSHS-B-K) were used to identify associations with depression. Incidence of severe, definite depression as assessed by a score of 25 or above on the Korean CES-D was approximately 50% on an average at 60.9 days after injury. Burn patients with the Korean CES-D≥25 had significantly higher total mean patient scar assessment scores (43.34±11.49 vs. 36.84±9.56, t=3.265, p=.001), and lower burn-specific health subscale scores compared to patients with Korean CES-DPatient Scar Assessment, ranging from r=.196 to .335 except scar color. Depression was significantly correlated with all subscales of the BSHS-B-K, range from r=-.320 to -.725. Results indicate that incidence of symptoms of depression is relatively high, and depressed burn patients report worse burn scar or sensation and lower levels of burn-specific health. Early, timely recognition and management of depression in these patients are warranted. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  3. Importance of transboundary transport of biomass burning emissions to regional air quality in Southeast Asia during a high fire event

    Science.gov (United States)

    Aouizerats, B.; van der Werf, G. R.; Balasubramanian, R.; Betha, R.

    2015-01-01

    Smoke from biomass and peat burning has a notable impact on ambient air quality and climate in the Southeast Asia (SEA) region. We modeled a large fire-induced haze episode in 2006 stemming mostly from Indonesia using the Weather Research and Forecasting model coupled with chemistry (WRF-Chem). We focused on the evolution of the fire plume composition and its interaction with the urbanized area of the city state of Singapore, and on comparisons of modeled and measured aerosol and carbon monoxide (CO) concentrations. Two simulations were run with WRF-Chem using the complex volatility basis set (VBS) scheme to reproduce primary and secondary aerosol evolution and concentration. The first simulation referred to as WRF-FIRE included anthropogenic, biogenic and biomass burning emissions from the Global Fire Emissions Database (GFED3) while the second simulation referred to as WRF-NOFIRE was run without emissions from biomass burning. To test model performance, we used three independent data sets for comparison including airborne measurements of particulate matter (PM) with a diameter of 10 μm or less (PM10) in Singapore, CO measurements in Sumatra, and aerosol optical depth (AOD) column observations from four satellite-based sensors. We found reasonable agreement between the model runs and both ground-based measurements of CO and PM10. The comparison with AOD was less favorable and indicated the model underestimated AOD, although the degree of mismatch varied between different satellite data sets. During our study period, forest and peat fires in Sumatra were the main cause of enhanced aerosol concentrations from regional transport over Singapore. Analysis of the biomass burning plume showed high concentrations of primary organic aerosols (POA) with values up to 600 μg m-3 over the fire locations. The concentration of POA remained quite stable within the plume between the main burning region and Singapore while the secondary organic aerosol (SOA) concentration

  4. [THERMOMETRY APPLICATION FOR ESTIMATION OF THE SKIN BURNS DEPTH].

    Science.gov (United States)

    Kovalenko, A O

    2015-04-01

    Determination of the burn wound depth, using noncontact infrared thermometry, permits to predict the burn affection severity, basing on the revealed difference between local, perifocal temperature and temperature in certain nonaffected areas of the body surface. The temperature difference (ΔT) over 1 °C constitutes a strict criterion of the skin burn presence. The temperature 34 °C have been considered a border one for the skin burns. If the burn wound temperature in 24 h after trauma was lower 34 °C and ΔT 2 °C and more, it have witnessed the presence of deep burn of the skin. High sensitivity (87%) and specificity (96%) of thermometric test in 24 h after trauma were established. In epidermal burns the temperature of the burn wounds have constituted (35.9 ± 0.3) °C at average, in superficial burns of the skin--(35.1 ± 0.6) °C, and in the deep burns--(33.6 ± 0.8) °C.

  5. The Effect of Humidity on the Knock Behavior in a Medium BMEP Lean-Burn High-Speed Gas Engine

    NARCIS (Netherlands)

    van Essen, Vincent Martijn; Gersen, Sander; van Dijk, Gerco; Mundt, Torsten; Levinsky, Howard

    2016-01-01

    The effects of air humidity on the knock characteristics of fuels are investigated in a lean-burn, high-speed medium BMEP engine fueled with a CH4 + 4.7 mole% C3H8 gas mixture. Experiments are carried out with humidity ratios ranging from 4.3 to 11 g H2O/kg dry air. The measured pressure profiles at

  6. 严重烧伤病人的综合康复疗效分析%Synthetic rehabilitation effects analysis of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    杜永军; 冯祥生; 沈锐; 阮树斌

    2002-01-01

    Background:Appearance and function damage after burn are caused by scar hyperplasia after wound repair.So main task of burn rehabilitation is prevention and treatment of hypertrophic scar. Pressure therapy can promote scar maturation;decrease itching,consistency and thick of scar.

  7. Hand chemical burns.

    Science.gov (United States)

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  8. Pharmacokinetics of Imipenem/Cilastatin Burn Intensive Care Unit Patients Undergoing High-Dose Continuous Venovenous Hemofiltration.

    Science.gov (United States)

    Boucher, Bradley A; Hudson, Joanna Q; Hill, David M; Swanson, Joseph M; Wood, G Christopher; Laizure, S Casey; Arnold-Ross, Angela; Hu, Zhe-Yi; Hickerson, William L

    2016-12-01

    High-dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently in patients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I/C), we evaluated the systemic and extracorporeal clearances (CLs) of I/C in patients with burns undergoing high-dose CVVH. Prospective clinical pharmacokinetic study. Ten adult patients with burns receiving I/C for a documented infection and requiring high-dose CVVH were studied. Blood and effluent samples for analysis of I/C concentrations were collected for up to 6 hours after the I/C infusion for calculation of I/C total CL (CLTotal ), CL by CVVH (CLHF ), half-life during CVVH, volume of distribution at steady state (Vdss ), and the percentage of drug eliminated by CVVH. In this patient sample, the mean age was 50 ± 17 years, total body surface area burns was 23 ± 27%, and 80% were male. Nine patients were treated with high-dose CVVH for acute kidney injury and one patient for sepsis. The mean delivered CVVH dose was 52 ± 14 ml/kg/hour (range 32-74 ml/kg/hr). The imipenem CLHF was 3.27 ± 0.48 L/hour, which accounted for 23 ± 4% of the CLTotal (14.74 ± 4.75 L/hr). Cilastatin CLHF was 1.98 ± 0.56 L/hour, which accounted for 45 ± 19% of the CLTotal (5.16 + 2.44 L/hr). The imipenem and cilastatin half-lives were 1.77 ± 0.38 hours and 4.21 ± 2.31 hours, respectively. Imipenem and cilastatin Vdss were 35.1 ± 10.3 and 32.8 ± 13.8 L, respectively. Efficient removal of I/C by high-dose CVVH, a high overall clearance, and a high volume of distribution in burn intensive care unit patients undergoing this CRRT method warrant aggressive dosing to treat serious infections effectively depending on the infection site and/or pathogen. © 2016 Pharmacotherapy Publications, Inc.

  9. High abundances of water-soluble dicarboxylic acids, ketocarboxylic acids and α-dicarbonyls in the mountaintop aerosols over the North China Plain during wheat burning season

    Directory of Open Access Journals (Sweden)

    K. Kawamura

    2013-08-01

    Full Text Available Aerosol (TSP samples were collected at the summit of Mount Tai (elevation: 1534 m a.s.l., 36.25° N, 117.10° E located in the North China Plain using a high-volume air sampler and pre-combusted quartz filters. Sampling was conducted on day/night or 3 h basis in the period from 29 May to 28 June 2006 during the field burning of wheat straw residue and the post-burning season. The filter samples were analyzed for low-molecular-weight dicarboxylic acids, ketoacids and α-dicarbonyls using capillary gas chromatography (GC and GC-MS employing water extraction and butyl ester derivatization. Molecular distributions of dicarboxylic acids (C2-C11, 220–6070 ng m−3 were characterized by a predominance of oxalic (C2 acid (105–3920 ng m−3 followed by succinic (C4 or malonic (C3 acid. Unsaturated aliphatic diacids, including maleic (M, isomaleic (iM and fumaric (F acids, were also detected together with aromatic diacids (phthalic, isophthalic and terephthalic acids. ω-oxocarboxylic acids (C2-C9, 24–610 ng m−3 were detected as the second most abundant compound class with the predominance of glyoxylic acid (11–360 ng m−3, followed by α-ketoacid (pyruvic acid, 3–140 ng m−3 and α-dicarbonyls (glyoxal, 1–230 ng m−3 and methylglyoxal, 2–120 ng m−3. We found that these levels (>6000 ng m−3 for diacids are several times higher than those reported in Chinese megacities at ground levels. The concentrations of diacids increased from late May to early June, showing a maximum on 7 June, and then significantly decreased during the period 8–11 June, when the wind direction shifted from southerly to northerly. Similar temporal trends were found for ketocarboxylic acids and α-dicarbonyls as well as total carbon (TC and water-soluble organic carbon (WSOC. The temporal variations of water-soluble organics were interpreted by the direct emission from the field burning of agricultural wastes (wheat straw in the North China Plain and the

  10. Recent view to the results of pulse tests in the IGR reactor with high burn-up fuel

    Energy Technology Data Exchange (ETDEWEB)

    Asmolov, V.; Yegorova, L. [Russian Research Centre, Moscow (Russian Federation)

    1996-03-01

    Testing of 43 fuel elements (13 fuel elements with high burn-up fuel, 10 fuel elements with preirradiated cladding and fresh fuel, and 20 non-irradiated fuel elements) was carried out in the IGR pulse reactor with a half width of the reactor power pulse of about 0.7 sec. Tests were conducted in capsules with no coolant flow and with standard initial conditions in the capsule of 20{degrees}C and 0.2 MPa. Two types of coolant were used: water and air. One purpose of the test program was to determine the thresholds and mechanisms of fuel rod failure under RIA conditions for VVER fuel rods over their entire exposure range, from zero to high burn-up. These failure thresholds are often used in safety analyses. The tests and analyses were designed to reveal the influence on fuel rod failure of (1) the mechanical properties of the cladding, (2) the pellet-to-cladding gap, (3) fuel burn-up, (4) fuel-to-coolant heat transfer, and other parameters. The resulting data base can also be used for validation of computer codes used for analyzing fuel rod behavior. Three types of test specimens were used in the tests, and diagrams of these specimens are shown in Fig. 1. {open_quotes}Type-C{close_quotes} specimens were re-fabricated from commercial fuel rods of the VVER-1000 type that had been subjected to many power cycles of operation in the Novovoronezh Nuclear Power Plant (NV NPP). {open_quotes}Type-D{close_quotes} specimens were fabricated from the same commercial fuel rods used above, but the high burn-up oxide fuel was removed from the cladding and was replaced with fresh oxide fuel pellets. {open_quotes}Type-D{close_quotes} specimens thus provided a means of separating the effects of the cladding and the oxide fuel pellets and were used to examine cladding effects only.

  11. [Application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns].

    Science.gov (United States)

    Zang, C Y; Cao, Y Q; Xue, W J; Zhao, R; Zhang, M; Zhang, Y H; Feng, Z; Wang, Y B

    2017-02-20

    Objective: To investigate the application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns. Methods: Twenty-six patients with deep partial-thickness burns conforming to the study criteria were hospitalized in our unit from March 2015 to March 2016. Patients were all performed with dermabrasion. The structure of skin tissue and blood flow signals of uninjured side and wounds before dermabrasion, and those of wounds immediately post dermabrasion and on post dermabrasion day (PDD) 1, 3, 5, 7, 10, 14, and 21 were detected with high-frequency ultrasound, and the percentage of blood flow signals was calculated. According to the results of comparison between percentage of blood flow signals of wounds and that of normal skin before dermabrasion, patients were divided into no significant decrease group (NSD, n=19) and significant decrease group (SD, n=7). Wound healing time of patients in two groups was recorded. Data were processed with analysis of variance of repeated measurement, LSD test, t test and Chi-square test. The correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients were analyzed by Spearman correlation analysis. Results: (1) Epidermis of normal skin of patients in two groups before dermabrasion showed continuous smooth linear hyperecho, which was stronger than that of dermis, and boundary of dermis and subcutaneous tissue showed stronger discontinuous linear echo than that of dermis, which gradually transited to subcutaneous tissue. In group NSD, epidermis of wound of patients before dermabrasion showed intermittent rough linear echo, which was weaker than that of normal skin epidermis, and there was no obvious abnormity of boundary between dermis and subcutaneous tissue. Immediately post dermabrasion and on PDD 1, no linear hyperecho of epidermis was observed, showing complete attrition of epidermis, and the echo of dermis and subcutaneous tissue had

  12. Fibers innovative burning and reuse by Self-propagating High temperature Synthesis (SHS)

    Science.gov (United States)

    Caratto, Valentina; Belfortini, Claudio; Musi, Luigi; Gaggero, Laura; Ferretti, Maurizio

    2016-04-01

    The treatment of asbestos containing waste deriving from civil building and industrial applications is a social alert and an environmental problem. The project LIFE12 ENV/IT 000295 FIBERS "Fibers innovative burning and reuse by Self-propagating High temperature Synthesis (SHS)" has developed an innovative technique alternative to conventional high T processes. The University of Genoa has developed an apparatus and a technique for triggering the breakdown reaction of chrysotile by means of an alumino-thermic reaction in a process of combustion synthesis well known as Self-propagating High temperature Synthesis or SHS. This approach yielded interesting results and allowed the development of an efficient method for inerting natural asbestos fibers and man-made products carrying fibers at the scale of some grams [1]. The experiments were based on the couples Fe2O3/Mg by implementation of two prototype plants. The varying parameters were: 1) different Asbestos-Containing Waste (ACW) massive (Eternit, linoleum) and friable asbestos; 2) ACW abundance; 3) size of the pellet 4) under two triggering systems (induction by a W coil and oxyacetylene torch). The reactions were carried in two configurations: a) discontinuous, allowed us to obtain data for the development and fine-tuning of the reaction, b) continuous, was indispensable for the development and fine-tuning of the process parameters towards industrial scale up. After the combustive reaction all samples were characterized by SEM-EDS and XRPD analysis. All experiments demonstrated effective in destructing the fibrous habit of chrysotile, turning its composition to stubby olivine grains. We optimized the parameters to achieve complete conversion of the asbestos to mineral grains in all the cases. The efficiency of the SHS reaction in the discontinuous and continuous configurations was highlighted by the characterization of the post-combustion material under SEM-EDS and XRPD that verified the absence of fibers within

  13. The changes of intestinal trefoil factor expression in rat small intestine after severe burn injury%严重烧伤对大鼠肠三叶因子表达的影响

    Institute of Scientific and Technical Information of China (English)

    彭曦; 谭银玲; 陶麟辉; 王凤君; 赵云; 汪仕良

    2001-01-01

    Objective To explore the changes of intestinal trefoil factor(ITF) as well as ITF mRNA expression in rat small intestine after severe burn injury .  Methods The distribution and the content of ITF in intestine were quantitatively determined with in situ hybridization (ISH), immunohistochemistry and high performance liquid chromatography (HPLC).  Results ITF and ITF mRNA were distributed in whole small intestine and most of them localized in goblet cell of intestinal villus. After burn injury, the structure of intestinal mucosa was severely damaged and ITF mRNA expression was lessened. Moreover, the ability of goblet cell synthesis and ITF secretion, especially ITF dimmer were significantly decreased, i.e., from (369.33±65.56) ng/g before burn injury to (15.83±4.40) ng/g 7 days after burn injury, only accounting for 4% of that before injury. Conclusions The post burn damage to intestinal structure is the main cause for the declination in ability of goblet cell synthesis and ITF secretion; and ITF drop especially ITF dimmer can enhance intestinal mucosa injury and delay intestinal mucosa repair.%目的 探讨严重烧伤对大鼠肠三叶因子(ITF)及其mRNA表达的影响及意义。 方法 48只健康成年Wistar大鼠,制成30%TBSAⅢ度烧伤模型并随机分成正常对照组及伤后1,2,3,5,7 d共6组,每组8只。采用原位杂交、免疫组化等手段观察伤后ITF 及ITF mRNA表达的变化,并使用高效液相色谱仪对肠黏膜ITF含量进行定量检测。 结果 正常对照组大鼠小肠中ITF及ITF mRNA均有一定表达,它们主要分布于肠绒毛杯状细胞中。烧伤后肠黏膜组织结构受损,ITF mRNA表达明显减少,肠杯状细胞合成和分泌ITF的能力大幅下降(P<0.01),特别是ITF二聚体的含量远远低于伤前[(369.33±65.56) ng/g],伤后7 d[(15.83±4.40) ng/g]仅为伤前的4%。 结论 严重烧伤后肠黏膜组织结构受损是ITF合成

  14. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® "Observing Sounds and Visuals" Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study.

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G; Bistricky, Steven L; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J; Linehan, Marsha M

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  15. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G.; Bistricky, Steven L.; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V.; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J.; Linehan, Marsha M.

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  16. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Directory of Open Access Journals (Sweden)

    Jocelyn Gomez

    2017-09-01

    Full Text Available Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT® by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA severe flame burn injury.Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session.Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home.Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in

  17. An assessment of burn care professionals' attitudes to major burn.

    LENUS (Irish Health Repository)

    Murphy, A D

    2008-06-01

    The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.

  18. Burns and military clothing.

    Science.gov (United States)

    McLean, A D

    2001-02-01

    high heat loads in the laboratory, combat clothing can ignite, but there is little evidence that clothing ignition is a common occurrence in military burn casualties. Thermoplastic materials have many benefits in civil and military clothing. There is little objective evidence that they exacerbate burns, or complicate burn management. Their use in military clothing must be based on objective evidence, not hearsay.

  19. Functional training after acellular dermis graft relieving scar in 53 patients with severe burn%脱细胞真皮植皮后功能训练减轻重烧伤患者瘢痕53例

    Institute of Scientific and Technical Information of China (English)

    苏永涛; 邢晓萍; 吕陟; 赵继东

    2003-01-01

    @@ BACKGROUND:Fingers with a large area of burn often necroses due to infection and dehydration and amputation of finger is often forced to perform or severe contracture of scar,stiffness of joints occurred leading to dysfunction hard to repair.

  20. 严重烧伤患者的早期治疗与功能恢复%Early Treatment and Physical Function Recovery of Severe Burn Patients

    Institute of Scientific and Technical Information of China (English)

    陈璧; 贾赤宇; 苏映军; 徐明达; 朱雄翔

    2001-01-01

    目的 探讨严重烧伤患者早期治疗与功能训练的最佳方案。方法 9例烧伤面积>90%,Ⅲ度>70%患者采用同一部位反复供皮和Ⅱ度烧伤愈合后供皮以扩大皮源,以异体与自体皮相间移植和大片筛状皮移植为主,同时在创面愈合后即开始物理治疗和功能训练。结果 9例患者中3例恢复工作,6例能做些家务劳动,生活完全自理。结论 严重烧伤患者早期采取有效的植皮措施和功能训练是提高治愈率、减少并发症,促进患者功能恢复的有效保证。%Objective To investigate the optimal scheme for early treatmentand the physical function restoration. Methods Nine burn patients with burnt area >90 % of total body surface area (TBSA) and full thickness burnt area >70 % of TBSA were studied. In each of the skin grafts, donor cutaneous sheets were harvested repeatedly from the same sites or from healed area of partial thickness burnt wounds to enlarge the donor areas. For most of the wounds large autogenic mesh sheets grafting and modified Jackson's technique of autogenic-allogenic skin strip grafting were adopted. At the same time, physical therapy and function training were performed after wounds healed. Results Of the 9 patients, 3 restored to work and 6 could engage in the housework. Conclusion Early skin transplantation and function training in the patients with severe burn could increase the curative rate, decrease the incidence of the complications and promote the function recovery.

  1. Organic functional groups in aerosol particles from burning and non-burning forest emissions at a high-elevation mountain site

    Directory of Open Access Journals (Sweden)

    S. Takahama

    2011-01-01

    Full Text Available Ambient particles collected on teflon filters at the Peak of Whistler Mountain, British Columbia (2182 m a.s.l. during spring and summer 2009 were measured by Fourier transform infrared (FTIR spectroscopy for organic functional groups (OFG. The project mean and standard deviation of organic aerosol mass concentrations (OM for all samples was 3.2±3.3 (μg m−3. The OM was dominated by regional forest sources, burning, and non-burning that occurred mostly during June–September. On average, organic hydroxyl, alkane, carboxylic acid, ketone, and amine, groups represented 31%±11%, 34%±9%, 23%±6%, 6%±7%, and 6%±3% of OM, respectively. Ketone groups were associated with the forest aerosols and represented up to 27% of the OM in these aerosols. Additional measurements of aerosol mass fragments, size, and number concentrations were used to separate fossil-fuel combustion and burning and non-burning forest sources of the measured organic aerosol. The OM concentrations observed at Whistler Peak during this campaign were higher than those measured during a shorter period in the spring of 2008 at a site in Whistler valley, over one km lower than the peak location. The 2009 campaign was largely influenced by the wildfire emissions that were absent during the 2008 campaign.

  2. Chemical and Common Burns in Children.

    Science.gov (United States)

    Yin, Shan

    2017-05-01

    Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.

  3. [Enteral nutrition in burn patients].

    Science.gov (United States)

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

    1992-01-01

    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  4. Effect of the activation and secretion function of macrophage Notch1 after the stimulation of severe ;burn rat serum%重度烧伤大鼠血清对巨噬细胞 Notch1的激活及分泌功能的影响

    Institute of Scientific and Technical Information of China (English)

    王姝月; 樊磊; 白晓智; 杨龙龙; 蔡维霞; 赵彬; 苏琳琳; 石继红; 胡大海

    2015-01-01

    目的:研究重度烧伤大鼠血清刺激后巨噬细胞 Notch1蛋白表达变化,及其细胞分泌因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平变化。方法选取成年雄性 SD 大鼠24只,随机分为假伤组、烧伤24 h 组和烧伤7 d 组,每组8只。烧伤组 SD 大鼠造成约30%总体表面积(TBSA)Ⅲ度烧伤,分别于伤后24 h、7 d 收集血清;假伤组大鼠用37℃水浴,水浴后24 h 取其血清作为对照。用上述各组血清制成20%培养液,刺激小鼠源巨噬细胞系 RAW264.7,分别于加入血清刺激后即刻和刺激4、8、12、24、48 h 后收取细胞及其上清液。另外用含20%假伤血清+脂多糖(100 ng/mL)培养液刺激巨噬细胞,于相同时间点收样。Western Blot 检测各时间点巨噬细胞中Notch1蛋白表达变化,酶联免疫吸咐试验检测刺激24 h 后培养上清液中 IL-6及 TNF-α的含量变化。结果(1)假伤组血清刺激后即刻和刺激4、8、12、24、48 h 后,Notch1蛋白表达无明显变化;(2)烧伤24 h 组血清刺激后,Notch1蛋白表达明显升高,并随时间延长而达高峰;(3)烧伤7 d 组血清刺激后, Notch1蛋白表达无明显变化,与假伤组血清刺激结果类似;(4)假伤组血清+脂多糖混合刺激后, Notch1蛋白表达明显增加;(5)烧伤24 h 组血清及假伤组血清+脂多糖,上清液中 IL-6和 TNF-α含量均明显高于假伤组血清及烧伤7 d 组血清。结论烧伤血清刺激下的巨噬细胞 Notch1信号被激活,IL-6及 TNF-α分泌能力增强,且这种激活可被脂多糖刺激所模拟。%Objective To investigate the dynamic expression of Notch1 signaling and the secretion of interleukin-6 (IL-6)and tumor necrosis factor alpha(TNF-α)from macrophage RAW264.7 cells induced by severe burn rat serum.Methods Twenty-four male Sprague-Dawley rats were divided into sham burn group and burn at 24 h and 7

  5. Effects of recombinant human growth hormone on glucose and protein metabolism in severe burn patients%严重烧伤病人应用重组人生长激素对糖和蛋白质代谢的影响

    Institute of Scientific and Technical Information of China (English)

    曹丽萍; 邓诗琳; 高志刚; 谢宇钢; 梁彦辉

    2001-01-01

    目的分析rhGH对严重烧伤病人血糖及蛋白质代谢的影响。方法对24例应用rhGH严重烧伤病人的血清总蛋白、白蛋白及血糖升高发生率进行比较分析。并对同期未应用rhGH患者血糖及蛋白质的变化进行总结分析。结果严重烧伤病人应用rhGH后血清总蛋白、白蛋白较用药前明显升高,并高于同期对照组。伤后2周内血糖升高,特别伤后1周内明显升高,伤后2周内血糖升高发生率分别为52.38%、50.00%、20.00%。伤后一周内、二周内及二周后开始应用rhGH其血糖升高发生率分别为100%、50%、0%。结论严重烧伤病人应用rhGH能促进机体蛋白质合成,但伤后早期应用rhGH对血糖影响较大,伤后2周后应用rhGH是较合适的时机。%Objective To investigate the influence of rhGH on blood sugar andprotein synthesis in severe burn patients. Methods 24 severe burn patients were enrolled in this study.The rhGH was administered subcutaneously in the dose of 0.2~0.25 IU/kg*d-1 at 10pm every day for 10 to 14 days.Serum total pertein,albumin and blood sugar concentrations were determined and analyzed before treatment with rhGH and after. Results Serum total protein and albumin levels were sygnificantly increased of the rhGH provided than before and placebo control in the same stage.The bolld sugar level was enhanced in 2 weeks after burn injury,especially in a week after burn injury.The incidences of hyperglycemia were 52.38% in 3 days after burn injury,50.00% in a week nd 20.00% in two weeks in severe burn patients.When rhGH was administered in a week,two weeks and more than two weeks after burn injury,the incidences of hyperglycemia were 100%,50% and 0% respectively. Conclusions The rhGH could promote protein synthesis in severe burn patients.The rhGH could cause blood sugar increasing in early stage after burn injury,so it was in good time that the rhGH was provided rof severe burn patients during more than two weeks after

  6. Isotopic analyses and calculation by use of JENDL-3.2 for high burn-up UO{sub 2} and MOX spent fuels

    Energy Technology Data Exchange (ETDEWEB)

    Sasahara, Akihiro; Matsumura, Tetsuo [Central Research Inst. of Electric Power Industry, Komae, Tokyo (Japan). Komae Research Lab.; Nicolaou, G.; Betti, M.; Walker, C.T.

    1997-03-01

    The post irradiation examinations (PIE) were carried out for high burn-up UO{sub 2} spent fuel (3.8%U235, average burn-up:60GWd/t) and mixed oxide (MOX) spent fuel (5.07%Pu, average burn-up:45GWd/t). The PIE includes, (a) isotopic analysis, (b) electron probe microanalysis (EPMA) in pellet cross section and so on. The results of isotopic analyses and EPMA were compared with ORIGEN2/82 and VIM-BURN calculation results. In VIM-BURN calculation, the nuclear data of actinides were proceeded from new data file, JENDL-3.2. The sensitivities of power history and moderator density to nuclides composition were investigated by VIM-BURN calculation and consequently power history mainly effected on Am241 and Am242m and moderator density effected on fissile nuclides. From EPMA results of U and Pu distribution in pellet, VIM-BURN calculation showed reasonable distribution in pellet cross section. (author)

  7. 烧伤患者血小板微粒的变化及临床意义%Changes of platelet microparticles and its clinical significance in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    唐佳俊; 郇京宁

    2012-01-01

    Objective To investigate the clinical significance of changes of platelet microparticles (PMPs) in burn and burn infection patients.Methods The patients were divided into burn shock group (n =44),burn infection group (n =33) and control group (n =11 ).Plasma PMPs were determined by flow cytometry and were recorded in absolute value and in particle proportion.Also,the frequently used biochemical indicators were detected and analyzed for their relationship with PMPs.Results CD41 + PMPs levels in the burn shock and burn infection groups were higher than those in the control group (P < 0.01 ) and they showed positive relation with extent of burn ( r =0.258,P < 0.05 ).Stepwise regression analysis indicated that r-glutamyltranspeptidase (r-GT),extent of burn and alanine aminotransferase (ALT) entered CD41 + PMPs level regression equation.Conclusion The increase of PMPs levels may be closely correlated with the pathological coagulation state in severe burn patients.%目的 探讨烧伤和烧伤感染患者血小板微粒( platelet microparticles,PMPs)的变化及临床意义. 方法 选择烧伤休克期组(44例)、烧伤感染组(33例)和对照组(11例)患者,用流式细胞仪等方法检测血浆中PMPs水平,以绝对值和所占细胞微粒比例表示,同时检测临床常用生化指标,并分析与PMPs的相关性. 结果 烧伤休克期组和烧伤感染组CD41+ PMPs水平高于对照组(P<0.01),且与烧伤面积呈正相关(r =0.258,P<0.05).多元逐步回归分析进入CD41+ PMPs水平回归方程的有γ-谷氨酰转肽酶(γ-GT)、烧伤面积和谷丙转氨酶(ALT).结论 烧伤患者PMPs水平升高可能与烧伤后凝血状态密切相关.

  8. Social and Ecological Factors Influencing Attitudes Toward the Application of High-Intensity Prescribed Burns to Restore Fire Adapted Grassland Ecosystems

    Directory of Open Access Journals (Sweden)

    David Toledo

    2013-12-01

    Full Text Available Fire suppression in grassland systems that are adapted to episodic fire has contributed to the recruitment of woody species in grasslands worldwide. Even though the ecology of restoring these fire prone systems back to grassland states is becoming clearer, a major hurdle to the reintroduction of historic fires at a landscape scale is its social acceptability. Despite the growing body of literature on the social aspects of fire, an understanding of the human dimensions of applying high-intensity prescribed burns in grassland and savanna systems is lacking. We used structural equation modeling to examine how landowners' attitudes toward high-intensity prescribed burns are affected by previous experience with burning, perceptions of brush encroachment, land condition, proximity constraints, risk orientation, fire management knowledge and skill, access to fire management equipment, and subjective norms. Our results suggest that experience, risk taking orientation, and especially social norms, i.e., perceived support from others, when implementing prescribed burns play an important role in determining the attitudes of landowners toward the use of high-intensity prescribed burns. Concern over lack of skill, knowledge, and insufficient resources have a moderately negative effect on these attitudes. Our results highlight the importance of targeted engagement strategies to address risk perceptions, subjective norms, and landowner's concerns. With these concerns allayed, it is possible to increase the adoption of high-intensity prescribed burns that lead to landscape-scale grassland restoration and conservation.

  9. Initial evaluation and management of the critical burn patient.

    Science.gov (United States)

    Vivó, C; Galeiras, R; del Caz, Ma D P

    2016-01-01

    The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  10. Saturday-morning television: do sponsors promote high-risk behavior for burn injury?

    Science.gov (United States)

    Palmieri, Tina L; Aoki, Traci; Combs, Elena; Curri, Terese; Garma, Sylvia; Kaulkin, Cammie; Lawless, Mary Beth; Nelson, Kate; Sanders, Johanna; Warden, Nancy; Greenhalgh, David G

    2004-01-01

    Television has become an important tool for learning and socialization in children. Although television violence has been associated with adverse effects, data on depiction of fire and burn injury are lacking. We sought to determine whether Saturday-morning television programming, viewed primarily by children, depicts fire and burn injury as safe or without consequence, thus potentially increasing the incidence of burn injury in children. This was a prospective observational study. Saturday-morning children's television programs were videotaped from 7 AM to 11 AM for eight different television networks during a 6-month period. Tapes were scored for scenes depicting fire or smoke by independent observers. Recorded items included show category, scene type, gender target, context of fire, and outcome after exposure to flame. Fire events were documented during programs and their associated commercials. A total of 108 hours of children's programs, 16 hours per network, were recorded. Scenes depicting fire or smoke were identified 1960 times, with 39% of events occurring during the program itself and 61% in commercials. Fire was depicted as either safe or without consequence in 64% of incidents. Action adventure stories accounted for 56% of flame depictions. Overall, one incident involving flame and fire was portrayed for each 3 minutes of television programming. Saturday-morning television programming frequently depicts fire as safe, empowering, or exciting. The incidence of flame use in programming varies between stations but is most prevalent in action/adventure stories. Television commercials, although brief, provide the majority of the misinformation regarding fire. Medical professional societies should alert the public to this potential hazard and recommend responsible portrayal of fire in children's television programming.

  11. High-resolution historical emission inventories of crop residue burning in fields in China for the period 1990-2013

    Science.gov (United States)

    Li, Jing; Li, Yaqi; Bo, Yu; Xie, Shaodong

    2016-08-01

    High-resolution historical emission inventories of crop residue burning in fields in China were developed for the period 1990-2013. More accurate time-varying statistical data and locally observed emission factors were utilized to estimate crop residue open burning emissions at provincial level. Then pollutants emissions were allocated to a high spatial resolution of 10 km × 10 km and a high temporal resolution of 1 day based on the Moderate Resolution Imaging Spectroradiometer (MODIS) Fire Product (MOD/MYD14A1). Results show that China's CO emissions have increased by 5.67 times at an annual average rate of 24% from 1.06 Tg in 1990 to 7.06 Tg in 2013; the emissions of CO2, CH4, NMVOCs, N2O, NOx, NH3, SO2, PM2.5, OC, and BC have increased by 595%, 500%, 608%, 584%, 600%, 600%, 543%, 571%, 775%, and 500%, respectively, over the past 24 years. Spatially, the regions with high emissions had been notable expanding over the years, especially in the central eastern districts, the Northeastern of China, and the Sichuan Basin. Strong temporal pattern were observed with the highest emissions in June, followed by March to May and October. This work provides a better understanding of the spatiotemporal representation of agricultural fire emissions in China and can benefit both air quality modeling and management with improved accuracy.

  12. Application of Kangxiuke apozem in the treatment of severe burn shock%抗休克煎剂在烧伤休克治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    蔡良良; 谢龙炜; 虞俊杰; 吕国忠; 陆金根; 丁羚涛

    2012-01-01

    Objective To observe the clinical effect of Kangxiuke apozem in the treatment of severe bum shock.Methods 40 patients of severe burn shock were randomly divided into a treatment group and a control group,with 20 patients in each group.All the patients were treated by the same route of counter-shock therapy,and the treatment group was additionally given Kangxiuke apozem (nasal feeding,qd,150 ml/d).Level of blood lactic acid,heart rate and urinary volume were evaluated by time.Main shock symptoms,including restlessness,hydrodipsia,perspiration and coldness,were observed.Results The treatment group was significantly superior to the control group in the amelioration of blood lactic acid,heart rate and urinary volume ( t =10.485、3.219、7.429,P< 0.01 ).The symptomatic extinction of restlessness,hydrodipsia,perspiration and coldness in the extremities in the treatment group were significantly superior to those in the control group (x2=10.16、7.37、5.63、4.29,P<0.05).Conclusion At the same time of routine counter-shock therapy,thereby prompt burn patients to smoothly go through shock period and decreas late complications.%目的 观察抗休克煎剂治疗烧伤休克的临床效果.方法 将2008年3月至2010年10月江苏省无锡市中西医结合医院收治的40例重度烧伤休克患者以随机数据表法分为两组各20例,对照组患者采用常规抗休克治疗,治疗组在对照组治疗基础上鼻饲抗休克煎剂,1剂/d,150 ml/剂.观察并记录两组患者复苏前、复苏后24、48、72 h的血乳酸值,心率、尿量及烦躁、口渴、汗出、肢厥等体征和临床症状的变化情况.结果 入院72 h时,治疗组血乳酸值、心率、尿量改善均优于对照组(t值分别为10.485、3.219、7.429,P均<0.01),烦躁、口渴、汗出、肢厥休克症状的消失优于对照组(x2值分别为10.16、7.37、5.63、4.29,P均<0.05).结论 抗休克煎剂配合治疗重度烧伤休克,可使患者平稳度过休克期,减少后期并发症.

  13. Epidemiology of burns in Lithuania during 1991-2004.

    Science.gov (United States)

    Rimdeika, Rytis; Kazanavicius, Mindaugas; Kubilius, Darius

    2008-01-01

    The objective of this article is to overview and present the burn incidence and burn care in Lithuania. In this study, data from the period of 1991-2004 were collected from the Lithuanian Department of Statistics, Department of Fire and Rescue, Lithuanian Health Information Center, State Patient Fund, health care institutions, burn care facilities. In the 14-year period, 9459 persons per year (2.6/1000 population) in average sustained burn injuries. The majority of burned patients (74.8%) were adults and 25.2% were children; 21.5% of all burned patients were hospitalized (2013 inpatients per year). The number of hospitalizations per 100 000 individuals has decreased from 65.6 to 39.5, but it is still very high and worrying. Among all the patients admitted to hospitals, 67% were males and 33% females, with a male-to-female ratio of 2:1. The length of hospitalization decreased from 16.2 to 12.7 days. The number of fire-related deaths for the 14-year period was 289 deaths per year (8 per 100 000 persons). The number of deaths among inpatients was 63.6 deaths per year, the age being an important factor in mortality rates. Although the mortality of inpatients has increased in recent years, the mortality in the age group up to 14 years has decreased to 0. Children made up 24.6% of burn patients; among those admitted to hospital, they accounted for 41.1%. Mortality rates for males and females were almost the same. The number of burns is decreasing. The hospitalization rate and hospitalization time are becoming shorter. In the last few years, patients suffer from more severe burns, while children sustain more severe burns requiring hospitalization. Children and working-age persons make up 91.9% of hospitalized burn patients. Number of deaths in fire accidents is increasing.

  14. A primer on burn resuscitation

    Directory of Open Access Journals (Sweden)

    Bacomo Ferdinand

    2011-01-01

    Full Text Available Since the early 1900s, the scope of burn resuscitation has evolved dramatically. Due to various advances in pre-hospital care and training, under-resuscitation of patients with severe burns is now relatively uncommon. Over-resuscitation, otherwise known as "fluid creep", has emerged as one of the most important problems during the initial phases of burn care over the past decade. To avoid the complications of over-resuscitation, careful hourly titration of fluid rates based on compilation of various clinical end points by a bedside provider is vital. The aim of this review is to provide a practical approach to the resuscitation of severely burned patients.

  15. The Fire INventory from NCAR (FINN): a high resolution global model to estimate the emissions from open burning

    Science.gov (United States)

    C. Wiedinmyer; S. K. Akagi; R. J. Yokelson; L. K. Emmons; J. A. Al-Saadi; J. J. Orlando; A. J. Soja

    2010-01-01

    The Fire INventory from NCAR version 1.0 (FINNv1) provides daily, 1 km resolution, global estimates of the trace gas and particle emissions from open burning of biomass, which includes wildfire, agricultural fires, and prescribed burning and does not include 5 biofuel use and trash burning. Emission factors used in the calculations have been updated with recent data,...

  16. Burn mouse models

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus

    2014-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third-degree b......Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third......-degree burn injury was induced with a hot-air blower. The third-degree burn was confirmed histologically. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear...... neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization of the skin showed an increased polymorphonuclear neutrophil granulocytes dominated inflammation in the group of mice...

  17. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN; McCauley, RL

    2002-01-01

    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally use

  18. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN; McCauley, RL

    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally

  19. Burn epidemiology and cost of medication in paediatric burn patients.

    Science.gov (United States)

    Koç, Zeliha; Sağlam, Zeynep

    2012-09-01

    Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication.

  20. A review of hydrofluoric acid burn management

    OpenAIRE

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    The clinical presentation and severity of hydrofluoric acid burns vary considerably, making management particularly challenging. Given that current knowledge of HF burns is derived from small case series, case reports, animal studies and anecdotal evidence, this narrative review discusses the current understanding of the effects associated with severe hydrofluoric acid burns, describing the mechanism of injury, systemic toxicity and treatment options.

  1. Titanium tetrachloride burns to the eye.

    OpenAIRE

    Chitkara, D K; McNeela, B. J.

    1992-01-01

    We present eight cases of chemical burns of the eyes from titanium tetrachloride, an acidic corrosive liquid. However it causes severe chemical burns which have a protracted course and features more akin to severe alkali burns. Injuries related to titanium tetrachloride should be treated seriously and accordingly appropriate management is suggested.

  2. MRI findings of the brain in high-voltage electrical burn patient: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheung Sook; Hong, Sung Hwan; Lee, Myung Joon; Cho, Seong Whi; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-05-01

    We report the delayed sequelae arising in a case of electrical injury, reviewing the literature on the subject and focusing on the MRI findings of the brain. A 23-year-old male suffered burns to the left parietal scalp, both feet, and the anterior chest wall. Neurological symptoms and MRI abnormalities appeared 14 days after the insult and continued for about three months. T1-weight MR images demonstrated homogeneous hypointensity, while T2-weighted images depicted hyperintense finger-like projections. Contrast-enhanced T1-weighted images demonstrated strong band-like enhancement, indicating meningeal hyperemia. Follow-up MR imaging showed that the lesion had disappeared, indicating that the cerebral edema and meaningeal hyperemia were reversible.

  3. Burn-Up Determination by High Resolution Gamma Spectrometry: Axial and Diametral Scanning Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, R.S.; Blackadder, W.H.; Ronqvist, N.

    1967-02-15

    In the gamma spectrometric determination of burn-up the use of a single fission product as a monitor of the specimen fission rate is subject to errors caused by activity saturation or, in certain cases, fission product migration. Results are presented of experiments in which all the resolvable gamma peaks in the fission product spectrum have been used to calculate the fission rate; these results form a pattern which reflect errors in the literature values of the gamma branching ratios, fission yields etc., and also represent a series of empirical correction factors. Axial and diametral scanning experiments on a long-irradiated low-enrichment fuel element are also described and demonstrate that it is possible to differentiate between fissions in U-235 and in Pu-239 respectively by means of the ratios of the Ru-106 activity to the activities of the other fission products.

  4. Topical Pain Relievers May Cause Burns

    Science.gov (United States)

    ... Consumers Consumer Updates Topical Pain Relievers May Cause Burns Share Tweet Linkedin Pin it More sharing options ... rare, have ranged from mild to severe chemical burns with use of such brand-name topical muscle ...

  5. A review of hydrofluoric acid burn management.

    Science.gov (United States)

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns.

  6. Burn Injury Arise From Flying Balloon Toys

    OpenAIRE

    Yalcin Kulahci; Fatih Zor; Mehmet Bozkurt; Serdar Ozturk; Mustafa Sengezer

    2007-01-01

    Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloon...

  7. Charcoal reflectance reveals early holocene boreal deciduous forests burned at high intensities.

    Science.gov (United States)

    Hudspith, Victoria A; Belcher, Claire M; Kelly, Ryan; Hu, Feng Sheng

    2015-01-01

    Wildfire size, frequency, and severity are increasing in the Alaskan boreal forest in response to climate warming. One of the potential impacts of this changing fire regime is the alteration of successional trajectories, from black spruce to mixed stands dominated by aspen, a vegetation composition not experienced since the early Holocene. Such changes in vegetation composition may consequently alter the intensity of fires, influencing fire feedbacks to the ecosystem. Paleorecords document past wildfire-vegetation dynamics and as such, are imperative for our understanding of how these ecosystems will respond to future climate warming. For the first time, we have used reflectance measurements of macroscopic charcoal particles (>180μm) from an Alaskan lake-sediment record to estimate ancient charring temperatures (termed pyrolysis intensity). We demonstrate that pyrolysis intensity increased markedly from an interval of birch tundra 11 ky ago (mean 1.52%Ro; 485°C), to the expansion of trees on the landscape ~10.5 ky ago, remaining high to the present (mean 3.54%Ro; 640°C) irrespective of stand composition. Despite differing flammabilities and adaptations to fire, the highest pyrolysis intensities derive from two intervals with distinct vegetation compositions. 1) the expansion of mixed aspen and spruce woodland at 10 cal. kyr BP, and 2) the establishment of black spruce, and the modern boreal forest at 4 cal. kyr BP. Based on our analysis, we infer that predicted expansion of deciduous trees into the boreal forest in the future could lead to high intensity, but low severity fires, potentially moderating future climate-fire feedbacks.

  8. Development of newly designed wood burning systems with low emissions and high efficiency; Tehokkaan ja vaehaepaeaestoeisen puulaemmitysjaerjestelmaen kehittaeminen

    Energy Technology Data Exchange (ETDEWEB)

    Hyytiaeinen, H. [Tulisydaen Oy, Vantaa (Finland)

    1997-12-01

    The investigations in the project will focus on the combustion behaviour of wood burning systems of untreated wood fuels with batch-wise and quasi-continuous mechanical feeding. The objectives will be to minimise the pollutant release of these combustion systems during the different operational phases by a consequent optimisation of the fuel burning technique and to reduce the CO release by increasing the efficiency of the combustion. To reduce the pollutant release during the operation phases and to increase the efficiency, products of incomplete combustion i.e. carbon monoxide, toxic organic compounds like benzene, polycyclic aromatic hydrocarbons and soot have to be minimised in a further extent. For that the following goals will be attained: improvement of the mixing process of combustion gases in the reaction zones, averaging the residence time spectrum in the burnout zone reduction, of emissions during initial and burnout phase in firings with batch-wise feeding reduction of emissions under partial-load conditions in firings with quasi-continuous feeding, higher combustion stability even in case of changing fuel qualities, defining guidelines for the design of stoves and boilers with low emissions and high efficiency. By the foreseen reduction of the pollutant release and improved efficiency the environmental acceptance of wood combustion firings can be increased and for instance local restrictions can be removed. The project is funded in part by The European Commission in the framework of The Non Nuclear Energy Programme. (orig.)

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

    Science.gov (United States)

    Zang, Tuo; Broszczak, Daniel A; Broadbent, James A; Cuttle, Leila; Lu, Haitao; Parker, Tony J

    2016-01-01

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

  10. Development of a method for xenon determination in the microstructure of high burn-up nuclear fuel[Dissertation 17527

    Energy Technology Data Exchange (ETDEWEB)

    Horvath, M. I

    2008-07-01

    In nuclear fuel, in approximately one quarter of the fissions, one of the two formed fission products is gaseous. These are mainly the noble gases xenon and krypton with isotopes of xenon contributing up to 90% of the product gases. These noble fission gases do not combine with other species, and have a low solubility in the normally used uranium oxide matrix. They can be dissolved in the fuel matrix or precipitate in nanometer-sized bubbles within the fuel grain, in micrometer-sized bubbles at the grain boundaries, and a fraction also precipitates in fuel pores, coming from fuel fabrication. A fraction of the gas can also be released into the plenum of the fuel rod. With increasing fission, and therefore burn-up, the ceramic fuel material experiences a transformation of its structure in the 'cooler' rim region of the fuel. A subdivision occurs of the original fuel grains of few microns size into thousands of small grains of sub-micron sizes. Additionally, larger pores are formed, which also leads into an increasing porosity in the fuel rim, called high burn-up structure. In this structure, only a small fraction of the fission gas remains in the matrix, the major quantity is said to accumulate in these pores. Because of this accumulation, the knowledge of the quantities of gas within these pores is of major interest in consideration to burn-up, fuel performance and especially for safety issues. In case of design based accidents, i.e. rapidly increasing temperature transients, the behavior of the fuel has to be estimated. Various analytical techniques have been used to determine the Xe concentration in nuclear fuel samples. The capabilities of EPMA (Electron Probe Micro-Analyser) and SIMS (Secondary Ion Mass Spectrometry) have been studied and provided some qualitative information, which has been used for determining Xe-matrix concentrations. First approaches combining these two techniques to estimate pore pressures have been recently reported. However

  11. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  12. Highly Absorbent Antibacterial Hemostatic Dressing for Healing Severe Hemorrhagic Wounds

    Directory of Open Access Journals (Sweden)

    Ting-Ting Li

    2016-09-01

    Full Text Available To accelerate healing of severe hemorrhagic wounds, a novel highly absorbent hemostatic dressing composed of a Tencel®/absorbent-cotton/polylactic acid nonwoven base and chitosan/nanosilver antibacterial agent was fabricated by using a nonwoven processing technique and a freeze-drying technique. This study is the first to investigate the wicking and water-absorbing properties of a nonwoven base by measuring the vertical wicking height and water absorption ratio. Moreover, blood agglutination and hemostatic second tests were conducted to evaluate the hemostatic performance of the resultant wound dressing. The blending ratio of fibers, areal weight, punching density, and fiber orientation, all significantly influenced the vertical moisture wicking property. However, only the first two parameters markedly affected the water absorption ratio. After the nonwoven base absorbed blood, scanning electron microscope (SEM observation showed that erythrocytes were trapped between the fibrin/clot network and nonwoven fibers when coagulation pathways were activated. Prothrombin time (PT and activated partial thromboplastin time (APTT blood agglutination of the resultant dressing decreased to 14.34 and 50.94 s, respectively. In the femoral artery of the rate bleeding model, hemostatic time was saved by 87.2% compared with that of cotton cloth. Therefore, the resultant antibacterial wound dressing demonstrated greater water and blood absorption, as well as hemostatic performance, than the commercially available cotton cloth, especially for healing severe hemorrhagic wounds.

  13. Development of ultrasonic high temperature system for severe accidents research

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kil Mo; Kang, Kyung Ho; Kim, Young Ro and others

    2000-07-01

    The aims of this study are to find a gap formation between corium melt and the reactor lower head vessel, to verify the principle of the gap formation and to analyze the effect of the gap formation on the thermal behavior of corium melt and the lower plenum. This report aims at suggesting development of a new high temperature measuring system using an ultrasonic method which overcomes the limitations of the present thermocouple method used for severe accident experiments. Also, this report describes the design and manufacturing method of the ultrasonic system. At that time, the sensor element is fabricated to a reflective element using 1mm diameter and 50 mm and 80 mm long tungsten alloy wires. This temperature measuring system is intended to measure up to 2800 deg C.

  14. High-frequency percussive ventilation and initial biomarker levels of lung injury in patients with minor burns after smoke inhalation injury.

    Science.gov (United States)

    Reper, P; Heijmans, W

    2015-02-01

    Several biological markers of lung injury are predictors of morbidity and mortality in patients with acute respiratory distress syndrome (ARDS). Some lung-protective ventilation strategies, such as low tidal volume, are associated with a significant decrease in plasma biomarker levels compared to the high tidal volume ventilation strategy. The primary objective of this study was to test whether the institution of high-frequency percussive ventilation (HFPV) to patients with respiratory distress after smoke inhalation injury influenced initial biomarker levels of lung injury (just before and after using percussive ventilation). A prospective observational cohort study was conducted in the intensive care unit of the Brussels Burn Center. Fifteen intubated, mechanically ventilated patients with minor burns and ARDS following smoke inhalation were enrolled in our study. Physiologic data and serum samples were collected before intubation and at four different time points within the first 48h after intubation to measure the concentration of interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF alpha). The differences in biomarker levels before and after starting HFPV were analyzed using repeated measure analysis of variance and a paired t test with correction for multiple comparisons. Before starting HFPV under endotracheal intubation, all biological markers (IL-6, IL-8, and TNF alpha) were elevated in the spontaneously breathing patients with acute lung injury (ALI). After intubation and institution of a positive pressure ventilation with HFPV (tidal volume 5.6-6.6ml/kg per ideal body weight), none of the biological markers were increased significantly at either an early (3±2h) or a later point in time. However, the levels of IL-8 had decreased significantly after intubation at a later point in time. During the post-intubation period, the PaO2/FiO2 (partial pressure of arterial oxygen/fraction of the inspired oxygen) ratio increased significantly and the plateau

  15. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    Houston, TX Purpose:Patients with severe facial burns often suffer indirect damage to their eyes. Burn wound contracture of the periocular skin...periocular muscles , are injured and the protective blink reflex is lost. With loss of the blink reflex the patient quickly develops exposure keratitis

  16. Using Coupled Mesoscale Experiments and Simulations to Investigate High Burn-Up Oxide Fuel Thermal Conductivity

    Science.gov (United States)

    Teague, Melissa C.; Fromm, Bradley S.; Tonks, Michael R.; Field, David P.

    2014-12-01

    Nuclear energy is a mature technology with a small carbon footprint. However, work is needed to make current reactor technology more accident tolerant and to allow reactor fuel to be burned in a reactor for longer periods of time. Optimizing the reactor fuel performance is essentially a materials science problem. The current understanding of fuel microstructure have been limited by the difficulty in studying the structure and chemistry of irradiated fuel samples at the mesoscale. Here, we take advantage of recent advances in experimental capabilities to characterize the microstructure in 3D of irradiated mixed oxide (MOX) fuel taken from two radial positions in the fuel pellet. We also reconstruct these microstructures using Idaho National Laboratory's MARMOT code and calculate the impact of microstructure heterogeneities on the effective thermal conductivity using mesoscale heat conduction simulations. The thermal conductivities of both samples are higher than the bulk MOX thermal conductivity because of the formation of metallic precipitates and because we do not currently consider phonon scattering due to defects smaller than the experimental resolution. We also used the results to investigate the accuracy of simple thermal conductivity approximations and equations to convert 2D thermal conductivities to 3D. It was found that these approximations struggle to predict the complex thermal transport interactions between metal precipitates and voids.

  17. High abundances of water-soluble dicarboxylic acids, ketocarboxylic acids and α-dicarbonyls in the mountain aerosols over the North China Plain during wheat burning season

    Directory of Open Access Journals (Sweden)

    K. Okuzawa

    2013-02-01

    Full Text Available Aerosol (TSP samples were collected at the summit of Mount Tai (elevation: 1534 m a.s.l., 36.25° N; 117.10° E located in the North China Plain using a high-volume air sampler and pre-combusted quartz filters. Sampling was conducted on day/night or 3 h basis in the period from 29 May to 28 June 2006 during the field burning of wheat straw residue and the post-burning season. The filter samples were analyzed for low molecular weight dicarboxylic acids, ketoacids and α-dicarbonyls using capillary gas chromatography (GC and GC-MS employing water extraction and butyl ester derivatization. Dicarboxylic acids (C2–C11, 220–6070 ng m−3 were characterized by a predominance of oxalic (C2 acid (105–3920 ng m−3 followed by succinic (C4 or malonic (C3 acid. Unsaturated aliphatic diacids, including maleic (M, isomaleic (iM and fumaric (F acid, were also detected together with aromatic diacids (phthalic, iso-phthalic and tere-phthalic acids. ω-Oxocarboxylic acids (C2–C9, 24–610 ng m−3 were detected as the second most abundant compound class with the predominance of glyoxylic acid (11–360 ng m−3, followed by α-ketoacid (pyruvic acid, 3–140 ng m−3 and α-dicarbonyls (glyoxal, 1–230 ng m−3 and methylglyoxal, 2–120 ng m−3. We found that these levels (> 6000 ng m−3 for diacids are several times higher than those reported in Chinese megacities at ground levels. The concentrations of diacids increased from late May to early June showing a maximum on 7 June and then significantly decreased during 8–11 June when the wind direction shifted from northeasterly to northerly. Similar temporal trends were found for ketocarboxylic acids and α-dicarbonyls as well as total carbon (TC and water-soluble organic carbon (WSOC. The temporal variations of water-soluble organics

  18. Review of Adult Electrical Burn Injury Outcomes Worldwide: An Analysis of Low-Voltage vs High-Voltage Electrical Injury.

    Science.gov (United States)

    Shih, Jessica G; Shahrokhi, Shahriar; Jeschke, Marc G

    The aims of this article are to review low-voltage vs high-voltage electrical burn complications in adults and to identify novel areas that are not recognized to improve outcomes. An extensive literature search on electrical burn injuries was performed using OVID MEDLINE, PubMed, and EMBASE databases from 1946 to 2015. Studies relating to outcomes of electrical injury in the adult population (≥18 years of age) were included in the study. Forty-one single-institution publications with a total of 5485 electrical injury patients were identified and included in the present study. Fourty-four percent of these patients were low-voltage injuries (LVIs), 38.3% high-voltage injuries (HVIs), and 43.7% with voltage not otherwise specified. Forty-four percentage of studies did not characterize outcomes according to LHIs vs HVIs. Reported outcomes include surgical, medical, posttraumatic, and others (long-term/psychological/rehabilitative), all of which report greater incidence rates in HVI than in LVI. Only two studies report on psychological outcomes such as posttraumatic stress disorder. Mortality rates from electrical injuries are 2.6% in LVI, 5.2% in HVI, and 3.7% in not otherwise specified. Coroner's reports revealed a ratio of 2.4:1 for deaths caused by LVI compared with HVI. HVIs lead to greater morbidity and mortality than LVIs. However, the results of the coroner's reports suggest that immediate mortality from LVI may be underestimated. Furthermore, on the basis of this analysis, we conclude that the majority of studies report electrical injury outcomes; however, the majority of them do not analyze complications by low vs high voltage and often lack long-term psychological and rehabilitation outcomes after electrical injury indicating that a variety of central aspects are not being evaluated or assessed.

  19. The Role of Nutrition Support Therapy in Treatment of Severe Burns%营养支持疗法在严重烧伤治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    田甜; 常春娟; 胡国栋; 王瑞晨; 贾赤宇

    2013-01-01

    烧伤救治是一个复杂的系统工程,涉及急救、复苏、感染、创面、营养、康复及心理等.营养支持已成为中度以上烧伤患者的重要治疗措施之一:积极正确的营养支持,可促进合成、增强免疫和加速创面愈合,对烧伤救治疗效有明显的改善作用.相反,营养不良可使创面愈合延缓、降低身体抵抗力、易并发感染等并发症,严重影响预后.给予合理的营养支持治疗来维持烧伤患者的营养是严重烧伤治疗中重要措施之一.因此,重视营养支持,相关治疗措施才会发挥应有疗效,烧伤的整体治疗水平才可能提高.%Burn treatment is a complicated system engineering,involving of first aid,resuscitation,infection,wound,nutrition,rehabilitation and psychology,and so on.Nutritional support has become one of the important treatment of severe burn patients.The positive right of nutritional support,can promote synthesis,enhance immunity and accelerating wound healing,and has obvious improving effect to burn treatment efficacy.Instead,poor nutrition can make the wound healing delay,lower body resistance,easy intercurrent infection complications,and so on,seriously affect the prognosis.Reasonable nutrition support treatment for burn patients nutrtion is one of important measures in severe burn treatment.Therefore,only paying more attention to nutritional support therapy,it's possible that the relevant treatment measures can play the efficacy and the overall levels of burn treatments can be improved.

  20. High Temperature Reactor (HTR) Deep Burn Core and Fuel Analysis: Design Selection for the Prismatic Block Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Francesco Venneri; Chang-Keun Jo; Jae-Man Noh; Yonghee Kim; Claudio Filippone; Jonghwa Chang; Chris Hamilton; Young-Min Kim; Ji-Su Jun; Moon-Sung Cho; Hong-Sik Lim; MIchael A. Pope; Abderrafi M. Ougouag; Vincent Descotes; Brian Boer

    2010-09-01

    The Deep Burn (DB) Project is a U.S. Department of Energy sponsored feasibility study of Transuranic Management using high burnup fuel in the high temperature helium cooled reactor (HTR). The DB Project consists of seven tasks: project management, core and fuel analysis, spent fuel management, fuel cycle integration, TRU fuel modeling, TRU fuel qualification, and HTR fuel recycle. In the Phase II of the Project, we conducted nuclear analysis of TRU destruction/utilization in the HTR prismatic block design (Task 2.1), deep burn fuel/TRISO microanalysis (Task 2.3), and synergy with fast reactors (Task 4.2). The Task 2.1 covers the core physics design, thermo-hydraulic CFD analysis, and the thermofluid and safety analysis (low pressure conduction cooling, LPCC) of the HTR prismatic block design. The Task 2.3 covers the analysis of the structural behavior of TRISO fuel containing TRU at very high burnup level, i.e. exceeding 50% of FIMA. The Task 4.2 includes the self-cleaning HTR based on recycle of HTR-generated TRU in the same HTR. Chapter IV contains the design and analysis results of the 600MWth DB-HTR core physics with the cycle length, the average discharged burnup, heavy metal and plutonium consumptions, radial and axial power distributions, temperature reactivity coefficients. Also, it contains the analysis results of the 450MWth DB-HTR core physics and the analysis of the decay heat of a TRU loaded DB-HTR core. The evaluation of the hot spot fuel temperature of the fuel block in the DB-HTR (Deep-Burn High Temperature Reactor) core under full operating power conditions are described in Chapter V. The investigated designs are the 600MWth and 460MWth DB-HTRs. In Chapter VI, the thermo-fluid and safety of the 600MWth DB-HTRs has been analyzed to investigate a thermal-fluid design performance at the steady state and a passive safety performance during an LPCC event. Chapter VII describes the analysis results of the TRISO fuel microanalysis of the 600MWth and 450

  1. Instant release of fission products in leaching experiments with high burn-up nuclear fuels in the framework of the Euratom project FIRST- Nuclides

    Science.gov (United States)

    Lemmens, K.; González-Robles, E.; Kienzler, B.; Curti, E.; Serrano-Purroy, D.; Sureda, R.; Martínez-Torrents, A.; Roth, O.; Slonszki, E.; Mennecart, T.; Günther-Leopold, I.; Hózer, Z.

    2017-02-01

    The instant release of fission products from high burn-up UO2 fuels and one MOX fuel was investigated by means of leach tests. The samples covered PWR and BWR fuels at average rod burn-up in the range of 45-63 GWd/tHM and included clad fuel segments, fuel segments with opened cladding, fuel fragments and fuel powder. The tests were performed with sodium chloride - bicarbonate solutions under oxidizing conditions and, for one test, in reducing Ar/H2 atmosphere. The iodine and cesium release could be partially explained by the differences in sample preparation, leading to different sizes and properties of the exposed surface areas. Iodine and cesium releases tend to correlate with FGR and linear power rating, but the scatter of the data is significant. Although the gap between the fuel and the cladding was closed in some high burn-up samples, fissures still provide possible preferential transport pathways.

  2. 特重度烧伤并发急性肾功能衰竭的因素分析%Analysis of the factors of severe burn complicated with acute renal failure

    Institute of Scientific and Technical Information of China (English)

    王野; 朱志军; 边曦

    2014-01-01

    目的:探讨特重度烧伤并发急性肾功能衰竭(acute renal failure,ARF)的相关因素,为临床早期防治ARF提供依据。方法分析我科2003年1月至2012年12月收治的特重度烧伤362例烧伤后开始接受液体复苏治疗的时间和方法,并结合测定的生化指标,分析特重度烧伤与ARF的相关性。结果362例特重度烧伤中有27例并发ARF,烧伤面积>90%组ARF发生比例明显高于其他各组(P<0.05)。烧伤面积>70%组,伤后2 h以后开始接受液体复苏治疗组发生ARF明显高于伤后2 h以内开始治疗组(P<0.05)。发生ARF者,血尿素氮(BUN)在伤后14 d明显高于无ARF者(P<0.05),血肌酐(Scr)在伤后7 d明显高于无ARF者(P<0.05),胱抑素C(CysC)在伤后2 d明显高于无ARF者(P<0.05)。结论烧伤面积和伤后液体复苏开始治疗时间均与烧伤并发ARF呈正相关,发生ARF时患者BUN、Scr、CysC均明显升高,CysC测定可能成为早期检测ARF的敏感指标。%Objective Through investigation the related factors of acute renal failure(ARF) with severely thermal burn, and provide evidence for clinical early prevention and treatment of ARF. Methods 362 cases data with ARF admitted into our department during January 2003 to December 2012 with severely thermal burn were enrolled to analyze the time and method began to receive fluid resuscitation therapy, combined with their biochemical index determination, to analyze the correlation of severely thermal burn with ARF. Results In 362 cases of severely thermal burn patients were 27 cases complicated with ARF, and the ARF incidence of burn area more than 90%was significantly higher than the other groups (P<0.05). In burn area more than 70%group, the ARF incidence of 2 hours after injury began to accept fluid resuscitation group was significantly higher than within 2 hours after injury to the treatment group (P<0.05). In 27 cases of ARF, blood urea

  3. Status of post-traumatic growth of severe burn patients and its influencing factors%严重烧伤患者创伤后成长状况及对策

    Institute of Scientific and Technical Information of China (English)

    梁英; 肖文芳; 焦丹丹

    2016-01-01

    Objective To understand the status of post-traumatic growth of severe burn patients and analyze its influencing factors. Methods General information questionnaire and post-traumatic growth inventory (PTGI) were used to investigate thirty patients with severe burn. Multi-linear regression method was used to analyze the post-traumatic influencing factors. Results The average score of PTGI was (68.30 ± 10.90), which was in media level. The main influencing factors included burn area, active exercise, time and expense of treatment, marital status and sear proliferation. Conclusion In order to improve the post-traumatic growth,nurses should enhance psychological intervention, teach effective coping strategies and increase the social level to the burn patients.%目的 了解严重烧伤患者创伤后成长水平状况及探讨其护理对策.方法 采用一般情况调查表,创伤后成长量表(posttraumatic growth inventory,PTGI)对30例严重烧伤患者进行调查.结果 本组30例严重烧伤患者PTGI总分为(68.30±10.90)分,处于中等水平.结论 护理人员应加强对严重烧伤患者心理的疏导,指导其采取积极有效的应对策略,提高其创伤后成长水平.

  4. Mapping burned areas using dense time-series of Landsat data

    Science.gov (United States)

    Hawbaker, Todd J.; Vanderhoof, Melanie; Beal, Yen-Ju G.; Takacs, Joshua; Schmidt, Gail L.; Falgout, Jeff T.; Williams, Brad; Brunner, Nicole M.; Caldwell, Megan K.; Picotte, Joshua J.; Howard, Stephen M.; Stitt, Susan; Dwyer, John L.

    2017-01-01

    Complete and accurate burned area data are needed to document patterns of fires, to quantify relationships between the patterns and drivers of fire occurrence, and to assess the impacts of fires on human and natural systems. Unfortunately, in many areas existing fire occurrence datasets are known to be incomplete. Consequently, the need to systematically collect burned area information has been recognized by the United Nations Framework Convention on Climate Change and the Intergovernmental Panel on Climate Change, which have both called for the production of essential climate variables (ECVs), including information about burned area. In this paper, we present an algorithm that identifies burned areas in dense time-series of Landsat data to produce the Landsat Burned Area Essential Climate Variable (BAECV) products. The algorithm uses gradient boosted regression models to generate burn probability surfaces using band values and spectral indices from individual Landsat scenes, lagged reference conditions, and change metrics between the scene and reference predictors. Burn classifications are generated from the burn probability surfaces using pixel-level thresholding in combination with a region growing process. The algorithm can be applied anywhere Landsat and training data are available. For this study, BAECV products were generated for the conterminous United States from 1984 through 2015. These products consist of pixel-level burn probabilities for each Landsat scene, in addition to, annual composites including: the maximum burn probability and a burn classification. We compared the BAECV burn classification products to the existing Global Fire Emissions Database (GFED; 1997–2015) and Monitoring Trends in Burn Severity (MTBS; 1984–2013) data. We found that the BAECV products mapped 36% more burned area than the GFED and 116% more burned area than MTBS. Differences between the BAECV products and the GFED were especially high in the West and East where the

  5. Acute Kidney Injury and Renal Replacement Therapy in Burns

    Directory of Open Access Journals (Sweden)

    Burak Canver

    2011-07-01

    Full Text Available Acute kidney injury (AKI is a common complication in patients with severe burn injury and one of the major causes of death. It has a negative prognostic value and almost always develops in the context of multiple organ dysfunction syndrome (MODS induced by sepsis. Over the last 20 years, according to data avaliable, the mortality rate has been reported to reach about 75%. Several definitions of AKI have been used , but nowadays the RIFLE classification is considered the gold standard, enabling a more objective comparison of populations. There are several ways to treat AKI in burn patients, including peritoneal dialysis (PD, intermittent hemodialysis, and continuous renal replacement therapy (CRRT. CRRT is generally used in patients in whom intermittent hemodialysis has failed to control hypovolemia, as well as in patients who cannot tolerate intermittent hemodialysis. Additionally, PD is not suitable for patients with burns within the abdominal area. For these reasons, most patients with unstable hemodynamic conditions receive CRRT. In burn patients with acute renal failure the dialytic treatment with continuous renal replacement therapies permitted us to achieve a survival and dialytic adequacy; however, mortality rate is high and related to septic shock and MODS. Despite the wide variation of the analysed burn populations and definitions of AKI, this review clearly showed that AKI remains prevalent and is associated with increased mortality in patients with severe burn injury. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 46-50

  6. 抗内毒素Fab'对严重烧伤早期炎症细胞因子的影响%Effects of Fab' against LPS on inflanunatory cytokines during the early stage of severe burns in mice

    Institute of Scientific and Technical Information of China (English)

    庄颖; 张雅萍; 马思远

    2008-01-01

    目的 观察抗内毒素Fab'对严重烧伤早期肠源性内毒素血症小鼠肠道损伤的保护作用.方法 采用严重烧伤早期肠源性内毒素血症小鼠模型,分为烧伤组、治疗组及对照组,分别于6、12、24、48 h四个时相点测定血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-lβ、IL-10的浓度.结果 与正常对照组比较,烧伤后血清TNF-α、IL-1β、IL-10水平增高,差异有统计学意义(P<0.01);治疗组血清TNF-α、IL-1β、IL-10水平较烧伤组显著降低(P<0.01).病理检查结果提示治疗组较烧伤组肠黏膜损伤明显减轻.结论 抗内毒素Fab'能抑制内毒素所诱导的TNF-α、IL-1β产生,同时调节血清中的IL-10水平,减轻内毒素对机体的损害,从而起到对严重烧伤后肠源性脓毒症的防治作用.%Objective To investigate the effect of the Fab' against LPS on intestinal mucosa during the early stage of severe bums in mice. Methods The gut-derived endotoximia mice model in the early stage of severe burn was created. The mice were randomly divided into three groups: burn group, control group and treatment group. At 6,12,24 and 48 h after burns ,levels of serum TNF-a,IL-1β and IL-10 were detenninated by enzyme linked immunosorbant assay. Results After burns,levels of serum TNF-α,IL-1 β and IL-10 in burn group were significantly higher than those in the control group (P<0.01). The levels of serum TNF-α,IL-β and IL-10 in treatment group were significantly lowere than in the burn group (P < 0.01 ). Pathological examinations revealed that the damage to the intestinal mucosa in treatment group was obviously alleviated as compared with bum group. Conclusion The Fab' against LPS can significantly decrease the levels of serum TNF-α,IL-1β and IL-10 during the early stage in severely burned gut-derived endotoximia mice, and inhibit injury by LPS,then prevent and cure burn sepsis.

  7. Single particle characterization of biomass burning organic aerosol (BBOA: evidence for non-uniform mixing of high molecular weight organics and potassium

    Directory of Open Access Journals (Sweden)

    A. K. Y. Lee

    2015-11-01

    Full Text Available Biomass burning is a major source of black carbon (BC and primary organic aerosol globally. In particular, biomass burning organic aerosol (BBOA is strongly associated with atmospheric brown carbon (BrC that absorbs near ultraviolet and visible light, resulting in significant impacts on regional visibility degradation and radiative forcing. The mixing state of BBOA can play a critical role in the prediction of aerosol optical properties. In this work, single particle measurements from a soot-particle aerosol mass spectrometer coupled with a light scattering module (LS-SP-AMS were performed to examine the mixing state of BBOA, refractory black carbon (rBC and potassium (K+, a tracer for biomass burning aerosol in an air mass influenced by aged biomass burning. Cluster analysis of single particle measurements identified five BBOA-related particle types. rBC accounted for 3–14 w.t. % of these particle types on average. Only one particle type exhibited a strong ion signal for K+, with mass spectra characterized by low molecular weight organic species. The remaining four particle types were classified based on the apparent molecular weight of the BBOA constituents. Two particle types were associated with low potassium content and significant amounts of high molecular weight (HMW organic compounds. Our observations indicate non-uniform mixing of particles within a biomass burning plume in terms of molecular weight and illustrate that HMW BBOA can be a key contributor to low-volatility BrC observed in BBOA particles.

  8. Acute concentrated phenol dermal burns: Complications and management

    Directory of Open Access Journals (Sweden)

    Tapan Jayantilal Parikh

    2015-01-01

    Full Text Available Phenol burns can result in multiple organ failure. This is a case report of acute severe phenol dermal burn after accidental splash of 94% phenol on 35-year-old patient′s body who was brought to hospital after 90 min of exposure. Decontamination was done with high-density water and glycerol. Early complications in form of metabolic acidosis and acute renal failure required hemodialysis. Extensive protein denaturation was managed with IV albumin and high protein diet. Patient also developed pleural effusion and acute respiratory distress syndrome, but these were successfully managed by intercostal drain tube insertion and noninvasive ventilation. The patient survived after multiple organ failures and widespread burns despite the fact that it has been observed that outcome of phenol burns with >60 2 inches of skin affected or two or more organs failure involving renal system is nearly fatal.

  9. 严重烧伤后恐怖症患者的心理状态相关因素分析%Analysis the related factors of psychological state in phobia patient after severely burn

    Institute of Scientific and Technical Information of China (English)

    韩小燕

    2011-01-01

    Objective: To investigate the terrorist severely burned patients related to psychological factors. Methods: In our hospital from January 2006 -June 2009, 324 cases of severe burn treated patients as research subjects, the use of mental health self - assessment questionnaire and clinical questions and answers for phobia diagnosis, occurrence of those factors phobia Statistical analysis. Results: The group of 324 severely burned patients after diagnosis of phobia after burning were 157 cases of nerve, the rate was 48.5%. The sex, age, bum size, bum location, marital status and wound treatment and burns were the occurrence of neurological phobia, with statistical significance. Conclusion: The incidence of bum phobia is higher, and with a variety of factors related to clinical treatment should be targeted based on this psychological counseling and treatment to reduce the incidence of bum phobia.%目的:探讨严重烧伤患者发生恐怖心理状态的相关因素.方法:选取我院2006年1月~2009年6月收治的324例严重烧伤患者作为研究对象,采用心理健康自评问卷和临床问答的方式进行恐怖症诊断,对恐怖症发生者的相关因素进行分析统计.结果:本组324例严重烧伤患者经确诊为烧伤后恐怖神经症者157例,发生率为48.5%.性别、年龄、烧伤面积、烧伤部位、婚姻状况及创面处理方法均与烧伤后恐怖性神经症的发生有关,具有统计学意义.结论:烧伤后恐怖症的发生率较高,且与多种因素相关,临床治疗中应根据此进行有针对性的心理辅导和治疗,降低烧伤后恐怖症的发生.

  10. High cardiovascular risk in severely obese young children and adolescents

    NARCIS (Netherlands)

    Emmerik, N.M.A. van; Renders, C.M.; Veer, M. van de; Buuren, S. van; Baan-Slootweg, O.H. van der; Kist-van Holthe, J.E.; HiraSing, R.A.

    2012-01-01

    Objective: To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents. Methods: A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2-18-year-old

  11. High cardiovascular risk in severely obese young children and adolescents

    NARCIS (Netherlands)

    Emmerik, N.M.A. van; Renders, C.M.; Veer, M. van de; Buuren, S. van; Baan-Slootweg, O.H. van der; Kist-van Holthe, J.E.; HiraSing, R.A.

    2012-01-01

    Objective: To assess the prevalence of cardiovascular risk factors in severely obese children and adolescents. Methods: A nationwide prospective surveillance study was carried out from July 2005 to July 2007 where paediatricians were asked to report all new cases of severe obesity in 2-18-year-old c

  12. Burns (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Burns KidsHealth > For Parents > Burns A A A What's ... outlets, etc.) overexposure to the sun Types of Burns Burns are often categorized as first-, second-, or ...

  13. Energy and nitrogen balances in 24 severely burned patients receiving 4 isocaloric diets of about 10 MJ/m2/day (2392 Kcalories/m2/day).

    Science.gov (United States)

    Serog, P; Baigts, F; Apfelbaum, M; Guilbaud, J; Chauvin, B; Pecqueur, M L

    1983-07-01

    Twenty-four subjects with burns ranging from 25-70 per cent received for 12 days exclusively per os a series of 4 isocaloric diets of about 4000 Kcal--'normal', or hyperproteic, or hyperlipidic, or hyperglucidic according to a randomized schedule. Oxygen consumptions were measured at the end of each diet and nitrogen balance was determined every day. Though patients were not massively overfed there remained a positive energy gap. The nitrogen balance was found to be equilibrated on the whole but clearly positive with the hyperproteic diet and clearly negative with the hyperlipidic-normoproteic diet. Thus there is no rationale for the huge energy overfeeding classically used.

  14. Chemical states of fission products in irradiated (U 0.3Pu 0.7)C 1+ x fuel at high burn-ups

    Science.gov (United States)

    Agarwal, Renu; Venugopal, V.

    2006-12-01

    The chemical states of fission products have been theoretically determined for the irradiated carbide fuel of Fast Breeder Test Reactor (FBTR) at Kalpakkam, India, at different burn-ups. The SOLGASMIX-PV computer code was used to determine the equilibrium chemical composition of the fuel. The system was assumed to be composed of a gaseous phase at one atmosphere pressure, and various solid phases. The distribution of elements in these phases and their chemical states at different temperatures were calculated as a function of burn-up. The FBTR fuel, (U 0.3Pu 0.7)C 1+ x, was loaded with C/M values in the range, 1.03-1.06. The present calculations indicated that even for the lowest starting C/M of 1.03 in the FBTR fuel, the liquid metal phase of (U, Pu), should not appear at a burn-up as high as 150 GWd/t.

  15. The Burning Truth(s)

    African Journals Online (AJOL)

    The pathophysiology caused by a severe burn is complicated and involves changes in all ... The interstitial pressure and intravascular oncotic pressures decrease while the ... South African Family Practice 2014; 56(6):24-26. Open Access ...

  16. Proposing "the burns suite" as a novel simulation tool for advancing the delivery of burns education.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2014-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named "The Burns Suite" (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained "realism" props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4-5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was "real" and they were "able to behave as if in a real resuscitation environment," and 2) TBS "addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn't" (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience.

  17. Very High Temperature Reactor (VHTR) Deep Burn Core and Fuel Analysis -- Complete Design Selection for the Pebble Bed Reactor

    Energy Technology Data Exchange (ETDEWEB)

    B. Boer; A. M. Ougouag

    2010-09-01

    The Deep-Burn (DB) concept focuses on the destruction of transuranic nuclides from used light water reactor fuel. These transuranic nuclides are incorporated into TRISO coated fuel particles and used in gas-cooled reactors with the aim of a fractional fuel burnup of 60 to 70% in fissions per initial metal atom (FIMA). This high performance is expected through the use of multiple recirculation passes of the fuel in pebble form without any physical or chemical changes between passes. In particular, the concept does not call for reprocessing of the fuel between passes. In principle, the DB pebble bed concept employs the same reactor designs as the presently envisioned low-enriched uranium core designs, such as the 400 MWth Pebble Bed Modular Reactor (PBMR-400). Although it has been shown in the previous Fiscal Year (2009) that a PuO2 fueled pebble bed reactor concept is viable, achieving a high fuel burnup, while remaining within safety-imposed prescribed operational limits for fuel temperature, power peaking and temperature reactivity feedback coefficients for the entire temperature range, is challenging. The presence of the isotopes 239-Pu, 240-Pu and 241-Pu that have resonances in the thermal energy range significantly modifies the neutron thermal energy spectrum as compared to a ”standard,” UO2-fueled core. Therefore, the DB pebble bed core exhibits a relatively hard neutron energy spectrum. However, regions within the pebble bed that are near the graphite reflectors experience a locally softer spectrum. This can lead to power and temperature peaking in these regions. Furthermore, a shift of the thermal energy spectrum with increasing temperature can lead to increased absorption in the resonances of the fissile Pu isotopes. This can lead to a positive temperature reactivity coefficient for the graphite moderator under certain operating conditions. The effort of this task in FY 2010 has focused on the optimization of the core to maximize the pebble discharge

  18. Corneal Protection for Burn Patients

    Science.gov (United States)

    2014-11-01

    Amniotic Membrane for the Treatment of Severe Exposure Keratopathy in the New Zealand White Rabbit Introduction: Patients with severe facial burns...often suffer indirect damage to their eyes as a sequela of ocular surface exposure keratopathy. Burn wound contracture of the periocular skin causes...inflammatory properties, amniotic membrane has developed into a mainstay of treatment to help maintain the ocular surface when skin grafting is delayed

  19. Development of a method for xenon determination in the microstructure of high burn-up nuclear fuel[Dissertation 17527

    Energy Technology Data Exchange (ETDEWEB)

    Horvath, M. I

    2008-07-01

    In nuclear fuel, in approximately one quarter of the fissions, one of the two formed fission products is gaseous. These are mainly the noble gases xenon and krypton with isotopes of xenon contributing up to 90% of the product gases. These noble fission gases do not combine with other species, and have a low solubility in the normally used uranium oxide matrix. They can be dissolved in the fuel matrix or precipitate in nanometer-sized bubbles within the fuel grain, in micrometer-sized bubbles at the grain boundaries, and a fraction also precipitates in fuel pores, coming from fuel fabrication. A fraction of the gas can also be released into the plenum of the fuel rod. With increasing fission, and therefore burn-up, the ceramic fuel material experiences a transformation of its structure in the 'cooler' rim region of the fuel. A subdivision occurs of the original fuel grains of few microns size into thousands of small grains of sub-micron sizes. Additionally, larger pores are formed, which also leads into an increasing porosity in the fuel rim, called high burn-up structure. In this structure, only a small fraction of the fission gas remains in the matrix, the major quantity is said to accumulate in these pores. Because of this accumulation, the knowledge of the quantities of gas within these pores is of major interest in consideration to burn-up, fuel performance and especially for safety issues. In case of design based accidents, i.e. rapidly increasing temperature transients, the behavior of the fuel has to be estimated. Various analytical techniques have been used to determine the Xe concentration in nuclear fuel samples. The capabilities of EPMA (Electron Probe Micro-Analyser) and SIMS (Secondary Ion Mass Spectrometry) have been studied and provided some qualitative information, which has been used for determining Xe-matrix concentrations. First approaches combining these two techniques to estimate pore pressures have been recently reported. However

  20. Post-fire effects and short-term regeneration dynamics following high-severity crown fires in a Mediterranean forest

    Directory of Open Access Journals (Sweden)

    Garbarino M

    2012-06-01

    Full Text Available Resilience against fire disturbance of Mediterranean vegetation has been frequently described. However, due to climatic change and abandonment of local land use practices, the fire regime is changing, probably leading to higher intensities and frequencies of disturbance events. The forthcoming scenario calls for a full understanding of post-disturbance tree recruitment processes, structural resilience and possible consequences on the overall forest biodiversity. In particular, knowledge on severe crown fires’ effects on forest stand structural attributes needs to be further explored. In this work, we describe and quantify fire impact and short-term response of a Mediterranean forest affected by high severity crown fires, focusing on the compositional and structural diversity of living and dead trees, spatial pattern of fire-induced mortality, recovery dynamics of tree species. The analysis, based on a synchronic approach, was carried out within four burned and two not burned fully stem-mapped research plots located in NW Italy, belonging to two forest categories differing for their main tree restoration strategies. Distance-dependent and distance-independent indices were applied to assess structural diversity dynamics over time since fire occurrence. Within the analyzed forests fire was found to affect mostly forest structure rather than its composition. Number of snags largely increases immediately after the fire, but it levels off due to their fall dynamics. Regeneration strategies and fire severity influenced species abundance and consequently diversity patterns. Stem diameter and height diversity were modified as well, with a strong increase in the first post-fire year and a sharp reduction six years after the disturbance. Fire determined also a higher heterogeneity in crown cover and vertical structure. Spatial patterns of surviving trees and snags were greatly affected by fire, producing an increase in aggregation and segregation

  1. The biology of burn injury.

    Science.gov (United States)

    Evers, Lars H; Bhavsar, Dhaval; Mailänder, Peter

    2010-09-01

    Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

  2. Characterization of biomass burning smoke from cooking fires, peat, crop residue and other fuels with high resolution proton-transfer-reaction time-of-flight mass spectrometry

    Science.gov (United States)

    Stockwell, C. E.; Veres, P. R.; Williams, J.; Yokelson, R. J.

    2014-08-01

    We deployed a high-resolution proton-transfer-reaction time-of-flight mass spectrometer (PTR-TOF-MS) to measure biomass burning emissions from peat, crop-residue, cooking fires, and many other fire types during the fourth Fire Lab at Missoula Experiment (FLAME-4) laboratory campaign. A combination of gas standards calibrations and composition sensitive, mass dependent calibration curves were applied to quantify gas-phase non-methane organic compounds (NMOCs) observed in the complex mixture of fire emissions. We used several approaches to assign best identities to most major "exact masses" including many high molecular mass species. Using these methods approximately 80-96% of the total NMOC mass detected by PTR-TOF-MS and FTIR was positively or tentatively identified for major fuel types. We report data for many rarely measured or previously unmeasured emissions in several compound classes including aromatic hydrocarbons, phenolic compounds, and furans; many of which are suspected secondary organic aerosol precursors. A large set of new emission factors (EFs) for a range of globally significant biomass fuels is presented. Measurements show that oxygenated NMOCs accounted for the largest fraction of emissions of all compound classes. In a brief study of various traditional and advanced cooking methods, the EFs for these emissions groups were greatest for open 3-stone cooking in comparison to their more advanced counterparts. Several little-studied nitrogen-containing organic compounds were detected from many fuel types that together accounted for 0.1-8.7% of the fuel nitrogen and some may play a role in new particle formation.

  3. Characterization of biomass burning emissions from cooking fires, peat, crop residue, and other fuels with high-resolution proton-transfer-reaction time-of-flight mass spectrometry

    Science.gov (United States)

    Stockwell, C. E.; Veres, P. R.; Williams, J.; Yokelson, R. J.

    2015-01-01

    We deployed a high-resolution proton-transfer-reaction time-of-flight mass spectrometer (PTR-TOF-MS) to measure biomass-burning emissions from peat, crop residue, cooking fires, and many other fire types during the fourth Fire Lab at Missoula Experiment (FLAME-4) laboratory campaign. A combination of gas standard calibrations and composition sensitive, mass-dependent calibration curves was applied to quantify gas-phase non-methane organic compounds (NMOCs) observed in the complex mixture of fire emissions. We used several approaches to assign the best identities to most major "exact masses", including many high molecular mass species. Using these methods, approximately 80-96% of the total NMOC mass detected by the PTR-TOF-MS and Fourier transform infrared (FTIR) spectroscopy was positively or tentatively identified for major fuel types. We report data for many rarely measured or previously unmeasured emissions in several compound classes including aromatic hydrocarbons, phenolic compounds, and furans; many of these are suspected secondary organic aerosol precursors. A large set of new emission factors (EFs) for a range of globally significant biomass fuels is presented. Measurements show that oxygenated NMOCs accounted for the largest fraction of emissions of all compound classes. In a brief study of various traditional and advanced cooking methods, the EFs for these emissions groups were greatest for open three-stone cooking in comparison to their more advanced counterparts. Several little-studied nitrogen-containing organic compounds were detected from many fuel types, that together accounted for 0.1-8.7% of the fuel nitrogen, and some may play a role in new particle formation.

  4. Study Burning Performance of Several Different Insulation Materials%几种不同保温材料燃烧性能的研究

    Institute of Scientific and Technical Information of China (English)

    马烨红; 李建新; 罗振海; 刘轩; 高金墙

    2012-01-01

    Insulation materials as the main materials of the existing building energy efficiency, has been widely used in the construction industry, but a wide range of insulation materials, there are still large differences in their fire performance. In the study, randomly selected from the project site to use various types of insulation materials, using the latest burning performance test methods and test equipment to detect the burning properties of inorganic, organic, composite insulation materials and thermal insulation. The result showed that organic insulation materials burning poor performance and inorganic insulation materials were non-combustible materials, composite insulation materials suggestions on the combustion properties of composite materials. In the thesis, the above results had decided to make relevant comments and recommendations around the use of insulation materials.%保温材料作为国内现有建筑节能的主要材料,已在建筑行业得到广泛的应用,但保温材料种类繁多,其防火性能仍然存在较大的差异,本研究随机选取工程现场使用的各类保温材料,采用最新的燃烧性能试验方法以及试验仪器,对无机、有机、复合保温材料以及保温浆料的燃烧性能进行检测;试验得出有机保温材料燃烧性能差,无机保温材料属下不燃材料,复合保温材料决定于复合材料的燃烧性能。同时本论文综合以上实验结果对保温材料的使用提出相关意见和建议。

  5. 严重烧伤合并吸入性损伤的呼吸道护理管理110例分析%Analysis of 110 Cases of Respiratory Care Management of Severely Burned Patients with Inhalation Injury

    Institute of Scientific and Technical Information of China (English)

    张银花; 袁晓敏

    2013-01-01

    目的:探讨对严重烧伤合并吸入性损伤进行气道护理的措施。方法:选取110例严重烧伤合并吸入性损伤患者的临床资料进行回顾分析,对患者行积极抗休克治疗,对创面合并外伤进行清创修复处理,并做好呼吸道管理,做好气管切开排痰等护理措施。结果:本组110例严重烧伤合并吸入性损伤患者,治愈102例,放弃治疗4例,死亡4例,治愈率为92.7%。结论:恰当又细心的呼吸道管理,是成功治疗大面积烧伤患者的关键。%Objective:Discussion on severe burns complicated by inhalation injury of airway nursing measures.Method:Clinical data of 110 cases of severe burn with inhalation injury patients were retrospectively analyzed,patients were treated with positive anti-shock,combined trauma wound debridement and repair process,meanwhile,patients need to be given good management of the respiratory tract and the nursing care measures of tracheotomy expectoration.Result:Select 110 cases of severe burn combined retrospective analysis the clinical data of patients with inhalation injury,to patients with positive anti shock,debridement was carried out on the wound with trauma repair processing,and make the respiratory tract management,completes the tracheotomy nursing measures such as row of phlegm.Conclusion:Appropriate and careful respiratory management play a key on successful treatment of severe burn patients.

  6. Clinical study of prevention of infections in severe burn patients during shock stage%重度烧伤患者休克期感染防治的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨帆; 姚忠军; 周伟; 徐风瑞; 李江华; 李亢

    2015-01-01

    OBJECTIVE To explore the prevention measures for infections in the severe burn patients during shock stage so as to provide guidance for clinical treatment of infections .METHODS A total of 106 severe burn patients who were treated in the hospital from Apr 2010 to May 2013 were enrolled in the study ,the patients were compli‐cated with different degrees of hypovolemic shock symptoms at the admission to hospital ,and they were treated with body fluid resuscitation ,gastrointestinal nutrition ,wound sealing ,and protection of functions of multiple or‐gans .RESULTS The length of hospital stay of the 106 severe burn patients ranged between 25 and 76 days ,75 ca‐ses were cured or remarkably improved ,and 31 cases died ,among whom 10 cases died of sepsis ,9 cases died of gastrointestinal hemorrhage ,9 cases died of pulmonary infections ,2 cases died of acute renal failure ,and 1 case died of heart failure .CONCLUSION It is necessary for the severe burn patients complicated with shock to perform effective body fluid resuscitation ,gastrointestinal nutrition ,wound sealing ,and protection of functions of multiple organs .%目的:探讨重度烧伤患者休克期的感染防治措施,为临床抗感染提供参考依据。方法选取2010年4月-2013年5月在医院收治的106例重度烧伤患者,入院时伴不同程度的低血容量休克症状,对其进行体液复苏、胃肠道营养、创面封闭及多器官功能的保护治疗。结果106例重度烧伤患者,住院时间25~76 d ,75例治愈或明显好转,占70.8%,31例死亡,其中死于脓毒血症10例、消化道出血9例、肺部感染9例、急性肾功能衰竭2例、心力衰竭1例。结论对于重度烧伤伴休克患者需及时进行有效的体液复苏、胃肠道营养、创面的封闭和多器官功能的保护。

  7. Neuropsychological Divergence of High-Level Autism and Severe Dyslexia.

    Science.gov (United States)

    Rumsey, Judith M.; Hamburger, Susan D.

    1990-01-01

    To determine variations in cognitive characteristics, 10 nonretarded men with infantile autism, residual state, were compared with 15 severely dyslexic men and 25 controls on a neuropsychological test battery. The dyslexics showed a reduced digit span and the autistic group exhibited impaired problem-solving skills. (Author/JDD)

  8. Several Organic Salts with High Two-Photon Active

    Institute of Scientific and Technical Information of China (English)

    TIAN, Yu-Peng; JIANG, Min-Hua; WANG, He-Zhou; FANG, Qi

    2001-01-01

    Several organic salts with D-A molecular structure and different counterion have been prepared and experimentally investigated. The two-photon induced frequency-upconverted spectra and two-photon pumped lasing are measured for the organic salt solutions in various solvents. The results indicate that counterions have influence on their stability and lasing property.

  9. In Developping a Bench-Scale Circulating Fluidized Bed Combustor to Burn High Ash Brazilian Coal-Dolomites Mixtures

    Science.gov (United States)

    Ramírez Behainne, Jhon Jairo; Hory, Rogério Ishikawa; Goldstein, Leonardo; Bernárdez Pécora, Araí Augusta

    This work considers some of the questions in burning high ash Brazilian coal-dolomite mixtures in a bench-scale circulating fluidized bed combustor (CFBC). Experimental tests were performed with the CE4500 coal from Santa Catarina State, in southern Brazil, with a Sauter mean diameter d p =43 μm. The coal particles were mixed with dolomite particles of d p = 111 μm and this fuel mixture was fed into the circulating fluidized reactor, previously loaded with quartz sand particles of d p =353 μm. This inert material was previously heated by the combustion of liquefied petroleum gas up to the ignition temperature of the fuel mixture. The CFBC unit has a 100mm internal diameter riser, 4.0m high, as well as a 62.8mm internal diameter downcomer. The loop has a cyclone, a sampling valve to collect particles and a 62.8mm internal diameter L-valve to recirculate the particles in the loop. A screw feeder with a rotation control system was used to feed the fuel mixture to the reactor. The operational conditions were monitored by pressure taps and thermocouples installed along the loop. A data acquisition system showed the main operational conditions to control. Experimental tests performed put in evidence the problems found during bed operation, with special attention to the solids feed device, to the L-valve operation, to particle size, solids inventory, fluidized gas velocity, fuel mixture and recirculated solids feeding positions.

  10. Research into the prevention and treatment of burns due to specific causes should be highly strengthened%特殊原因烧伤的防治研究不容忽视

    Institute of Scientific and Technical Information of China (English)

    谢卫国

    2012-01-01

    So far there is no clear and accurate definition for burns due to specific causes,though they are encountered sometimes.Burns due to specific causes sometimes are neglected because of their low incidence,and many surgeons,even burn specialists are not familiar with them because of low incidence,thus leading to poor results in the treatment.Burns due to specific causes are often involved in complicated and compound injuries.The treatment is often difficult,leading to delayed wound healing.In this paper,the definition,classification,and clinical characteristics of burns due to specific causes are described.Problems involved in diagnosis and treatment of common ones such as electrical,chemical,and compound burns are discussed.Facing an increase of those bums with specific causes,the author suggests that the research into the prevention and treatment should be highly strengthened.

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

    OpenAIRE

    2015-01-01

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

  12. COMPARISON OF RESISTANCE FOR SEVERAL DISPLACEMENT HIGH PERFORMANCE VEHICLES

    Institute of Scientific and Technical Information of China (English)

    LU Xiao-ping; LI Yun; DONG Zu-shun

    2005-01-01

    According to the linear wave resistance theory, a comparison among the ship resistance for the high speed round bilge ships, the deep "Vee" vessels, the wave-piercing catamarans, and the high speed trimarans was given by using the high-speed round-bilge ship as a benchmark. And the optimal speed range of each ship form was also suggested by using the analysis of the research results.

  13. High-Frequency Percussive Ventilation and Low Tidal Volume Ventilation in Burns: A Randomized Controlled Trial

    Science.gov (United States)

    2010-01-01

    links.lww.com/CCM/A159]). Criteria for changing modes were as follows: severe hy- poxemia with arterial partial pressure of oxy- gen ( PaO2 ) 60 mm Hg despite a...injury on admission (16). Additional second- ary outcome measures included the ratio of PaO2 to FIO2 and the oxygenation index in the first 7 days...after randomization. Oxygenation index was defined as the product of the FIO2 in percent and mean airway pressure in cm H2O divided by the PaO2 . Plasma

  14. Soil geochemistry controls fire severity: A soil approach to improved understanding of forest fire consequences in southwest Montana.

    Science.gov (United States)

    Callahan, R.; Hartshorn, T.

    2014-12-01

    Fire severity can be defined using satellite imagery to ratio mid (~2.2 um) to near (~0.8 um) infrared reflectance values. We examined how lithology and topography affected burn severity, and how post-fire soils data could be used to ground-truth burn severity at two sites in southwestern Montana. A burned area reflectance classification (BARC), lithology, and terrain attributes were used to predict burn severity for the Millie Fire, which was triggered two years ago by lightning and burned ~4,000 ha. Burn severity showed a strong dependence on lithology: the ratio of areas with high burn severity vs. low or moderate burn severities was 2.9 for gneiss (vs. 0.3 for volcanics). The high-severity burn area for the gneiss was larger than the volcanics, despite the latter lithology covering ~270% greater area (~2,600 ha). Aspect and elevation also influenced burn severity with lower severity at higher elevations (2,600-3,000 m) and higher severity at lower elevations (1,800-2,400 m). Southern and western aspects burned more severely than northern and eastern aspects. To clarify whether post-fire soil geochemical changes might predict ground-based estimates of fire severity, a lab experiment was carried out . We expected residual enrichment of trace metal concentrations, as soil organic matter (SOM) was combusted, which we quantified as loss on ignition (LOI). To test this approach, burned and unburned soils were sampled from the ~6000 ha Beartrap 2 fire, which also burned two years. We simulated differing fire severities on unburned soil using a muffle furnace factorially (duration [5, 15, 30, 45, or 60 minutes] x temperature [50, 100, 200, 300, 400, or 500ºC]). Consistent with expectations, unburned samples had a lower mean (±1SD) concentrations for 23 of 30 elements than field-burned samples. For example, barium concentrations ([Ba]) in unburned samples were (708±37μg/g), 16% lower than field-burned [Ba] (841±7 μg/g). Simulated burning yielded smaller [Ba] (732

  15. Evaluation of the U.S. Geological Survey Landsat burned area essential climate variable across the conterminous U.S. using commercial high-resolution imagery

    Science.gov (United States)

    Vanderhoof, Melanie; Brunner, Nicole M.; Beal, Yen-Ju G.; Hawbaker, Todd J.

    2017-01-01

    The U.S. Geological Survey has produced the Landsat Burned Area Essential Climate Variable (BAECV) product for the conterminous United States (CONUS), which provides wall-to-wall annual maps of burned area at 30 m resolution (1984–2015). Validation is a critical component in the generation of such remotely sensed products. Previous efforts to validate the BAECV relied on a reference dataset derived from Landsat, which was effective in evaluating the product across its timespan but did not allow for consideration of inaccuracies imposed by the Landsat sensor itself. In this effort, the BAECV was validated using 286 high-resolution images, collected from GeoEye-1, QuickBird-2, Worldview-2 and RapidEye satellites. A disproportionate sampling strategy was utilized to ensure enough burned area pixels were collected. Errors of omission and commission for burned area averaged 22 ± 4% and 48 ± 3%, respectively, across CONUS. Errors were lowest across the western U.S. The elevated error of commission relative to omission was largely driven by patterns in the Great Plains which saw low errors of omission (13 ± 13%) but high errors of commission (70 ± 5%) and potentially a region-growing function included in the BAECV algorithm. While the BAECV reliably detected agricultural fires in the Great Plains, it frequently mapped tilled areas or areas with low vegetation as burned. Landscape metrics were calculated for individual fire events to assess the influence of image resolution (2 m, 30 m and 500 m) on mapping fire heterogeneity. As the spatial detail of imagery increased, fire events were mapped in a patchier manner with greater patch and edge densities, and shape complexity, which can influence estimates of total greenhouse gas emissions and rates of vegetation recovery. The increasing number of satellites collecting high-resolution imagery and rapid improvements in the frequency with which imagery is being collected means greater opportunities to utilize these sources

  16. Surgical treatment of severe or moderate axillary burn scar contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients--A clinical experience of 15 cases.

    Science.gov (United States)

    Chen, Baoguo; Xu, Minghuo; Chai, Jiake; Song, Huifeng; Gao, Quanwen

    2015-06-01

    Axillary burn scar contracture is common and troublesome. With the aim of restoring the function of the upper extremities, a proper local flap with minor damage and preclusion from recurrence should be developed to guarantee satisfactory results. A minor webbed scar contracture was rectified by Z-plasty. However, severe or moderate contracture must be constructed by a local flap. An island scapular flap has been used in pediatric patients for repairing axillary contracture. However, no detailed description of the use of a transverse island scapular flap (TISF) was reported to correct the deformity. Moreover, an expanded transverse island scapular flap (ETISF) used for increasing the volume of skin for severe axillary contracture in adults and developing children was also not presented. From 2006 to 2013, TISFs were harvested for 12 pediatric patients (5-12 years of age) with 15 sides of severe or moderate axillary burn scar contractures. Four ETISFs were designed for two adult patients (38 and 32 years of age). The flap size was between 10 cm×5 cm and 20 cm×10 cm. In one pediatric patient, a cicatrix was observed on the surface of the flap's donor site. Handheld Doppler was applied to detect the pedicle. The patients were required to lift their upper arms regularly each day after the operation. All 19 flaps survived completely. Axillary burn scar contractures were corrected successfully in 11 patients with no expander implantation. The lifting angle was enhanced considerably with 1-3 years of follow-up in the 11 patients. Only one pediatric patient with cicatrix on the donor site displayed tight skin on the back and a little restraint on the shoulder. The patient's parents were told to intensify the chin-up movement on the horizontal bar. She was in the process of a 3-month follow-up. The lifting angle was also improved significantly in the latter three cases of expander implantation although they were followed up for a short duration of 3 months. Due to poor

  17. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    2000-01-01

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

  18. Fungal infections in burns: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Capoor Malini

    2010-10-01

    Full Text Available Burn wound infection (BWI is a major public health problem and the most devastating form of trauma worldwide. Fungi cause BWI as part of monomicrobial or polymicrobial infection, fungaemia, rare aggressive soft tissue infection and as opportunistic infections. The risk factors for acquiring fungal infection in burns include age of burns, total burn size, body surface area (BSA (30-60%, full thickness burns, inhalational injury, prolonged hospital stay, late surgical excision, open dressing, artificial dermis, central venous catheters, antibiotics, steroid treatment, long-term artificial ventilation, fungal wound colonisation (FWC, hyperglycaemic episodes and other immunosuppressive disorders. Most of the fungal infections are missed owing to lack of clinical awareness and similar presentation as bacterial infection coupled with paucity of mycology laboratories. Expedient diagnosis and treatment of these mycoses can be life-saving as the mortality is otherwise very high. Emergence of resistance in non-albicans Candida spp., unusual yeasts and moulds in fungal BWI, leaves very few fungi susceptible to antifungal drugs, leaving many patients susceptible. There is a need to speciate fungi as far as the topical and systemic antifungal is concerned. Deep tissue biopsy and other relevant samples are processed by standard mycological procedures using direct microscopy, culture and histopathological examination. Patients with FWC should be treated by aggressive surgical debridement and, in the case of fungal wound infection (FWI, in addition to surgical debridement, an intravenous antifungal drug, most commonly amphotericin B or caspofungin, is prescribed followed by de-escalating with voriconazole or itraconazole, or fluconazole depending upon the species or antifungal susceptibility, if available. The propensity for fungal infection increases, the longer the wound is present. Therefore, the development of products to close the wound more rapidly

  19. Soil heating and impact of prescribed burning

    Science.gov (United States)

    Stoof, Cathelijne

    2016-04-01

    Prescribed burning is highly uncommon in the Netherlands, where wildfire awareness is increasing but its risk management does not yet include fuel management strategies. A major exception is on two military bases, that need to burn their fields in winter and spring to prevent wildfires during summer shooting practice. Research on these very frequent burns has so far been limited to effects on biodiversity, yet site managers and policy makers have questions regarding the soil temperatures reached during these burns because of potential impact on soil properties and soil dwelling fauna. In March 2015, I therefore measured soil and litter temperatures under heath and grass vegetation during a prescribed burn on military terrain in the Netherlands. Soil and litter moisture were sampled pre- and post-fire, ash was collected, and fireline intensity was estimated from flame length. While standing vegetation was dry (0.13 g water/g biomass for grass and 0.6 g/g for heather), soil and litter were moist (0.21 cm3/cm3 and 1.6 g/g, respectively). Soil heating was therefore very limited, with maximum soil temperature at the soil-litter interface remaining being as low as 6.5 to 11.5°C, and litter temperatures reaching a maximum of 77.5°C at the top of the litter layer. As a result, any changes in physical properties like soil organic matter content and bulk density were not significant. These results are a first step towards a database of soil heating in relation to fuel load and fire intensity in this temperate country, which is not only valuable to increase understanding of the relationships between fire intensity and severity, but also instrumental in the policy debate regarding the sustainability of prescribed burns.

  20. High Job Demands, Still Engaged and Not Burned Out? The Role of Job Crafting

    NARCIS (Netherlands)

    Hakanen, Jari J.; Seppälä, Piia; Peeters, Maria C W

    2017-01-01

    Purpose: Traditionally, employee well-being has been considered as resulting from decent working conditions arranged by the organization. Much less is known about whether employees themselves can make self-initiated changes to their work, i.e., craft their jobs, in order to stay well, even in highly

  1. [Current treatment strategies for paediatric burns].

    Science.gov (United States)

    Küntscher, M V; Hartmann, B

    2006-06-01

    Paediatric burns occupy the third place in the severe accident statistics in Germany after traffic injuries and drowning. The paper reviews current treatment concepts of pre-hospital management, fluid resuscitation and surgical therapy in paediatric burned patients. Specific features in the approximation of the total body surface area burn and indications for transfer of paediatric burn victims to specialized units are discussed. The therapy of severe paediatric burns requires an interdisciplinary team consisting of especially skilled plastic or paediatric surgeons,anaesthetists, psychiatrists or psychologists, specifically trained nurses, physiotherapists and social workers. The rehabilitation process starts basically with admission to the burn unit. A tight cooperation between therapists and the relatives of the paediatric burn victim is needed for psychological recovery and reintegration into society.'The adaptation to the suffered trauma resulting in life-long disability and disfigurement is the main task of psychotherapy.

  2. Packaged triboelectric nanogenerator with high endurability for severe environments

    Science.gov (United States)

    Gu, Long; Cui, Nuanyang; Liu, Jinmei; Zheng, Youbin; Bai, Suo; Qin, Yong

    2015-10-01

    Many factors in the environment (such as dust, moisture and rain) severely influence the output performance of a triboelectric nanogenerator (TNG), which greatly limits its application. In this work, we designed and fabricated a kind of packaged TNG (PTNG) that can work normally in dust and humidity for harvesting noise energy. Under a sound wave of 110 dB and 200 Hz, the PTNG can generate a maximum output voltage of 72 V and a maximum output current of 0.66 mA. In the structure of the PTNG, the frictional layers are fully isolated from the ambient environment, which makes it work steadily in dusty and humid conditions without any damping of the output performance. Moreover, it can be used as a stable power source to directly light up 24 red commercial light emitting diodes (LEDs) driven by sound even in a severely rainy environment. This PTNG has great potential to be applied in real environments, which is critically important to the application of TNGs.Many factors in the environment (such as dust, moisture and rain) severely influence the output performance of a triboelectric nanogenerator (TNG), which greatly limits its application. In this work, we designed and fabricated a kind of packaged TNG (PTNG) that can work normally in dust and humidity for harvesting noise energy. Under a sound wave of 110 dB and 200 Hz, the PTNG can generate a maximum output voltage of 72 V and a maximum output current of 0.66 mA. In the structure of the PTNG, the frictional layers are fully isolated from the ambient environment, which makes it work steadily in dusty and humid conditions without any damping of the output performance. Moreover, it can be used as a stable power source to directly light up 24 red commercial light emitting diodes (LEDs) driven by sound even in a severely rainy environment. This PTNG has great potential to be applied in real environments, which is critically important to the application of TNGs. Electronic supplementary information (ESI) available. See

  3. High-cooling-efficiency cryogenic quadrupole ion trap and UV-UV hole burning spectroscopy of protonated tyrosine

    Science.gov (United States)

    Ishiuchi, Shun-ichi; Wako, Hiromichi; Kato, Daichi; Fujii, Masaaki

    2017-02-01

    The cooling efficiency of a cryogenic three-dimensional quadrupole ion trap (QIT) is drastically improved by using copper electrodes instead of conventional stainless-steel ones. The temperature of trapped ions (protonated tyrosine TyrH+) was estimated based on the ultraviolet (UV) photo-dissociation spectra. The UV spectrum of TryH+ shows almost no hot bands, and thus the high cooling efficiency of the copper ion trap was proven. The temperature was also estimated by simulating the observed band contour in the UV spectra, which is determined by the population in the rotationally excited levels. From the simulations, the temperature of TryH+ was estimated to be ∼13 K, while that in the stainless-steel QIT was 45-50 K. In addition, to demonstrate the advantage of the copper QIT, UV-UV hole burning (HB) spectra, i.e. conformation-selected UV spectra, were measured. It was confirmed that four different conformers, A∼D, coexist in the ultra-cold protonated tyrosine. By comparing with the calculated Franck-Condon spectra, their structural assignments were discussed, including the orientation of the OH group.

  4. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı

    2011-07-01

    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

  5. The mechanism of burn-in loss in a high efficiency polymer solar cell

    Energy Technology Data Exchange (ETDEWEB)

    Peters, Craig H.; Sachs-Quintana, I.T.; Mateker, William R.; Heumueller, Thomas; Rivnay, Jonathan; Beiley, Zach M.; Salleo, Alberto; McGehee, Michael D. [Department of Materials Science and Engineering, Stanford University, CA (United States); Noriega, Rodigo; Hoke, Eric T. [Department of Applied Physics, Stanford University, CA (United States)

    2012-02-02

    Degradation in a high efficiency polymer solar cell is caused by the formation of states in the bandgap. These states increase the energetic disorder in the system. The power conversion efficiency loss does not occur when current is run through the device in the dark but occurs when the active layer is photo-excited. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  6. The Mechanism of Burn-in Loss in a High Efficiency Polymer Solar Cell

    KAUST Repository

    Peters, Craig H.

    2011-10-11

    Degradation in a high efficiency polymer solar cell is caused by the formation of states in the bandgap. These states increase the energetic disorder in the system. The power conversion efficiency loss does not occur when current is run through the device in the dark but occurs when the active layer is photo-excited. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Two cases of burns caused by misuse of coagulation unit and monitoring.

    Science.gov (United States)

    Rolly, G

    1978-01-01

    Two cases of severe burns with monitoring apparatus are described. In a female patient of 45 years, a severe third degree burn occurred by misuse of coagulation apparatus (inversion of the poles of an older Bovie apparatus), in the presence of a non-floating ECG monitoring device. A high intensity current was established from the coagulation unit, via the earth plate under the buttocks, to the indifferent electrode placed on the chest, where burns occurred. In an 8 month female baby, having laparotomy for a neuroblastoma, a third degree burn of 5 cm diameter occurred with a non-floating ECG monitor. A twin-wired disposable earth plate was placed just beneath the indifferent ECG electrode on the leg. A burning current was established between the Bovie coagulation unit and the monitor.

  8. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

    Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

  9. [Reconstruction of facial burn sequelae].

    Science.gov (United States)

    Foyatier, J L; Comparin, J P; Boulos, J P; Bichet, J C; Jacquin, F

    2001-06-01

    The deep burns of the face can lead to horrible scars functionally and aesthetically. Treatment of these scars need several surgical interventions frequently and during many years. In our region we deal with this type of wounds as team work, multidisciplinary approach carrying out many process starting by emergency treatment of acute burns till the social rehabilitation. The expansion technique was great help in improving the shape of scars, by using the expanding skin as full thickness grafts. Reconstruction of the anatomical units and application of aesthetic techniques (like rhinoplasty, lifting, tattooing and autologous fat injections) participate equally in improving the quality of results. Many examples of treatments of burns scars are shown.

  10. SEM Characterization of the High Burn-up Microstructure of U-7Mo Alloy

    Energy Technology Data Exchange (ETDEWEB)

    Dennis D. Keiser, Jr.; Jan-Fong Jue; Jian Gan; Brandon Miller; Adam Robinson; Pavel Medvedev; James Madden; Dan Wachs; M. Teague

    2014-04-01

    During irradiation, the microstructure of U-7Mo evolves until at a fission density near 5x1021 f/cm3 a high-burnup microstructure exists that is very different than what was observed at lower fission densities. This microstructure is dominated by randomly distributed, relatively large, homogeneous fission gas bubbles. The bubble superlattice has collapsed in many microstructural regions, and the fuel grain sizes, in many areas, become sub-micron in diameter with both amorphous fuel and crystalline fuel present. Solid fission product precipitates can be found inside the fission gas bubbles. To generate more information about the characteristics of the high-fission density microstructure, three samples irradiated in the RERTR-7 experiment have been characterized using a scanning electron microscope equipped with a focused ion beam. The FIB was used to generate samples for SEM imaging and to perform 3D reconstruction of the microstructure, which can be used to look for evidence of possible fission gas bubble interlinkage.

  11. Is aridity a high-order control on the hydro-geomorphic response of burned landscapes?

    Science.gov (United States)

    Sheridan, Gary; Van der Sant, Rene; Nyman, Petter; Lane, Patrick

    2015-04-01

    Fire results in hydro-geomorphic changes that are spatially variable and difficult to predict. In this study we compile 294 infiltration measurements, ten other soil, catchment runoff and erosion datasets, and a year of new data from 15 natural runoff plots across an aridity gradient from the eastern Victorian uplands in SE Australia. The results show that aridity (a function of the long term mean precipitation and net radiation) is associated with low post-fire infiltration capacities, increasing the chance of surface runoff, and strongly increasing the chance of debris flows. Runoff plots from the wettest site (aridity = 1.1) had an average runoff ratio of 0.3% compared with 33.6% for the most arid sites (aridity = 2.4). Post-fire debris flows were only observed in the more arid locations within the Victorian uplands, and resulted in erosion rates more than two orders of magnitude greater than non-debris flow processes. We therefore argue that in south eastern Australia aridity is a high-order control on the magnitude of post-wildfire hydro-geomorphic processes. The results from this Australian study may also help to provide insight into the landscape controls on post fire debris flows elsewhere. Aridity is a landscape-scale parameter that is mappable at a high resolution and therefore is a useful predictor of the spatial variability of the magnitude of post-fire hydro-geomorphic responses.

  12. An attempt to reproduce high burn-up structure by ion irradiation of SIMFUEL

    Energy Technology Data Exchange (ETDEWEB)

    Baranov, V.G. [National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoye Shosse 31, Moscow 115409 (Russian Federation); Lunev, A.V., E-mail: AVLunev@mephi.ru [National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoye Shosse 31, Moscow 115409 (Russian Federation); Reutov, V.F. [Joint Institute for Nuclear Research (JINR), Flerov Laboratory of Nuclear Reactions (FLNR), 141980 Dubna, Moscow Region (Russian Federation); Tenishev, A.V.; Isaenkova, M.G.; Khlunov, A.V. [National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoye Shosse 31, Moscow 115409 (Russian Federation)

    2014-09-15

    Experiments in IC-100 and U-400 cyclotrons were conducted with SIMFUEL pellets (11.47 wt.% of fission products simulators) to reproduce some aspects of the long-term irradiation conditions in epithermal reactors. Pellets were irradiated with Xe{sup 16+}, Xe{sup 24+} and He{sup +} at energies ranging from 20 keV (He{sup +}) to 320 keV (Xe{sup 16+}) and 1–90 MeV (Xe{sup 24+}). Some samples were subsequently annealed to obtain larger grain sizes and to study defects recovery. The major microstructural changes consisted in grain sub-division observed on SEM and AFM images and change in composition registered by EPMA (pellets irradiated with 1–90 MeV Xe{sup 24+} ions at fluence of 5 × 10{sup 15} cm{sup −2}). Lattice distortion and increase in dislocation density is also noted according to X-ray data. At low energies and high fluences formation of bubbles (20 keV He{sup +} at 5.5 × 10{sup 17} cm{sup −2}) was observed. Grain sub-division exhibits full coverage of the grain body and preservation of former grain boundaries. The size of sub-grains depends on local dislocation density and changes from 200 nm to 400 nm along the irradiated surface. Beneath it the size ranges from 150 to 600 nm. Sub-grains are not observed in samples irradiated by low-energy ions even at high dislocation densities.

  13. Pediatric burns due to hot water from water dispenser: a neglected issue that should be highly concerned

    Institute of Scientific and Technical Information of China (English)

    MA Bing; XI Hui-jun; WANG Jia-lin; YAN Ying; TANG Hong-tai; ZHU Shi-hui; L(U) Kai-yang; XIA Zhao-fan

    2012-01-01

    Background More and more Chinese drink hot water from water dispensers while many children were scalded due to this change.The present study aimed to propose a feasible strategy for prevention.Methods A retrospective study was conducted for all water dispensers related pediatric burns admitted to Changhai Hospital from January 2005 to December 2009.Results The number of new cases and incidences of pediatric burns due to hot water from water dispensers was significantly increasing year after year.In the total 238 involved cases,175 cases happened on males and 78.9% were at the age of 1-4 years.The burn areas were mainly located in upper extremities.All water dispensers in the surveyed families had no isolate protection devices and 85.2% of their locations were easy for children to reach.Nearly half of the children were in the same room with their guardians when injured.Total 196 burned children were playing the taps of water dispensers before injured,unfortunately,80.6% of them have not been stopped until burned.Conclusion As the kind of bums is quite serious and with bad outcome,some recommendations should be followed,such as buying water dispensers with protection devices,keeping children from touching them and so on.

  14. Microskin autografting in the treatment of burns over 70% of total body surface area: 14 years of clinical experience.

    Science.gov (United States)

    Chen, Xu-Lin; Liang, Xun; Sun, Li; Wang, Fei; Liu, Sheng; Wang, Yong-Jie

    2011-09-01

    Despite the fact that early excision and grafting have significantly improved burn outcomes, the management of severely burned patients whose burn size exceeds 70% total body surface area (TBSA) still represents a big challenge for burn surgeons all over the world. During the period of 1997-2010 at our centre, aggressive excision and microskin autografting were performed in 63 severely burned patients. Their burn sizes ranged from 70% to 98% TBSA with a mean of 84.9%. The average full-thickness burn was 66.3% (range, 29-94%). Thirty patients had concomitant inhalation injury. Two to 7 days after burn, these patients underwent aggressive excisions ranging from 25% to 60% TBSA and transplantation of microskin autograft overlaid with allograft. The ratios of donor-site to recipient-site surface area were between 1:6 and 1:18. Signs of epithelialization were shown within 35-55 days. The wound healing rate was 74.9% (176/235), with 51.1% of cases (120/235) healing completely and 23.8% (56/235) improving. Microskin autografting yielded an overall survival rate of 63.5%; only 23 patients died. Our clinical experience in using the microskin autografting for burn coverage suggests that the technique is very effective in covering extensive burns, and that it is particularly useful when graft donor sites are very limited due to its high utilization rate of donor site. The factors affecting the outcome of microskin autografting are discussed herein.

  15. High-precision timeline for Earth's most severe extinction.

    Science.gov (United States)

    Burgess, Seth D; Bowring, Samuel; Shen, Shu-zhong

    2014-03-04

    The end-Permian mass extinction was the most severe loss of marine and terrestrial biota in the last 542 My. Understanding its cause and the controls on extinction/recovery dynamics depends on an accurate and precise age model. U-Pb zircon dates for five volcanic ash beds from the Global Stratotype Section and Point for the Permian-Triassic boundary at Meishan, China, define an age model for the extinction and allow exploration of the links between global environmental perturbation, carbon cycle disruption, mass extinction, and recovery at millennial timescales. The extinction occurred between 251.941 ± 0.037 and 251.880 ± 0.031 Mya, an interval of 60 ± 48 ka. Onset of a major reorganization of the carbon cycle immediately precedes the initiation of extinction and is punctuated by a sharp (3‰), short-lived negative spike in the isotopic composition of carbonate carbon. Carbon cycle volatility persists for ∼500 ka before a return to near preextinction values. Decamillenial to millennial level resolution of the mass extinction and its aftermath will permit a refined evaluation of the relative roles of rate-dependent processes contributing to the extinction, allowing insight into postextinction ecosystem expansion, and establish an accurate time point for evaluating the plausibility of trigger and kill mechanisms.

  16. First Aid: Burns

    Science.gov (United States)

    ... Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild ...

  17. First Aid: Burns

    Science.gov (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild to life threatening, ...

  18. 重返工作岗位对重度烧伤患者身心健康的影响%Influence of Returning to Work on Health-Related Quality of Life on Patients after Severe Burn Inj ury

    Institute of Scientific and Technical Information of China (English)

    李东文; 王红梅; 孙瑛; 崔琳; 刘文清

    2014-01-01

    Objective To investigate the influence of returning to work on life quality of patients with se-vere burn injury.Methods By convenience sampling,76 patients suffered severe burns were randomly se-lected from one city general hospital during January 2007 to January 2011.The data of patients were collected by SF-36、BSHS-B、IES- R、HADS.Results Within 76 patients with severe burn injury,54 of them had returned to work.The score of physiological function,physical role,physical pain,general health status and social function in those patients who did not return to work were lower than general scale of Si-chuan Province and group of patients who had returned to work.IES-R score and each dimension of BSHS-B (except body image,interpersonal relationship and sex life)were significantly lower than group of patients who had not return to work (P0.05).Conclusion Returning to work can promote the health-related quality of life and psychological health of severe burn patients.%探讨重返工作岗位对重度烧伤患者康复期身心健康的影响.方法采用目的抽样法选择2007年1月至2011年1月在成都市某三级甲等医院住院的76例重度烧伤患者为研究对象,采用 SF-36健康调查量表、精简烧伤健康量表(burn specific health scale-brief,BSHS-B)、事件影响量表修订版(impact of event scale-revised,IES-R)、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)等对其身心健康进行测评.结果76例重度烧伤患者中,54例重返工作岗位,未返工作岗位组患者的生理功能、生理职能、躯体疼痛、总体健康及社会功能得分均低于四川省常模和重返工作岗位组,重返工作岗位组 IES-R得分、BSHS-B 各维度(除体像、人际关系及性生活外)得分明显低于未返工作岗位组(P<0.05或P<0.01),两组HADS得分差异无统计学意义(P>0.05).结论重返工作岗位有助于促进重度烧伤患者的身心康复.

  19. Overview of ethno-folkloric burns in the Republic of Slovenia.

    Science.gov (United States)

    Stritar, A; Brčić, A; Drnovšek, F; Malvasio, V

    2016-03-31

    The article describes typical folkloric- and ethnographic-related burns/scalds in Slovenia. All of the mentioned burns/scalds derive from the life of a nation, and are primarily a result of specific customs, traditions and activities carried out in a rural environment. Prolonged periods of lying on a hot tiled wood burner results in deep contact burns. The preparation work for pig slaughtering ('koline') is dangerous due to the large quantities of boiling water required for the slaughter process and meat production technology. Distilling spirits in an improvised domestic setting is another cause of burns/scalds, as the production of spirits is carried out in several stages with a high risk of burn trauma in the event of negligence. These types of burns/scalds occur in rural farming areas. Such injuries are most often ignored and patients, children excepted, do not seek medical help until later, after they have completed their activity. Due to aggressive thermal agents, these are deep burns that often require specialist surgical care with long-term treatment. Results are evaluated on the basis of a tenyear statistical and clinical experience. Incidence of the aforementioned burns is considerably lower today than it was in the past due to national prevention measures and new European legislation on energy and agriculture. In the future, we expect these distinctive burns/scalds to become a rarity.

  20. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

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

  1. Iatrogenic severe depression of high-density lipoprotein cholesterol.

    Science.gov (United States)

    Mymin, D; Dembinski, T; Friesen, M H

    2009-07-01

    The authors present 5 cases of paradoxical depression of high-density lipoprotein (HDL) cholesterol induced by fibrate drugs. In a 24-month review of all cases seen in one physician's practice at the Winnipeg Health Sciences Centre Lipid Clinic, 492 patients made a total of 1187 visits. Sixty-eight of them were given a fibrate drug (14%). Ten patients had HDL cholesterol levels that were less than 0.5 mmol/L (2%), and of these, 5 cases were due to exposure to fenofibrate (1%). These 5 cases comprised 7.4% of the 68 patients who were given any fibrate drug during that period. Mean levels were as follows: HDL cholesterol on fenofibrate 0.27, off fenofibrate 1.0 mmol/L and apo A1 on fenofibrate 0.41, off fenofibrate 1.17 g/L. A literature review revealed documented cases in 37 patients involving fibrates alone or in combination with other drugs known to cause decreased HDL cholesterol levels. In 13 patients, exposure was to fibrate therapy alone; in those exposed to combinations, the effect was clearly attributable to fibrates in 9; in 14, the nonfibrates (mostly rosiglitazone) were the attributable drugs; and in 1, it was impossible to tell. Thus, fibrate therapy should always be suspected as a cause of profoundly depressed HDL cholesterol.

  2. Development and application of a high-temperature sampling probe for burning chamber conditions of fluidized-bed combustion; Korkean laempoetilan naeytteenottosondin kehittaeminen ja soveltaminen leijukerrospolton tulipesaeolosuhteisiin

    Energy Technology Data Exchange (ETDEWEB)

    Larjava, K.; Paerkkae, M.; Jormanainen, P.; Roine, J.; Paakkinen, K. [VTT Chemistry, Espoo (Finland); Linna, V. [VTT Energy, Jyvaeskylae (Finland)

    1996-12-01

    A sampling probe for the burning chamber conditions of fluidized-bed combustion will be developed in this project. The probe will be suitable for sampling vaporous heavy and alkali metals and other condensing compounds (e.g. chlorides) as well combustion gases and alternatively also flue gas particles at high temperatures. The knowledge gained with the probe will help understanding, developing and modeling combustion processes and will thus aid the manufacturers of the boilers. (author)

  3. Critical Size for the Particle Burn-out of Solid Carbon and/or Boron as the High-Energy Density Fuel

    OpenAIRE

    2013-01-01

    It is intended to demonstrate an existence of the critical size for the particle burn-out, exposed directly to oxidizers at high temperatures under which oxide vaporization can be facilitated, with the solid carbon taken as an example, under recognition that particles considered are too small to support a gas-phase envelop-flame even at elevated temperatures. After describing the temporal variations of the particle temperature and size, use has been made of the asymptotics to derive the gover...

  4. Adult campfire burns: two avenues for prevention.

    Science.gov (United States)

    Klein, Matthew B; Heimbach, David M; Honari, Shari; Engrav, Loren H; Gibran, Nicole S

    2005-01-01

    Campfires are a common component of outdoor festivities. Pediatric campfire burns have been well described. Adult campfire injuries also are common and have several important distinguishing characteristics. We performed a retrospective review of adult patients admitted with campfire burns to our burn center from July 1998 to July 2003. Medical records were reviewed with attention to mechanism of injury, intoxication level, burn size, and surgeries performed. A total of 27 patients with this injury were treated as inpatients over the course of the study period. Two distinct mechanisms of injury emerged: 1) contact with the campfire and 2) flash/flame injuries from igniting the fire. Eighty-one percent (13/16) of patients who sustained contact burns were intoxicated, as compared with 11% (1/11) of those who sustained flash/flame injuries. Nearly half of the patients with contact burns and more than half the patients with flash/flame burns required excision and grafting.

  5. Burns (For Parents)

    Science.gov (United States)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting ... What's in this article? Common Causes Types of Burns First-Degree Burns Second-Degree Burns ...

  6. 严重烧伤后应激性溃疡的发病机制及防治策略%The Pathogenesis and Prevention Strategies of Stress Ulcer after Severe Burn

    Institute of Scientific and Technical Information of China (English)

    张杨杨; 邱啸臣; 周国勇; 刘真; 贾赤宇

    2013-01-01

    With the development of things,principal contradiction is dominant and play a decisive role,while secondary contradiction in a subordinate position,play a secondary role.The pathogenesis of stress ulcer after severe burns,such as neuroendocrine disorders,gastric mucosal barrier miopragia,infection,and psychological stress,etc,as well as its prevention and treatment strategies,such as countershock therapy,manage burn wound actively,improve gastric mucosal ischemia,early enteral nutritional,prevention of infection and so on,are concrete manifestation of this principle.%在事物发展的过程中,主要矛盾处于支配地位、对事物发展起决定作用,次要矛盾处于从属地位、对事物发展起次要作用.烧伤后应激性溃疡的发病机制如:神经-内分泌失调、胃黏膜屏障功能减弱、感染和心理应激等,以及防治方法,如:抗休克治疗、积极处理创面,改善胃黏膜缺血,早期肠内营养和防治感染等是这一原理的具体体现.

  7. Effects of Surgical and Physical Therapy on Functional Reconstruction post Severe Burn%外科手术结合物理治疗对严重烧伤后功能重建的效果

    Institute of Scientific and Technical Information of China (English)

    陈静; 王甲汉; 杨磊; 李志清; 任加良

    2013-01-01

    Objective To evaluate the effects of surgical and physical therapy on functional reconstruction post severe burn. Methods 21 patients with severe burn accepted comprehensive rehabilitation, while the other 18 cases accepted surgical therapy only. Modified Barthel Index and Vancouver Scar Scale were applied to assess their activities of daily living (ADL) and scar recovery 3 months, 1 year or 2 years post injury. Results Compared with the control group, the observation significantly improved in ADL and scar recovery with fewer opera-tions (P<0.01). Conclusion The surgical and physical therapy facilitates to improve the functional recovery post severe burn.%目的:评估外科手术结合物理治疗对严重烧伤后功能重建的影响。方法39例严重烧伤患者中,21例(观察组)接受规范化功能康复体系治疗,18例(对照组)仅定期返院接受外科手术治疗。手术和物理治疗分别在烧伤治疗中心和医学康复中心完成。采用改良Barthel指数和温哥华瘢痕量表观测患者伤后3个月、1年和2年的日常生活活动能力及体表瘢痕康复情况。结果与对照组相比,观察组日常生活活动能力明显提高(P<0.01),体表瘢痕明显改善(P<0.01),整形手术总次数明显减少(P<0.01)。结论外科手术结合物理治疗可提高严重烧伤后期功能障碍矫正效果。

  8. The causes and prevention methods of severe burn patients complicated with stress ulcer bleeding%重度烧伤并发应激性溃疡出血的原因及防治

    Institute of Scientific and Technical Information of China (English)

    李峥; 张兵; 李巍; 王强

    2014-01-01

    目的:探讨重度烧伤并发应激性溃疡出血发生的原因及防治方法。方法我院2008年1月至2013年12月共收治892例重度烧伤患者,回顾分析其中53例并发应激性溃疡出血患者的临床资料。结果重度烧伤并发应激性溃疡出血的53例患者中,经积极治疗,显效24例,有效22例,总有效率为87%;休克患者出血发生率明显高于无休克患者(χ2=138.20,P<0.05),应激性溃疡出血与休克之间存在较强关联性(χ2=62.82,P<0.05,r=0.65)。结论对于存在休克的重度烧伤患者需提高警惕,注意监测有无应激性溃疡出血发生,早期行综合治疗,防治休克是预防应激性溃疡出血的有利措施。%Objective To study the causes and prevention methods of severe burn patients complicated with stress ulcer bleed -ing.Methods From January 2001 to December 2012 , a total of 892 cases of severe burn patients were treated in our hospital .Clinical data of 53 cases complicated with stress ulcer bleeding were retrospectively analyzed .Results Of the 53 patients, therapy was marked-ly effective in 24 cases and effective in 22 patients.The total effective rate was 87%.The incidence of bleeding in shock patients was significantly higher than that in non-shock patients (χ2=138.20 , P<0.05 ) .There was a significant correlation between shock and stress ulcer bleeding (χ2=62.82 ,P<0.05 ,r=0.65 ) .Conclusion It should be wary of severe burn patients with shock to monitor the presence of stress ulcer hemorrhage , so that to carry out early comprehensive treatment .The prevention and treatment of shock are fa-vorable measures for stress ulcer bleeding .

  9. Analysis of Influencing Factors for the Occurence of Delirium in Patients with Severe Burns and Related Nursing Research%重度烧伤患者谵妄发生影响因素分析及护理研究

    Institute of Scientific and Technical Information of China (English)

    张海英; 曾郞平; 麦秋芳

    2014-01-01

    目的:分析重度烧伤患者谵妄发生的影响因素,并进行针对性的护理;研究针对性护理的效果。方法200例谵妄患者用传统护理的方法,并研究谵妄发生的影响因素。100例谵妄患者采用针对性护理,比较传统护理和针对性护理的效果。结果年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素(P<0.05)。针对性护理的护理效果优于传统护理(P<0.05)。结论年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素,而针对性护理为最佳护理策略。%Objective To analyze influencing factors of the occurrence of delirium in patients with severe burns, and to explore the efficacy of targeted care. Methods We assigned 200 cases of patients with delirium to traditional nursing care and studied the delirium risk factors. Another 100 cases of patients with delirium received targeted nursing care. The primary outcome was the comparison of the efficacy of traditional nursing and targeted care. Results Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns (P <0.05). Targeted care was superior to the traditional nursing (P <0.05). Conclusions Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns. Targeted nursing is the best care strategy to choose.

  10. [Burning mouth syndrome (glossalgia)].

    Science.gov (United States)

    2014-01-01

    Burning mouth syndrome (glossalgia) is manifested by oral pin and tingling sensations, numbness and even burning and severe pains, more frequently in the tongue. Unpleasant sensations may involve the anterior two thirds of the tongue or be extended to the front part of the hard palate and the mucous membrane of the lower lip. This condition is characterized by "mirror" and "food dominant" symptoms, disordered salivation, dysgeusia, or psychological disorders. The disease shows a chronic course. Its etiology may be multifactorial. There are no universally accepted diagnostic criteria; the diagnosis of glossalgia is made to rule out all other causes. A thorough examination should be conducted to establish a differential diagnosis. Glossalgia occurs primarily in middle-aged and elderly people. Women get sick much more frequently than men of the same age. Glossalgia remains difficult to treat. Continuous symptomatic treatment and follow-up help relieve its symptoms.

  11. Methylated spirit burns: an ongoing problem.

    Science.gov (United States)

    Jansbeken, J R H; Vloemans, A F P M; Tempelman, F R H; Breederveld, R S

    2012-09-01

    Despite many educational campaigns we still see burns caused by methylated spirit every year. We undertook a retrospective study to analyse the impact of this problem. We retrospectively collected data of all patients with burns caused by methylated spirit over twelve years from 1996 to 2008. Our main endpoints were: incidence, age, mechanism of injury, total body surface area (TBSA) burned, burn depth, need for surgery and length of hospital stay. Ninety-seven patients with methylated spirit burns were included. During the study period there was no decrease in the number of patients annually admitted to the burn unit with methylated spirit burns. 28% of the patients (n=27) were younger than eighteen years old, 15% (n=15) were ten years old or younger. The most common cause of burns was carelessness in activities involving barbecues, campfires and fondues. Mean TBSA burned was 16% (SD 12.4). 70% (n=68) had full thickness burns. 66% (n=64) needed grafting. Mean length of hospital stay was 23 days (SD 24.7). The use of methylated spirit is an ongoing problem, which continues to cause severe burns in adults and children. Therefore methylated spirit should be banned in households. We suggest sale only in specialised shops, clear labelling and mandatory warnings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  12. Occupational burns treated in emergency departments.

    Science.gov (United States)

    Reichard, Audrey A; Konda, Srinivas; Jackson, Larry L

    2015-03-01

    Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences. We used the National Electronic Injury Surveillance System-Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data. From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15-24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns. Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns. © 2015 Wiley Periodicals, Inc.

  13. Psychological Nursing Care for 64 Patients with Severe Burn Complicated by Psychological Disorder%重度烧伤并发心理障碍64例心理护理体会

    Institute of Scientific and Technical Information of China (English)

    陈远芳

    2013-01-01

    Objective To analyze and investigate the psychological disorders and psychological status of patients with severe burn, and to summarize the effective psychological nursing care. Methods Various degree of fear and tension existed in 64 patients with severe burn in this study. All patients had a strong fear in the face of pain and many other psychological disorders such as fear for disability and despair. Appropriate psychological nursing care was carried out in accordance with specific conditions. The patients were randomly divided into two groups, with 32 cases in each group. The routine nursing care was carried out in one group, while that combined with psychological nursing care was given to the other group. Then the effects on two groups were compared. Results The indicators such as anxiety and depression of patients in the combined nursing care group were significantly lower than those in the routine nursing care group (P<0.05). Conclusion The psychological nursing care for psychological disorders of patients with severe burn is conducive to the rehabilitation of patient. To some extent, it is very important to improve the psychological status, and ease the anxious and depressive mood of patients with severe burn.%  目的针对重度烧伤患者出现的心理障碍以及心理状况进行分析与研究,总结行之有效的心理护理体会。方法本文选择64例重度烧伤患者,都在不同程度上存在恐惧以及紧张心理,在面对疼痛时有非常强烈的畏惧心理以及害怕伤残、悲观失望等等诸多心理障碍。我们根据具体情况进行相应心理护理,将患者随机分成两组,各32例,其中一组行常规护理法,另一组在接受常规护理的基础上,结合心理护理进行护理,之后对比两组疗效。结果采用常规护理结合心理护理一组患者在焦虑、抑郁等方面的指标明显低于常规护理组(P<0.05)。结论对于重度烧伤患者的心理障碍所

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

    Science.gov (United States)

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

    2008-01-01

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

  15. Effect of psychological intervention on the quality of life during convalescence in patients with severe burn%心理干预对重度烧伤患者康复期生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    谢丽珍; 叶小兰; 杨芳

    2014-01-01

    Objective:To explore the effect of psychological intervention on the quality of life during convalescence in patients with se -vere burn.Methods:52 patients with severe burn were randomly divided into the intervention group and the control group (26 cases in each group).The patients in the control group were only given routine treatment ,nursing care and functional exercise and the extra psychological intervention was given to the patients in the intervention group .The anxiety state and the changes of quality of life of the patients were com-pared between the two groups befroe and after the intervention .Results:The scores of SDS and SAS were significantly lower after the inter-vention for one month than those before the intervention in the intervention group (P<0.05);the total score of quality of life of the patients was significantly higher in the intervention group than the control group (P<0.05).Conclusion:The psychological intervention can effec-tively alleviate the anxiety and pessimism of patients with severe burn so as to improve their quality of life .%目的:探讨心理干预对重度烧伤患者康复期生活质量的影响。方法:将52例重度烧伤患者随机分为干预组和对照组各26例,对照组仅进行常规治疗、护理及功能锻炼,干预组在此基础上实施心理干预。比较两组患者干预前后焦虑状态及生活质量变化情况。结果:1个月后,干预组SDS、SAS评分明显低于干预前(P<0.05),生活质量总分明显高于对照组(P<0.05)。结论:心理干预能有效缓解重度烧伤患者的焦虑、悲观情绪,提高患者生活质量。

  16. Clinical significance of continuous thrombocytopenia in predicting sepsis after severe burn%持续血小板减少症预测严重烧伤并发脓毒症的临床意义

    Institute of Scientific and Technical Information of China (English)

    郭峰; 梁勋; 郇京宁

    2014-01-01

    Objective To explore the relationship between continuous thrombocytopenia and sepsis in patients with severe burns.Methods Clinical data of 148 severely burned patients admitted to our two burn centers from January 2007 to December 2011 and conforming to the study criteria were retrospectively analyzed.All patients were divided into sepsis group (n =44) and non-sepsis group (n =104) according to the presence or absence of sepsis within post burn day (PBD) 30.The data of age,gender,total burn area,full-thickness burn area,fluid infusion volume within post burn hour (PBH) 24,plasma concentration of calcium ion on PBD 1,plasma concentration of albumin on PBD 1,platelet count on PBD 1,acute physiology and chronic health evaluation (APACHE) Ⅱ score on admission,the presence or absence of hypovolemic shock or inhalation injury on admission,the presence or absence of disseminated intravascular coagulation (DIC) within PBH 48,operation or no operation within PBD 3,thrombocytopenia duration within PBD 10,and mortality were statistically compared between two groups to screen the independent risk factors of sepsis.Data were processed with t test,chi-square test,single factor Logistic regression analysis,and multi-factor Logistic regression analysis.Results Between two groups,there were statistically significant differences in total burn area,full-thickness burn area,plasma concentration of calcium ion on PBD 1,plasma concentration of albumin on PBD I,APACHE Ⅱ score on admission,presence or absence of hypovolemic shock on admission,presence or absence of inhalation injury on admission,presence or absence of DIC within PBH 48,and mortality (with t values from 2.433 to 4.082,x2 values from 8.818 to 31.528,P <0.05 or P < 0.01).Furthermore,the duration of thrombocytopenia within PBD 10 in sepsis group was (5.2 ±2.4) d,which was significantly longer than that in non-sepsis group [(2.9±1.9) d,t =6.189,P <0.01].There were no statistically significant differences in the

  17. 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

    2015-01-01

    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

  18. Fluid management in major burn injuries

    Directory of Open Access Journals (Sweden)

    Haberal Mehmet

    2010-10-01

    Full Text Available It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

  19. Epidemiology of pediatric burns requiring hospitalization in China: a literature review of retrospective studies.

    Science.gov (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

    2008-07-01

    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

  20. Effects of Xuebijing on intestinal function and inflammatory responses in patients with severe burn%血必净对严重烧伤患者肠道功能及炎症反应的影响

    Institute of Scientific and Technical Information of China (English)

    蔡晨; 徐庆连; 胡宏; 唐益忠; 戚伟伟

    2010-01-01

    Objective To investigate the effects of Xuebijing injectio (Chinese herb preparation) on intestinal function and inflammatory responses in severe burn patients. Method Thirty-two patients with comparable severity in burn injury were randomly divided into Xuebijing injectio treatment group (n = 16) and control group (n = 16). Patients in both groups received routine burn therapy, while those in Xuebijing treatment group additionally received Xuebijing injectio 100mL in intravenous drip twice a day for 7 days. Before the treatment and on the 3rd and the 7th day after the treatment, blood concentrations of diamine oxidase (DAO), lipopolysaccharide (LPS) ,tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were determined in both groups. Analysis was made by SPSS 12.0 software. Results The plasma levels of DAO, LPS, TNF-α and IL-6 were decreased in both groups after the treatment. However, the plasma levels of DAO, LPS, TNF-α and IL-6 in the Xuebijing treatment group were significantly lower than those in control group on the 3rd and 7th day after the treatment (P< 0.05).Conclusions Xuebijing injectio could protect intestinal function, decrease the plasma level of endotoxin and lessen zhe inflammatory responses in severe burn patients.%目的 探讨血必净注射液对严重烧伤患者肠道功能及炎症反应的影响.方法 将同期严重程度相当的32例严重烧伤患者随机(随机数字法)分为血必净治疗组(n=16)和对照组(n=16).对照组按烧伤常规治疗;治疗组在常规治疗基础上给予血必净注射液,每次100 mL,静脉滴注,2次/d,连续使用7 d.检测两组患者治疗前与治疗后3 d和7 d血浆二胺氧化酶(DAO)、内毒素(LPS)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平变化.采用SPSS 12.0统计软件进行统计分析.结果 两组烧伤患者治疗后,血浆DAO,LPS,TNF-α及IL-6水平均较治疗前下降(P<0.05);血必净治疗组在治疗后3 d和7 d,血浆DAO,LPS,TNF-α及IL-6

  1. The application of FORMOSAT-2 high-temporal- and high-spatial resolution imagery for monitoring open straw burning and carbon emission detection

    Directory of Open Access Journals (Sweden)

    C.-C. Liu

    2013-03-01

    Full Text Available Rice is produced in more than 95 countries worldwide and is a staple food for over half of the world's population. Rice is also a major food crop of Taiwan. There are numerous rice crops planted on the western plains of Taiwan, and, after the harvest season, the left-over straw is often burned on-site. The air pollutants from the burning emissions include CO2, CO, CH4 and other suspended particles, most of these being the greenhouse gases which cause global climate change. In this study FORMOSAT-2 satellite images and ground-truth data from 2008 and 2009 are used to conduct supervised classification and calculate the extent of the straw burning areas. It was found that 10% of the paddies in the study area were burned after harvest during this 2-yr period. On this pro rata basis, we calculated the overall carbon emissions from the burning of the straw. The findings showed that these few farmers produced up to 34 000 tons of carbon emissions in 2008, and 40 000 tons in 2009. The study results indicate that remotely sensed images can be used to efficiently evaluate the important characteristics for carbon emission detection. It also provides quantitative results that are relevant to tracking sources of transport pollution, postharvest burning, and Asian dust in Taiwan.

  2. The application of FORMOSAT-2 high-temporal- and high-spatial resolution imagery for monitoring open straw burning and carbon emission detection

    Science.gov (United States)

    Liu, C.-C.; Tseng, P.-Y.; Chen, C.-Y.

    2013-03-01

    Rice is produced in more than 95 countries worldwide and is a staple food for over half of the world's population. Rice is also a major food crop of Taiwan. There are numerous rice crops planted on the western plains of Taiwan, and, after the harvest season, the left-over straw is often burned on-site. The air pollutants from the burning emissions include CO2, CO, CH4 and other suspended particles, most of these being the greenhouse gases which cause global climate change. In this study FORMOSAT-2 satellite images and ground-truth data from 2008 and 2009 are used to conduct supervised classification and calculate the extent of the straw burning areas. It was found that 10% of the paddies in the study area were burned after harvest during this 2-yr period. On this pro rata basis, we calculated the overall carbon emissions from the burning of the straw. The findings showed that these few farmers produced up to 34 000 tons of carbon emissions in 2008, and 40 000 tons in 2009. The study results indicate that remotely sensed images can be used to efficiently evaluate the important characteristics for carbon emission detection. It also provides quantitative results that are relevant to tracking sources of transport pollution, postharvest burning, and Asian dust in Taiwan.

  3. Patient safety measures in burn care: do National reporting systems accurately reflect quality of burn care?

    Science.gov (United States)

    Mandell, Samuel P; Robinson, Ellen F; Cooper, Claudette L; Klein, Matthew B; Gibran, Nicole S

    2010-01-01

    Recently, much attention has been placed on quality of care metrics and patient safety. Groups such as the University Health-System Consortium (UHC) collect and review patient safety data, monitor healthcare facilities, and often report data using mortality and complication rates as outcomes. The purpose of this study was to analyze the UHC database to determine if it differentiates quality of care across burn centers. We reviewed UHC clinical database (CDB) fields and available data from 2006 to 2008 for the burn product line. Based on the September 2008 American Burn Association (ABA) list of verified burn centers, we categorized centers as American Burn Association-verified burn centers, self-identified burn centers, and other centers that are not burn units but admit some burn patients. We compared total burn admissions, risk pool, complication rates, and mortality rates. Overall mortality was compared between the UHC and National Burn Repository. The UHC CDB provides fields for number of admissions, % intensive care unit admission, risk pool, length of stay, complication profiles, and mortality index. The overall numbers of burn patients in the database for the study period included 17,740 patients admitted to verified burn centers (mean 631 admissions/burn center/yr or per 2 years), 10,834 for self-identified burn centers (mean 437 admissions/burn center/yr or per 2 years), and 1,487 for other centers (mean 11.5 admissions/burn center/yr or per 2 years). Reported complication rates for verified burn centers (21.6%), self-identified burn centers (21.3%), and others (20%) were similar. Mortality rates were highest for self-identified burn centers (3.06%), less for verified centers (2.88%), and lowest for other centers (0.74%). However, these outcomes data may be misleading, because the risk pool criteria do not include burn-specific risk factors, and the inability to adjust for injury severity prevents rigorous comparison across centers. Databases such as the

  4. Mechanism of Burn Resistance of Alloy Ti40

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The Ti fire found in high performance engines promotes the development of burn resistant Ti alloys. The burn resistant mechanism of Ti40 alloy is investigated. Ti40 alloy reveals good burn resistance. Its interfacial products between burning products and the matrix are tenacious,which retard the diffusion of oxygen into the matrix. Two burn resistant mechanisms, that is, fast scatter dispersion of heat and suppression of oxygen diffusion, are proposed.

  5. Nosocomial fungal infections in 18 severely burn patients: an retrospective clinical analysis%18例危重烧伤患者医院感染真菌回顾性分析

    Institute of Scientific and Technical Information of China (English)

    吴祖煌; 宋斌; 卓燕舞; 陈国养

    2011-01-01

    目的 分析烧伤后真菌性感染的相关因素,进一步探讨真菌性医院感染的防治措施.方法 回顾性分析2004年1月-2008年12月18例危重烧伤(烧伤面积≥30%体表总面积)后真菌性感染的病例资料.结果 白色假丝酵母菌是危重烧伤真菌性医院感染的主要病原菌,占75.8%;长期使用广谱抗菌药物是最常见的诱因,烧伤程度重、住院时间长、低白蛋白血症、侵入性操作、高龄、大剂量激素的应用等也是该病重要的危险因素;临床表现无特异性,临床症状不典型.结论积极控制感染相关危险因素,合理使用抗菌药物,减少侵入性操作,提高患者机体免疫力和尽早切削痂治疗等是预防真菌性医院感染的主要措施.%OBJECTIVE To analyze the predisposing factors and investigate the preventive measures for nosocomial fungal infection. METHODS The clinical features, therapy and outcome of 18 patients with in nosocomial fungal infection burn patients which happened from Jan 2004 to Dec 2008 were retrospectively reviewed. RESULTS Candida albican was the main pathogens causing nosocomial fungal infection. The rate of nosocomial fungal infection was higher in burn patients with long-term use of broad-spectrum antibiotic> severity of burn, long bed-days, hypoalbuminemia, invasive operation, long aging, abuse application of hormone. CONCLUSIONS We must take some measures to control the risk factors, reasonably use antibiotics, reduce the invasive procedure, improve physical immunity of the patients and perform crust treatment in early stage, which are key to prevention of nosocomial fungal infection.

  6. Gram-negative bacterial infection in thigh abscess can migrate to distant burn depending on burn depth

    National Research Council Canada - National Science Library

    Hamrahi, Victoria; Hamblin, Michael R; Jung, Walter; Benjamin, John B; Paul, Kasie W; Fischman, Alan J; Tompkins, Ronald G; Carter, Edward A

    2012-01-01

    Sepsis remains the major cause of death in patients with major burn injuries. In the present investigation we evaluated the interaction between burn injuries of varying severity and preexisting distant infection...

  7. Gram-Negative Bacterial Infection in Thigh Abscess Can Migrate to Distant Burn Depending on Burn Depth

    National Research Council Canada - National Science Library

    Hamrahi, Victoria; Hamblin, Michael R; Jung, Walter; Benjamin, John B; Paul, Kasie W; Fischman, Alan J; Tompkins, Ronald G; Carter, Edward A

    2012-01-01

    Sepsis remains the major cause of death in patients with major burn injuries. In the present investigation we evaluated the interaction between burn injuries of varying severity and preexisting distant infection...

  8. Timing constraints on remote sensing of wildland fire burned area in the southeastern US

    Science.gov (United States)

    Picotte, Joshua J.; Robertson, Kevin

    2011-01-01

    Remote sensing using Landsat Thematic Mapper (TM) satellite imagery is increasingly used for mapping wildland fire burned area and burn severity, owing to its frequency of collection, relatively high resolution, and availability free of charge. However, rapid response of vegetation following fire and frequent cloud cover pose challenges to this approach in the southeastern US. We assessed these timing constraints by using a series of Landsat TM images to determine how rapidly the remotely sensed burn scar signature fades following prescribed burns in wet flatwoods and depression swamp community types in the Apalachicola National Forest, Florida, USA during 2006. We used both the Normalized Burn Ratio (NBR) of reflectance bands sensitive to vegetation and exposed soil cover, as well as the change in NBR from before to after fire (dNBR), to estimate burned area. We also determined the average and maximum amount of time following fire required to obtain a cloud-free image for burns in each month of the year, as well as the predicted effect of this time lag on percent accuracy of burn scar estimates. Using both NBR and dNBR, the detectable area decreased linearly 9% per month on average over the first four months following fire. Our findings suggest that the NBR and dNBR methods for monitoring burned area in common southeastern US vegetation community types are limited to an average of 78–90% accuracy among months of the year, with individual burns having values as low as 38%, if restricted to use of Landsat 5 TM imagery. However, the majority of burns can still be mapped at accuracies similar to those in other regions of the US, and access to additional sources of satellite imagery would improve overall accuracy.

  9. Analysis of drug resistance of Staphylococcus aureus infection at severely burned wounds surface%重度烧伤创面金黄色葡萄球菌感染的耐药性分析

    Institute of Scientific and Technical Information of China (English)

    孟朝晖; 钱小毛; 王亚玲

    2014-01-01

    目的:了解重度烧伤患者创面金黄色葡萄球菌(SAU )感染的耐药性,为临床预防和治疗用药提供科学依据。方法共207株S A U均为2009年1月-2011年12月重度烧伤患者创面分离株;药敏试验采用 K-B法;MRSA检测采用头孢西丁纸片法;克林霉素诱导性耐药采用D试验。结果 SAU对万古霉素、利奈唑胺、替加环素和呋喃妥因全部敏感,其他药物的耐药率:替考拉宁为1.4%,磺胺甲噁唑/甲氧苄啶为36.2%;对红霉素耐药而对克林霉素敏感的36株进行D试验,结果有19株阳性,阳性率52.8%;207株S A U共检出M RS A 134株,检出率64.7%;MRSA的耐药率明显高于MSSA。结论 SAU创面感染株的耐药性很高,临床应及时做病原菌检测,充分利用实验室所提供的细菌耐药趋势和有关耐药机制的信息,合理使用抗菌药物,积极处理烧伤创面,严格执行消毒隔离制度,有助于减少SAU感染,降低感染菌的耐药性。%OBJECTIVE To investigate the status of drug resistance of a Staphylococcus aureus (SAU ) isolated from a severe burn wound ,thereby providing the scientific evidence for the clinical prevention and treatment of pharmacy .METHODS From Jan .2009 to Dec .2011 ,samples of 207 strains of SAU were acquired from severe burn wounds and then their drug sensitivity tests were carried out by K-B .Cefoxitin disk was used to detect MRSA .D-test was used to detect the inducible resistance of clindamycin .RESULTS All bacterial strains were sensitive to vancomycin ,linezolid ,tigecycline and nitrofurantoin .The rate of drug resistance of other drugs were 1 .4% against teicoplanin , 36 .2% against sulfamethoxazole/trimethoprim ; The 36 strains resistant to erythromycin but sensitive to clindamycin were given D-test ,19 strains were positive ,accounting for 52 .8% ;Among 207 strains of SAU ,134 strains of MRSA were detected ,accounting for 64 .7% ;the resistant rate of

  10. [Cell apoptosis and expression of hypoxia-inducible transcription factor-1 alpha in kidney tissue after severe burn with delayed fluid resuscitation in rats in areas of different altitude].

    Science.gov (United States)

    Jiang, Jiang; Liu, Yi; Zhang, Shi-fan; Cai, Qian; Zhang, Xian-ying; Zhang, Bin; Xiao, Bin

    2008-07-01

    To explore the relationship of cell apoptosis and expression regularity of hypoxia-inducible transcription factor (HIF)-1 alpha after severe burn with delayed fluid resuscitation in areas of different altitude. A total of 240 male Wistar rats, which were raised in areas of different altitude (1,517 and 3,840 meters), were employed as the experimental models [They received a 30% total body surface area (TBSA)III degree scald injury], and then they were randomly divided into 3 groups: delayed fluid resuscitation group (DFR, n=50), immediate fluid resuscitation group (IFR, n=60) and control group (CG, n=10). Renal tissue samples were harvested at 1, 6, 12, 24, 72 and 168 hours after burn, respectively. Cell apoptosis was detected by tissue chip technology and terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling (TUNEL). The expression of HIF-1 alpha was assessed by immunohistochemistry and image analysis. With increase in altitude, cellular edema, degeneration, necrosis and disintegration of renal tissue were gradually worsening, the capillaries of renal glomeruli became dilated and engorged, with degeneration and necrosis of endothelial cells, engorgement and edema of renal interstitium, and infiltration of inflammatory cells. Pathological changes in DFR group were more serious than that of IFR group. Cell apoptosis and the expression of HIF-1 alpha were both enhanced, the latter mainly appeared in nuclei of renal cells, and they were more marked at 3,840 meters compared with those at 1,517 meters. They were more marked in experimental groups than in control group, especially so in DFR group (Pkidney cell apoptosis.

  11. Long-term RF burn-in effects on dielectric charging of MEMS capacitive switches

    KAUST Repository

    Molinero, David G.

    2013-03-01

    This paper experimentally quantified the long-term effects of RF burn-in, in terms of burn-in and recovery times, and found the effects to be semipermanent. Specifically, most of the benefit could be realized after approximately 20 min of RF burn-in, which would then last for several months. Additionally, since similar effects were observed on both real and faux switches, the effects appeared to be of electrical rather than mechanical nature. These encouraging results should facilitate the application of the switches in RF systems, where high RF power could be periodically applied to rejuvenate the switches. © 2001-2011 IEEE.

  12. Qualitative research on posttraumatic growth in patients with severe burn injuries%严重烧伤患者创伤后成长的质性研究

    Institute of Scientific and Technical Information of China (English)

    翟建霞; 蒋红; 吴菁; 刘晓虹

    2011-01-01

    Objective To explore the dimensions of posttraumatic growth in patients with severe bum injuries. Methods Phenomenological methodology was used in the study. A depth interveiw was conducted on 10 patients with severe bum injuries recruited by purposive sampling method. Results The factors which could contribute to posttraumatic growth were personal strength,new life philosophy,sharing of self with significant others and altruism born of sufferings. Conclusion There are commonalities and differences between the Chinese sample and Tedeschi and Calhoun's model on the process and outcomes of posttraumatic growth.%目的 探索严重烧伤患者创伤后成长的心路历程。方法 采用现象学研究方法,以目的抽样法抽取10例康复后期的严重烧伤患者,进行深度访谈。结果 多种因素可促进患者创伤后成长过程,主要体现在个人力量、新生活哲学、与亲密的人分享自我情感、苦难衍生的利他4个维度。结论 访谈获得的严重烧伤患者创伤后成长维度,与美国Tedeschi和Calhoun提出的创伤后成长维度既有共性,也存在文化差异。

  13. A comparison of the epidemiology of paediatric burns in Scotland and South Africa.

    Science.gov (United States)

    Teo, A I C; Van As, A B; Cooper, J

    2012-09-01

    In South Africa burns affect 3.2% of the population annually and are particularly common among children. In Scotland paediatric burns are generally much less common and less severe. This study aimed to explore the epidemiological differences in the emergency presentation of paediatric burns in the Royal Aberdeen Children's Hospital (RACH) in Scotland and the Red Cross War Memorial Children's Hospital (RXH) in Cape Town. Data was retrieved retrospectively for all paediatric burns presenting in 2009 from RACH patient records and the RXH trauma database. Data was recorded in Microsoft Excel for subsequent statistical analysis. During 2009 RACH received 192 children with burns (1% total emergencies) and RXH received 994 (11% total emergencies). Children ≤ 2 years old were the most commonly injured age group in both centres. At RXH most children came from informal settlements and were of low socioeconomic status, while RACH patients were evenly distributed among all socioeconomic groups. Burn injuries were significantly more likely to present in the evening at both centres (pburns involved the hands and were single site (79%) while at RXH most were multiple site (76%) and involved the face. At RACH the commonest modes of injury were scald (45%) and contact burn (43%), while at RXH scalds accounted for the majority (77%). At RACH 89% children were discharged immediately, whereas 49% of RXH patients were admitted to the burn unit. Paediatric burns are more common and generally more severe in Cape Town than in Aberdeen. All children have the right to a safe environment and protection from harm; to reduce the high burns incidence in Cape Town preventative strategies should be targeted at creating safer homes.

  14. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

    Directory of Open Access Journals (Sweden)

    Kemalettin Koltka

    2011-07-01

    Full Text Available A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. In zone of hyperemia tissue perfusion is increased. At the beginning, cardiac output falls and systemic vascular resistance increases; cardiac performance improves as hypovolemia is corrected with fluid resuscitation. While cardiac output increases systemic vascular resistance falls below normal values and a hypermetabolic state develops. Pulmonary vascular resistance increases immediately after thermal injury and this is more prolonged. To avoid secondary pulmonary complications, the smallest resuscitation volume of fluids that maintains adequate tissue perfusion should be given. Changes parallel to the cardiovascular response develop in other organ systems. The reasons of burn injury can be thermal, electrical, chemical or radiation. It is important to know the exact mechanism of burn injury because of different therapies for a specific cause. In this review information about burn depth, local and systemic responses to burn injury and major causes of burn injury are presented. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl:1-6

  15. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  16. Severe burn patients of central venous catheter colonization and control measures%重度烧