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Sample records for satellite-inferred burn severity

  1. A new metric for quantifying burn severity: The Relativized Burn Ratio

    Science.gov (United States)

    Sean A. Parks; Gregory K. Dillon; Carol Miller

    2014-01-01

    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...

  2. Burn severity of areas reburned by wildfires in the Gila National Forest, New Mexico, USA

    Science.gov (United States)

    Zachary A. Holden; Penelope Morgan; Andrew T. Hudak

    2010-01-01

    We describe satellite-inferred burn severity patterns of areas that were burned and then reburned by wildland fire from 1984 to 2004 within the Gila Aldo Leopold Wilderness Complex, New Mexico, USA. Thirteen fires have burned 27 000 hectares across multiple vegetation types at intervals between fires ranging from 3 yr to 14 yr. Burn severity of reburned areas showed...

  3. Is proportion burned severely related to daily area burned?

    International Nuclear Information System (INIS)

    Birch, Donovan S; Morgan, Penelope; Smith, Alistair M S; Kolden, Crystal A; Hudak, Andrew T

    2014-01-01

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day. (letters)

  4. Diarrhea in severely burned children.

    Science.gov (United States)

    Thakkar, Kalpesh; Kien, C Lawrence; Rosenblatt, Judah I; Herndon, David N

    2005-01-01

    Diarrhea is a common problem in critically ill patients. Our patients are fed a high-carbohydrate enteral formula. We hypothesized that diarrhea in our patients may be related to the osmotic effects of unabsorbed carbohydrate in the small intestine and colon. We studied 19 patients, 3 months to 17 years, with burns >40% total body surface area. Each subject was studied weekly for up to 4 weeks postburn. Breath H2 concentration was measured. For the 24-hour period before the breath H2 measurement, the enteral carbohydrate intake, stool volume, and total enteral fluid volume were recorded. At each of several weekly intervals for each subject, the times when stool volume and enteral carbohydrate intake were each maximal were noted. Maximal stool volume ranged from 12 to 69 mL/kg/d. At the time point of maximal carbohydrate intake, diarrhea (stool volume >10 mL/kg/d) occurred in 18 of 19 patients, and maximal stool volume occurred in 10 of 19. Breath H2 concentration (ppm/5% CO2; mean +/- SEM) was 5.5 +/- 3.5 at the time of maximal carbohydrate intake, and was 25 +/- 20 at maximal stool volume. There were no correlations among breath H2 concentration, stool volume, enteral fluid intake, and enteral carbohydrate intake. Almost all the subjects had diarrhea over several weeks postburn. The lack of correlation of either carbohydrate intake or breath H2 with stool volume suggests that diarrhea in these patients may be caused by factors other than carbohydrate malabsorption. These data do not support altering nutrition support because of watery diarrhea.

  5. Myocardial Autophagy after Severe Burn in Rats

    Science.gov (United States)

    Zhang, Qiong; Shi, Xiao-hua; Huang, Yue-sheng

    2012-01-01

    Background Autophagy plays a major role in myocardial ischemia and hypoxia injury. The present study investigated the effects of autophagy on cardiac dysfunction in rats after severe burn. Methods Protein expression of the autophagy markers LC3 and Beclin 1 were determined at 0, 1, 3, 6, and 12 h post-burn in Sprague Dawley rats subjected to 30% total body surface area 3rd degree burns. Autophagic, apoptotic, and oncotic cell death were evaluated in the myocardium at each time point by immunofluorescence. Changes of cardiac function were measured in a Langendorff model of isolated heart at 6 h post-burn, and the autophagic response was measured following activation by Rapamycin and inhibition by 3-methyladenine (3-MA). The angiotensin converting enzyme inhibitor enalaprilat, the angiotensin receptor I blocker losartan, and the reactive oxygen species inhibitor diphenylene iodonium (DPI) were also applied to the ex vivo heart model to examine the roles of these factors in post-burn cardiac function. Results Autophagic cell death was first observed in the myocardium at 3 h post-burn, occurring in 0.008 ± 0.001% of total cardiomyocytes, and continued to increase to a level of 0.022 ± 0.005% by 12 h post-burn. No autophagic cell death was observed in control hearts. Compared with apoptosis, autophagic cell death occurred earlier and in larger quantities. Rapamycin enhanced autophagy and decreased cardiac function in isolated hearts 6 h post-burn, while 3-MA exerted the opposite response. Enalaprilat, losartan, and DPI all inhibited autophagy and enhanced heart function. Conclusion Myocardial autophagy is enhanced in severe burns and autophagic cell death occurred early at 3 h post-burn, which may contribute to post-burn cardiac dysfunction. Angiotensin II and reactive oxygen species may play important roles in this process by regulating cell signaling transduction. PMID:22768082

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

    Science.gov (United States)

    Hsieh, Yu-Hsiu

    2016-02-01

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

  7. RECENT ADVANCES IN BIOMARKERS IN SEVERE BURNS.

    Science.gov (United States)

    Ruiz-Castilla, Mireia; Roca, Oriol; Masclans, Joan R; Barret, Joan P

    2016-02-01

    The pathophysiology of burn injuries is tremendously complex. A thorough understanding is essential for correct treatment of the burned area and also to limit the appearance of organ dysfunction, which, in fact, is a key determinant of morbidity and mortality. In this context, research into biomarkers may play a major role. Biomarkers have traditionally been considered an important area of medical research: the measurement of certain biomarkers has led to a better understanding of pathophysiology, while others have been used either to assess the effectiveness of specific treatments or for prognostic purposes. Research into biomarkers may help to improve the prognosis of patients with severe burn injury. The aim of the present clinical review is to discuss new evidence of the value of biomarkers in this setting.

  8. Self-esteem in severely burned adults.

    Science.gov (United States)

    Imran Haider Zaidi, Syed Muhammad; Yaqoob, Nazia; Noreen, Sidra

    2017-12-01

    A cross-sectional study was conducted to investigate the level of and gender difference in self-esteem among adult victims of severe burn injuries. Severely burned adults aged 20 to 40 years participated in this investigation from March 2015 to April 2016 in five hospitals of Faisalabad and Lahore. Purposive sampling technique was used and a self-esteem scale was used to assess different dimensions of self-esteem. Out of 40 patients, there were 25 men (62.5%) and 15 women (37.5%) with mean age of 28.28±4.60 years (range: 20-40 years). A significant positive relationship between subscales of self-esteem scale were found: self-acceptance and self-competence r=0.55, pself-acceptance and academic self-competence r=0.47, pself-acceptance and social and physical acceptance r=0.57, pself-competence and academic self-competence r=0.48, pself-competence and social and physical acceptance r=0.50, pself-competence and social and physical acceptance r=0.45, pself-competence among severely burned men and women (t=2.18; pself-competency component of self-esteem among women victims.

  9. Comparing the reported burn conditions for different severity burns in porcine models: a systematic review.

    Science.gov (United States)

    Andrews, Christine J; Cuttle, Leila

    2017-12-01

    There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post-burn and method for depth of injury assessment specified. Conditions causing deep dermal scald burns compared to contact burns of equivalent severity were disparate, with lower temperatures and shorter durations reported for scald burns (83°C for 14 seconds) compared to contact burns (111°C for 23 seconds). A valuable archive of the different mechanisms and materials used for porcine burn models is presented to aid design and optimisation of future models. Significantly, this review demonstrates the effect of the mechanism of injury on burn severity and that caution is recommended when burn conditions established by porcine contact burn models are used by regulators to guide scald burn prevention strategies. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  10. 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

  11. Coagulopathy and its management in patients with severe burns

    NARCIS (Netherlands)

    Glas, G. J.; Levi, M. [=Marcel M.; Schultz, M. J.

    2016-01-01

    Severe burn injury is associated with systemic coagulopathy. The changes in coagulation described in patients with severe burns resemble those found patients with sepsis or major trauma. Coagulopathy in patients with severe burns is characterized by procoagulant changes, and impaired fibrinolytic

  12. Music therapy for children with severe burn injury

    OpenAIRE

    Edwards, Jane

    1998-01-01

    peer-reviewed Music therapy for children with severe burns is a developing field of practice and research interest in pediatric music therapy. The following article presents an overview of the nature of severe burn injury and provides a rationale for the use of music therapy in the Burn Unit. The application of song writing techniques to address needs of children receiving care for severe burns in a hospital setting is presented.

  13. Burn severity mapping using simulation modeling and satellite imagery

    Science.gov (United States)

    Eva C. Karau; Robert E. Keane

    2010-01-01

    Although burn severity maps derived from satellite imagery provide a landscape view of fire impacts, fire effects simulation models can provide spatial fire severity estimates and add a biotic context in which to interpret severity. In this project, we evaluated two methods of mapping burn severity in the context of rapid post-fire assessment for four wildfires in...

  14. Postfire soil burn severity mapping with hyperspectral image unmixing

    Science.gov (United States)

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

    2007-01-01

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

  15. Predictors of muscle protein synthesis after severe pediatric burns.

    Science.gov (United States)

    Diaz, Eva C; Herndon, David N; Lee, Jinhyung; Porter, Craig; Cotter, Matthew; Suman, Oscar E; Sidossis, Labros S; Børsheim, Elisabet

    2015-04-01

    Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. A total of 87 children with 40% or greater total body surface area (TBSA) burned were included. Patients participated in stable isotope infusion studies at 1, 2, and approximately 4 weeks after burn and at 6, 12, and 24 months after injury to determine skeletal muscle protein fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. Patients (8 ± 6 years) had large (62, 51-72% TBSA) and deep (47% ± 21% TBSA third degree) burns. Muscle protein fractional synthesis rate was elevated throughout the first 12 months after burn compared with established values from healthy young adults. Muscle protein fractional synthesis rate was lower in boys, in children older than 3 years, and when burns were greater than 80% TBSA. Muscle protein synthesis is elevated for at least 1 year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiologic response to burn trauma. Muscle protein synthesis is highly affected by sex, age, and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn patients. Prognostic study, level III.

  16. Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

    Science.gov (United States)

    Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard; Durkin, Anthony J.

    2013-06-01

    Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns.

  17. The relation between forest structure and soil burn severity

    Science.gov (United States)

    Theresa B. Jain; Russell T. Graham; David S. Pilliod

    2006-01-01

    A study funded through National Fire Plan evaluates the relation between pre-wildfire forest structure and post-wildfire soil burn severity across three forest types: dry, moist, and cold forests. Over 73 wildfires were sampled in Idaho, Oregon, Montana, Colorado, and Utah, which burned between 2000 and 2003. Because of the study’s breadth, the results are applicable...

  18. 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.

  19. Skin bioengineering and stem cells for severe burn treatment

    International Nuclear Information System (INIS)

    Lataillade, J.J.; Trouillas, M.; Alexaline, M.; Brachet, M.; Bey, E.; Duhamel, P.; Leclerc, T.; Bargues, L.

    2015-01-01

    Severely burned patients need definitive and efficient wound coverage. The outcome of massive burns has improved with cultured epithelial auto-grafts (CEA). In spite of its fragility, percentage of success, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in some burn centres. The first improvements involved combining CEA and dermis-like substitutes. Cultured skin substitutes provide faster skin closure and satisfying functional results. These methods have been used successfully in massive burns. A second improvement was to enable skin regeneration by using epidermal stem cells. Stem cells can differentiate into keratinocytes, to promote wound repair and to regenerate skin appendages. Human mesenchymal stem cells foster wound healing and were used in cutaneous radiation syndrome. Skin regeneration and tissue engineering methods remain a complex challenge and offer the possibility of new treatment for injured and burned patients. (authors)

  20. Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN

    Hypothesis: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. Design: Before-after trial. Setting: A 30-bed burn referral center in a private, university-affiliated hospital. Methods: We studied 35 severely burned children who were divided into 2

  1. A project for monitoring trends in burn severity

    Science.gov (United States)

    Eidenshink, Jeffery C.; Schwind, Brian; Brewer, Ken; Zhu, Zhu-Liang; Quayle, Brad; Howard, Stephen M.

    2007-01-01

    Jeff Eidenshink, Brian Schwind, Ken Brewer, Zhi-Liang Zhu, Brad Quayle, and Elected officials and leaders of environmental agencies need information about the effects of large wildfires in order to set policy and make management decisions. Recently, the Wildland Fire Leadership Council (WFLC), which implements and coordinates the National Fire Plan (NFP) and Federal Wildland Fire Management Policies (National Fire Plan 2004), adopted a strategy to monitor the effectiveness of the National Fire Plan and the Healthy Forests Restoration Act (HFRA). One component of this strategy is to assess the environmental impacts of large wildland fires and identify the trends of burn severity on all lands across the United States. To that end, WFLC has sponsored a six-year project, Monitoring Trends in Burn Severity (MTBS), which requires the U.S. Department of Agriculture Forest Service (USDA-FS) and the U.S. Geological Survey (USGS) to map and assess the burn severity for all large current and historical fires. Using Landsat data and the differenced Normalized Burn Ratio (dNBR) algorithm, the USGS Center for Earth Resources Observation and Science (EROS) and USDA-FS Remote Sensing Applications Center will map burn severity of all fires since 1984 greater than 202 ha (500ac) in the east, and 404 ha (1,000 ac) in the west. The number of historical fires from this period combined with current fires occurring during the course of the project will exceed 9,000. The MTBS project will generate burn severity data, maps, and reports, which will be available for use at local, state, and national levels to evaluate trends in burn severity and help develop and assess the effectiveness of land management decisions. Additionally, the information developed will provide a baseline from which to monitor the recovery and health of fire-affected landscapes over time. Spatial and tabular data quantifying burn severity will augment existing information used to estimate risk associated with a range

  2. Covering techniques for severe burn treatment: lessons for radiological burn accidents

    International Nuclear Information System (INIS)

    Carsin, H.; Stephanazzi, J.; Lambert, F.; Curet, P.M.; Gourmelon, P.

    2002-01-01

    Covering techniques for severe burn treatment: lessons for radiological burn accidents. After a severe burn, the injured person is weakened by a risk of infection and a general inflammation. The necrotic tissues have to be removed because they are toxic for the organism. The injured person also needs to be covered by a cutaneous envelope, which has to be done by a treatment centre for burned people. The different techniques are the following: - auto grafts on limited burned areas; - cutaneous substitutes to cover temporary extended burned areas. Among them: natural substitutes like xenografts (pork skin, sheep skin,..) or allografts (human skin), - treated natural substitutes which only maintain the extracellular matrix. Artificial skins belong to this category and allow the development of high quality scars, - cell cultures in the laboratory: multiplying the individual cells and grafting them onto the patient. This technique is not common but allows one to heal severely injured patients. X-ray burns are still a problem. Their characteristics are analysed: intensive, permanent, antalgic resistant pain. They are difficult to compare with heat burns. In spite of a small number of known cases, we can give some comments and guidance on radio necrosis cures: the importance of the patients comfort, of ending the pain, of preventing infection, and nutritional balance. At the level of epidermic inflammation and phlyctena (skin blisters), the treatment may be completed by the use of growth factors. At the level of necrosis, after a temporary cover, an auto graft can be considered only if a healthy basis is guaranteed. The use of cellular cultures in order to obtain harmonious growth factors can be argued. (author)

  3. Live Skin Allograft in the Management of Severe Burns

    African Journals Online (AJOL)

    skin substitute should in some way be incorporated into the healing wound as ... liquid nitrogen or they may be lyophilized and freeze- dried (4, 5). ... more severe the burn the greater the degree of immunosuppresion. ... Humby knife under spinal anesthesia. .... Alloantibody Effect on Skin Graft Survival in Mice. Hiroshima J ...

  4. [Clinical and biological monitoring of nutritional status in severe burns].

    Science.gov (United States)

    Bargues, L; Cottez-Gacia, S; Jault, P; Renard, C; Vest, P

    2009-01-01

    Burn patients are subject to hypermetabolism and catabolic states. Aim was to evaluate our current practice in nutrition. Twenty-one severely burned patients were prospectively included during three months period. Body weight was measured at least two times in a week during all stay in burn ICU. Biological markers of inflammation (C-reactive protein, CRP) and nutrition (prealbumin) were performed weekly. Protocol included early nasogastric feeding, tolerated gastric stasis less than 250 mL at four hours nasogastric aspirations, caloric target value of 40 Kcal/kg per day and measurement of total daily calorie intakes. Patient demographics showed a mean percent total body surface burn of 51.1+/-27 % (range 20-90), age of 38.7+/-13.1 years (range 18-67) and 57.3 % of smoke inhalation. All patients were ventilated and 19 patients survived. Length of stay was 75.7+/-47 days (range 22-184). Patients received only 58.9+/-10 % of calorie intakes recommended by French burn society. Loss of body mass was 15.2+/-9 kg (range 3-31) or 19.1+/-10 % of admission weight (range 5-37). Erosion of body mass was not correlated with burned surface (p=0.08), calorie intakes (p=0.26), smoke inhalation (p=0.46), lengths of stay (p=0.53), lengths of ventilation (p=0.08) or nutrition (p=0.12), days of antibiotic (p=0.72), number of dressing changes (p=0.6) or surgery (p=0.64). Biological parameters showed CRP decreasing and prealbumin improving values. New strategies of nutrition are necessary to improve outcome and reduce body mass loss in burns.

  5. Clostridium difficile infections in patients with severe burns

    Science.gov (United States)

    2011-01-01

    placards indicating that hand hygiene should involve soap and water. Periodic hand hygiene compliance surveys have indicated relatively consistent...care unit: epidemiology, costs, and colonization pressure. Infect Control Hosp Epidemiol 2007;28:123–30. [6] Marcon AP, Gamba MA, Vianna LA. Nosocomial ...Clostridium difficile infections in patients with severe burns§ Scott J. Crabtree a, Janelle L. Robertson a,b, Kevin K. Chung c, Evan M. Renz b,c

  6. 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

  7. Sensitivity of Landsat image-derived burn severity indices to immediate post-fire effects

    Science.gov (United States)

    A. T. Hudak; S. Lewis; P. Robichaud; P. Morgan; M. Bobbitt; L. Lentile; A. Smith; Z. Holden; J. Clark; R. McKinley

    2006-01-01

    The USFS Remote Sensing Applications Center (RSAC) and the USGS Center for Earth Resources Observation and Science (EROS) produce Burned Area Reflectance Classification (BARC) maps as a rapid, preliminary indication of burn severity on large wildfire events. Currently the preferred burn severity index is the delta Normalized Burn Ratio (dNBR), which requires NBR values...

  8. Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual

    OpenAIRE

    Morisada, S.; Nosaka, N.; Tsukahara, K.; Ugawa, T.; Sato, K.; Ujike, Y.

    2015-01-01

    The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive b...

  9. 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,...

  10. [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.

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

    Directory of Open Access Journals (Sweden)

    Lennert Schepers

    2014-02-01

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

  12. 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...

  13. Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

    Science.gov (United States)

    van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p burned (p  0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively. © 2012 by the Wound Healing Society.

  14. Outcome after burns: An observational study on burn scar maturation and predictors for severe scarring

    NARCIS (Netherlands)

    van der Wal, M.B.A.; Vloemans, J.F.P.M.; Tuinebreijer, W.E.; van de Ven, P.M.; van Unen, E.; van Zuijlen, P.P.M.; Middelkoop, E.

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in

  15. Landscape Patterns of Burn Severity in the Soberanes Fire of 2016

    Science.gov (United States)

    Potter, Christopher

    2016-01-01

    The Soberanes Fire started on July 22, 2016 in Monterey County on the California Central Coast from an illegal campfire. This fire burned for 10 weeks at a record cost of more than $208 million for protection and control. A progressive analysis of the normalized burn ratio from the Landsat satellite showed that the final high burn severity (HBS) area for the Soberanes Fire comprised 22 percent of the total area burned, whereas final moderate burn severity (MBS) area comprised about 10 percent of the total area burned of approximately 53,470 ha (132,130 acres). The resulting landscape pattern of burn severity classes from the 2016 Soberanes Fire revealed that the majority of HBS area was located in the elevation zone between 500 and 1000 m, in the slope zone between 15 percent and 30 percent, or on south-facing aspects.

  16. Burn Severities, Fire Intensities, and Impacts to Major Vegation Types from the Cerro Grande Fire

    International Nuclear Information System (INIS)

    Balice, R.G.; Bennett, K.D.; Wright, M.A.

    2005-01-01

    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. According to the burn severity map and the fire intensity map, the Cerro Grande Fire is estimated to have covered 42,885.4 acres and 42,854.7 acres, respectively. Of this, 57.0 percent was burned at low severity and 34.7 percent was burned at high severity. Similarly, 40.0 percent of the Cerro Grande Fire burned at high fire intensity, greater than 70 percent mortality, while 33.1 percent burned at moderately low intensity, 10 to 40 percent mortality. The most frequently burned cover types over the entire Cerro Grande Fire were ponderosa pine forest and mixed conifer forest, at approximately 43 percent each. However, portions of the fire that burned on Los Alamos National Laboratory (LANL) property were predominantly in ponderosa pine forests, whereas the Cerro Grande Fire burned primarily in mixed conifer forests on lands managed by other agencies. Some of the polygons of burn severities and fire intensities were extensive. The two largest burn severity polygons were 10,111 acres and 10,903 acres and these were burned at low severity. The next two largest polygons were 8999 acres (14 square miles) and 1551 acres (2.4 square miles) and both of these polygons

  17. 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

  18. Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual.

    Science.gov (United States)

    Morisada, S; Nosaka, N; Tsukahara, K; Ugawa, T; Sato, K; Ujike, Y

    2015-09-30

    The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive burns (SEB) treated before and after implementation of these new guidelines at this institution. The patients included in this study had a burn index (BI) ≥30 or a prognostic burn index (PBI = BI + patient's age) ≥100. The survival rate of the patients with BI ≥30 was 65.2% with the traditional treatment and 100% with the new guidelines. Likewise, the survival rate of the patients with PBI ≥100 was 61.1% with the traditional treatment compared to 100% with the new guidelines. Together, these data demonstrate that the new treatment guidelines dramatically improved the treatment outcome and survival of SEB patients.

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

    Science.gov (United States)

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

    2014-01-01

    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...

  20. Prehospital cooling of severe burns: Experience of the Emergency ...

    African Journals Online (AJOL)

    Only cooling performed by the patient, their family, bystanders or prehospital staff was recorded. Cooling performed by the Edendale Hospital ED staff was not included. Duration of cooling with water was documented as per the report given by the patient. Variables assessed included age, gender, time of burn, day of week,.

  1. Severe burning treatment tested on lowland pine sites

    Science.gov (United States)

    S. Little; E. B. Moore

    1953-01-01

    Since the prescribed use of fire is a fairly new silvicultural technique for preparing seedbeds for pine in the New Jersey pine region, it has been used rather cautiously. Burning treatments have been made in the winter, when periodic light fires can be easily controlled. The treatments have been used almost exclusively on upland sites.

  2. The effect of seasonality on burn incidence, severity and outcome in Central Malawi.

    Science.gov (United States)

    Tyson, Anna F; Gallaher, Jared; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G

    2017-08-01

    In much of the world, burns are more common in cold months. However, few studies have described the seasonality of burns in sub-Saharan Africa. This study examines the effect of seasonality on the incidence and outcome of burns in central Malawi. A retrospective analysis was performed at Kamuzu Central Hospital and included all patients admitted from May 2011 to August 2014. Demographic data, burn mechanism, total body surface area (%TBSA), and mortality were analyzed. Seasons were categorized as Rainy (December-February), Lush (March-May), Cold (June-August) and Hot (September-November). A negative binomial regression was used to assess the effect of seasonality on burn incidence. This was performed using both the raw and deseasonalized data in order to evaluate for trends not attributable to random fluctuation. A total of 905 patients were included. Flame (38%) and Scald (59%) burns were the most common mechanism. More burns occurred during the cold season (41% vs 19-20% in the other seasons). Overall mortality was 19%. Only the cold season had a statistically significant increase in burn . The incidence rate ratios (IRR) for the hot, lush, and cold seasons were 0.94 (CI 0.6-1.32), 1.02 (CI 0.72-1.45) and 1.6 (CI 1.17-2.19), respectively, when compared to the rainy season. Burn severity and mortality did not differ between seasons. The results of this study demonstrate the year-round phenomenon of burns treated at our institution, and highlights the slight predominance of burns during the cold season. These data can be used to guide prevention strategies, with special attention to the implications of the increased burn incidence during the cold season. Though burn severity and mortality remain relatively unchanged between seasons, recognizing the seasonal variability in incidence of burns is critical for resource allocation in this low-income setting. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  3. [Advance on human umbilical cord mesenchymal stem cells for treatment of ALI in severe burns].

    Science.gov (United States)

    Wang, Yu; Hu, Xiaohong

    2017-01-01

    Severe burn is often accompanied by multiple organ damage. Acute lung injury (ALI) is one of the most common complications, and often occurs in the early stage of severe burns. If it is not treated in time, it will progress to acute respiratory distress syndrome (ARDS), which will be a serious threat to the lives of patients. At present, the treatment of ALI in patients with severe burn is still remained in some common ways, such as the liquid resuscitation, the primary wound treatment, ventilation support, and anti-infection. In recently, human umbilical cord mesenchymal stem cells (hUCMSCs) have been found having some good effects on ALI caused by various causes, but few reports on the efficacy of ALI caused by severe burns were reported. By reviewing the mechanism of stem cell therapy for ALI, therapeutic potential of hUCMSCs in the treatment of severe burns with ALI and a new approach for clinical treatment was provided.

  4. 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.

  5. Predicting gully rejuvenation after wildfire using remotely sensed burn severity data

    Science.gov (United States)

    Hyde, Kevin; Woods, Scott W.; Donahue, Jack

    2007-05-01

    The loss of surface vegetation and reduced infiltration caused by wildfires can trigger gully rejuvenation, resulting in damage to downstream aquatic resources and risk to human life and property. We developed a spatially explicit metric of burn severity — the Burn Severity Distribution Index (BSDI) — and tested its ability to predict post-fire gully rejuvenation in 1st and 2nd order basins burned in the 2000 Valley Complex fires in the Sapphire Mountains of western Montana. The BSDI was derived from burn severity data interpreted from Landsat 7 satellite imagery using the Normalized Burn Ratio (NBR) method, and ranged from 0.0 for completely unburned basins to 4.0 for basins burned entirely at high severity. In July 2001 rainstorms with peak 30-minute intensities of up to 17 mm h - 1 triggered gully rejuvenation in 66 of the 171 basins examined. The frequency of gully rejuvenation was higher in basins with higher BSDI values, increasing from zero for basins with a BSDI less than 1.3 to 67% for basins with a BSDI greater than 3.0. Binary logistic regression indicated that BSDI was a more significant predictor of gully rejuvenation than basin morphometric variables. The absence of gully rejuvenation in several basins with a high BSDI was attributed to low gradient, dense riparian vegetation, or concentration of high burn severity at lower elevations in the basin. The presence of gully rejuvenation in several basins with a low BSDI was associated with false negative NBR classification errors in northwest aspects, and concentration of severe burn impacts in the drainage headslopes. BSDI is a useful metric for predicting gully rejuvenation after wildfire. The use of the BSDI in Burned Area Emergency Response team assessments could improve the planning, implementation, and monitoring of burned area recovery treatments.

  6. Burn Severity and Its Impact on Soil Properties: 2016 Erskine Fire in the Southern Sierra Nevada

    Science.gov (United States)

    Haake, S.; Guo, J.; Krugh, W. C.

    2017-12-01

    Wildfire frequency in the southern Sierra Nevada has increased over the past decades. The effects of wildfires on soils can increase the frequency of slope failure and debris flow events, which pose a greater risk to people, as human populations expand into foothill and mountainous communities of the Sierra Nevada. Alterations in the physical properties of burned soils are one such effect that can catalyze slope failure and debris flow events. Moreover, the degree of a soil's physical alteration resulting from wildfire is linked to fire intensity. The 2016 Erskine fire occurred in the southern Sierra Nevada, burning 48,019 acres, resulting in soils of unburned, low, moderate, and high burn severities. In this study, the physical properties of soils with varying degrees of burn severity are explored within the 2016 Erskine fire perimeter. The results constrain the effects of burn severity on soil's physical properties. Unburned, low, moderate, and high burn severity soil samples were collected within the Erskine fire perimeter. Alterations in soils' physical properties resulting from burn severity are explored using X-ray diffractometry analysis, liquid limit, plastic limit, and shear strength tests. Preliminary results from this study will be used to assess debris flow and slope failure hazard models within burned areas of the Kern River watershed in the southern Sierra Nevada.

  7. 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.

  8. Post-Fire Regeneration and Diversity Response to Burn Severity in Pinus halepensis Mill. Forests

    Directory of Open Access Journals (Sweden)

    Sonsoles González-De Vega

    2018-05-01

    Full Text Available In recent decades, fire regimes have been modified by various factors such as changes in land use, global change or forest management policies. The vulnerability of Mediterranean terrestrial ecosystems is increasing due to more severe and frequent droughts. This study aimed to determine the plant response of ecosystems during the short-term post-fire period by relating alpha diversity, floristic richness and tree recruitment dynamics to burn severity 5 years after a wildfire. Our results conclude that in the short term, Pinus halepensis Mill. stands in southeastern Spain quickly recovered alpha diversity values, mainly in areas burned with low severity. We observed that moderate and high severities affected the ecosystem more significantly, showing higher values for the Shannon Index but lower for the Simpson index. Pine recruitment was higher in burned areas, and we found the highest number of Aleppo pine seedlings under a moderate burn severity. Post-fire regeneration functional groups (obligate seeders and resprouters were promoted under moderate and high burn severity, increasing their abundance. Annual species (mainly herbs colonized burned areas, persisting with higher presence under moderate burn severity. Restoration tools should be focused on reducing fire severity, mainly in areas at high risk of desertification, and promoting resistance, vulnerability and resilience of these ecosystems.

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

    Science.gov (United States)

    Baer, L.A.; Wu, X.; Tou, J. C.; Johnson, E.; Wolf, S.E.; Wade, C.E.

    2012-01-01

    Burn and disuse results in metabolic and bone changes associated with substantial and sustained bone loss. Such loss can lead to an increased fracture incidence and osteopenia. We studied the independent effects of burn and disuse on bone morphology, composition and strength, and microstructure of the bone alterations 14 days after injury. Sprague-Dawley rats were randomized into four groups: Sham/Ambulatory (SA), Burn/Ambulatory (BA), Sham/Hindlimb Unloaded (SH) and Burn/Hindlimb Unloaded (BH). Burn groups received a 40% total body surface area full-thickness scald burn. Disuse by hindlimb unloading was initiated immediately following injury. Bone turnover was determined in plasma and urine. Femur biomechanical parameters were measured by three-point bending tests and bone microarchitecture was determined by microcomputed tomography (uCT). On day 14, a significant reduction in body mass was observed as a result of burn, disuse and a combination of both. In terms of bone health, disuse alone and in combination affected femur weight, length and bone mineral content. Bending failure energy, an index of femur strength, was significantly reduced in all groups and maximum bending stress was lower when burn and disuse were combined. Osteocalcin was reduced in BA compared to the other groups, indicating influence of burn. The reductions observed in femur weight, BMC, biomechanical parameters and indices of bone formation are primarily responses to the combination of burn and disuse. These results offer insight into bone degradation following severe injury and disuse. PMID:23142361

  10. Adjunctive hyperbaric oxygen therapy in severe burns: Experience in Taiwan Formosa Water Park dust explosion disaster.

    Science.gov (United States)

    Chiang, I-Han; Chen, Shyi-Gen; Huang, Kun-Lun; Chou, Yu-Ching; Dai, Niann-Tzyy; Peng, Chung-Kan

    2017-06-01

    Despite major advances in therapeutic strategies for the management of patients with severe burns, significant morbidity and mortality is observed. Hyperbaric oxygen therapy (HBOT) increases the supply of oxygen to burn areas. The aim of this study was to determine whether HBOT is effective in the treatment of major thermal burns. On June 27, 2015 in New Taipei, Taiwan, a mass casualty disaster occurred as fire erupted over a large crowd, injuring 499 people. Fifty-three victims (20 women and 33 men) were admitted to Tri-Service General Hospital. Thirty-eight patients underwent adjunctive HBOT (HBOT group), and 15 patients received routine burn therapy (control group). Serum procalcitonin (PCT) level, a sepsis biomarker, was measured until it reached normal levels (burn care combined with adjunctive HBOT improves sepsis control compared with standard treatment without HBOT. Prospective studies are required to define the role of HBOT in extensive burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. 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

    2017-12-01

    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 Elsevier Inc. All rights reserved.

  12. Fuel treatments and landform modify landscape patterns of burn severity in an extreme fire event

    Science.gov (United States)

    Susan J. Prichard; Maureen C. Kennedy

    2014-01-01

    Under a rapidly warming climate, a critical management issue in semiarid forests of western North America is how to increase forest resilience to wildfire. We evaluated relationships between fuel reduction treatments and burn severity in the 2006 Tripod Complex fires, which burned over 70 000 ha of mixed-conifer forests in the North Cascades range of Washington State...

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

    Science.gov (United States)

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

    2014-01-01

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

  14. 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 ...

  15. Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model.

    Science.gov (United States)

    Mehra, Tarun; Koljonen, Virve; Seifert, Burkhardt; Volbracht, Jörk; Giovanoli, Pietro; Plock, Jan; Moos, Rudolf Maria

    2015-01-01

    Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established. The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782-328 618 CHF vs 4 874-27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range -6 720 - 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of -33 178 CHF (30 856 EUR) (interquartile range -95 533 - 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2 of 0.67 (p <0.001 for LOS). Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns.

  16. Domestic bioethanol-fireplaces--a new source of severe burn accidents.

    Science.gov (United States)

    Neubrech, Florian; Kiefer, Jurij; Schmidt, Volker J; Bigdeli, Amir K; Hernekamp, J Frederick; Kremer, Thomas; Kneser, Ulrich; Radu, Christian Andreas

    2016-02-01

    Bioethanol-fueled fireplaces are popular interior home decoration accessories. Although their safety is promoted frequently, actual presentations of severe burn injuries in our burn intensive care unit (ICU) have focused the authors on safety problems with these devices. In this article we want to explore the mechanisms for these accidents and state our experiences with this increasingly relevant risk for severe burn injuries. The computerized medical records of all burn intensive care patients in our burn unit between 2000 and 2014 were studied. Since 2010, 12 patients with bioethanol associated burn injuries were identified. Their data was compared to the values of all patients, except the ones injured by bioethanol fireplaces that presented themselves to our burn ICU between the years 2010 and 2014. At time of admission the bioethanol patients had a mean ABSI-score of 4.8 (+/- 2.2 standard deviation (SD)). A mean of 17 percent (+/- 9.1 SD) body surface area was burned. Involvement of face and hands was very common. An operative treatment was needed in 8 cases. A median of 20 days of hospitalization (range 3-121) and a median of 4.5 days on the ICU (range 1-64) were necessary. No patient died. In most cases the injuries happened while refilling or while starting the fire, even though safety instructions were followed. In the control group, consisting of 748 patients, the mean ABSI-score was 5.6 (+/- 2.7 SD). A mean of 16.5 percent (+/- 10.1 SD) body surface area was burned. Treatment required a median of 3 days on the burn ICU (range 1-120). Regarding these parameters, the burden of disease was comparable in both groups. Bioethanol-fueled fireplaces for interior home decoration are a potential source for severe burn accidents even by intended use. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  17. 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

  18. Season and severity of prescribed burn in ponderosa pine forests: implications for understory native and exotic plants.

    Science.gov (United States)

    Becky K. Kerns; Walter G. Thies; Christine G. Niwa

    2006-01-01

    We investigated herbaceous richness and cover in relation to fire season and severity, and other variables, five growing seasons following prescribed fires. Data were collected from six stands consisting of three randomly applied treatments: no burn, spring burn, and fall burn. Fall burns had significantly more exotic/native annual/biennial (an/bi) species and greater...

  19. 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.

  20. 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.

  1. Hot soup! Correlating the severity of liquid scald burns to fluid and biomedical properties.

    Science.gov (United States)

    Loller, Cameron; Buxton, Gavin A; Kerzmann, Tony L

    2016-05-01

    Burns caused by hot drinks and soups can be both debilitating and costly, especially to pediatric and geriatric patients. This research is aimed at better understanding the fluid properties that can influence the severity of skin burns. We use a standard model which combines heat transfer and biomedical equations to predict burn severity. In particular, experimental data from a physical model serves as the input to our numerical model to determine the severity of scald burns as a consequence of actual fluid flows. This technique enables us to numerically predict the heat transfer from the hot soup into the skin, without the need to numerically estimate the complex fluid mechanics and thermodynamics of the potentially highly viscous and heterogeneous soup. While the temperature of the soup is obviously is the most important fact in determining the degree of burn, we also find that more viscous fluids result in more severe burns, as the slower flowing thicker fluids remain in contact with the skin for longer. Furthermore, other factors can also increase the severity of burn such as a higher initial fluid temperature, a greater fluid thermal conductivity, or a higher thermal capacity of the fluid. Our combined experimental and numerical investigation finds that for average skin properties a very viscous fluid at 100°C, the fluid must be in contact with the skin for around 15-20s to cause second degree burns, and more than 80s to cause a third degree burn. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  2. 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.

  3. 78 FR 57486 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Science.gov (United States)

    2013-09-19

    ... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as one of the... severe burn injuries, the Chairman of the Senate Committee on Veterans' Affairs explained that, ``[d]ue...

  4. 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

    ... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... the Armed Forces with Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile... (U.S.C.), by reformatting the statute and adding ``severe burn injury (as determined pursuant to...

  5. 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

    ... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... reformatting the statute and adding ``severe burn injury (as determined pursuant to regulations prescribed by...)(iv), VA proposes to amend 38 CFR 3.808 to define the term ``severe burn injury.'' In the proposed...

  6. A decadal glimpse on climate and burn severity influences on ponderosa pine post-fire recovery

    Science.gov (United States)

    Newingham, B. A.; Hudak, A. T.; Bright, B. C.; Smith, A.; Khalyani, A. H.

    2016-12-01

    Climate change is predicted to affect plants at the margins of their distribution. Thus, ecosystem recovery after fire is likely to vary with climate and may be slowest in drier and hotter areas. However, fire regime characteristics, including burn severity, may also affect vegetation recovery. We assessed vegetation recovery one and 9-15 years post-fire in North American ponderosa pine ecosystems distributed across climate and burn severity gradients. Using climate predictors derived from downscaled 1993-2011 climate normals, we predicted vegetation recovery as indicated by Normalized Burn Ratio derived from 1984-2012 Landsat time series imagery. Additionally, we collected field vegetation measurements to examine local topographic controls on burn severity and post-fire vegetation recovery. At a regional scale, we hypothesized a positive relationship between precipitation and recovery time and a negative relationship between temperature and recovery time. At the local scale, we hypothesized southern aspects to recovery slower than northern aspects. We also predicted higher burn severity to slow recovery. Field data found attenuated ponderosa pine recovery in hotter and drier regions across all burn severity classes. We concluded that downscaled climate data and Landsat imagery collected at commensurate scales may provide insight into climate effects on post-fire vegetation recovery relevant to ponderosa pine forest managers.

  7. [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.

  8. 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.

  9. Complex Relationships of the Effects of Topographic Characteristics and Susceptible Tree Cover on Burn Severity

    Directory of Open Access Journals (Sweden)

    Hyun-Joo Lee

    2018-01-01

    Full Text Available Forest fires and burn severity mosaics have profound impacts on the post-fire dynamics and complexity of forest ecosystems. Numerous studies have investigated the relationship between topographic variables and susceptible tree covers with regard to burn severity. However, these relationships have not been fully elucidated, because most studies have assumed linearity in these relationships. Therefore, we examined the linearity and the nonlinearity in the relationships between topographic variables and susceptible tree covers with burn severity by comparing linear and nonlinear models. The site of the Samcheok fire, the largest recorded forest fire in Korea, was used as the study area. We generated 802 grid cells with a 500-m resolution that encompassed the entire study area and collected a dataset that included the topographic variables and percentage of red pine trees, which are the most susceptible tree cover types in Korea. We used conventional linear models and generalized additive models to estimate the linear and the nonlinear models based on topographic variables and Japanese red pine trees. The results revealed that the percentage of red pine trees had linear effects on burn severity, reinforcing the importance of silviculture and forest management to lower burn severity. Meanwhile, the topographic variables had nonlinear effects on burn severity. Among the topographic variables, elevation had the strongest nonlinear effect on burn severity, possibly by overriding the effects of susceptible fuels over elevation effects or due to the nonlinear effects of topographic characteristics on pre-fire fuel conditions, including the spatial distribution and availability of susceptible tree cover. To validate and generalize the nonlinear effects of elevation and other topographic variables, additional research is required at different fire sites with different tree cover types in different geographic locations.

  10. Land surface temperature as potential indicator of burn severity in forest Mediterranean ecosystems

    Science.gov (United States)

    Quintano, C.; Fernández-Manso, A.; Calvo, L.; Marcos, E.; Valbuena, L.

    2015-04-01

    Forest fires are one of the most important causes of environmental alteration in Mediterranean countries. Discrimination of different degrees of burn severity is critical for improving management of fire-affected areas. This paper aims to evaluate the usefulness of land surface temperature (LST) as potential indicator of burn severity. We used a large convention-dominated wildfire, which occurred on 19-21 September, 2012 in Northwestern Spain. From this area, a 1-year series of six LST images were generated from Landsat 7 Enhanced Thematic Mapper (ETM+) data using a single channel algorithm. Further, the Composite Burn Index (CBI) was measured in 111 field plots to identify the burn severity level (low, moderate, and high). Evaluation of the potential relationship between post-fire LST and ground measured CBI was performed by both correlation analysis and regression models. Correlation coefficients were higher in the immediate post-fire LST images, but decreased during the fall of 2012 and increased again with a second maximum value in summer, 2013. A linear regression model between post-fire LST and CBI allowed us to represent spatially predicted CBI (R-squaredadj > 85%). After performing an analysis of variance (ANOVA) between post-fire LST and CBI, a Fisher's least significant difference test determined that two burn severity levels (low-moderate and high) could be statistically distinguished. The identification of such burn severity levels is sufficient and useful to forest managers. We conclude that summer post-fire LST from moderate resolution satellite data may be considered as a valuable indicator of burn severity for large fires in Mediterranean forest ecosytems.

  11. [Effects of hydrogen on the lung damage of mice at early stage of severe burn].

    Science.gov (United States)

    Qin, C; Bian, Y X; Feng, T T; Zhang, J H; Yu, Y H

    2017-11-20

    Objective: To investigate the effects of hydrogen on the lung damage of mice at early stage of severe burn. Methods: One hundred and sixty ICR mice were divided into sham injury, hydrogen, pure burn, and burn+ hydrogen groups according to the random number table, with 40 mice in each group. Mice in pure burn group and burn+ hydrogen group were inflicted with 40% total body surface area full-thickness scald (hereafter referred to as burn) on the back, while mice in sham injury group and hydrogen group were sham injured. Mice in hydrogen group and burn+ hydrogen group inhaled 2% hydrogen for 1 h at post injury hour (PIH) 1 and 6, respectively, while mice in sham injury group and pure burn group inhaled air for 1 h. At PIH 24, lung tissue of six mice in each group was harvested, and then pathological changes of lung tissue were observed by HE staining and the lung tissue injury pathological score was calculated. Inferior vena cava blood and lung tissue of other eight mice in each group were obtained, and then content of high mobility group box 1 (HMGB1) and interleukin-6 (IL-6) in serum and lung tissue was determined by enzyme-linked immunosorbent assay. Activity of superoxide dismutase (SOD) in serum and lung tissue was detected by spectrophotometry. After arterial blood of other six mice in each group was collected for detection of arterial partial pressure of oxygen (PaO(2)), the wet and dry weight of lung tissue were weighted to calculate lung wet to dry weight ratio. The survival rates of the other twenty mice in each group during post injury days 7 were calculated. Data were processed with one-way analysis of variance, LSD test and log-rank test. Results: (1) At PIH 24, lung tissue of mice in sham injury group and hydrogen group showed no abnormality. Mice in pure burn group were with pulmonary interstitial edema, serious rupture of alveolar capillary wall, and infiltration of a large number of inflammatory cells. Mice in burn+ hydrogen group were with mild

  12. Can we make an early 'do not resuscitate' decision in severe burn patients?

    Science.gov (United States)

    Yüce, Yücel; Acar, Hakan Ahmet; Erkal, Kutlu Hakan; Tuncay, Erhan

    2017-03-01

    The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. Between January 2009 and December 2014, 29 patients (3.44%) with very severe burns were admitted to burn unit. Average total burn surface area (TBSA) was 94.24% (range: 85-100%), and in 10 patients, TBSA was 100%. Additional inhalation burns were present in 26 of the patients (89.65%). All of the patients died, despite every medical intervention. Mean survival was 4.75 days (range: 1-24 days). Total of 17 patients died within 72 hours. Lethal dose 50 (% TBSA at which certain group has 50% chance of survival) rate of our burn center is 62%. Baux indices were used for prognostic evaluation of the patients; mean total Baux score of the patients was 154.13 (range: 117-183). It is well known that numerous problems may be encountered during triage of severely burned patients in Turkey. These patients are referred to burn centers and are frequently transferred via air ambulance between cities, and even countries. They are intubated and mechanical ventilation is initiated at burn center. Many interventions are performed to treat these patients, such as escharotomy, fasciotomy, tangential or fascial excision, central venous catheterization and tracheostomy, or hemodialysis. Yet despite such interventions, these patients die, typically within 48 to 96 hours. Integrity of the body is often lost as result of aggressive intervention with no real benefit, and there are also economic costs to hospital related to use of materials, bed occupancy, and distribution of workforce. For these reasons, as well as patient comfort

  13. Transcriptome modulation by hydrocortisone in severe burn shock: ancillary analysis of a prospective randomized trial.

    Science.gov (United States)

    Plassais, Jonathan; Venet, Fabienne; Cazalis, Marie-Angélique; Le Quang, Diane; Pachot, Alexandre; Monneret, Guillaume; Tissot, Sylvie; Textoris, Julien

    2017-06-16

    Despite shortening vasopressor use in shock, hydrocortisone administration remains controversial, with potential harm to the immune system. Few studies have assessed the impact of hydrocortisone on the transcriptional response in shock, and we are lacking data on burn shock. Our objective was to assess the hydrocortisone-induced transcriptional modulation in severe burn shock, particularly modulation of the immune response. We collected whole blood samples during a randomized controlled trial assessing the efficacy of hydrocortisone administration in burn shock. Using whole genome microarrays, we first compared burn patients (n = 32) from the placebo group to healthy volunteers to describe the transcriptional modulation induced by burn shock over the first week. Then we compared burn patients randomized for either hydrocortisone administration or placebo, to assess hydrocortisone-induced modulation. Study groups were similar in terms of severity and major outcomes, but shock duration was significantly reduced in the hydrocortisone group. Many genes (n = 1687) were differentially expressed between burn patients and healthy volunteers, with 85% of them exhibiting a profound and persistent modulation over seven days. Interestingly, we showed that hydrocortisone enhanced the shock-associated repression of adaptive, but also innate immunity. We found that the initial host response to burn shock encompasses wide and persistent modulation of gene expression, with profound modulation of pathways associated with metabolism and immunity. Importantly, hydrocortisone administration may worsen the immunosuppression associated with severe injury. These data should be taken into account in the risk ratio of hydrocortisone administration in patients with inflammatory shock. ClinicalTrials.gov, NCT00149123 . Registered on 6 September 2005.

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

    Science.gov (United States)

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

    2018-01-20

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

  15. Combination of Landsat and Sentinel-2 MSI data for initial assessing of burn severity

    Science.gov (United States)

    Quintano, C.; Fernández-Manso, A.; Fernández-Manso, O.

    2018-02-01

    Nowadays Earth observation satellites, in particular Landsat, provide a valuable help to forest managers in post-fire operations; being the base of post-fire damage maps that enable to analyze fire impacts and to develop vegetation recovery plans. Sentinel-2A MultiSpectral Instrument (MSI) records data in similar spectral wavelengths that Landsat 8 Operational Land Imager (OLI), and has higher spatial and temporal resolutions. This work compares two types of satellite-based maps for evaluating fire damage in a large wildfire (around 8000 ha) located in Sierra de Gata (central-western Spain) on 6-11 August 2015. 1) burn severity maps based exclusively on Landsat data; specifically, on differenced Normalized Burn Ratio (dNBR) and on its relative versions (Relative dNBR, RdNBR, and Relativized Burn Ratio, RBR) and 2) burn severity maps based on the same indexes but combining pre-fire data from Landsat 8 OLI with post-fire data from Sentinel-2A MSI data. Combination of both Landsat and Sentinel-2 data might reduce the time elapsed since forest fire to the availability of an initial fire damage map. Interpretation of ortho-photograph Pléiades 1 B data (1:10,000) provided us the ground reference data to measure the accuracy of both burn severity maps. Results showed that Landsat based burn severity maps presented an adequate assessment of the damage grade (κ statistic = 0.80) and its spatial distribution in wildfire emergency response. Further using both Landsat and Sentinel-2 MSI data the accuracy of burn severity maps, though slightly lower (κ statistic = 0.70) showed an adequate level for be used by forest managers.

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

    Directory of Open Access Journals (Sweden)

    Laurent Thefenne

    Full Text Available 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.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 December 2013 and then admitted to one of three centres specialised in the rehabilitation of patients with burns. Multivariate analysis was carried out to analyse the relationship between HO development and demographic and clinical data.805 patients were included. 32 patients (4.0% developed a total of 74 heterotopic ossifications, that is a little higher incidence than the incidence found in the literature. The epidemiological characteristics of the population studied was similar to the literature. HOs were mainly localized around the elbows, followed by the hips, shoulders and knees. Each case-patient was paired with 3 control-patients. There were significant associations between HO development and the length of stay in the burns intensive care unit, the extent and depth of the burns, the occurrence of pulmonary or cutaneous infections, use of curare and use of an air-fluidized bed.In addition to recognized risk factors (duration of stay in the intensive care burns unit, extent and depth of burns, pulmonary and cutaneous infections, the use of curare and the use of a fluidized bed (with the duration of use were significantly associated with HO formation.

  17. 14 year follow-up for a severe electrical burn to mouth and lip: case report.

    Science.gov (United States)

    Valencia, Roberto; Garcia, Javier; Espinosa, Roberto; Saadia, Marc; Valencia, Evaristo

    2010-01-01

    Electrical burns range from 4 to 7% of the total burn accidents and many of them affect primarily children biting on a live wire. Great confusion exists in the literature about the proper management of electrical burns to the mouth in the acute and late phases. 14 year results are shown in a severe electrical burn sustained in a 1 year 2 months old girl, involving 90% of the lips and commissures, tongue, alveolar ridges and teeth (primary central incisors and permanent dental germs). Two weeks after she was out of danger, an active splint expansion device was built and used for 8 months to prevent secondary microstomia. Later a new active splint device was used for a year after lip plastic surgery. At age 13, orthopedics and orthodontics were accomplished with a lip tattoo completed at age 15. No matter how good the final esthetic and occlusal results are, prevention is always the best option.

  18. Severe burn injuries caused by bioethanol-design fireplaces-an overview on recreational fire threats.

    Science.gov (United States)

    Kraemer, Robert; Knobloch, Karsten; Lorenzen, Johan; Breuing, Karl H; Koennecker, Soeren; Rennekampff, Hans-Oliver; Vogt, Peter M

    2011-01-01

    Commercially available bioethanol-fueled fireplaces have become increasingly popular additions for interior home decoration in Europe and more recently in the United States. These fireplaces are advertised as smokeless, ecologically friendly, and do not require professional installation, formal gas lines, or venting. Although manufacturers and businesses promote their safety, recent presentations of injuries have alerted the authors to the relevant danger bioethanol fireplaces can pose for the incautious user. Are bioethanol fireplaces going to become the future threat in domestic burn accidents beside common barbeque burns? A Medline literature search on barbeque and domestic fireplace accidents was performed to compare and stratify the injury patterns reported and to identify a risk profile for contemporary bioethanol-fueled fireplaces. To exemplify, two representative clinical cases of severe burn accidents caused by bioethanol-fueled fireplaces, both treated in the burn unit of the authors, are being presented. Design fireplaces are being recognized as an increasing source of fuel and fire-related danger in the home. This risk may be underestimated by the uninformed customer, resulting in severe burn injuries. Because bioethanol-fueled fireplaces have become more commonplace, they may overtake barbecue-related injury as the most common domestic burn injury.

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

    Science.gov (United States)

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

    2006-08-01

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

  20. 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.

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

    Science.gov (United States)

    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

    2015-05-04

    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. Sixty-nine adult patients with burns covering ≥ 30% of the total body surface area (TBSA) were enrolled in this IRB-approved study. Patients received standard burn care with (n = 35) or without (control, n = 34) propranolol. Propranolol was administered within 48 hours of burns and given throughout hospital discharge to decrease heart rate by approximately 20% from admission levels. Wound healing was determined by comparing the time between grafting procedures. Blood loss was determined by comparing pre- and postoperative hematocrit while factoring in operative graft area. Data were collected between first admission and first discharge. Demographics, burn size, and mortality were comparable in the control and propranolol groups. Patients in the propranolol group received an average propranolol dose of 3.3 ± 3.0 mg/kg/day. Daily average heart rate over the first 30 days was significantly lower in the propranolol group (P operative intervention is optimal.

  2. 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.

  3. Contribution of Bacterial and Viral infections to Attributable Mortality in Patients with Severe Burns: An Autopsy Series

    Science.gov (United States)

    2010-01-01

    and related mortality following severe burns. Burns 2008;3(4):1108 12. [5] Nash G , Foley FD. Herpetic infection of the middle and lower respiratory...Albrecht M, Griffith M, Murray C, Chung K, Horvath E, Ward J, et al. Impact of Acinetobacter infection on the mortality of burn patients. J Am Coll... Mason AD. Survival benefit conferred by topical antimicrobial preparations in burn patients: a historical perspective. J Trauma 2004;56:863 6. [27

  4. [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.

  5. Role of autophagy and its molecular mechanisms in mice intestinal tract after severe burn.

    Science.gov (United States)

    Zhang, Duan Y; Qiu, Wei; Jin, PeiS; Wang, Peng; Sun, Yong

    2017-10-01

    Severe burn can lead to hypoxia/ischemia of intestinal mucosa. Autophagy is the process of intracellular degradation, which is essential for cell survival under stresses, such as hypoxia/ischemia and nutrient deprivation. The present study was designed to investigate whether there were changes in intestinal autophagy after severe burn in mice and further to explore the effect and molecular mechanisms of autophagy on intestinal injury. This study includes three experiments. Kunming species mice were subjected to 30% total body surface area third-degree burn. First, we determined protein of LC3 (light chain 3), beclin-1, and cleaved-caspase3 by Western blotting and immunohistochemical (paraffin) staining to investigate whether there were changes in intestinal autophagy after severe burn in mice. Then, changes of the status of enteric damage postburn were measured by observing intestinal mucosa morphology under a magnifier, hematoxylin and eosin staining, enzyme-linked immunosorbent assay, Western blotting under the condition that the intestinal autophagy was respectively activated by rapamycin and inhibited by 3-methyladenine. Finally, protein of the AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway, LC3-II and beclin-1 were assayed, and mice were treated with compound C before burn. The protein of LC3 and beclin-1 were observed at 1 hour postburn and increased to peak-point at 24 hours, reaching the normal level at 96 hours. The cleaved caspase-3 expression increased at 1 hour postburn, but the peak point occurred at 12 hours and had dropped to normal level at 72 hours. In addition, rapamycin enhanced intestinal autophagy and alleviated burn-induced gut damage, while 3-methyladenine showed the against behavior. The AMPK/mTOR pathway which was inhibited decreased the expression of phosphorylated AMPK, LC3-II, and beclin-1, increasing the expression of phosphorylated mTOR. Intestinal autophagy is activated and response to intestinal

  6. Spatial patterns of ponderosa pine regeneration in high-severity burn patches

    Science.gov (United States)

    Suzanne M. Owen; Carolyn H. Sieg; Andrew J. Sanchez. Meador; Peter Z. Fule; Jose M. Iniguez; L. Scott. Baggett; Paula J. Fornwalt; Michael A. Battaglia

    2017-01-01

    Contemporary wildfires in southwestern US ponderosa pine forests can leave uncharacteristically large patches of tree mortality, raising concerns about the lack of seed-producing trees, which can prevent or significantly delay ponderosa pine regeneration. We established 4-ha plots in high-severity burn patches in two Arizona wildfires, the 2000 Pumpkin and 2002 Rodeo-...

  7. [Severe burns of lower limb due to association of hot water and citrullus colocynthis].

    Science.gov (United States)

    Fejjal, N; Gharib, N E; El Mazouz, S; Abbassi, A; Belmahi, A

    2011-06-30

    The case is reported of a patient suffering from severe burns through having used Citrullus colocynthis as a medicinal plant together with hot water. This led to carbonization of the foot and to its amputation. A description of the plant and its toxicity is given.

  8. Peatland water repellency: Importance of soil water content, moss species, and burn severity

    Science.gov (United States)

    Moore, P. A.; Lukenbach, M. C.; Kettridge, N.; Petrone, R. M.; Devito, K. J.; Waddington, J. M.

    2017-11-01

    Wildfire is the largest disturbance affecting peatlands, with northern peat reserves expected to become more vulnerable to wildfire as climate change enhances the length and severity of the fire season. Recent research suggests that high water table positions after wildfire are critical to limit atmospheric carbon losses and enable the re-establishment of keystone peatland mosses (i.e. Sphagnum). Post-fire recovery of the moss surface in Sphagnum-feathermoss peatlands, however, has been shown to be limited where moss type and burn severity interact to result in a water repellent surface. While in situ measurements of moss water repellency in peatlands have been shown to be greater for feathermoss in both a burned and unburned state in comparison to Sphagnum moss, it is difficult to separate the effect of water content from species. Consequently, we carried out a laboratory based drying experiment where we compared the water repellency of two dominant peatland moss species, Sphagnum and feathermoss, for several burn severity classes including unburned samples. The results suggest that water repellency in moss is primarily controlled by water content, where a sharp threshold exists at gravimetric water contents (GWC) lower than ∼1.4 g g-1. While GWC is shown to be a strong predictor of water repellency, the effect is enhanced by burning. Based on soil water retention curves, we suggest that it is highly unlikely that Sphagnum will exhibit strong hydrophobic conditions under field conditions.

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

    NARCIS (Netherlands)

    Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.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

  10. 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

  11. 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.

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

    Science.gov (United States)

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

    2016-07-01

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

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

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    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.

  14. Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients.

    Science.gov (United States)

    Oda, Jun; Ueyama, Masashi; Yamashita, Katsuyuki; Inoue, Takuya; Noborio, Mitsuhiro; Ode, Yasumasa; Aoki, Yoshiki; Sugimoto, Hisashi

    2006-01-01

    Secondary abdominal compartment syndrome is a lethal complication after resuscitation from burn shock. Hypertonic lactated saline (HLS) infusion reduces early fluid requirements in burn shock, but the effects of HLS on intraabdominal pressure have not been clarified. Patients admitted to our burn unit between 2002 and 2004 with burns > or =40% of the total body surface area without severe inhalation injury were entered into a fluid resuscitation protocol using HLS (n = 14) or lactated Ringer's solution (n = 22). Urine output was monitored hourly with a goal of 0.5 to 1.0 mL/kg per hour. Hemodynamic parameters, blood gas analysis, intrabladder pressure as an indicator of intraabdominal pressure (IAP), and the peak inspiratory pressure were recorded. Pulmonary compliance and the abdominal perfusion pressure were also calculated. In the HLS group, the amount of intravenous fluid volume needed to maintain adequate urine output was less at 3.1 +/- 0.9 versus 5.2 +/- 1.2 mL/24 h per kg per percentage of total body surface area, and the peak IAP and peak inspiratory pressure at 24 hours after injury were significantly lower than those in the lactated Ringer's group. Two of 14 patients (14%) in the HLS group and 11 of 22 patients (50%) developed IAH within 20.8 +/- 7.2 hours after injury. In patients with severe burn injury, a large intravenous fluid volume decreases abdominal perfusion during the resuscitative period because of increased IAP. Our data suggest that HLS resuscitation could reduce the risk of secondary abdominal compartment syndrome with lower fluid load in burn shock patients.

  15. 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

  16. 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, Xuexia; Vogelmann, James E.; Rollins, Matt; Ohlen, Donald; Key, Carl H.; Yang, Limin; Huang, Chengquan; Shi, Hua

    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.

  17. Impact of stress-induced diabetes on outcomes in severely burned children.

    Science.gov (United States)

    Finnerty, Celeste C; Ali, Arham; McLean, Josef; Benjamin, Nicole; Clayton, Robert P; Andersen, Clark R; Mlcak, Ronald P; Suman, Oscar E; Meyer, Walter; Herndon, David N

    2014-04-01

    Post-burn hyperglycemia leads to graft failure, multiple organ failure, and death. A hyperinsulinemic-euglycemic clamp is used to keep serum glucose between 60 and 110 mg/dL. Because of frequent hypoglycemic episodes, a less-stringent sliding scale insulin protocol is used to maintain serum glucose levels between 80 and 160 mg/dL after elevations >180 mg/dL. We randomized pediatric patients with massive burns into 2 groups, patients receiving sliding scale insulin to lower blood glucose levels (n = 145) and those receiving no insulin (n = 98), to determine the differences in morbidity and mortality. Patients 0 to 18 years old with burns covering ≥ 30% of the total body surface area and not randomized to receive anabolic agents were included in this study. End points included glucose levels, infections, resting energy expenditure, lean body mass, bone mineral content, fat mass, muscle strength, and serum inflammatory cytokines, hormones, and liver enzymes. Maximal glucose levels occurred within 6 days of burn injury. Blood glucose levels were age dependent, with older children requiring more insulin (p patients not receiving insulin, only in patients who received insulin (p patients receiving insulin (p Burn-induced hyperglycemia develops in a subset of severely burned children. Length of stay was reduced in the no insulin group, and there were no deaths in this group. Administration of insulin positively impacted bone mineral content and muscle strength, but increased resting energy expenditure, hypoglycemic episodes, and mortality. New glucose-lowering strategies might be needed. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Outcome predictors and quality of life of severe burn patients admitted to intensive care unit

    Directory of Open Access Journals (Sweden)

    Buoninsegni Laura

    2010-04-01

    Full Text Available Abstract Background Despite significant medical advances and improvement in overall mortality rate following burn injury, the treatment of patients with extensive burns remains a major challenge for intensivists. We present a study aimed to evaluate the short- and the long-term outcomes of severe burn patients (total body surface area, TBSA > 40% treated in a polyvalent intensive care unit (ICU and to assess the quality of life of survivors, one year after the injury using the EuroQol-5D (EQ-5D questionnaire. Methods A prospective-observational study was performed in an ICU of a University-affiliated hospital. Logistic regression analysis was used to identify the factors predicting in-hospital mortality. The EQ-5D questionnaire was used to asses participant's long term self-reported general health. Results During a period of five years, 50 patients participated in the study. Their mean age was 53.8 ± 19.8; they had a mean of %TBSA burned of 54.5 ± 18.1. 44% and 10% of patients died in the ICU and in the ward after ICU discharge, respectively. Baux index, SAPS II and SOFA on admission to the ICU, infectious and respiratory complications, and time of first burn wound excision were found to have a significant predictive value for hospital mortality. The level of health of all survivors was worse than before the injury. Problems in the five dimensions studied were present as follows: mobility (moderate 68.5%; extreme 0%, self-care (moderate 21%; extreme 36.9%, usual activities (moderate 68.5%; extreme 21%, pain/discomfort (moderate 68.5%; extreme 10.5%, anxiety/depression (moderate 36.9%; extreme 42.1%. Conclusions In severe burn patients, Baux index, severity of illness on admission to the ICU, complications, and time of first burn wound excision were the major contributors to hospital mortality. Quality of life was influenced by consequences of injury both in psychological and physical health.

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

    Science.gov (United States)

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

    2004-01-01

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

  20. Clinical and protein metabolic efficacy of glutamine granules-supplemented enteral nutrition in severely burned patients.

    Science.gov (United States)

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

    2005-05-01

    As an abundant amino acid in the human body, glutamine has many important metabolic roles that may protect or promote tissue integrity and enhance the immune system. A relative deficiency of glutamine in such patients could compromise recovery and result in prolonged illness and an increase in late mortality. The purpose of this clinical study is to observe the effects of enteral supplement with glutamine granules on protein metabolism in severely burned patients. Forty-eight severe burn patients (total burn surface area 30-75%, full thickness burn area 20-58%) who met the requirements of the protocol joined this double-blind randomized controlled clinical trial. Patients were randomly divided into two groups: burn control group (B group, 23 patients) and glutamine treated group (Gln group, 25 patients). There was isonitrogenous and isocaloric intake in both groups, glutamine and B group patents were supplemented with glutamine granules or placebo (glycine) at 0.5 g/kg per day for 14 days with oral feeding or tube feeding, respectively. The level of plasma glutamine, plasma protein content, urine nitrogen and urine 3-methylhistidine (3-MTH) excretion were determined, wound healing rate of the burned area and hospital stay were recorded. The results showed that there were significant reductions in plasma glutamine level and abnormal protein metabolism. After supplement with glutamine granules for 14 days, the plasma glutamine concentration was significantly higher than that in B group (607.86+/-147.25 micromol/L versus 447.63+/-132.38 micromol/L, P0.05). On the other hand, the amount of urine nitrogen and 3-MTH excreted in Gln group were significantly lower than that in B group. In addition, wound healing was faster and hospital stay days were shorter in Gln group than B group (46.59+/-12.98 days versus 55.68+/-17.36 days, P<0.05). These indicated that supplement glutamine granules with oral feeding or tube feeding could abate the degree of glutamine depletion

  1. "Fire Moss" Cover and Function in Severely Burned Forests of the Western United States

    Science.gov (United States)

    Grover, H.; Doherty, K.; Sieg, C.; Robichaud, P. R.; Fulé, P. Z.; Bowker, M.

    2017-12-01

    With wildfires increasing in severity and extent throughout the Western United States, land managers need new tools to stabilize recently burned ecosystems. "Fire moss" consists of three species, Ceratodon purpureus, Funaria hygrometrica, and Bryum argentum. These mosses colonize burned landscapes quickly, aggregate soils, have extremely high water holding capacity, and can be grown rapidly ex-situ. In this talk, I will focus on our efforts to understand how Fire Moss naturally interacts with severely burned landscapes. We examined 14 fires in Arizona, New Mexico, Washington, and Idaho selecting a range of times since fire, and stratified plots within each wildfire by winter insolation and elevation. At 75+ plots we measured understory plant cover, ground cover, Fire Moss cover, and Fire Moss reproductive effort. On plots in the Southwest, we measured a suite of soil characteristics on moss covered and adjacent bare soil including aggregate stability, shear strength, compressional strength, and infiltration rates. Moss cover ranged from 0-75% with a mean of 16% across all plots and was inversely related to insolation (R2 = .32, p = stability and infiltration rates as adjacent bare ground. These results will allow us to model locations where Fire Moss will naturally increase postfire hillslope soil stability, locations for targeting moss restoration efforts, and suggest that Fire Moss could be a valuable tool to mitigate post wildfire erosion.

  2. 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.

  3. Post-fire burn severity and vegetation response following eight large wildfires across the Western United States

    Science.gov (United States)

    Leigh B. Lentile; Penelope Morgan; Andrew T. Hudak; Michael J. Bobbitt; Sarah A. Lewis; Alistair M. S. Smith; Peter R. Robichaud

    2007-01-01

    Vegetation response and burn severity were examined following eight large wildfires that burned in 2003 and 2004: two wildfires in California chaparral, two each in dry and moist mixed-conifer forests in Montana, and two in boreal forests in interior Alaska. Our research objectives were: 1) to characterize one year post-fire vegetation recovery relative to initial fire...

  4. Two-year follow-up of outcomes related to scarring and distress in children with severe burns.

    Science.gov (United States)

    Wurzer, Paul; Forbes, Abigail A; Hundeshagen, Gabriel; Andersen, Clark R; Epperson, Kathryn M; Meyer, Walter J; Kamolz, Lars P; Branski, Ludwik K; Suman, Oscar E; Herndon, David N; Finnerty, Celeste C

    2017-08-01

    We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models. Significance was accepted at p body areas over time (p self-conscious with respect to their body image even 2 years after burn injury. Implications for Rehabilitation According to self-assessment questionnaires, severely burned children perceive significant improvements in scarring and distress during the first 2 years post burn. Significant improvements were seen in reduction of pain, itching, sleeping disturbances, tightness, range of motion, and strength (p body areas. The rehabilitation team should provide access to wigs or other aids to pediatric burn survivors to address these needs.

  5. Development of Metabolic Indicators of Burn Injury: Very Low Density Lipoprotein (VLDL and Acetoacetate Are Highly Correlated to Severity of Burn Injury in Rats

    Directory of Open Access Journals (Sweden)

    Maria-Louisa Izamis

    2012-07-01

    Full Text Available Hypermetabolism is a significant sequela to severe trauma such as burns, as well as critical illnesses such as cancer. It persists in parallel to, or beyond, the original pathology for many months as an often-fatal comorbidity. Currently, diagnosis is based solely on clinical observations of increased energy expenditure, severe muscle wasting and progressive organ dysfunction. In order to identify the minimum number of necessary variables, and to develop a rat model of burn injury-induced hypermetabolism, we utilized data mining approaches to identify the metabolic variables that strongly correlate to the severity of injury. A clustering-based algorithm was introduced into a regression model of the extent of burn injury. As a result, a neural network model which employs VLDL and acetoacetate levels was demonstrated to predict the extent of burn injury with 88% accuracy in the rat model. The physiological importance of the identified variables in the context of hypermetabolism, and necessary steps in extension of this preliminary model to a clinically utilizable index of severity of burn injury are outlined.

  6. Examining Spatial Variation in the Effects of Japanese Red Pine (Pinus densiflora on Burn Severity Using Geographically Weighted Regression

    Directory of Open Access Journals (Sweden)

    Hyun-Joo Lee

    2017-05-01

    Full Text Available Burn severity has profound impacts on the response of post-fire forest ecosystems to fire events. Numerous previous studies have reported that burn severity is determined by variables such as meteorological conditions, pre-fire forest structure, and fuel characteristics. An underlying assumption of these studies was the constant effects of environmental variables on burn severity over space, and these analyses therefore did not consider the spatial dimension. This study examined spatial variation in the effects of Japanese red pine (Pinus densiflora on burn severity. Specifically, this study investigated the presence of spatially varying relationships between Japanese red pine and burn severity due to changes in slope and elevation. We estimated conventional ordinary least squares (OLS and geographically weighted regression (GWR models and compared them using three criteria; the coefficients of determination (R2, Akaike information criterion for small samples (AICc, and Moran’s I-value. The GWR model performed considerably better than the OLS model in explaining variation in burn severity. The results provided strong evidence that the effect of Japanese red pine on burn severity was not constant but varied spatially. Elevation was a significant factor in the variation in the effects of Japanese red pine on burn severity. The influence of red pine on burn severity was considerably higher in low-elevation areas but became less important than the other variables in high-elevation areas. The results of this study can be applied to location-specific strategies for forest managers and can be adopted to improve fire simulation models to more realistically mimic the nature of fire behavior.

  7. A protocol guided by transpulmonary thermodilution and lactate levels for resuscitation of patients with severe burns.

    Science.gov (United States)

    Berger, Mette M; Que, Yok Ai

    2013-11-11

    Over-resuscitation is deleterious in many critically ill conditions, including major burns. For more than 15 years, several strategies to reduce fluid administration in burns during the initial resuscitation phase have been proposed, but no single or simple parameter has shown superiority. Fluid administration guided by invasive hemodynamic parameters usually resulted in over-resuscitation. As reported in the previous issue of Critical Care, Sánchez-Sánchez and colleagues analyzed the performance of a 'permissive hypovolemia' protocol guided by invasive hemodynamic parameters (PiCCO, Pulsion Medical Systems, Munich, Germany) and vital signs in a prospective cohort over a 3-year period. The authors' results confirm that resuscitation can be achieved with below-normal levels of preload but at the price of a fluid administration greater than predicted by the Parkland formula (2 to 4 mL/kg per% burn). The classic approach based on an adapted Parkland equation may still be the simplest until further studies identify the optimal bundle of resuscitation goals.

  8. Toll like receptors gene expression of human keratinocytes cultured of severe burn injury.

    Science.gov (United States)

    Cornick, Sarita Mac; Noronha, Silvana Aparecida Alves Corrêa de; Noronha, Samuel Marcos Ribeiro de; Cezillo, Marcus V B; Ferreira, Lydia Masako; Gragnani, Alfredo

    2014-01-01

    To evaluate the expression profile of genes related to Toll Like Receptors (TLR) pathways of human Primary Epidermal keratinocytes of patients with severe burns. After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol(r) (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific TLR pathways PCR Arrays plates (SA Biosciences). After the analysis of gene expression we found that 21% of these genes were differentially expressed, of which 100% were repressed or hyporegulated. Among these, the following genes (fold decrease): HSPA1A (-58), HRAS (-36), MAP2K3 (-23), TOLLIP (-23), RELA (-18), FOS (-16), and TLR1 (-6.0). This study contributes to the understanding of the molecular mechanisms related to TLR pathways and underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome.

  9. Innate and adaptive immunity gene expression of human keratinocytes cultured of severe burn injury.

    Science.gov (United States)

    Noronha, Silvana Aparecida Alves Corrêa de; Noronha, Samuel Marcos Ribeiro de; Lanziani, Larissa Elias; Ferreira, Lydia Masako; Gragnani, Alfredo

    2014-01-01

    Evaluate the expression profile of genes related to Innate and Adaptive Immune System (IAIS) of human Primary Epidermal keratinocytes (hPEKP) of patients with severe burns. After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol(r) (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific IAIS PCR Arrays plates (SA Biosciences). After the analysis of gene expression we found that 63% of these genes were differentially expressed, of which 77% were repressed and 23% were hyper-regulated. Among these, the following genes (fold increase or decrease): IL8 (41), IL6 (32), TNF (-92), HLA-E (-86), LYS (-74), CCR6 (- 73), CD86 (-41) and HLA-A (-35). This study contributes to the understanding of the molecular mechanisms underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome.

  10. Pyogenic cervical spondylitis with quadriplegia as a complication of severe burns: Report of a case.

    Science.gov (United States)

    Asakage, Naoki; Katami, Atsuo; Takekawa, Satoru; Suzuki, Tetsuya; Goto, Michitoshi; Fukai, Ryuta

    2006-01-01

    We report a case of cervical pyogenic spondylitis complicated by epidural abscess with quadriplegia during treatment of severe burns. The patient was a 49-year-old man with 3rd-degree burns to 20% of his body, involving the lower extremities. We performed escharectomy of the 3rd-degree necrosis on days 7 and 16, followed by the first skin graft on day 23. Pseudomonas aeruginosa was detected in the postoperative graft wound culture. On day 23 after the skin graft, he became febrile and began to experience cervical pain and muscle weakness of the extremities. By day 24, quadriplegia had developed. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylitis with an epidural abscess, which was causing the quadriplegia. We treated the patient by performing curettage of the pyogenic lesion and anterior fixation of the cervical vertebral bodies. The fact that P. aeruginosa was detected in the pyogenic focus culture indicated that burn wound sepsis was responsible for the infection. This case reinforces that acting on a strong suspicion helps to establish a diagnosis and initiate appropriate treatment early.

  11. The view of severely burned patients and healthcare professionals on the blind spots in the aftercare process: a qualitative study.

    Science.gov (United States)

    Christiaens, Wendy; Van de Walle, Elke; Devresse, Sophie; Van Halewyck, Dries; Benahmed, Nadia; Paulus, Dominique; Van den Heede, Koen

    2015-08-01

    In most Western countries burn centres have been developed to provide acute and critical care for patients with severe burn injuries. Nowadays, those patients have a realistic chance of survival. However severe burn injuries do have a devastating effect on all aspects of a person's life. Therefore a well-organized and specialized aftercare system is needed to enable burn patients to live with a major bodily change. The aim of this study is to identify the problems and unmet care needs of patients with severe burn injuries throughout the aftercare process, both from patient and health care professional perspectives in Belgium. By means of face-to-face interviews (n = 40) with individual patients, responsible physicians and patient organizations, current experiences with the aftercare process were explored. Additionally, allied healthcare professionals (n = 17) were interviewed in focus groups. Belgian burn patients indicate they would benefit from a more integrated aftercare process. Quality of care is often not structurally embedded, but depends on the good intentions of local health professionals. Most burn centres do not have a written discharge protocol including an individual patient-centred care plan, accessible to all caregivers involved. Patients reported discontinuity of care: nurses working at general wards or rehabilitation units are not specifically trained for burn injuries, which sometimes leads to mistakes or contradictory information transmission. Also professionals providing home care are often not trained for the care of burn injuries. Some have to be instructed by the patient, others go to the burn centre to learn the right skills. Finally, patients themselves underestimate the chronic character of burn injuries, especially at the beginning of the care process. The variability in aftercare processes and structures, as well as the failure to implement locally developed best-practices on a wider scale emphasize the need for a comprehensive network

  12. Severe Burn-Induced Intestinal Epithelial Barrier Dysfunction Is Associated With Endoplasmic Reticulum Stress and Autophagy in Mice

    Science.gov (United States)

    Huang, Yalan; Feng, Yanhai; Wang, Yu; Wang, Pei; Wang, Fengjun; Ren, Hui

    2018-01-01

    The disruption of intestinal barrier plays a vital role in the pathophysiological changes after severe burn injury, however, the underlying mechanisms are poorly understood. Severe burn causes the disruption of intestinal tight junction (TJ) barrier. Previous studies have shown that endoplasmic reticulum (ER) stress and autophagy are closely associated with the impairment of intestinal mucosa. Thus, we hypothesize that ER stress and autophagy are likely involved in burn injury-induced intestinal epithelial barrier dysfunction. Mice received a 30% total body surface area (TBSA) full-thickness burn, and were sacrificed at 0, 1, 2, 6, 12 and 24 h postburn. The results showed that intestinal permeability was increased significantly after burn injury, accompanied by the damage of mucosa and the alteration of TJ proteins. Severe burn induced ER stress, as indicated by increased intraluminal chaperone binding protein (BIP), CCAAT/enhancer-binding protein homologous protein (CHOP) and inositol-requiring enzyme 1(IRE1)/X-box binding protein 1 splicing (XBP1). Autophagy was activated after burn injury, as evidenced by the increase of autophagy related protein 5 (ATG5), Beclin 1 and LC3II/LC3I ratio and the decrease of p62. Besides, the number of autophagosomes was also increased after burn injury. The levels of p-PI3K(Ser191), p-PI3K(Ser262), p-AKT(Ser473), and p-mTOR were decreased postburn, suggesting that autophagy-related PI3K/AKT/mTOR pathway is involved in the intestinal epithelial barrier dysfunction following severe burn. In summary, severe burn injury induces the ER stress and autophagy in intestinal epithelia, leading to the disruption of intestinal barrier. PMID:29740349

  13. 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.

  14. 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.

  15. Clinical Trial of Imipenem/Cilastatin in Severely Burned and Infected Patients

    Science.gov (United States)

    1987-07-01

    34"OT FILE CO.Y CLINICAL TRIAL OF IMIPENEM /CILASTATIN IN SEVERELY BURNED AND INFECTED PATIENTS Gary R. Culbertson, M.D., Albert T. McManus, PH.D., D T...NOV 1 3 1987 San Antonio, Texas b H Imipenem /cilastatin was examined for safety and effi- ,-;Opportunistic organisms causing infections in cacy in a...All of the clinical failures were in the pulmonary in ec- imipenem /cilastatin, a novel thienamycin alti- tion group. No serious toxicity or side

  16. [Clinical study on the postburn change in the hypothalamus-pituitary-adrenal hormones in severely burned patients].

    Science.gov (United States)

    Li, Hong-mian; Liang, Zi-qian; Luo, Zuo-jie

    2003-06-01

    To investigate the postburn dynamic changes in the hypothalamus-pituitary-adrenal hormones in severely burned patients. Fifty burn patients were enrolled in the study. The plasma contents of total GC (cortisol), ACTH and aldosterone (ALDO) and urinary contents of 17-OHO and 17-KS were determined with radio-immunological assay (RIA) method after burn injury to compare with the normal values which were well established clinically. The postburn plasma and urinary contents of the above indices were increased evidently with two peak values in shock and infectious stages, whilst the majority of he indices were lower than the normal values after 6 postburn weeks (PBWs). The values of these hormones were the lowest in dying patients. On the other hand, the values approached normal levels in those patients whose burn wounds were healing. Increases of the plasma and urinary levels of hypothalamus-pituitary -adrenal hormones in severely burned patients were constantly seen. Burn shock and infection seemed to be the two major factors in inducing postburn stress reaction in burn victims. Abrupt decrease of the hormone levels in plasma and or urine indicated adrenal failure predicting a poor prognosis of the burn patients.

  17. Heterogeneity in fire severity within early season and late season prescribed burns in a mixed-conifer forest

    Science.gov (United States)

    Knapp, E.E.; Keeley, J.E.

    2006-01-01

    Structural heterogeneity in forests of the Sierra Nevada was historically produced through variation in fire regimes and local environmental factors. The amount of heterogeneity that prescription burning can achieve might now be more limited owing to high fuel loads and increased fuel continuity. Topography, woody fuel loading, and vegetative composition were quantified in plots within replicated early and late season burn units. Two indices of fire severity were evaluated in the same plots after the burns. Scorch height ranged from 2.8 to 25.4 m in early season plots and 3.1 to 38.5 m in late season plots, whereas percentage of ground surface burned ranged from 24 to 96% in early season plots and from 47 to 100% in late season plots. Scorch height was greatest in areas with steeper slopes, higher basal area of live trees, high percentage of basal area composed of pine, and more small woody fuel. Percentage of area burned was greatest in areas with less bare ground and rock cover (more fuel continuity), steeper slopes, and units burned in the fall (lower fuel moisture). Thus topographic and biotic factors still contribute to the abundant heterogeneity in fire severity with prescribed burning, even under the current high fuel loading conditions. Burning areas with high fuel loads in early season when fuels are moister may lead to patterns of heterogeneity in fire effects that more closely approximate the expected patchiness of historical fires.

  18. How robust are burn severity indices when applied in a new region? Evaluation of alternate field-based and remote-sensing methods

    Science.gov (United States)

    C. Alina Cansler; Donald. McKenzie

    2012-01-01

    Remotely sensed indices of burn severity are now commonly used by researchers and land managers to assess fire effects, but their relationship to field-based assessments of burn severity has been evaluated only in a few ecosystems. This analysis illustrates two cases in which methodological refinements to field-based and remotely sensed indices of burn severity...

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

    Science.gov (United States)

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

    2011-06-01

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

  20. Intensive insulin therapy improves insulin sensitivity and mitochondrial function in severely burned children.

    Science.gov (United States)

    Fram, Ricki Y; Cree, Melanie G; Wolfe, Robert R; Mlcak, Ronald P; Qian, Ting; Chinkes, David L; Herndon, David N

    2010-06-01

    oxidative capacity while decreasing resting energy expenditure in severely burned children.

  1. Resiliency characteristics and Rorschach variables in children and adolescents with severe burns.

    Science.gov (United States)

    Holaday, M; Terrell, D

    1994-01-01

    Three raters classified 40 children and adolescents (ages 8 to 19 years) with severe burns who were placed in two groups designated as Resilient (N = 28) and Nonresilient (N = 12). Nine hypothesized differences in Rorschach responding between groups were developed through a review of the literature and operationalized through descriptive statements from a rating scale now being developed. The Resilient group gave more Cooperative Movement responses than the Nonresilient group (p = 0.0270), and they were more likely to have D scores that were within the normal range (p = 0.0700). The Nonresilient group had lower Egocentricity Index scores than the Resilient group (p = 0.0368) and more often had a positive Coping Deficit Index (p = 0.1285). Texture, Diffuse Shading, and Passive: Active responses appeared similar between groups. Differences found concerning Experience Actual and Z frequency were not statistically significant. Possible interventions addressing the emotional needs of burned children and adolescents such as strengthening certain personality characteristics are noted.

  2. 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.

  3. The interactive effects of surface-burn severity and canopy cover on conifer and broadleaf tree seedling ecophysiology

    Science.gov (United States)

    Sheel Bansal; Till Jochum; David A. Wardle; Marie-Charlotte Nilsson

    2014-01-01

    Fire has an important role for regeneration of many boreal forest tree species, and this includes both wildfire and prescribed burning following clear-cutting. Depending on the severity, fire can have a variety of effects on above- and belowground properties that impact tree seedling establishment. Very little is known about the impacts of ground fire severity on post-...

  4. 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

  5. Severe childhood burns in the Czech Republic: risk factors and prevention

    Science.gov (United States)

    Čelko, Alexander Martin; Dáňová, Jana; Barss, Peter

    2009-01-01

    Abstract Objective To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. Methods This study included all children aged 0–16 years hospitalized during 1993–2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996–2006. Personal, equipment and environmental risk factors were identified from hospital records. Findings The incidence of burn admissions among 0–14 year-olds increased from 85 to 96 per 100 000 between 1996 and 2006, mainly due to a 13% increase among 1–4 year-olds. Between 1993–2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. Conclusion Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful. PMID:19551256

  6. 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...

  7. Fire behavior, weather, and burn severity of the 2007 Anaktuvuk River tundra fire, North Slope, Alaska

    Science.gov (United States)

    Benjamin M. Jones; Crystal A. Kolden; Randi Jandt; John T. Abatzoglu; Frank Urban; Christopher D. Arp

    2009-01-01

    In 2007, the Anaktuvuk River Fire (ARF) became the largest recorded tundra fire on the North Slope of Alaska. The ARF burned for nearly three months, consuming more than 100,000 ha. At its peak in early September, the ARF burned at a rate of 7000 ha d-1. The conditions potentially responsible for this large tundra fire include modeled record high...

  8. [Effects of early enteral nutrition in the treatment of patients with severe burns].

    Science.gov (United States)

    Wu, Y W; Liu, J; Jin, J; Liu, L J; Wu, Y F

    2018-01-20

    Objective: To investigate the effects of early enteral nutrition (EEN) in the treatment of patients with severe burns. Methods: Medical records of 52 patients with severe burns hospitalized in the three affiliations of authors from August to September in 2014 were retrospectively analyzed and divided into EEN group ( n =28) and non-early enteral nutrition (NEEN) group ( n =24) according to the initiation time of enteral nutrition. On the basis of routine treatment, enteral nutrition was given to patients in group EEN within post injury day (POD) 3, while enteral nutrition was given to patients in group NEEN after POD 3. The following items were compared between patients of the two groups, such as the ratio of enteral nutrition intake to total energy intake, the ratio of parenteral nutrition intake to total energy intake, the ratio of total energy intake to energy target on POD 1, 2, 3, 4, 5, 6, 7, 14, 21, and 28, the levels of prealbumin, serum creatinine, blood urea nitrogen, total bilirubin, direct bilirubin, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score on POD 1, 3, 7, 14, and 28, the first operation time, the number of operations, and the frequencies of abdominal distension, diarrhea, vomiting, aspiration, catheter blockage, and low blood sugar within POD 28. Data were processed with χ (2)test, t test, Wilcoxon rank sum test, and Bonferroni correction. Results: (1) The ratio of parenteral nutrition intake to total energy intake of patients in group EEN on POD 1 was obviously lower than that in group NEEN ( Z =2.078, P 0.05). On POD 28, the prealbumin level of patients in group EEN was obviously higher than that in group NEEN ( t =3.163, P 0.05). (3) The APACHE Ⅱ scores of patients in group EEN were (22.5±3.1) and (15.6±3.8) points respectively on POD 1 and 3, which were close to (23.6±3.0) and (17.6±4.2) points of patients in group NEEN ( t =1.352, 1.733, P >0.05). The APACHE Ⅱ scores of patients in group EEN on POD 7, 14

  9. Skin graft fixation in severe burns: use of topical negative pressure.

    Science.gov (United States)

    Kamolz, L P; Lumenta, D B; Parvizi, D; Wiedner, M; Justich, I; Keck, M; Pfurtscheller, K; Schintler, M

    2014-09-30

    Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is invariably linked to the take rate and survival of skin grafts. The application of topical negative pressure (TNP) therapy devices has demonstrated improved graft take in comparison to conventional dressing methods alone. The aim of this study was to analyze the impact of TNP therapy on skin graft fixation in large burns. In all patients, we applied TNP dressings covering a %TBSA of >25. The following parameters were recorded and documented using BurnCase 3D: age, gender, %TBSA, burn depth, hospital length-of-stay, Baux score, survival, as well as duration and incidence of TNP dressings. After a burn depth adapted wound debridement, coverage was simultaneously performed using split-thickness skin grafts, which were fixed with staples and covered with fatty gauzes and TNP foam. The TNP foam was again fixed with staples to prevent displacement and finally covered with the supplied transparent adhesive film. A continuous subatmospheric pressure between 75-120 mm Hg was applied (VAC®, KCI, Vienna, Austria). The first dressing change was performed on day 4. Thirty-six out of 37 patients, suffering from full thickness burns, were discharged with complete wound closure; only one patient succumbed to their injuries. The overall skin graft take rate was over 95%. In conclusion, we consider that split thickness skin graft fixation by TNP is an efficient method in major burns, notably in areas with irregular wound surfaces or subject to movement (e.g. joint proximity), and is worth considering for the treatment of aged patients.

  10. A small single-nozzle rainfall simulator to measure erosion response on different burn severities in southern British Columbia, Canada

    Science.gov (United States)

    Covert, Ashley; Jordan, Peter

    2010-05-01

    To study the effects of wildfire burn severity on runoff generation and soil erosion from high intensity rainfall, we constructed an effective yet simple rainfall simulator that was inexpensive, portable and easily operated by two people on steep, forested slopes in southern British Columbia, Canada. The entire apparatus, including simulator, pumps, hoses, collapsible water bladders and sample bottles, was designed to fit into a single full-sized pick-up truck. The three-legged simulator extended to approximately 3.3 metres above ground on steep slopes and used a single Spraying Systems 1/2HH-30WSQ nozzle which can easily be interchanged for other sized nozzles. Rainfall characteristics were measured using a digital camera which took images of the raindrops against a grid. Median drop size and velocity 5 cm above ground were measured and found to be 3/4 of the size of natural rain drops of that diameter class, and fell 7% faster than terminal velocity. The simulator was used for experiments on runoff and erosion on sites burned in 2007 by two wildfires in southern British Columbia. Simulations were repeated one and two years after the fires. Rainfall was simulated at an average rate of 67 mm hr-1 over a 1 m2 plot for 20 minutes. This rainfall rate is similar to the 100 year return period rainfall intensity for this duration at a nearby weather station. Simulations were conducted on five replicate 1 m2 plots in each experimental unit including high burn severity, moderate burn severity, unburned, and unburned with forest floor removed. During the simulation a sample was collected for 30 seconds every minute, with two additional samples until runoff ceased, resulting in 22 samples per simulation. Runoff, overland flow coefficient, infiltration and sediment yield were compared between treatments. Additional simulations were conducted immediately after a 2009 wildfire to test different mulch treatments. Typical results showed that runoff on plots with high burn

  11. 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.

  12. Importance of risk factors in the development of complications of infectious and inflammatory genesis in patients with severe burns

    Directory of Open Access Journals (Sweden)

    B. V. Guzenko

    2013-06-01

    Full Text Available Introduction. Infectious and inflammatory complications , such as pneumonia and burn sepsis, often develop in patients with extensive burns, thus causing high mortality. The aim of the work was to determine the risk factors for the development of infectious and inflammatory complications in patients with burns. Materials and methods. The study involved 140 burned patients divided into two groups: Group 1 – 78 patients who underwent necrectomy within 3-7 days after the burn, Group 2 (control – 62 patients with necrectomy performed in later period. Results of the research. In the 1st group pneumonia was diagnosed in 11 (14.10 ± 3.94% patients, sepsis – in 13 (16.67 ± 4.22%. In the control group pneumonia was diagnosed in 20 (32.26 ± 5.94% patients, sepsis – in 23 (37.10 ± 6.13% (p < 0.05. In the burned patients of the main group the development of infectious and inflammatory complications was observed mainly in patients over 45 years of age (43%, that is 2.9 times more often than in the patients of younger age (p < 0.05. In patients with the severity index of burn damage exceeding 90 units complications were diagnosed in 32.14 ± 6.24% of cases, which is 7 times more than in the other subgroup (p < 0.05. In the control group patients with the severity index of destruction exceeding 90 units had complications in 56.41 ± 7.94% of cases, which is 2.6 times more than in patients with less severity index (p = 0.004. If the total area of the skin burns was over 40%, the number of sepsis and pneumonia complications significantly increased in both groups, and was 1.7 times greater than in patients with a smaller area of the burn. If the area of deep skin burns was over 25%, the number of cases of pneumonia and sepsis in patients of the main group increased in 2.4 times, and in the control group it was in 1.6 times higher. Among patients with area of deep burns exceeding 40% the incidence of sepsis and pneumonia was 78% (p = 0.03 in the main

  13. 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.

  14. 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.

  15. Both topography and climate affected forest and woodland burn severity in two regions of the western US, 1984 to 2006

    Science.gov (United States)

    Gregory K. Dillon; Zachery A. Holden; Penelope Morgan; Michael A. Crimmins; Emily K. Heyerdahl; Charles H. Luce

    2011-01-01

    Fire is a keystone process in many ecosystems of western North America. Severe fires kill and consume large amounts of above- and belowground biomass and affect soils, resulting in long-lasting consequences for vegetation, aquatic ecosystem productivity and diversity, and other ecosystem properties. We analyzed the occurrence of, and trends in, satellite-derived burn...

  16. Did enhanced afforestation cause high severity peat burn in the Fort McMurray Horse River wildfire?

    Science.gov (United States)

    Wilkinson, S. L.; Moore, P. A.; Flannigan, M. D.; Wotton, B. M.; Waddington, J. M.

    2018-01-01

    Climate change mediated drying of boreal peatlands is expected to enhance peatland afforestation and wildfire vulnerability. The water table depth-afforestation feedback represents a positive feedback that can enhance peat drying and consolidation and thereby increase peat burn severity; exacerbating the challenges and costs of wildfire suppression efforts and potentially shifting the peatland to a persistent source of atmospheric carbon. To address this wildfire management challenge, we examined burn severity across a gradient of drying in a black spruce dominated peatland that was partially drained in 1975-1980 and burned in the 2016 Fort McMurray Horse River wildfire. We found that post-drainage black spruce annual ring width increased substantially with intense drainage. Average (±SD) basal diameter was 2.6 ± 1.2 cm, 3.2 ± 2.0 cm and 7.9 ± 4.7 cm in undrained (UD), moderately drained (MD) and heavily drained (HD) treatments, respectively. Depth of burn was significantly different between treatments (p threshold will aid in developing effective adaptive management techniques and protecting boreal peatland carbon stocks.

  17. 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.

  18. Severe Vaginal Burns in a 5-Year-Old Girl Due to an Alkaline Battery in the Vagina.

    Science.gov (United States)

    Semaan, Alexander; Klein, Tobias; Vahdad, Mohammad Reza; Boemers, Thomas M; Pohle, Rebecca

    2015-10-01

    The ingestion or insertion of alkaline batteries in the body can cause severe damage to hollow organs. We report here a case of severe vaginal burns in a young patient caused by an alkaline battery. A 5-year-old girl presented to our outpatient department with pelvic pain and vaginal discharge. Further workup suggested the presence of a vaginal foreign body. Under general anesthesia, an alkaline battery was removed from her vagina, which showed severe burns with partial-thickness necrosis. Complete healing was confirmed at 3 months after initial presentation. In this rare case of an alkaline battery present in the vagina of a prepubescent girl, we discuss the available treatment and management options in comparison to similar previously reported cases. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

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

  20. The relation between tree burn severity and forest structure in the Rocky Mountains

    Science.gov (United States)

    Theresa B. Jain; Russell T. Graham

    2007-01-01

    Many wildfire events have burned thousands of hectares across the western United States, such as the Bitterroot (Montana), Rodeo-Chediski (Arizona), Hayman (Colorado), and Biscuit (Oregon) fires. These events led to Congress enacting the Healthy Forest Restoration Act of 2003, which, with other policies, encourages federal and state agencies to decrease wildfire risks...

  1. Previous fires moderate burn severity of subsequent wildland fires in two large western US wilderness areas

    Science.gov (United States)

    Sean A. Parks; Carol Miller; Cara R. Nelson; Zachary A. Holden

    2014-01-01

    Wildland fire is an important natural process in many ecosystems. However, fire exclusion has reduced frequency of fire and area burned in many dry forest types, which may affect vegetation structure and composition, and potential fire behavior. In forests of the western U.S., these effects pose a challenge for fire and land managers who seek to restore the ecological...

  2. 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.

  3. FIVE-YEAR OUTCOMES AFTER LONG-TERM OXANDROLONE ADMINISTRATION IN SEVERELY BURNED CHILDREN: A RANDOMIZED CLINICAL TRIAL

    OpenAIRE

    Reeves, Patrick T; Herndon, David N; Tanksley, Jessica D; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Clayton, Robert P; Crites, Nancy N; Hays, Joshua P; Andersen, Clark; Lee, Jong O; Meyer, Walter; Suman, Oscar E; Finnerty, Celeste C

    2016-01-01

    Administration of oxandrolone, a non-aromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD...

  4. The largest forest fires in Portugal: the constraints of burned area size on the comprehension of fire severity.

    Science.gov (United States)

    Tedim, Fantina; Remelgado, Ruben; Martins, João; Carvalho, Salete

    2015-01-01

    Portugal is a European country with highest forest fires density and burned area. Since beginning of official forest fires database in 1980, an increase in number of fires and burned area as well as appearance of large and catastrophic fires have characterized fire activity in Portugal. In 1980s, the largest fires were just a little bit over 10,000 ha. However, in the beginning of 21st century several fires occurred with a burned area over 20,000 ha. Some of these events can be classified as mega-fires due to their ecological and socioeconomic severity. The present study aimed to discuss the characterization of large forest fires trend, in order to understand if the largest fires that occurred in Portugal were exceptional events or evidences of a new trend, and the constraints of fire size to characterize fire effects because, usually, it is assumed that larger the fire higher the damages. Using Portuguese forest fire database and satellite imagery, the present study showed that the largest fires could be seen at the same time as exceptional events and as evidence of a new fire regime. It highlighted the importance of size and patterns of unburned patches within fire perimeter as well as heterogeneity of fire ecological severity, usually not included in fire regime description, which are critical to fire management and research. The findings of this research can be used in forest risk reduction and suppression planning.

  5. Plasma NGAL predicts early acute kidney injury no earlier than s-creatinine or cystatin C in severely burned patients.

    Science.gov (United States)

    Rakkolainen, Ilmari; Vuola, Jyrki

    2016-03-01

    Neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker used in acute kidney injury (AKI) diagnostics. Studies on burn patients have highlighted it as a promising biomarker for early detection of AKI. This study was designed to discover whether plasma NGAL is as a biomarker superior to serum creatinine and cystatin C in detecting AKI in severely burned patients. Nineteen subjects were enrolled from March 2013 to September 2014 in the Helsinki Burn Centre. Serum creatinine, cystatin C, and plasma NGAL were collected from the patients at admission and every 12h during the first 48h and thereafter daily until seven days following admission. AKI was defined by acute kidney injury network criteria. Nine (47%) developed AKI during their intensive care unit stay and two (11%) underwent renal replacement therapy. All biomarkers were significantly higher in the AKI group but serum creatinine- and cystatin C values reacted more rapidly to changes in kidney function than did plasma NGAL. Plasma NGAL tended to rise on average 72h±29h (95% CI) later in patients with early AKI than did serum creatinine. Area-under-the-curve values calculated for each biomarker were 0.92 for serum creatinine, 0.87 for cystatin C, and 0.62 for plasma NGAL predicting AKI by the receiver-operating-characteristic method. This study demonstrated serum creatinine and cystatin C as faster and more reliable biomarkers than plasma NGAL in detecting early AKI within one week of injury in patients with severe burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Jaechul Yoon

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

  7. 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.

  8. Effects of different duration exercise programs in children with severe burns.

    Science.gov (United States)

    Clayton, Robert P; Wurzer, Paul; Andersen, Clark R; Mlcak, Ronald P; Herndon, David N; Suman, Oscar E

    2017-06-01

    Burns lead to persistent and detrimental muscle breakdown and weakness. Standard treatment at our institution includes a voluntary 12-week rehabilitative exercise program to limit and reverse the effects of increased muscle catabolism. In the present work, we investigated if different durations of exercise, 6 or 12 weeks, produce comparable improvements in muscle strength, body composition, and cardiopulmonary fitness. We prospectively enrolled and randomized patients with ≥30% total body surface area (TBSA) burned to receive 6 or 12 weeks of exercise rehabilitation. Patients were evaluated for muscle strength, oxygen consumption capacity, and lean body mass at discharge (n=42) and after exercise. After 6 weeks (n=18) or 12 weeks (n=24) of exercise training, leg muscle strength was assessed as peak torque per body weight using a Biodex isokinetic dynamometer. Oxygen consumption capacity, measured as peak VO 2 , was studied using a standard treadmill-based test, and lean body mass was determined using dual-energy X-ray absorptiometry. Significant improvements in muscle strength, peak VO 2 , and lean body mass were seen after 6 weeks of exercise training (pburn patients. However, continuation of at- or near-home cardiopulmonary training following the 6 weeks of at-hospital rehabilitation may be useful. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  9. Young Children's Acute Stress After a Burn Injury: Disentangling the Role of Injury Severity and Parental Acute Stress.

    Science.gov (United States)

    Haag, Ann-Christin; Landolt, Markus A

    2017-09-01

    Although injury severity and parental stress are strong predictors of posttraumatic adjustment in young children after burns, little is known about the interplay of these variables. This study aimed at clarifying mediation processes between injury severity and mother's, father's, and young child's acute stress. Structural equation modeling was used to examine the relationships between injury severity and parental and child acute stress. Parents of 138 burn-injured children (ages 1-4 years) completed standardized questionnaires on average 19 days postinjury. Sixteen children (11.7%) met Diagnostic and Statistical Manual of Mental Disorders, 5th edition, preschool criteria for posttraumatic stress disorder (excluding time criterion). The model revealed a significant mediation of maternal acute stress, with the effect of injury severity on a child's acute stress mediated by maternal acute stress. Paternal acute stress failed to serve as a mediating variable. Our findings confirm mothers' crucial role in the posttraumatic adjustment of young children. Clinically, mothers' acute stress should be monitored. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Sustained oxidative stress causes late acute renal failure via duplex regulation on p38 MAPK and Akt phosphorylation in severely burned rats.

    Directory of Open Access Journals (Sweden)

    Yafei Feng

    Full Text Available BACKGROUND: Clinical evidence indicates that late acute renal failure (ARF predicts high mortality in severely burned patients but the pathophysiology of late ARF remains undefined. This study was designed to test the hypothesis that sustained reactive oxygen species (ROS induced late ARF in a severely burned rat model and to investigate the signaling mechanisms involved. MATERIALS AND METHODS: Rats were exposed to 100°C bath for 15 s to induce severe burn injury (40% of total body surface area. Renal function, ROS generation, tubular necrosis and apoptosis, and phosphorylation of MAPK and Akt were measured during 72 hours after burn. RESULTS: Renal function as assessed by serum creatinine and blood urea nitrogen deteriorated significantly at 3 h after burn, alleviated at 6 h but worsened at 48 h and 72 h, indicating a late ARF was induced. Apoptotic cells and cleavage caspase-3 in the kidney went up slowly and turned into significant at 48 h and 72 h. Tubular cell ROS production shot up at 6 h and continuously rose during the 72-h experiment. Scavenging ROS with tempol markedly attenuated tubular apoptosis and renal dysfunction at 72 h after burn. Interestingly, renal p38 MAPK phosphorylation elevated in a time dependent manner whereas Akt phosphorylation increased during the first 24 h but decreased at 48 h after burn. The p38 MAPK specific inhibitor SB203580 alleviated whereas Akt inhibitor exacerbated burn-induced tubular apoptosis and renal dysfunction. Furthermore, tempol treatment exerted a duplex regulation through inhibiting p38 MAPK phosphorylation but further increasing Akt phosphorylation at 72 h postburn. CONCLUSIONS: These results demonstrate that sustained renal ROS overproduction induces continuous tubular cell apoptosis and thus a late ARF at 72 h after burn in severely burned rats, which may result from ROS-mediated activation of p38 MAPK but a late inhibition of Akt phosphorylation.

  11. Exploring the Relationship between Burn Severity Field Data and Very High Resolution GeoEye Images: The Case of the 2011 Evros Wildfire in Greece

    OpenAIRE

    Eleni Dragozi; Ioannis Z. Gitas; Sofia Bajocco; Dimitris G. Stavrakoudis

    2016-01-01

    Monitoring post-fire vegetation response using remotely-sensed images is a top priority for post-fire management. This study investigated the potential of very-high-resolution (VHR) GeoEye images on detecting the field-measured burn severity of a forest fire that occurred in Evros (Greece) during summer 2011. To do so, we analysed the role of topographic conditions and burn severity, as measured in the field immediately after the fire (2011) and one year after (2012) using the Composite Burn ...

  12. Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn.

    Science.gov (United States)

    Csontos, C; Rezman, B; Foldi, V; Bogar, L; Drenkovics, L; Röth, E; Weber, G; Lantos, J

    2012-05-01

    Oxidative stress and inflammation generate edema in burns. The aim of our study was to assess effect of N-acetylcysteine (NAC) on oxidative stress, inflammation, fluid requirement, multiple organ dysfunction (MOD) score and vasoactive drug requirement. In this study 15 patients were on standard therapy, whereas for other 15 patients NAC was supplemented. Blood samples were taken on admission and on the next five consecutive mornings. Levels of malondialdehyde, protein sulfhydril (PSH) groups, reduced gluthation (GSH), activity of myeloperoxidase, catalase and superoxide dismutase enzymes and induced free radical generating capacity were measured as well as concentrations of TNF-α, IL-6, IL-8, and IL-10. MOD score, use of vasopressor agents and fluid utilisation were recorded daily. NAC treatment increased GSH level on days 4-5 (ptreatment is associated with a diminished oxidative stress reflected in preserved antioxidant levels, lower inflammation mirrored in lower interleukin levels and less vasopressor requirement. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  13. FIVE-YEAR OUTCOMES AFTER LONG-TERM OXANDROLONE ADMINISTRATION IN SEVERELY BURNED CHILDREN: A RANDOMIZED CLINICAL TRIAL.

    Science.gov (United States)

    Reeves, Patrick T; Herndon, David N; Tanksley, Jessica D; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Clayton, Robert P; Crites, Nancy N; Hays, Joshua P; Andersen, Clark; Lee, Jong O; Meyer, Walter; Suman, Oscar E; Finnerty, Celeste C

    2016-04-01

    Administration of oxandrolone, a nonaromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD). Patients between 0 and 18 years of age with ≥30% of total body surface area burned were consented to an IRB-approved protocol and randomized to receive either placebo (n = 84) or 0.1 mg/kg oxandrolone orally twice daily for 24 months (n = 35). Patients were followed prospectively from the time of admission until 5 years postburn in a single-center, intent-to-treat setting. Height, weight, BMC, and BMD were recorded annually through 5 years postinjury. The long-term administration of oxandrolone for 16 ± 1 months postburn (range, 12.1-25.2 months) significantly increased whole-body (WB) BMC (p patients who were in growth spurt years (7-18 years). When adjusted for height, sex, and age, LS BMD was found to significantly increase with long-term oxandrolone administration (p patients receiving oxandrolone exhibited LS BMD z scores below -2.0 as compared with controls, indicating a significantly reduced risk for future fracture with oxandrolone administration. Long-term oxandrolone patients had significantly greater height velocity than controls throughout the first 2-year postburn (p patients receiving long-term oxandrolone to previously described patients receiving 12 months of oxandrolone revealed that long-term oxandrolone administration imparted significantly greater increases in WB-BMC, WB-BMD, and LS-BMD (p burned pediatric patients significantly improves WB BMC, LS BMC, LS BMD, and height velocity. The administration of long-term oxandrolone was more efficacious than

  14. 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.

  15. 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.

  16. Impact of anesthesia, analgesia, and euthanasia technique on the inflammatory cytokine profile in a rodent model of severe burn injury.

    Science.gov (United States)

    Al-Mousawi, Ahmed M; Kulp, Gabriela A; Branski, Ludwik K; Kraft, Robert; Mecott, Gabriel A; Williams, Felicia N; Herndon, David N; Jeschke, Marc G

    2010-09-01

    Anesthetics used in burn and trauma animal models may be influencing results by modulating inflammatory and acute-phase responses. Accordingly, we determined the effects of various anesthetics, analgesia, and euthanasia techniques in a rodent burn model. Isoflurane (ISO), ketamine-xylazine (KX), or pentobarbital (PEN) with or without buprenorphine were administered before scald-burn in 72 rats that were euthanized without anesthesia by decapitation after 24 h and compared with unburned shams. In a second experiment, 120 rats underwent the same scald-burn injury using KX, and 24 h later were euthanized under anesthesia or carbon dioxide (CO2). In addition, we compared euthanasia by exsanguination with that of decapitation. Serum cytokine levels were determined by an enzyme-linked immunosorbent assay. In the first experiment, ISO was associated with elevation of cytokine-induced neutrophil chemoattractant 2 (CINC-2) and monocyte chemotactic protein 1 (MCP-1), and KX and PEN was associated with elevation of CINC-1,CINC-2, IL-6, and MCP-1. Pentobarbital also decreased IL-1". IL-6 increased significantly when ISO or PEN were combined with buprenorphine. In the second experiment, euthanasia performed by exsanguination under ISO was associated with reduced levels of IL-1", CINC-1, CINC-2, and MCP-1, whereas KX reduced CINC-2 and increased IL-6 levels. Meanwhile, PEN reduced levels of IL-1" and MCP-1, and CO2 reduced CINC-2 and MCP-1. In addition,decapitation after KX, PEN, or CO2 decreased IL-1" and MCP-1, although we found no significant difference between ISO and controls. Euthanasia by exsanguination compared with decapitation using the same agent also led to modulation of several cytokines. Differential expression of inflammatory markers with the use of anesthetics and analgesics should be considered when designing animal studies and interpreting results because these seem to have a significant modulating impact. Our findings indicate that brief anesthesia with ISO

  17. The influence of burn severity on post-fire vegetation recovery and albedo change during early succession in North American boreal forests

    Science.gov (United States)

    Jin, Y.; Randerson, J. T.; Goetz, S. J.; Beck, P. S.; Loranty, M. M.; Goulden, M.

    2011-12-01

    Severity of burning can influence multiple aspects of forest composition, carbon cycling, and climate forcing. We quantified how burn severity affected vegetation recovery and albedo change during early succession in Canadian boreal regions by combining satellite observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Canadian Large Fire Data Base (LFDB). We used the difference Normalized Burn Ratio (dNBR) and changes in spring albedo derived from MODIS 500m albedo product as measures of burn severity. We found that the most severe burns had the greatest reduction in summer EVI in first year after fire, indicating greater loss of vegetation cover immediately following fire. By 5-7 years after fire, summer EVI for all severity classes had recovered to within 90-110% of pre-fire levels. Burn severity had a positive effect on the increase of post-fire spring albedo during the first 7 years after fire, and a shift from low to moderate or moderate to severe fires led to amplification of the post-fire albedo increase by approximately 30%. Fire-induced increases in both spring and summer albedo became progressively larger with stand age from years 1-7, with the trend in spring albedo likely driven by continued losses of needles and branches from trees killed by the fire (and concurrent losses of black carbon coatings on remaining debris), and the summer trend associated with increases in leaf area of short-stature herbs and shrubs. Our results suggest that increases in burn severity and carbon losses observed in some areas of boreal forests (e.g., Turetsky et al., 2011) may be at least partly offset by increases in negative forcing associated with changes in surface albedo.

  18. Pathological changes after bone marrow and skin allograft transplantation in rats inflicted with severe combined radiation-burn injury

    International Nuclear Information System (INIS)

    Zheng Huaien; Cheng Tianmin; Yan Yongtang

    1994-01-01

    Bone marrow and skin allografts from the same donor were transplanted to rats inflicted with 8 Gy γ-radiation combined with third degree burns of 15% body surface area within 6 hr post injury. Pathological changes of hematopoietic tissues and skin allografts were studied. All injured controls died within 7 days post injury without bone marrow regeneration; 50% of treated rats survived with living skin allografts on 50th day post injury. On days 100 and 480 post operation, grafted skin still survived well on recipients with normal ultrastructure. Epidermic cells of skin allografts proliferated on day 5, developed and repaired on day 10. Histological structure of the skin returned to normal on day 30 post operation. The regeneration of bone marrow appeared on 5th day, increased markedly on day 10, and almost completed on day 15 after bone marrow transplantation. However, the regeneration of lymphocytes in cortex of spleen and lymph nodes did not appear until day 15 of BMT. The results show that bone marrow and skin allograft transplantation at early time post injury in most severe combined radiation-burn injury have tremendous beneficial effects, and the skin allograft can survive for a long time

  19. The efficacy and safety of oxandrolone treatment for patients with severe burns: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Hui; Guo, Yinan; Yang, Zhenyu; Roy, Mridul; Guo, Qulian

    2016-06-01

    The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of using oxandrolone in patients with severe burns. PubMed, Medline, Ovid, Cochrane Library, Elsevier Science, ProQuest, and Springer Link databases were searched. Randomized trials were included, and clinically important measures were selected. The outcomes were pooled with Revman 5.2. Other outcomes that could not be pooled were described in detail. Finally, 15 randomized controlled trials (RCTs) were identified for analysis in this review, including 806 participants. 1. Mortality, infection, and hepatic function: Oxandrolone therapy did not affect mortality (relative risk (RR)=0.85, 95% confidence interval (CI)=(0.38, 1.89), P=0.69) or infection (RR=0.87, (0.69, 1.11), P=0.26). The two groups (oxandrolone group vs. control group) showed no significant difference in liver dysfunction (RR=1.15, (0.83, 1.59), P=0.41). All the 15 RCTs reported no incidence of hepatic insufficiency in controls or treatment groups. 2. In the catabolic phase: Treatment with oxandrolone shortened length of stay by 3.02 (2.37, 3.66) days, donor-site healing time by 4.41 (3.41, 5.41) days, the time between surgical procedures by 0.63 (0.11, 1.16) days, as well as reduced weight loss by 5 (3.70, 6.30) kg and nitrogen loss by 8.19 (6.87, 9.52) g/day, with all PTreatment with oxandrolone shortened the length of stay to 6.45 (4.20, 8.69) days, as well as decreased weight loss by 0.86 (0.76, 0.96) kg/week and reduction of lean body mass by 5% (3.34, 6.66), with all Ptreatment led to an additional gain in lean body mass of 3.99% (3.08, 4.89) after 6 months and 10.78% (9.92, 11.64) after 12 months in patients with severe burns, with all Ptreatment of severe burns with oxandrolone is significantly effective without obvious side effects. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  20. Use of multi-sensor active fire detections to map fires in the United States: the future of monitoring trends in burn severity

    Science.gov (United States)

    Picotte, Joshua J.; Coan, Michael; Howard, Stephen M.

    2014-01-01

    The effort to utilize satellite-based MODIS, AVHRR, and GOES fire detections from the Hazard Monitoring System (HMS) to identify undocumented fires in Florida and improve the Monitoring Trends in Burn Severity (MTBS) mapping process has yielded promising results. This method was augmented using regression tree models to identify burned/not-burned pixels (BnB) in every Landsat scene (1984–2012) in Worldwide Referencing System 2 Path/Rows 16/40, 17/39, and 1839. The burned area delineations were combined with the HMS detections to create burned area polygons attributed with their date of fire detection. Within our study area, we processed 88,000 HMS points (2003–2012) and 1,800 Landsat scenes to identify approximately 300,000 burned area polygons. Six percent of these burned area polygons were larger than the 500-acre MTBS minimum size threshold. From this study, we conclude that the process can significantly improve understanding of fire occurrence and improve the efficiency and timeliness of assessing its impacts upon the landscape.

  1. 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.

  2. Repair effect of transplantation of bone marrow mesenchymal stem cells on liver injury in severe burned rats and its mechanism

    International Nuclear Information System (INIS)

    Chen Hao; Zhou Yubo; Zhang Ying; Qin Yonggang; Guo Li; Yin Fei; Meng Chunyang; Yang Xiaoyu

    2014-01-01

    Objective: To investigate the repair effect of transplantation of bone marrow mesenchymal stem cells (BMSCs) on liver injury in severe burned rats, and to clarify its mechanism. Methods: The BMSCs of rats were isolated, cultured, amplified, identified, and labeled in vitro. 30 Wistar rats were randomly divided into normal control group (n=10), model group (n=10) and cell therapy group (n=10). The burned rat model was established. The BMSCs labeled by chlormethyl-benzamidodialkylcarbocyanine (CM-Dil) were transplanted into the rats in cell therapy group by retro-orbital intravenous injection and the saline was injected into the rats in model group. The general status of all rats were observed. The liver tissues of rats were obtained 2 weeks after transplantation, and the pathohistological changes were observed and the pathohistological scores were detected; the apoptotic rate of liver cells was detected by TUNEL method; the engraftment of BMSCs in liver tissues of the rats was observed under laser scanning confocal microscope. Results: 2 weeks after transplantation, the rats in model group were obviously malaise dispirited and the rats in cell therapy group showed obviously better, and the body weight of the rats in cell therapy group was higher than that in model group (P<0.05). The pathohistological results showed the normal liver lobules of the rats in model group disappeared, and the liver cords disordered, and some liver sinusoids dilated and congested, lymphocytes infiltrated with occasional focal aggregating, and cell edema was found, cytoplasm loose and steatosis were seen in liver tissue. However, the pathohistological changes of liver tissue of the rats in cell therapy group were significantly better than those in model group. The pathohistological score of the rats in cell therapy group was significantly lower than that in model group (P<0.05). The TUNEL staining results showed that there were lots of apoptotic liver cells in liver tissue of the rats in

  3. Exploring the Relationship between Burn Severity Field Data and Very High Resolution GeoEye Images: The Case of the 2011 Evros Wildfire in Greece

    Directory of Open Access Journals (Sweden)

    Eleni Dragozi

    2016-07-01

    Full Text Available Monitoring post-fire vegetation response using remotely-sensed images is a top priority for post-fire management. This study investigated the potential of very-high-resolution (VHR GeoEye images on detecting the field-measured burn severity of a forest fire that occurred in Evros (Greece during summer 2011. To do so, we analysed the role of topographic conditions and burn severity, as measured in the field immediately after the fire (2011 and one year after (2012 using the Composite Burn Index (CBI for explaining the post-fire vegetation response, which is measured using VHR satellite imagery. To determine this relationship, we applied redundancy analysis (RDA, which allowed us to identify which satellite variables among VHR spectral bands and Normalized Difference Vegetation Index (NDVI can better express the post-fire vegetation response. Results demonstrated that in the first year after the fire event, variations in the post-fire vegetation dynamics can be properly detected using the GeoEye VHR data. Furthermore, results showed that remotely-sensed NDVI-based variables are able to encapsulate burn severity variability over time. Our analysis showed that, in this specific case, burn severity variations are mildly affected by the topography, while the NDVI index, as inferred from VHR data, can be successfully used to monitor the short-term post-fire dynamics of the vegetation recovery.

  4. Effect of gamma-hydroxybutyrate on keratinocytes proliferation: A preliminary prospective controlled study in severe burn patients

    Science.gov (United States)

    Rousseau, Anne-Françoise; Bargues, Laurent; Bever, Hervé Le; Vest, Philippe; Cavalier, Etienne; Ledoux, Didier; Piérard, Gérald E.; Damas, Pierre

    2014-01-01

    Background: Hypermetabolism and hyposomatotropism related to severe burns lead to impaired wound healing. Growth hormone (GH) boosts wound healing notably following stimulation of the production of insulin-like growth factor-1 (IGF1), a mitogen factor for keratinocytes. Gamma-hydroxybutyrate (GHB) stimulates endogenous GH secretion. Aim: To assess effects of GHB sedation on keratinocytes proliferation (based on immunohistochemical techniques). Design: Monocentric, prospective, controlled trial. Materials and Methods: Patients (aging 18-65 years, burn surface area >30%, expected to be sedated for at least one month) were alternately allocated, at the 5th day following injury, in three groups according to the intravenous GHB dose administered for 21 days: Evening bolus of 50 mg/kg (Group B), continuous infusion at the rate of 10 mg/kg/h (Group C), or absence of GHB (Group P). They all received local standard cares. Immunohistochemistry (Ki67/MIB-1, Ulex europaeus agglutinin-1 and Mac 387 antibodies) was performed at D21 on adjacent unburned skin sample for assessing any keratinocyte activation. Serum IGF1 levels were measured at initiation and completion of the protocol. Statistical Analysis: Categorical variables were compared with Chi-square test. Comparisons of medians were made using Kruskal-Wallis test. Post hoc analyses were performed using Mann-Whitney test with Bonferroni correction for multiple comparisons. A P study (Group B: n = 5, Group C: n = 5, Group P: n = 4). Continuous administration of GHB was associated with a significant higher Ki67 immunolabeling at D21 (P = 0.049) and with a significant higher increase in the IGF1 concentrations at D21 (P = 0.024). No adverse effects were disclosed. Conclusions: Our preliminary data support a positive effect of GHB on keratinocyte proliferation and are encouraging enough to warrant large prospective studies. PMID:25024938

  5. Temporal characterisation of soil-plant natural recovery related to fire severity in burned Pinus halepensis Mill. forests.

    Science.gov (United States)

    Moya, D; González-De Vega, S; García-Orenes, F; Morugán-Coronado, A; Arcenegui, V; Mataix-Solera, J; Lucas-Borja, M E; De Las Heras, J

    2018-05-28

    Despite Mediterranean ecosystems' high resilience to fire, both climate and land use change, and alterations in fire regimes increase their vulnerability to fire by affecting the long-term natural recovery of ecosystem services. The objective of this work is to study the effects of fire severity on biochemical soil indicators, such as chemical composition or enzymatic activity, related to time after fire and natural vegetation recovery (soil-plant interphase). Soil samples from three wildfires occurring 3, 15 and 21 years ago were taken in the south-eastern Iberian Peninsula (semiarid climate). Sampling included three fire severity levels in naturally regenerated (and changing to shrublands) Pinus halepensis Mill. forests. In the short-term post-fire period, phosphorus concentration, electrical conductivity and urease activity were positively linked to fire severity, and also influenced β-glucosidade activity in a negative relationship. During the 15-21-year post-fire period, the effects related to medium-high fire severity were negligible and soil quality indicators were linked to natural regeneration success. The results showed that most soil properties recovered in the long term after fire (21 years). These outcomes will help managers and stakeholders to implement management tools to stabilise soils and to restore burned ecosystems affected by medium-high fire severity. Such knowledge can be considered in adaptive forest management to reduce the negative effects of wildfires and desertification, and to improve the resilience of vulnerable ecosystems in a global change scenario. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Simulating high spatial resolution high severity burned area in Sierra Nevada forests for California Spotted Owl habitat climate change risk assessment and management.

    Science.gov (United States)

    Keyser, A.; Westerling, A. L.; Jones, G.; Peery, M. Z.

    2017-12-01

    Sierra Nevada forests have experienced an increase in very large fires with significant areas of high burn severity, such as the Rim (2013) and King (2014) fires, that have impacted habitat of endangered species such as the California spotted owl. In order to support land manager forest management planning and risk assessment activities, we used historical wildfire histories from the Monitoring Trends in Burn Severity project and gridded hydroclimate and land surface characteristics data to develope statistical models to simulate the frequency, location and extent of high severity burned area in Sierra Nevada forest wildfires as functions of climate and land surface characteristics. We define high severity here as BA90 area: the area comprising patches with ninety percent or more basal area killed within a larger fire. We developed a system of statistical models to characterize the probability of large fire occurrence, the probability of significant BA90 area present given a large fire, and the total extent of BA90 area in a fire on a 1/16 degree lat/lon grid over the Sierra Nevada. Repeated draws from binomial and generalized pareto distributions using these probabilities generated a library of simulated histories of high severity fire for a range of near (50 yr) future climate and fuels management scenarios. Fuels management scenarios were provided by USFS Region 5. Simulated BA90 area was then downscaled to 30 m resolution using a statistical model we developed using Random Forest techniques to estimate the probability of adjacent 30m pixels burning with ninety percent basal kill as a function of fire size and vegetation and topographic features. The result is a library of simulated high resolution maps of BA90 burned areas for a range of climate and fuels management scenarios with which we estimated conditional probabilities of owl nesting sites being impacted by high severity wildfire.

  7. Strength and Cardiorespiratory Exercise Rehabilitation for Severely Burned Patients During Intensive Care Units: A Survey of Practice.

    Science.gov (United States)

    Cambiaso-Daniel, Janos; Parry, Ingrid; Rivas, Eric; Kemp-Offenberg, Jennifer; Sen, Soman; Rizzo, Julie A; Serghiou, Michael A; Kowalske, Karen; Wolf, Steven E; Herndon, David N; Suman, Oscar E

    2018-03-22

    Minimizing the deconditioning of burn injury through early rehabilitation programs (RP) in the intensive care unit (ICU) is of importance for improving the recovery time. The aim of this study was to assess current standard of care (SOC) for early ICU exercise programs in major burn centers. We designed a survey investigating exercise RP on the ICU for burn patients with >30% total burned surface area. The survey was composed of 23 questions and submitted electronically via SurveyMonkey® to six major (pediatric and adult) burn centers in Texas and California. All centers responded and reported exercise as part of their RP on the ICU. The characteristics of exercises implemented were not uniform. All centers reported to perform resistive and aerobic exercises but only 83% reported isotonic and isometric exercises. Determination of intensity of exercise varied with 50% of centers using patient tolerance and 17% using vital signs. Frequency of isotonic, isometric, aerobic, and resistive exercise was reported as daily by 80%, 80%, 83%, and 50% of centers, respectively. Duration for all types of exercises was extremely variable. Mobilization was used as a form of exercise by 100% of burn centers. Our results demonstrate that although early RP seem to be integral during burn survivor's ICU stay, no SOC exists. Moreover, early RP are inconsistently administered and large variations exist in frequency, intensity, duration, and type of exercise. Thus, future prospective studies investigating the various components of exercise interventions are needed to establish a SOC and determine how and if early exercise benefits the burn survivor.

  8. Application of the cultured epidermal autograft "JACE(®") for treatment of severe burns: Results of a 6-year multicenter surveillance in Japan.

    Science.gov (United States)

    Matsumura, Hajime; Matsushima, Asako; Ueyama, Masashi; Kumagai, Norio

    2016-06-01

    In the 1970s, Green et al. developed a method that involved culturing keratinocyte sheets and used for treatment of burns. Since then, the take rate of cultured epidermal autograft (CEA) onto fascia, granulation tissue, or allografts has been extensively reported, while that on an artificial dermis in a large case series is not. Moreover, the contribution of CEA to patient survival has not been analyzed in a multicenter study. We conducted a 6-year multicenter surveillance on the application of the CEA "JACE(®") for treatment of burns >30% total body surface area (TBSA) across 118 Japanese hospitals. This surveillance included 216 patients and 718 graft sites for efficacy analysis. The CEA take rate at 4 weeks after grafting was evaluated, and safety was monitored until 52 weeks. In addition, the survival curve obtained in this study and the data obtained from the Tokyo Burn Unit Association (TBUA) were compared. The mean CEA take rates at week 4 were 66% (sites) and 68% (patients), and the rate on the artificial dermis was 65% for 226 sites. CEA application combined with wide split-thickness auto or patch autograft increased the CEA take rate. On comparison with the data obtained from the TBUA, which included data on individuals with burns of the same severity, CEA application was found to contribute to patient survival until 7 weeks after burn. We reported the take rate of CEA based on a 6-year multicenter surveillance. From our results, we found that the application of CEA is a useful treatment for the patients with extensive burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  9. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    Science.gov (United States)

    Baker, William L

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984-2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984-2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046-2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire in

  10. The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study.

    Science.gov (United States)

    Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer

    2013-09-01

    Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  11. 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...

  12. Calibration and validation of the relative differenced Normalized Burn Ratio (RdNBR) to three measures of fire severity in the Sierra Nevada and Klamath Mountains, California, USA

    Science.gov (United States)

    Miller, J.D.; Knapp, E.E.; Key, C.H.; Skinner, C.N.; Isbell, C.J.; Creasy, R.M.; Sherlock, J.W.

    2009-01-01

    Multispectral satellite data have become a common tool used in the mapping of wildland fire effects. Fire severity, defined as the degree to which a site has been altered, is often the variable mapped. The Normalized Burn Ratio (NBR) used in an absolute difference change detection protocol (dNBR), has become the remote sensing method of choice for US Federal land management agencies to map fire severity due to wildland fire. However, absolute differenced vegetation indices are correlated to the pre-fire chlorophyll content of the vegetation occurring within the fire perimeter. Normalizing dNBR to produce a relativized dNBR (RdNBR) removes the biasing effect of the pre-fire condition. Employing RdNBR hypothetically allows creating categorical classifications using the same thresholds for fires occurring in similar vegetation types without acquiring additional calibration field data on each fire. In this paper we tested this hypothesis by developing thresholds on random training datasets, and then comparing accuracies for (1) fires that occurred within the same geographic region as the training dataset and in similar vegetation, and (2) fires from a different geographic region that is climatically and floristically similar to the training dataset region but supports more complex vegetation structure. We additionally compared map accuracies for three measures of fire severity: the composite burn index (CBI), percent change in tree canopy cover, and percent change in tree basal area. User's and producer's accuracies were highest for the most severe categories, ranging from 70.7% to 89.1%. Accuracies of the moderate fire severity category for measures describing effects only to trees (percent change in canopy cover and basal area) indicated that the classifications were generally not much better than random. Accuracies of the moderate category for the CBI classifications were somewhat better, averaging in the 50%-60% range. These results underscore the difficulty in

  13. Reducing the Indication for Ventilatory Support in the Severely Burned Patient: Results of a New Protocol Approach at a Regional Burn Center.

    Science.gov (United States)

    Gille, Jochen; Bauer, Nicole; Malcharek, Michael J; Dragu, Adrian; Sablotzki, Armin; Taha, Hischam; Czeslick, Elke

    2016-01-01

    Initial management of the severely injured routinely includes sedation and mechanical ventilatory support. However, nonjudiciously applied mechanical ventilatory support can itself lead to poorer patient outcomes. In an attempt to reduce this iatrogenic risk, a standardized, in-house, five-point protocol providing clinical guidance on the use and duration of ventilation was introduced and analyzed, and the impact on patient outcomes was assessed. In 2007, a protocol for early spontaneous breathing was introduced and established in clinical practice. This protocol included: 1) early extubation (≤6 hours after admission) in the absence of absolute ventilatory indication; 2) avoidance of "routine intubation" in spontaneously breathing patients; 3) early postoperative extubation, including patients requiring multiple surgical interventions; 4) intensive chest and respiratory physiotherapy with routine application of expectorants; and 5) early active mobilization. A retrospective clinical study compared patients (group A) over a 2-year period admitted under the new protocol with a historical patient group (group B). Patients in group A (n = 38) had fewer ventilator days over the time-course of treatment (3 [1; 5.8] vs 18.5 days [0.5; 20.5]; P = .0001) with a lower rate of tracheostomies (15.8 vs 54%; P = .0003). Patients on ventilation at admission in group A had shorter ventilation periods after admission (4.75 [4; 22.25] vs 378 hours [8.5; 681.5]; P = .0003), and 66.7% of these patients were extubated within 6 hours of admission (vs 9.1% in group B). No patients fulfilling the inclusion criteria required re- or emergency intubation. In the first 5 days of treatment, significantly lower Sequential Organ Failure Assessment scores were recorded in group A. There was also a trend for lower mortality rates (0 [0%] vs 6 [14%]), sepsis rates (24 [63.2%] vs 37 [88.1%]), and cumulative fluid balance on days 3 and 7 in group A. In contrast, group A demonstrated an elevated

  14. A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall.

    Science.gov (United States)

    Brown, Darnell J; Lu, Kuo Jung G; Chang, Kristina; Levin, Jennifer; Schulz, John T; Goverman, Jeremy

    2018-01-01

    Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL. The internal degloving caused significant devascularization of the overlying soft tissue and skin which required surgical drainage of hematoma, abdominal wall reconstruction with tangential excision, allografting, negative pressure wound therapy, and ultimately autografting. MLL is a rare, often overlooked, internal degloving injury. Surgeons must maintain a high index of suspicion when dealing with third degree friction burns as they may mask underlying injuries such as MLL, and a delay in diagnosis can lead to increased morbidity.

  15. Regional citrate anticoagulation for continuous renal replacement therapy in severe burns-a retrospective analysis of a protocol-guided approach.

    Science.gov (United States)

    Gille, Jochen; Sablotzki, Armin; Malcharek, Michael; Raff, Thomas; Mogk, Martin; Parentin, Torsten

    2014-12-01

    For critically ill patients, the use of regional citrate anticoagulation as part of continuous renal replacement therapy (CRRT) has become increasingly common in recent years. However, there are scarce data on the use of this technique in patients with burns. The aim of this study was to examine the effectiveness, feasibility and complications of regional citrate anticoagulation for CRRT in burn patients, as well as the effects on coagulation and the electrolyte and acid-base balance. This retrospective study included all patients who received renal replacement therapy with citrate anticoagulation to treat acute kidney injury (AKI) between January 1, 2004 and December 31, 2009 at the burn unit of St. Georg Hospital GmbH in Leipzig. During the examination period, 18 patients were treated using CRRT with regional citrate anticoagulation (CVVHDF in the pre-dilution mode). The median patient age was 64 years (49.5; 71), with a median TBSA of 42.5% (33.25; 52.5) and a median ABSI score of 10 (9; 10). The CRRT was initiated on a median of 6 days (4; 8.75) after admission to the hospital and continued for a median duration of 7 days (5; 8). The median dialysis dose was 38.2mlkgBW(-1)h(-1) (31.8; 42.1). The median effective filter operation time was 67h (46; 72). No relevant disorders associated with acid-base balance, electrolytes or coagulation occurred, and there were no bleeding complications. In terms of bleeding risk and electrolyte and acid-base balance, regional citrate anticoagulation may be considered to be an effective, safe and user-friendly procedure for patients with severe burns and AKI. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  16. The effects of sildenafil in liver and kidney injury in a rat model of severe scald burn: a biochemical and histopathological study.

    Science.gov (United States)

    Gökakın, Ali Kağan; Atabey, Mustafa; Deveci, Koksal; Sancakdar, Enver; Tuzcu, Mehmet; Duger, Cevdet; Topcu, Omer

    2014-09-01

    Severe burn induces systemic inflammation and reactive oxygen species leading to lipid peroxidation which may play role in remote organs injury. Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil reduces oxidative stress and inflammation in distant organs. The aim of the present study was to evaluate the effects of different dosages of sildenafil in remote organs injury. A total of thirty-two rats were randomly divided into four equal groups. The groups were designated as follows: Sham, Control, 10, and T20 mg/kg sildenafil treatment groups. Levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), VEGF receptor (Flt-1), activities of glutathione peroxidase (Gpx), levels of total antioxidative capacity (TAC), and total oxidant status (TOS) were measured in both tissues and serum, and a semi-quantitative scoring system was used for the evaluation of histopathological findings. Sildenafil increased levels of Gpx, and Flt-1, and decreased MDA and VEGF levels in tissues. Sildenafil also increased serum levels of TAC and Flt-1 and decreased TOS, OSI, and VEGF. Sildenafil decreased inflammation scores in remote organs in histopathological evaluation. It has protective effects in severe burn-related remote organ injuries by decreasing oxidative stress and inflammation.

  17. A protocol of early aggressive acceleration of tube feeding increases ileus without perceptible benefit in severely burned patients.

    Science.gov (United States)

    Kesey, Jennifer; Dissanaike, Sharmila

    2013-01-01

    Optimal nutrition is essential to the recovery of burned patients. The authors evaluated the efficacy of an aggressive nutrition delivery protocol. The following protocol was implemented: initiation of tube feeds within 4 hours, acceleration to goal rate within 8 hours, and tolerance of gastric residual volumes of 400 ml. Patients on the protocol formed the study group whereas patients admitted immediately before implementation served as controls for a study period of 7 days after admission. Outcome variables included ileus, prokinetic medication use, intensive care unit and overall length of stay, ventilator days and mortality. Variables were compared using bivariate analysis. The 42 study subjects and 34 controls were similar at baseline. Time to initiation was similar (6.8 vs 9.4 hours; P = .226), however, goal rate was achieved much sooner in the study group (11.2 vs 20.9 hours; P protocol was successfully implemented and resulted in early achievement of goal tube feed rates. However, this resulted in tube feed intolerance as manifested by more cases of clinical ileus.

  18. 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

  19. 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...... with infected burn wound compared with the burn wound only group. The burn mouse model resembles the clinical situation and provides an opportunity to examine or develop new strategies like new antibiotics and immune therapy, in handling burn wound victims much....

  20. [Effects of lung protective ventilation strategy combined with lung recruitment maneuver on patients with severe burn complicated with acute respiratory distress syndrome].

    Science.gov (United States)

    Li, Xiaojian; Zhong, Xiaomin; Deng, Zhongyuan; Zhang Xuhui; Zhang, Zhi; Zhang, Tao; Tang, Wenbin; Chen, Bib; Liu, Changling; Cao, Wenjuan

    2014-08-01

    To investigate the effects of lung protective ventilation strategy combined with lung recruitment maneuver on ARDS complicating patients with severe burn. Clinical data of 15 severely burned patients with ARDS admitted to our burn ICU from September 2011 to September 2013 and conforming to the study criteria were analyzed. Right after the diagnosis of acute lung injury/ARDS, patients received mechanical ventilation with lung protective ventilation strategy. When the oxygenation index (OI) was below or equal to 200 mmHg (1 mmHg = 0. 133 kPa), lung recruitment maneuver was performed combining incremental positive end-expiratory pressure. When OI was above 200 mmHg, lung recruitment maneuver was stopped and ventilation with lung protective ventilation strategy was continued. When OI was above 300 mmHg, mechanical ventilation was stopped. Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, variables of blood gas analysis (pH, PaO2, and PaCO2) were obtained by blood gas analyzer, and the OI values were calculated; hemodynamic parameters including heart rate, mean arterial pressure (MAP), central venous pressure (CVP) of all patients and the cardiac output (CO), extravascular lung water index (EVLWI) of 4 patients who received pulse contour cardiac output (PiCCO) monitoring were monitored. Treatment measures and outcome of patients were recorded. Data were processed with analysis of variance of repeated measurement of a single group and LSD test. (1) Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the levels of PaO2 and OI of patients were respectively (77 ± 8), (113 ± 5), (142 ± 6) mmHg, and (128 ± 12), (188 ± 8), (237 ± 10) mmHg. As a whole, levels of PaO2 and OI changed significantly at different time points (with F values respectively 860. 96 and 842. 09, P values below

  1. Determination of silver and cerium in the liver and the kidney from a severely burned infant treated with silver sulfadiazine and cerium nitrate

    International Nuclear Information System (INIS)

    Hirakawa, Keiko

    1983-01-01

    Silver and cerium in the liver and the kidney from severely burned infant were analyzed by neutron activation method. The patient was treated topically with cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for 3 months. Then, the treatment with these drugs was stopped because o f abdominal distention. The patient died 1 month after the cessation of the treatment with these drugs. The tissue specimens, blank liver sample and reference standards were irradiated with TRIGA MARK II Reactor of Rikkyo University. About 1 month after the irradiation, the activities were measured with a Ge(Li) detector coupled to a 4096 channel pulse height analyzer. A large amount of silver was detected both in the liver and in the kidney and a trace of cerium only in the liver. A considerable amount of silver was detected in the liver and its quantity was about 1600 times more than that of normal livers reported by Hamilton, Minski and Cleary (1972 -- 73). Neither silver nor cerium were detected in the blank liver. These results suggest that prolonged topical chemotherapy of cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for the extensive burn injuries causes considerable absorption of silver and cerium into the liver and the kidney. (author)

  2. CONTAIN code calculations of the effects on the source term of CsI to I/sub 2/ conversion due to severe hydrogen burns

    International Nuclear Information System (INIS)

    Valdez, G.D.; Williams, D.C.

    1986-01-01

    In experiments conducted at Sandia National Laboratories large amounts of elemental iodine were produced when CsI-Al 2 O 3 aerosol was exposed to hydrogen/air combustion. To evaluate some of the implications of the iodide conversion (observed to occur with up to 75% efficiency) for the severe accident source term, computational simulations of representative accident sequences were conducted with the CONTAIN code. The following conclusions can be drawn from this preliminary source term assessment: (1) If the containment sprays are inoperative during the accident, or failed by the hydrogen burn, the late-time source term is almost tripled when the iodide is converted to I 2 . (2) With the sprays active, the amount released without conversion of the CsI aerosol is 63% higher than for the case when conversion occurs. (3) For the case where CsI is converted to I 2 continued operation of the sprays reduces the release by a factor of 40, relative to the case in which the sprays fail at the time of the hydrogen burn. When there is no conversion, the reduction factor for continued spray operation is about a factor of 9, relative to the failed spray case

  3. The effect of supplemental enteral glutamine on plasma levels, gut function, and outcome in severe burns: a randomized, double-blind, controlled clinical trial.

    Science.gov (United States)

    Zhou, Ye-Ping; Jiang, Zhu-Ming; Sun, Yong-Hua; Wang, Xiu-Rong; Ma, En-Ling; Wilmore, Douglas

    2003-01-01

    This research was conducted to evaluate the effect of enterally administered glutamine (gln) dipeptide on metabolic, gastrointestinal, and outcome parameters after severe burn injury. Forty thermally injured patients with total body surface burns ranging between 50% and 80%, and third-degree burns ranging between 20% and 40% and without respiratory injuries, were randomized into a prospective, double-blind, controlled clinical trial. One group received gln-enriched enteral nutrition and the other group received the standard enteral formulation. Tube feedings were initiated on postburn day 1 (PBD +1), and isocaloric and isonitrogenous feedings were administered to both groups until PBD +12. The gln was given as the dipeptide of alanyl-gln (Ajinomoto, Tokyo, Japan), which provided 0.35 g gln/kg body weight/d. Plasma amino acid profiles, serum endotoxin concentrations, and the lactulose/mannitol absorption ratio (which reflects gut permeability) were measured at specific times throughout the clinical course. Wound healing at day 30 was assessed, and length of hospital stay and total costs were determined at discharge. The 2 groups were similar in terms of age and extent of injury. Plasma gln concentrations were approximately 300 umol/L in both groups on PBD +1 and remained low in the control group (399 +/- 40 umol/L, mean +/- SD) but increased toward normal in the supplemented group to 591 +/- 74 (p = .048). Lactulose/mannitol ratios were increased above normal on POD +1 (control, 0.221 +/- 0.169; gln, 0.268 +/- 0.202; not significant), reflecting increased intestinal permeability after burn injury. On POD +3, the ratio in the gln group was lower than control (0.025 +/- 0.008 versus 0.049 +/- 0.016; p = .0001), and both groups returned toward normal ratios with time. Endotoxin levels on PBD +1 were elevated in both groups (control, 0.089 +/- 0.023 EU/mL; gln, 0.103 +/- 0.037 EU/mL; NS) but decreased significantly on PBD +3 in the patients receiving gln. Hospital stay

  4. 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.

  5. Burn Wise

    Science.gov (United States)

    Burn Wise is a partnership program of the U.S. Environmental Protection Agency that emphasizes the importance of burning the right wood, the right way, in the right appliance to protect your home, health, and the air we breathe.

  6. 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

  7. 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

  8. 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

  9. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study

    OpenAIRE

    Sánchez, Manuel; García-de-Lorenzo, Abelardo; Herrero, Eva; Lopez, Teresa; Galvan, Beatriz; Asensio, María José; Cachafeiro, Lucia; Casado, Cesar

    2013-01-01

    Introduction: The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload ...

  10. 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.

  11. High-severity fire: evaluating its key drivers and mapping its probability across western US forests

    Science.gov (United States)

    Parks, Sean A.; Holsinger, Lisa M.; Panunto, Matthew H.; Jolly, W. Matt; Dobrowski, Solomon Z.; Dillon, Gregory K.

    2018-04-01

    Wildland fire is a critical process in forests of the western United States (US). Variation in fire behavior, which is heavily influenced by fuel loading, terrain, weather, and vegetation type, leads to heterogeneity in fire severity across landscapes. The relative influence of these factors in driving fire severity, however, is poorly understood. Here, we explore the drivers of high-severity fire for forested ecoregions in the western US over the period 2002–2015. Fire severity was quantified using a satellite-inferred index of severity, the relativized burn ratio. For each ecoregion, we used boosted regression trees to model high-severity fire as a function of live fuel, topography, climate, and fire weather. We found that live fuel, on average, was the most important factor driving high-severity fire among ecoregions (average relative influence = 53.1%) and was the most important factor in 14 of 19 ecoregions. Fire weather was the second most important factor among ecoregions (average relative influence = 22.9%) and was the most important factor in five ecoregions. Climate (13.7%) and topography (10.3%) were less influential. We also predicted the probability of high-severity fire, were a fire to occur, using recent (2016) satellite imagery to characterize live fuel for a subset of ecoregions in which the model skill was deemed acceptable (n = 13). These ‘wall-to-wall’ gridded ecoregional maps provide relevant and up-to-date information for scientists and managers who are tasked with managing fuel and wildland fire. Lastly, we provide an example of the predicted likelihood of high-severity fire under moderate and extreme fire weather before and after fuel reduction treatments, thereby demonstrating how our framework and model predictions can potentially serve as a performance metric for land management agencies tasked with reducing hazardous fuel across large landscapes.

  12. Burning Feet

    Science.gov (United States)

    ... be accompanied by a pins and needles sensation (paresthesia) or numbness, or both. Burning feet may also be referred to as tingling feet or paresthesia. While fatigue or a skin infection can cause ...

  13. Burning issues

    International Nuclear Information System (INIS)

    Raloff, J.

    1993-01-01

    The idea of burning oil slicks at sea has intrigued oil-cleanup managers for more than a decade, but it wasn't until the advent of fireproof booms in the mid-1980's and a major spill opportunity (the March 1989 Exxon Valdez) that in-situ burning got a real sea trial. The results of this and other burning experiments indicate that, when conditions allow it, nothing can compete with fire's ability to remove oil from water. Burns have the potential to remove as much oil in one day as mechanical devices can in one month, along with minimal equipment, labor and cost. Reluctance to burn in appropriate situations comes primarily from the formation of oily, black smoke. Analysis of the potentially toxic gases have been done, indicating that burning will not increase the levels of polluting aldehydes, ketones, dioxins, furans, and PAHs above those that normally evaporate from spilled oil. This article contains descriptions of planned oil fires and the discussion on the advantages and concerns of such a policy

  14. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study.

    Science.gov (United States)

    Sánchez, Manuel; García-de-Lorenzo, Abelardo; Herrero, Eva; Lopez, Teresa; Galvan, Beatriz; Asensio, María; Cachafeiro, Lucia; Casado, Cesar

    2013-08-15

    The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload to allow for sufficient vital organ perfusion. We conducted a three-year prospective cohort study of 132 consecutive critically burned patients. These patients underwent resuscitation guided by MAP (>65 mmHg), urinary output (0.5 to 1 ml/kg), TPTD and lactate levels. Fluid therapy was adjusted to achieve a cardiac index (CI) >2.5 L/minute/m² and an intrathoracic blood volume index (ITBVI) >600 ml/m2, and to optimize lactate levels. Statistical analysis was performed using mixed models. We also used Pearson or Spearman methods and the Mann-Whitney U-test. A total of 98 men and 34 women (mean age, 48 ± 18 years) was studied. The mean total body surface area (TBSA) burned was 35% ± 22%. During the early resuscitation phase, lactate levels were elevated (2.58 ± 2.05 mmol/L) and TPTD showed initial hypovolemia by the CI (2.68 ± 1.06 L/minute/m²) and the ITBVI (709 ± 254 mL/m²). At 24 to 32 hours, the CI and lactic levels were normalized, although the ITBVI remained below the normal range (744 ± 276 ml/m²). The mean fluid rate required to achieve protocol targets in the first 8 hours was 4.05 ml/kg/TBSA burned, which slightly increased in the next 16 hours. Patients with a urine output greater than or less than 0.5 ml/kg/hour did not show differences in heart rate, mean arterial pressure, CI, ITBVI or lactate levels. Initial hypovolemia may be detected by TPTD monitoring during the early resuscitation phase. This hypovolemia might not be reflected by blood pressure and hourly urine output. An

  15. Análise do lavado broncoalveolar em vítimas de queimaduras faciais graves Bronchoalveolar lavage analysis in victims of severe facial burns

    Directory of Open Access Journals (Sweden)

    Eucir Rabello

    2009-04-01

    Full Text Available OBJETIVO: Analisar o lavado broncoalveolar (LBA de vítimas de queimaduras que inalaram fumaça a fim de identificar alterações que possam estar associadas à morte ou à sobrevida. MÉTODOS: Dezoito vítimas de queimaduras faciais foram submetidas a LBA até 24 h após o evento, sendo realizadas a análise do conteúdo celular e proteico, incluindo TNF-α, HLA-DR, CD14, CD68 e iNOS. RESULTADOS: Dos 18 pacientes submetidos à broncoscopia, 8 (44,4% morreram durante o seguimento. A média de idade dos pacientes que morreram foi significativamente maior (44,7 vs. 31,5 anos. A superfície corporal queimada foi em média de 60,1% nos pacientes que morreram e de 26,1% nos sobreviventes (p OBJECTIVE: To analyze bronchoalveolar lavage (BAL specimens of burn victims who inhaled smoke, in order to identify alterations associated with mortality or survival. METHODS: Eighteen victims of facial burns were submitted to BAL up to 24 h after the event. We investigated cell and protein content, including TNF-α, HLA-DR, CD14, CD68 and iNOS. RESULTS: Of the 18 patients submitted to bronchoscopy, 8 (44.4% died during the follow-up period. The mean age of patients who died was significantly higher (44.7 vs. 31.5 years. On average, the patients who died had burns covering 60.1% of the total body surface area, compared with 26.1% in the survivors (p < 0.0001. Of the 18 patients submitted to bronchoscopy, 11 (61.1% showed endoscopic signs of smoke inhalation injury, and 4 (36.4% of those 11 died. Of the 7 patients with no signs of smoke inhalation injury, 4 (57.1% died. The mean number of ciliated epithelial cells in the BAL fluid was significantly higher in the patients who died than in the survivors (6.6% vs. 1.4%; p = 0.03. There were no significant differences between the groups in terms of any of the other parameters evaluated. CONCLUSIONS: The total body surface area burned was a predictive factor for mortality. Increased numbers of ciliated epithelial cells

  16. Community integration after burn injuries.

    Science.gov (United States)

    Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

    2001-01-01

    Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

  17. 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.

  18. Wood burning

    Energy Technology Data Exchange (ETDEWEB)

    Winkelmann, H

    1955-01-01

    Discussed are the use of wood as a fuel, the technique of wood combustion and the operation of wood-burning stoves for cooking and heating. In addition, there is a section which reviews the use of wood stoves in various countries and lists manufacturers of stoves, central heating furnaces and in some cases sawdust burners.

  19. Educational Materials - Burn Wise

    Science.gov (United States)

    Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

  20. Prescribed burning: a topical issue

    Directory of Open Access Journals (Sweden)

    Bovio G

    2013-11-01

    Full Text Available Prescribed burning is a promising technique for the prevention of forest fires in Italy. The research deepened several ecological and operative aspects. However, legal issues need to be thoroughly investigated.

  1. “This is not a burning issue for me”: How citizens justify their use of wood heaters in a city with a severe air pollution problem

    International Nuclear Information System (INIS)

    Reeve, Ian; Scott, John; Hine, Donald W.; Bhullar, Navjot

    2013-01-01

    Although wood smoke pollution has been linked to health problems, wood burning remains a popular form of domestic heating in many countries across the world. In this paper, we describe the rhetoric of resistance to wood heater regulation amongst citizens in the regional Australian town of Armidale, where wood smoke levels regularly exceed national health advisory limits. We discuss how this is related to particular sources of resistance, such as affective attachment to wood heating and socio-cultural norms. The research draws on six focus groups with participants from households with and without wood heating. With reference to practice theory, we argue that citizen discourses favouring wood burning draw upon a rich suite of justifications and present this activity as a natural and traditional activity promoting comfort and cohesion. Such discourses also emphasise the identity of the town as a rural community and the supposed gemeinschaft qualities of such places. We show that, in this domain of energy policy, it is not enough to present ‘facts’ which have little emotional association or meaning for the populace. Rather, we need understand how social scripts, often localised, inform identity and practice. - Highlights: ► The negative health effects of wood smoke from wood heaters are known by citizens. ► Continued use of wood heating is justified with a rich suite of rhetorical strategies. ► Some strategies try to negate or diminish the case for phasing out wood heaters. ► Other strategies present wood heating as a natural, traditional and social activity

  2. Global Burned Area and Biomass Burning Emissions from Small Fires

    Science.gov (United States)

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

    2012-01-01

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

  3. Animal Models in Burn Research

    Science.gov (United States)

    Abdullahi, A.; Amini-Nik, S.; Jeschke, M.G

    2014-01-01

    Burn injury is a severe form of trauma affecting more than two million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury; to elucidate the pathophysiology and explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review paper aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research. PMID:24714880

  4. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

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

  5. 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

  6. [Inventory building of phages against extensively drug-resistant Acinetobacter baumannii isolated from wounds of patients with severe burn and related characteristic analysis].

    Science.gov (United States)

    Yang, Z C; Deng, L Y; Gong, Y L; Yin, S P; Jiang, B; Huang, G T; Peng, Y Z; Hu, F Q

    2016-09-20

    To build inventory of phages against extensively drug-resistant Acinetobacter Baumannii isolated from wounds of inpatients of burn ICU and analyze related characteristics. In 2014 and 2015, 131 strains of extensively drug-resistant Acinetobacter Baumannii were isolated from wounds of inpatients of burn ICU from one hospital in Chongqing. In 2015, 98 strains of extensively drug-resistant Acinetobacter Baumannii were isolated from wounds of inpatients of burn ICU from 6 hospitals in Guangdong province. Above-mentioned 229 strains were collected for conducting experiments as follows: (1) Multilocus sequence typing (MLST) of strains isolated from Chongqing and Guangdong province was analyzed. (2) Sewage co-culture method was applied for isolation of phages with above-mentioned strains and sewage from Chongqing and Guangdong province. Numbers of isolated phages and times of successful isolation and unsuccessful isolation were recorded. (3) The most prevalent subtypes of strains from Chongqing and Guangdong province in 2015 were collected, and their phages respectively underwent cross infection with all strains from Chongqing and those from Guangdong province. The lysis ability of phage was observed when phage underwent cross infection with the same subtype of strain or not the same, and the lytic ratio was calculated. (4) Fluid of phage in one type was randomly selected and equally divided into 3 parts, and its titer was determined by double dilution method. Then each part of phage fluid was subdivided into 3 small parts, which were cultured with LB fluid medium and respectively stored under the condition of -20 ℃, 4 ℃, and room temperature. After being stored for 1 month and 2 months, the titer of phage was determined for evaluating stability of phage. Data were processed with Fisher's exact test, chi-square test, and one-way analysis of variance. (1) The major type of strains from Chongqing in 2014 was ST368 (45%, 31/69), and major types of strains from Chongqing

  7. 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.

  8. Burning plasmas

    International Nuclear Information System (INIS)

    Furth, H.P.; Goldston, R.J.; Zweben, S.J.

    1990-10-01

    The fraction of fusion-reaction energy that is released in energetic charged ions, such as the alpha particles of the D-T reaction, can be thermalized within the reacting plasma and used to maintain its temperature. This mechanism facilitates the achievement of very high energy-multiplication factors Q, but also raises a number of new issues of confinement physics. To ensure satisfactory reaction operation, three areas of energetic-ion interaction need to be addressed: single-ion transport in imperfectly symmetric magnetic fields or turbulent background plasmas; energetic-ion-driven (or stabilized) collective phenomena; and fusion-heat-driven collective phenomena. The first of these topics is already being explored in a number of tokamak experiments, and the second will begin to be addressed in the D-T-burning phase of TFTR and JET. Exploration of the third topic calls for high-Q operation, which is a goal of proposed next-generation plasma-burning projects. Planning for future experiments must take into consideration the full range of plasma-physics and engineering R ampersand D areas that need to be addressed on the way to a fusion power demonstration

  9. Burning Mouth Syndrome

    Science.gov (United States)

    ... Care Home Health Info Health Topics Burning Mouth Burning Mouth Syndrome (BMS) is a painful, complex condition often described ... or other symptoms. Read More Publications Cover image Burning Mouth Syndrome Publication files Download Language English PDF — Number of ...

  10. Burning issues

    Energy Technology Data Exchange (ETDEWEB)

    Ashmore, C.

    1998-10-01

    Coal is world`s most abundant source of energy. Turning this potential pollutant into a clean, cost-effective fuel for power production has become a matter for global concern. Some problems and their solutions are highlighted in this article. Environmental problems caused by the giant Mae Moh plant in Thailand were overcome with an extensive retrofit programme that included flue gas desulfurisation systems. For new and smaller coal-fuelled plant, boilers using circulating fluidised bed (CFB) technology provide a cost effective and efficient system which meets environmental standards. A large independent power plant at Colver, Pennsylvania, USA uses CFB technology to burn bituminous gob. AMM and Alstom can provide turnkey packages for coal-fired power plant using a modular concept based on CFB technology. 2 photos.

  11. Parameters Affecting the Erosive Burning of Solid Rocket Motor

    OpenAIRE

    Abdelaziz Almostafa; Guozhu Liang; Elsayed Anwer

    2018-01-01

    Increasing the velocity of gases inside solid rocket motors with low port-to-throat area ratios, leading to increased occurrence and severity of burning rate augmentation due to flow of propellant products across burning propellant surfaces (erosive burning), erosive burning of high energy composite propellant was investigated to supply rocket motor design criteria and to supplement knowledge of combustion phenomena, pressure, burning rate and high velocity of gases all of these are parameter...

  12. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    Science.gov (United States)

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.

  13. 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.

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

    Science.gov (United States)

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

    2015-02-01

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

  15. Burning mouth syndrome: etiology.

    Science.gov (United States)

    Cerchiari, Dafne Patrícia; de Moricz, Renata Dutra; Sanjar, Fernanda Alves; Rapoport, Priscila Bogar; Moretti, Giovana; Guerra, Marja Michelin

    2006-01-01

    The Burning Mouth Syndrome (BMS) is an oral mucosa pain--with or without inflammatory signs--without any specific lesion. It is mostly observed in women aged 40-60 years. This pain feels like a moderate/severe burning, and it occurs more frequently on the tongue, but it may also be felt at the gingiva, lips and jugal mucosa. It may worsen during the day, during stress and fatigue, when the patient speaks too much, or through eating of spicy/hot foods. The burning can be diminished with cold food, work and leisure. The goal of this review article is to consider possible BMS etiologies and join them in 4 groups to be better studied: local, systemic, emotional and idiopathic causes of pain. Knowing the different diagnoses of this syndrome, we can establish a protocol to manage these patients. Within the local pain group, we must investigate dental, allergic and infectious causes. Concerning systemic causes we need to look for connective tissue diseases, endocrine disorders, neurological diseases, nutritional deficits and salivary glands alterations that result in xerostomia. BMS etiology may be of difficult diagnosis, many times showing more than one cause for oral pain. A detailed interview, general physical examination, oral cavity and oropharynx inspection, and lab exams are essential to avoid a try and error treatment for these patients.

  16. Comparison of tokamak burn cycle options

    International Nuclear Information System (INIS)

    Ehst, D.A.; Brooks, J.N.; Cha, Y.; Evans, K. Jr.; Hassanein, A.M.; Kim, S.; Majumdar, S.; Misra, B.; Stevens, H.C.

    1985-01-01

    Experimental confirmation of noninductive current drive has spawned a number of suggestions as to how this technique can be used to extend the fusion burn period and improve the reactor prospects of tokamaks. Several distinct burn cycles, which employ various combinations of Ohmic and noninductive current generation, are possible, and we will study their relative costs and benefits for both a commerical reactor as well as an INTOR-class device. We begin with a review of the burn cycle options

  17. Burning Mouth Syndrome

    OpenAIRE

    Renton, Tara

    2011-01-01

    Bruning mouth syndrome is a burning sensation of one or several oral soft tissues with the tongue being affected the most, and may be associated with some other symptoms outside the oral structures. The oral symptoms may appear suddenly or gradually within a time course, may be persistent throughout the day or get more intense as the day progresses in a complaint-free patient in the morning. The syndrome affects mostly women and those over 50 years old, and usually caused by multiple factors....

  18. Acute pain management in burn patients

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  19. Training and burn care in rural India

    Directory of Open Access Journals (Sweden)

    Chamania Shobha

    2010-10-01

    Full Text Available Burn care is a huge challenge in India, having the highest female mortality globally due to flame burns. Burns can happen anywhere, but are more common in the rural region, affecting the poor. Most common cause is flame burns, the culprit being kerosene and flammable flowing garments worn by the women. The infrastructure of healthcare network is good but there is a severe resource crunch. In order to bring a positive change, there will have to be more trained personnel willing to work in the rural areas. Strategies for prevention and training of burn team are discussed along with suggestions on making the career package attractive and satisfying. This will positively translate into improved outcomes in the burns managed in the rural region and quick transfer to appropriate facility for those requiring specialised attention.

  20. Global burned area and biomass burning emissions from small fires

    NARCIS (Netherlands)

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

    2012-01-01

    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often

  1. 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

  2. Burn Control Mechanisms in Tokamaks

    Science.gov (United States)

    Hill, M. A.; Stacey, W. M.

    2015-11-01

    Burn control and passive safety in accident scenarios will be an important design consideration in future tokamak reactors, in particular fusion-fission hybrid reactors, e.g. the Subcritical Advanced Burner Reactor. We are developing a burning plasma dynamics code to explore various aspects of burn control, with the intent to identify feedback mechanisms that would prevent power excursions. This code solves the coupled set of global density and temperature equations, using scaling relations from experimental fits. Predictions of densities and temperatures have been benchmarked against DIII-D data. We are examining several potential feedback mechanisms to limit power excursions: i) ion-orbit loss, ii) thermal instability density limits, iii) MHD instability limits, iv) the degradation of alpha-particle confinement, v) modifications to the radial current profile, vi) ``divertor choking'' and vii) Type 1 ELMs. Work supported by the US DOE under DE-FG02-00ER54538, DE-FC02-04ER54698.

  3. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  4. Suicide by burning: epidemiological and clinical profiles.

    Science.gov (United States)

    Theodorou, Panagiotis; Phan, Vu T Q; Weinand, Christian; Maegele, Marc; Maurer, Christoph A; Perbix, Walter; Leitsch, Sebastian; Lefering, Rolf; Spilker, Gerald

    2011-04-01

    Self-immolation constitutes a rare form of suicide in developed countries, though it accounts for unique injury characteristics in the burn intensive care unit. The aim of this study was to present the epidemiological and clinical features of patients burned during a suicidal attempt seen in a North Rhine-Westphalia burn intensive care unit (BICU). To address this aim, we undertook a 21-year retrospective study involving patients with thermal injuries admitted to the largest burn unit in Germany. A total of 125 suicide-related burn victims were identified in the study period (9.4%). Comparing the self-immolation group with the rest burn patient cohort, suicide victims were more likely to be single and to act under the influence of alcohol. The suicidal group had a larger extent of burns, higher incidence of inhalation injury, required more surgical procedures, catecholamines, blood transfusions, and a longer BICU stay. Their clinical course was complicated by prolonged intubation period, higher rate of multiple drug-resistant bacteria acquisition and sepsis, leading to a higher mortality rate. Although the proportion of self-immolation victims among all burned patients is not high, the markedly higher severity of their burns and their poorer quality of outcomes makes them an important clinical subgroup for further study.

  5. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)

    1999-01-01

    textabstractBurn injuries arc among the worst traumas which can happen to man. The larger a burn injury, the more severe the consequences and the highcr the chance of an adverse outcome or even death. In The Netherlands each year 40,000 people visit a general practitioner for treatment of a burn

  6. Epidemiology of burns

    NARCIS (Netherlands)

    Dokter, Jan

    2016-01-01

    The aim of this thesis is to understand the epidemiology, treatment and outcomes of specialized burn care in The Netherlands. This thesis is mainly based on historical data of the burn centre in Rotterdam from 1986, combined with historical data from the burn centres in Groningen and Beverwijk from

  7. Posttraumatic Stress and Cognitive Processes in Patients with Burns

    OpenAIRE

    Sveen, Josefin

    2011-01-01

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

  8. Partial-thickness burn wounds healing by topical treatment

    OpenAIRE

    Saeidinia, Amin; Keihanian, Faeze; Lashkari, Ardalan Pasdaran; Lahiji, Hossein Ghavvami; Mobayyen, Mohammadreza; Heidarzade, Abtin; Golchai, Javad

    2017-01-01

    Abstract Background: Burns are common event and associated with a high incidence of death, disability, and high costs. Centella asiatica (L.) is a medicinal herb, commonly growing in humid areas in several tropical countries that improve wound healing. On the basis of previous studies, we compared the efficacy of Centiderm versus silver sulfadiazine (SSD) in partial thickness burning patients. Methods: Study population comprised burn victims referred to Velayat Burning Hospital at Rasht, Iran...

  9. Pathophysiologic Response to Burns in the Elderly

    Directory of Open Access Journals (Sweden)

    Marc G. Jeschke

    2015-10-01

    Full Text Available Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50 burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p  0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly.

  10. To burn or not to burn

    International Nuclear Information System (INIS)

    Busch, L.

    1993-01-01

    While taking a match to an oil slick may sound like the making of a chaotic inferno, emergency response specialists say burning may be the most efficient way to remove large oil spills from the ocean's surface. But tests of this technique are being resisted by environmentalists as well as the Environmental Protection Agency (EPA), which has final authority over the matter. The debate over test burning arose most recently in Alaska when a proposal to spill and then ignite 1,000 barrels of crude on the Arctic Ocean this past summer was rejected by the EPA. The EPA didn't object to the technique or to the notion of burning spilled oil. However, it contends that it's not necessary to spill thousands of gallons of oil to conduct tests, and unnecessarily pollute the environment, when plenty of oil is already available from accidental spills. Researchers disagree, claiming they won't be able to use the burning technique on an actual spill until it has been tested in a controlled experiment. Despite such concerns, the Canadian government is going ahead with a test burn off the coast of Newfoundland next year. Faced with a choice of test burning or the kind of shoreline contamination left in the wake of the Exxon Valdez disaster, Environment Canada opts for testing. Learning valuable lessons about rapid oil-spill cleanup is worth the relatively minor risks to the environment that test burning would pose

  11. [Influence of three-level collaboration network of pediatric burns treatment in Anhui province on treatment effects of burn children].

    Science.gov (United States)

    Xia, Z G; Zhou, X L; Kong, W C; Li, X Z; Song, J H; Fang, L S; Hu, D L; Cai, C; Tang, Y Z; Yu, Y X; Wang, C H; Xu, Q L

    2018-03-20

    Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher's exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 ( χ (2)=2.672, P >0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close ( χ (2)=3.382, Z =-1.917, -1.911, χ (2)=3.133, P >0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 ( χ (2)=11.777, 6.948, 4.310, P burns transferred from the two periods of time were close ( χ (2)=1.181, P >0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6

  12. In-situ burning of heavy oils and Orimulsion : mid-scale burns

    International Nuclear Information System (INIS)

    Fingas, M.F.; Fieldhouse, B.; Brown, C.E.; Gamble, L.

    2004-01-01

    In-situ burning is considered to be a viable means to clean oil spills on water. In-situ burning, when performed under the right conditions, can reduce the volume of spilled oil and eliminate the need to collect, store, transport and dispose of the recovered oil. This paper presented the results of bench-scale in-situ burning tests in which Bunker C, Orimulsion and weathered bitumen were burned outdoors during the winter in burn pans of approximately 1 square metre. Each test was conducted on salt water which caused the separation of the bitumen from the water in the Orimulsion. Small amounts of diesel fuel was used to ignite the heavy oils. Quantitative removal of the fuels was achieved in all cases, but re-ignition was required for the Orimulsion. Maximum efficiency was in the order of 70 per cent. The residue was mostly asphaltenes and resins which cooled to a solid, glass like material that could be readily removed. The study showed that the type of oil burned influences the behaviour of the burns. Bunker C burned quite well and Orimulsion burned efficiently, but re-ignition was necessary. It was concluded that there is potential for burning heavy oils of several types in-situ. 6 refs., 7 tabs., 18 figs

  13. Infections in critically ill burn patients.

    Science.gov (United States)

    Hidalgo, F; Mas, D; Rubio, M; Garcia-Hierro, P

    2016-04-01

    Severe burn patients are one subset of critically patients in which the burn injury increases the risk of infection, systemic inflammatory response and sepsis. The infections are usually related to devices and to the burn wound. Most infections, as in other critically ill patients, are preceded by colonization of the digestive tract and the preventative measures include selective digestive decontamination and hygienic measures. Early excision of deep burn wound and appropriate use of topical antimicrobials and dressings are considered of paramount importance in the treatment of burns. Severe burn patients usually have some level of systemic inflammation. The difficulty to differentiate inflammation from sepsis is relevant since therapy differs between patients with and those without sepsis. The delay in prescribing antimicrobials increases morbidity and mortality. Moreover, the widespread use of antibiotics for all such patients is likely to increase antibiotic resistance, and costs. Unfortunately the clinical usefulness of biomarkers for differential diagnosis between inflammation and sepsis has not been yet properly evaluated. Severe burn injury induces physiological response that significantly alters drug pharmacokinetics and pharmacodynamics. These alterations impact antimicrobials distribution and excretion. Nevertheless the current available literature shows that there is a paucity of information to support routine dose recommendations. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  14. In-Situ Burning of Crude Oil on Water

    DEFF Research Database (Denmark)

    van Gelderen, Laurens

    in the small scale water basin. Boilovers were also observed during the burning of a heavy crude oil with a substantial light fraction without a water layer, however, which suggests that water is not essential for boilover occurrence. Further studies are required to determine the conditions under which......The fire dynamics and fire chemistry of in-situ burning of crude oil on water was studied in order to improve predictions on the suitability of this oil spill response method. For this purpose, several operational parameters were studied to determine the factors that control the burning efficiency...... of in-situ burning, i.e. the amount of oil (in wt%) removed from the water surface by the burning process. The burning efficiency is the main parameter for expressing the oil removal effectiveness of in-situ burning as response method and is thus relevant for suitability predictions of in-situ burning...

  15. Parameters Affecting the Erosive Burning of Solid Rocket Motor

    Directory of Open Access Journals (Sweden)

    Abdelaziz Almostafa

    2018-01-01

    Full Text Available Increasing the velocity of gases inside solid rocket motors with low port-to-throat area ratios, leading to increased occurrence and severity of burning rate augmentation due to flow of propellant products across burning propellant surfaces (erosive burning, erosive burning of high energy composite propellant was investigated to supply rocket motor design criteria and to supplement knowledge of combustion phenomena, pressure, burning rate and high velocity of gases all of these are parameters affect on erosive burning. Investigate the phenomena of the erosive burning by using the 2’inch rocket motor and modified one. Different tests applied to fulfil all the parameters that calculated out from the experiments and by studying the pressure time curve and erosive burning phenomena.

  16. Air Pollution Episodes Associated with Prescribed Burns

    Science.gov (United States)

    Hart, M.; Di Virgilio, G.; Jiang, N.

    2017-12-01

    Air pollution events associated with wildfires have been associated with extreme health impacts. Prescribed burns are an important tool to reduce the severity of wildfires. However, if undertaken during unfavourable meteorological conditions, they too have the capacity to trigger extreme air pollution events. The Australian state of New South Wales has increased the annual average area treated by prescribed burn activities by 45%, in order to limit wildfire activity. Prescribed burns need to be undertaken during meteorological conditions that allow the fuel load to burn, while still allowing the burn to remain under control. These conditions are similar to those that inhibit atmospheric dispersion, resulting in a fine balance between managing fire risk and managing ambient air pollution. During prescribed burns, the Sydney air shed can experience elevated particulate matter concentrations, especially fine particulates (PM2.5) that occasionally exceed national air quality standards. Using pollutant and meteorological data from sixteen monitoring stations in Sydney we used generalized additive model and CART analyses to profile the meteorological conditions influencing air quality during planned burns. The insights gained from this study will help improve prescribed burn scheduling in order to reduce the pollution risk to the community, while allowing fire agencies to conduct this important work.

  17. [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

  18. Assessment of burn-specific health-related quality of life and patient scar status following burn.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2017-11-01

    This study assessed patient-perceived levels of scar assessment and burn-specific quality of life (QOL) in Korean burn patients admitted to burn care centers and identified differences in scar assessment and QOL based on various patient characteristics. A cross-sectional descriptive study using anonymous paper-based survey methods was conducted with 100 burn patients from three burn centers specializing in burn care in South Korea. Mean subject age was 44.5 years old, and 69% of the subjects were men. The overall mean QOL was 2.91 out of 5. QOL was lowest for the work subdomain (2.25±1.45) followed by the treatment regimen subdomain (2.32±1.16). The subjects' mean total scar assessment score was 35.51 out of 60, and subjects were most unsatisfied with scar color. Subjects with low income, flame-source burns, severe burns, visible scars, and scars on face or hand reported significantly lower QOL. Subjects with severe burn degree and burn range perceived their burn scar condition to be worse than that of others. The results show that burn subjects experience the most difficulties with their work and the treatment regimen. Subjects with severe burn and visible scarring have a reduced QOL and a poor scar status. Scar management intervention may improve QOL of burn patients especially those with severe burn and visible scars. Further studies are warranted to evaluate the relationship between scar assessment and QOL. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  19. 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....

  20. Burning mouth syndrome

    OpenAIRE

    K A Kamala; S Sankethguddad; S G Sujith; Praveena Tantradi

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to different...

  1. Effects of cholecalciferol supplementation and optimized calcium intakes on vitamin D status, muscle strength and bone health: a one-year pilot randomized controlled trial in adults with severe burns.

    Science.gov (United States)

    Rousseau, Anne-Françoise; Foidart-Desalle, Marguerite; Ledoux, Didier; Remy, Christophe; Croisier, Jean-Louis; Damas, Pierre; Cavalier, Etienne

    2015-03-01

    Burn patients are at risk of hypovitaminosis D and osteopenia or sarcopenia. Vitamin D pleiotropic effects may influence bone and muscle health. The aim of this pilot study was to assess effects of a cholecalciferol (VD3) supplementation and an optimized calcium (Ca) regimen on vitamin D (VD) status, bone and muscle health during sequelar stage of burn injury. Monocentric randomized controlled trial. Fifteen adults with thermal burns dating from 2 to 5 years were randomized into two groups. For 12 months, they either received a quarterly IM injection of 200,000IU VD3 and daily oral Ca (Group D) or placebo (Group P). VD status and bone remodeling markers were assessed every 3 months. Knee muscle strength and bone mineral density were, respectively, assessed using isokinetic dynamometry and dual X-ray absorptiometry at initiation (M0) and completion (M12) of the protocol. Of all the patients, 66% presented with VD deficiency and 53% (with 3 men burn adults. When combined with optimized Ca intakes, it demonstrated positive effects on muscle health but not on bone health. A high prevalence of hypovitaminosis D and osteopenia in these patients, as well as their wide range of muscle performances, seem to be worrying when considering rehabilitation and quality of life. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  2. Choosing Wood Burning Appliances

    Science.gov (United States)

    Information to assist consumers in choosing a wood burning appliance, including types of appliances, the differences between certified and non-certified appliances, and alternative wood heating options.

  3. Treatment of burn injuries with keratinocyte cultures

    International Nuclear Information System (INIS)

    Syring, C.; Maenig, H.J.; Von Versen, R.; Bruck, J.

    1999-01-01

    The German Institute for Cell and Tissue Replacement (DIZG) provides burned patients with skin and amnion for a temporary wound closure. Severely burned patients (>60% BSA for adults, >40% BSA for children) were supplied with autologous and allogenic grafts from cultured keratinocytes. The keratinocyte culture is done under GMP-conditions using the method of Rheinwald and Green. The 3T3 fibroblasts were irradiated with 60 Gy and used as feeder cells to produce keratinocyte sheets within 3 weeks. In this time up to 6.000 cm are available. The sheets were harvested by detachment with dispase (1,2 U/ml), fixed to gauze and transported to the hospital. The DIZG has a 3 years experience in the treatment of burns with keratinocyte sheets. The sheets were transplanted to patients in different hospitals, the total transplanted area is about 30.000 cm. This paper describes the experiences with ten severely burned patients treated with keratinocyte sheet

  4. Burns and military clothing.

    Science.gov (United States)

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

  5. Tourniquet associated chemical burn

    Directory of Open Access Journals (Sweden)

    Jae-Hyuk Yang

    2012-01-01

    Full Text Available Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The two important mechanisms are maceration (friction and wetness underneath the tourniquent. In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

  6. Burns (For Parents)

    Science.gov (United States)

    ... small, and have sensitive skin that needs extra protection. Although some minor burns aren't cause for concern and can ... burns, the mildest of the three, are limited to the top layer of skin: Signs ... pain, and minor swelling. The skin is dry without blisters. Healing ...

  7. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    K A Kamala

    2016-01-01

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

  8. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... in 2018! Learn More For Loved Ones A burn injury doesn't just impact the survivor. Families ... to support longterm recovery, improve the quality of burn care, and prevent burn injury. Explore articles on ...

  9. An overview of acute burn management in the Emergency Centre

    Directory of Open Access Journals (Sweden)

    Adaira Landry

    2013-03-01

    Full Text Available Despite the frequency and severity of burns in Low Income Countries, including many in Africa, there is a paucity of research and funding for these populations to aid in prevention, treatment and recovery of burn patients. The objectives of this paper are four-fold. First, by addressing the pathophysiology of burns the reader may strengthen understanding of the clinical progression of burns. Second, through describing proper assessment of burn patients one will learn how to decide if patients can be discharged, admitted or transferred to burn centre. Third, the inclusion of treatments solidifies the steps necessary to manage a patient in a hospital setting. Lastly, the overall goal of the paper, is to raise awareness that more research, publication and funding is required to create a better understanding of burns in Africa and why they continue to be devastating social and economic burdens.

  10. The Parameters Controlling the Burning Efficiency of In-Situ Burning of Crude Oil on Water

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Jomaas, Grunde

    2017-01-01

    Parameters that control the burning efficiency of in-situ burning of crude oil on water were identified by studying the influence of the initial slick thickness, vaporization order, oil slick diameter, weathering state of the oil, heat losses to the water layer and heat flux to the fuel surface...... on the burning efficiency for light and heavy crude oils. These parameters were studied in several small scale and intermediate scale experimental setups. The results showed that the heat losses to the water layer increase with increasing burning time because the components in a crude oil evaporate from volatile...... to non-volatile. Due to the relatively low heat feedback (reradiation and convection, in kW/m2) to the fuel surface of small scale pool fires, as compared to large scale pool fires, these heat losses were shown to limit the burning efficiency in small scale experiments. By subjecting small scale crude...

  11. Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

    Science.gov (United States)

    Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

    2015-09-01

    Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  12. Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

    Science.gov (United States)

    Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

    2016-05-01

    Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Traditional Herbal Remedies for Burn Wound Healing in Canon of Avicenna

    OpenAIRE

    Aliasl, Jale; Khoshzaban, Fariba

    2013-01-01

    Burns are a worldwide problem. The incidence of severe burns has been higher than the combined incidence of tuberculosis and HIV infections. Throughout history there have been many different treatments prescribed for burns. The Canon is the masterpiece of Avicenna’s medical books. The Canon includes a description of 785 simple drugs. Avicenna believed in burn treatment, which follows two goals. The first goal is prevention of blistering and the second goal is treatment of the burn wound after...

  14. The Consensus of the Surgical Treatment of Burn Injuries in Belgium

    OpenAIRE

    BRUSSELAERS, NELE; Lafaire, C; Ortiz, S; Jacquemin, D; Monstrey, Stan

    2008-01-01

    On the occasion of the twentieth anniversary of the 'Belgian Association of Burn Injuries' an inventory was made of all surgical techniques used in the five largest Belgian burn centres in order to draw up a consensus document. A questionnaire covering the whole treatment of severely burned patients was sent to the surgeons of each burn unit, ranging, from emergency treatment, through diagnostic techniques, burn surgery and post-healing treatment (scars, contractures). During the past decade,...

  15. Burning mouth syndrome: an enigmatic disorder.

    Science.gov (United States)

    Javali, M A

    2013-01-01

    Burning mouth syndrome (BMS) is a chronic oral pain or burning sensation affecting the oral mucosa, often unaccompanied by mucosal lesions or other evident clinical signs. It is observed principally in middle-aged patients and postmenopausal women and may be accompanied by xerostomia and altered taste. Burning mouth syndrome is characterized by an intense burning or stinging sensation, preferably on the tongue or in other areas of mouth. This disorder is one of the most common, encountered in the clinical practice. This condition is probably of multifactorial origin; however the exact underlying etiology remains uncertain. This article discusses several aspects of BMS, updates current knowledge about the etiopathogenesis and describes the clinical features as well as the diagnosis and management of BMS patients.

  16. Ash and burn control through fishbones

    Energy Technology Data Exchange (ETDEWEB)

    Varadarajan, V.; Miley, G.H.

    1989-01-01

    The thermal alphas will accumulate in the center of the ignited thermonuclear plasma in the long pulse experiments. This accumulation increases the Z{sub eff} leading to increased synchrotron losses and decreases the effective fuel density which reduces the power output. Also the ignited plasma is burn-unstable and its temperature is expected to increase above the design point until a stable equilibrium is reached at a higher temperature. This higher operating temperature is not expected to be beneficial. Thus we are faced with the dual problem of ash accumulation and thermonuclear burn instability in the steadily burning tokamak plasma. So some means of controlling them is desirable. Several control schemes for both problems have been proposed. But it is felt that we need alternatives with more desirable characteristics. In this paper, we explore the use of fishbones' as possible scheme that will achieve the dual purpose of ash and burn control. 3 refs.

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

    Science.gov (United States)

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

    2014-08-01

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

  18. Predictors of PTSD symptoms in caregivers of pediatric burn survivors

    Directory of Open Access Journals (Sweden)

    Lucía Del Carmen Quezada Berumen

    2015-11-01

    Full Text Available Facing a severe injury in the children is one of the most devastating experiences that parents may face. The aim of this study was to explore the role of resilience showed by fathers and mothers of children with burns, the TBSA burned, age at the time of the burn and time since the burn in PTSD symptoms in caregivers. It was a cross-sectional study where fathers, mothers and guardians of 51 burn patients were evaluated. Results showed that the higher strength and confidence in caregivers, less severity in PTSD symptoms. The post-burn reactions of parents and guardians can affect the responses and welfare of their children. Therefore, a better understanding of factors related to the adaptation in caregivers, better attention by health services.

  19. Making of a burn unit: SOA burn center

    Directory of Open Access Journals (Sweden)

    Jayant Kumar Dash

    2016-01-01

    Full Text Available Each year in India, burn injuries account for more than 6 million hospital emergency department visits; of which many require hospitalization and are referred to specialized burn centers. There are few burn surgeons and very few burn centers in India. In our state, Odisha, there are only two burn centers to cater to more than 5000 burn victims per year. This article is an attempt to share the knowledge that I acquired while setting up a new burn unit in a private medical college of Odisha.

  20. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  1. American Burn Association

    Science.gov (United States)

    ... burn-related care, prevention, education, and research. Our multidisciplinary membership enhances our ability to work toward common goals with other organizations and educational programs. Membership Being a member of ...

  2. New Fashioned Book Burning.

    Science.gov (United States)

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  3. [Burn injuries to military personnel during the Six Day War].

    Science.gov (United States)

    Dreyfuss, U Y

    2000-05-01

    About 2500 soldiers were injured during the Six Day War (June 1967) of whom 115 suffered from burns. In 34 of them 15% or more of their body surface was involved and 11 died. Typical features of these burn cases were supplementary injuries, a high rate of infection, and long periods of hospitalization. Prophylactic antibiotics were not useful. The general condition of many deteriorated during the first week after injury, indicating the importance of treating severe burns in specialized facilities.

  4. Root Disease, Longleaf Pine Mortality, and Prescribed Burning

    Energy Technology Data Exchange (ETDEWEB)

    Otrosina, W.J; C.H. Walkinshaw; S.J. Zarnoch; S-J. Sung; B.T. Sullivan

    2001-01-01

    Study to determine factors involved in decline of longleaf pine associated with prescribed burning. Trees having symptoms were recorded by crown rating system based upon symptom severity-corresponded to tree physiological status-increased in hot burn plots. Root pathogenic fungi widespread throughout the study site. Histological studies show high fine root mortality rate in the hot burn treatment. Decline syndrome is complexed by root pathogens, soil factors, root damage and dysfunction.

  5. Burn-out

    OpenAIRE

    Patricia van Echtelt

    2014-01-01

    Deze publicatie is alleen elektronisch verkrijgbaar (downloaden van deze site) Burn-out (ofwel: emotionele uitputting) komt relatief vaak voor: ongeveer één op de acht werknemers in Nederland heeft er last van. Het wordt dan ook gezien als een serieus maatschappelijk probleem dat beleidsmatig aandacht vergt. Dit rapport presenteert de resultaten van twee specifieke analyses over burn-out. Ten eerste gaan we na wat het effect is van emotionele uitputting op de loopbaan van werknemers. Ten twee...

  6. Smartphone applications in burns.

    Science.gov (United States)

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

    2015-08-01

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

  7. Burning mouth syndrome

    OpenAIRE

    Zakrzewska, Joanna; Buchanan, John A. G.

    2016-01-01

    Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans. Its common features include a burning painful sensation in the mouth, often associated with dysgeusia and xerostomia, despite normal salivation. Classically, symptoms are better in the morning, worsen during the day and typically subside at night. Its etiology is largely multifactorial, and associated medical conditions may include gastrointestinal, urogenital, psychiatric, neurologic and met...

  8. Burning mouth syndrome: update

    OpenAIRE

    Cassol Spanemberg, Juliana; Rodríguez de Rivera Campillo, Ma Eugenia; Jané Salas, Enric; López López, José, 1958-

    2014-01-01

    Burning Mouth Syndrome (BMS) is a chronic disorder that predominately affects middle-aged women in the postmenopausal period. The condition is distinguished by burning symptoms of the oral mucosa and the absence of any clinical signs. The etiology of BMS is complex and it includes a variety of factors. Local, systemic and psychological factors such as stress, anxiety and depression are listed among the possible causes of BMS. BMS may sometimes be classified as BMS Type I, II or III. Although ...

  9. Burning mouth syndrome

    OpenAIRE

    Jimson, Sudha; Rajesh, E.; Krupaa, R. Jayasri; Kasthuri, M.

    2015-01-01

    Burning mouth syndrome (BMS) is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a...

  10. Control of invasive weeds with prescribed burning

    Science.gov (United States)

    DiTomaso, Joseph M.; Brooks, Matthew L.; Allen, Edith B.; Minnich, Ralph; Rice, Peter M.; Kyser, Guy B.

    2006-01-01

    Prescribed burning has primarily been used as a tool for the control of invasive late-season annual broadleaf and grass species, particularly yellow starthistle, medusahead, barb goatgrass, and several bromes. However, timely burning of a few invasive biennial broadleaves (e.g., sweetclover and garlic mustard), perennial grasses (e.g., bluegrasses and smooth brome), and woody species (e.g., brooms and Chinese tallow tree) also has been successful. In many cases, the effectiveness of prescribed burning can be enhanced when incorporated into an integrated vegetation management program. Although there are some excellent examples of successful use of prescribed burning for the control of invasive species, a limited number of species have been evaluated. In addition, few studies have measured the impact of prescribed burning on the long-term changes in plant communities, impacts to endangered plant species, effects on wildlife and insect populations, and alterations in soil biology, including nutrition, mycorrhizae, and hydrology. In this review, we evaluate the current state of knowledge on prescribed burning as a tool for invasive weed management.

  11. The Western Australia Population-based Burn Injury Project: Using record linkage to examine long-term effects of burn injury

    Directory of Open Access Journals (Sweden)

    Janine Duke

    2017-04-01

    Both minor and severe burns were associated with increased long-term cardiovascular and musculoskeletal morbidity and mortality. These results identify treatment needs for burn patients for a prolonged time after discharge. Further research that links primary care and pharmaceutical data is required to facilitate identification of at-risk patients and appropriate treatment pathways to reduce post-burn morbidity.

  12. Ethnicity and etiology in burn trauma.

    Science.gov (United States)

    Papp, Anthony; Haythornthwaite, Jordan

    2014-01-01

    The purpose of this study was to retrieve data from the British Columbia Professional Firefighters Burn Unit registry, with a focus on ethnicity and how it is involved in burn trauma. It is hypothesized that mechanism, severity, and other patient characteristics are significantly different among different ethnic groups. Furthermore, it is believed that these data can be used to augment burn prevention strategies. Data for burn patients admitted from 1979 to 2009 were reviewed from the burn registry. The main focus was with differences seen among the four main ethnicities throughout the analysis, Caucasian, Aboriginal, Asian, and Indoasian, reflecting the population distribution of the region. Age and sex were also considered when looking at burn mechanism, severity, contributing and copresenting factors. Caucasians were the largest group (79.1%) and included the largest male:female ratio (3.3:1), with high numbers of flame injury (53.9%). Caucasians presented with the highest mortality (6.6% compared with 4.1% for all other ethnicities; P workplace (28.9%) injuries with a larger proportion of scald injury (38.9%). Indoasian patients included larger numbers of women (36.4%) and household scald injuries (33.9%) whereas Aboriginals suffered the most flame injuries (60.1%) in rural areas with more frequent contributing factors such as alcohol. The study found multiple significant differences in the burn injury population when segmented by ethnicity. Though the exact reasons for these differences are difficult to say with certainty, it allows a unique opportunity to focus communication and prevention efforts to specific communities.

  13. Effects of radiation, burn and combined radiation-burn injury on hemodynamics

    International Nuclear Information System (INIS)

    Ye Benlan; Cheng Tianming; Xiao Jiasi

    1996-01-01

    Changes in hemodynamics after radiation, burn and combined radiation burn injury within eight hours post injury were studied. The results indicate: (1) Shock of rats in the combined injury group is more severe than that in the burn group. One of the reasons is that the blood volume in the combined injury group is less than that in the burn group. Radiation injury plays an important role in this effect, which enhances the increase in vascular permeability and causes the loss of plasma. (2) Decrease in cardiac output and stroke work and increase in vascular resistance in the combined radiation burn group are more drastic than those in the burn group, which may cause and enhance shock. Replenishing fluid is useful for recovery of hemodynamics. (3) Rb uptake is increased in the radiation group which indicates that compensated increase of myocardial nutritional blood flow may take place before the changes of hemodynamics and shock. Changes of Rb uptake in the combined injury group is different from that in the radiation groups and in the burn group. The results also suggest that changes of ion channel activities may occur to a different extent after injury. (4) Verapamil is helpful to the recovery of hemodynamics post injury. It is better to combine verapamil with replenishing fluid

  14. [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.

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

    African Journals Online (AJOL)

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

  16. Burning mouth disorder

    Directory of Open Access Journals (Sweden)

    Anand Bala

    2012-01-01

    Full Text Available Burning mouth disorder (BMD is a burning or stinging sensation affecting the oral mucosa, lips and/or tongue, in the absence of clinically visible mucosal lesions. There is a strong female predilection, with the age of onset being approximately 50 years. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. The causes of BMD are multifactorial and remain poorly understood. Recently, there has been a resurgence of interest in this disorder with the discovery that the pain of burning mouth syndrome (BMS may be neuropathic in origin and originate both centrally and peripherally. The most common sites of burning are the anterior tongue, anterior hard palate and lower lip, but the distribution of oral sites affected does not appear to affect the natural history of the disorder or the response to treatment BMS may persist for many years. This article provides updated information on BMS and presents a new model, based on taste dysfunction, for its pathogenesis.

  17. Acute pavement burns: a unique subset of burn injuries: a five-year review of resource use and cost impact.

    Science.gov (United States)

    Silver, Andrew G; Dunford, Gerrit M; Zamboni, William A; Baynosa, Richard C

    2015-01-01

    This study focuses on the hospital care of a rare subset of burn injuries caused by contact with environmentally heated pavement, to further understand the required use of resources. This article aims to show that pavement burns are typically more severe than their flame/scald counterparts. A retrospective review of patients admitted to the burn center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A representative sample of similarly sized flame and scald wounds treated in the same time period was compiled for comparison. Those with pavement burns had a significantly greater requirement for operative intervention, repetitive debridements, overall cost/percent burned, and lengthier hospital stays than those with flame/scald burns. Pavement burn victims with AMS were significantly more likely to require an operation, a greater cost/percent burned, and longer hospital stays than those without AMS. Pavement burns are significantly worse than similarly sized scald/flame burns with regards to length of stay and total hospital costs, and the necessity of initial and repetitive operative intervention. These discrepancies are even greater in patients with AMS as a concomitant inciting factor. It is apparent that these wounds often continue to deepen during a patient's stay, likely because of continued pressure on the wounds while recumbent. As such, this article highly recommends pressure off-loading beds and more aggressive debridement in the treatment of these unique injuries.

  18. Outpatient presentations to burn centers: data from the Burns Registry of Australia and New Zealand outpatient pilot project.

    Science.gov (United States)

    Gabbe, Belinda J; Watterson, Dina M; Singer, Yvonne; Darton, Anne

    2015-05-01

    Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSAburns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  19. How is the chlorophyll count affected by burned and unburned marsh areas?

    Science.gov (United States)

    Kendrick, C.

    2017-12-01

    Does marsh burnings, either man made or natural, hinder or help Louisiana's vitally important coastal plant life? Does the carbon produced from the fires have a negative effect on the chlorophyll count of these precious living protective barriers? Or does it help contribute to raising the plants chlorophyll count? Along Louisiana's Gulf Coast, marsh burnings are conducted every 2-4 years to destroy some of the Spartina patens. Fires and smoke may have an effect on the chlorophyll count of the plants found in Louisiana's marshes. Peat burns, root burns, and cover burns are the three types of marsh fires. These burns can be either man made or started by natural causes. Peat burns occur when the soil is dry due to a drained marsh. Root burns occur when plant roots are burned without the soil being consumed. Cover burns occur when several centimeters of water covers the soil. Cover burns are often used by Wildlife and Fisheries personnel to promote preferred plant food growth like Scirpus olneyi rather than the dominant Spartina patens. Our project was conducted by testing marsh plants and obtaining chlorophyll count of both a burned (cover burn) and an unburned area. Approximately one year after the burn, in August 2015, we tested the burned area's site. We retested the same site in December 2016. The results from our testing showed that there was a slightly higher chlorophyll count in the burned area. The chlorophyll count average from the two testing days was 33.5 in the burned area and 30.15 in the unburned area. Our hypothesis was that the chlorophyll content of "controlled" burned wetland areas will have a higher amount than the "no" burn area. The experiment results supported this hypothesis by showing an increase of 3.35 average in the burned area.

  20. Fancy a cup of scald? - The role of hot beverage burns in paediatric burns admissions in Ireland.

    Science.gov (United States)

    McGuire, F; Hegarty, M; Jennings, P; Marsden, P; Smith, L

    2017-06-09

    Burns and scalds are preventable injuries in children that typically occur in the home. This study aimed to examine the role of hot beverage scalds in paediatric burn admissions in order to identify key target audiences for future safety strategies. Using the Hospital Inpatient Enquiry System (HIPE) a retrospective study of paediatric burn admissions in 2014 examined demographics, cause and severity of injury and location of occurrence. There were 233 paediatric discharges (age 0-18 yrs.) with a principal diagnosis of burn injury; 57% of these occurred in children under three years and 95% of these occurred in the home. Scalds caused 74% of burn injuries; hot beverages accounted for least 33% of these of which 77% were partial thickness and 73% were upper body burns. Effective hot beverage scald prevention strategies, targeted towards caregivers in the home, are required.

  1. The Burns Registry of Australia and New Zealand: progressing the evidence base for burn care.

    Science.gov (United States)

    Cleland, Heather; Greenwood, John E; Wood, Fiona M; Read, David J; Wong She, Richard; Maitz, Peter; Castley, Andrew; Vandervord, John G; Simcock, Jeremy; Adams, Christopher D; Gabbe, Belinda J

    2016-03-21

    Analysis of data from the Burns Registry of Australia and New Zealand (BRANZ) to determine the extent of variation between participating units in treatment and in specific outcomes during the first 4 years of its operation. BRANZ, an initiative of the Australian and New Zealand Burn Association, is a clinical quality registry developed in accordance with the Australian Commission on Safety and Quality in Healthcare national operating principles. Patients with burn injury who fulfil pre-defined criteria are transferred to and managed in designated burn units. There are 17 adult and paediatric units in Australia and New Zealand that manage almost all patients with significant burn injury. Twelve of these units treat adult patients. Data on 7184 adult cases were contributed by ten acute adult burn units to the registry between July 2010 and June 2014.Major outcomes: In-hospital mortality, hospital length of stay, skin grafting rates, and rates of admission to intensive care units. Considerable variations in unit profiles (including numbers of patients treated), in treatment and in outcomes were identified. Despite the highly centralised delivery of care to patients with severe or complex burn injury, and the relatively small number of specialist burn units, we found significant variation between units in clinical management and in outcomes. BRANZ data from its first 4 years of operation support its feasibility and the value of further development of the registry. Based on these results, the focus of ongoing research is to improve understanding of the reasons for variations in practice and of their effect on outcomes for patients, and to develop evidence-informed clinical guidelines for burn management in Australia and New Zealand.

  2. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    Dalal P

    2010-10-01

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

  3. In situ oil burning in the marshland environment : soil temperatures resulting from crude oil and diesel fuel burns

    International Nuclear Information System (INIS)

    Bryner, N.P.; Walton, W.D.; Twilley, W.H.; Roadarmel, G.; Mendelssohn, I.A.; Lin, Q.; Mullin, J.V.

    2001-01-01

    The unique challenge associated with oil spill cleanups in sensitive marsh environments was discussed. Mechanical recovery of crude or refined hydrocarbons in wetlands may cause more damage to the marsh than the oil itself. This study evaluated whether in situ burning of oiled marshlands would provide a less damaging alternative than mechanical recovery. This was done through a series of 6 crude oil and 5 diesel fuel burns conducted in a test tank to examine the impact of intentional burning of oil spilled in a wetlands environment. There are several factors which may influence how well such an environment would recover from an in situ oil burn, such as plant species, fuel type and load, water level, soil type, and burn duration. This paper focused on soil, air and water temperatures, as well as total heat fluxes that resulted when 3 plant species were exposed to full-scale in situ burns that were created by burning diesel fuel and crude oil. The soil temperatures were monitored during the test burn at three different soil/water elevations for 700 second burn exposures. A total of 184 plant sods were harvested from marshlands in southern Louisiana and were subjected to the burning fuel. They were instrumental in characterizing the thermal and chemical stress that occur during an in-situ burn. The plants were inserted into the test tanks at various water and soil depths. The results indicated that diesel fuel and crude oil burns produced similar soil temperature profiles at each of three plant sod elevations. Although in-situ burning did not appear to remediate oil that had penetrated into the soil, it did effectively remove floating oil from the water surface, thereby preventing it from potentially contaminating adjacent habitats and penetrating the soil when the water recedes. The regrowth and recovery of the plants will be described in a separate report. 25 refs., 7 tabs., 15 figs

  4. Investigating the depth of thermal burns in elephants

    Directory of Open Access Journals (Sweden)

    A. Shakespeare

    2006-06-01

    Full Text Available Histological examination of burn injuries in elephants revealed that the depth was not as severe as expected from clinical observation. Although the actual burn depth was deep, the thickness of elephant skin, especially the dermis, resulted in the lesions being classified as less severe than expected. Examination of skin samples from selected areas showed that most lesions were either superficial (1st degree or superficial partial-thickness (superficial 2nd degree burns with the occasional deep partial thickness (deep 2nd degree wound. These lesions however, resulted in severe complications that eventually led to the death of a number of the elephants.

  5. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    Sudha Jimson

    2015-01-01

    Full Text Available Burning mouth syndrome (BMS is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms.

  6. Long standing intra oral acid burn

    NARCIS (Netherlands)

    Kumar, V.V.; Ebenezer, S.; Lobbezoo, F.

    2015-01-01

    Oral burn due to ingestion of corrosive substances can bring about debilitating consequences. It often brings mortality, and the survivors can have severe impairment of functions, especially in relation to the stomatognathic and gastrointestinal systems. This article presents a long-standing case

  7. Biomass burning in Africa: As assessment of annually burned biomass

    International Nuclear Information System (INIS)

    Delmas, R.A.; Loudjani, P.; Podaire, A.; Menaut, J.C.

    1991-01-01

    It is now established that biomass burning is the dominant phenomenon that controls the atmospheric chemistry in the tropics. Africa is certainly the continent where biomass burning under various aspects and processes is the greatest. Three different types of burnings have to be considered-bush fires in savanna zones which mainly affect herbaceous flora, forest fires due to forestation for shifting agriculture or colonization of new lands, and the use of wood as fuel. The net release of carbon resulting from deforestation is assumed to be responsible for about 20% of the CO 2 increase in the atmosphere because the burning of forests corresponds to a destorage of carbon from the biospheric reservoir. The amount of reactive of greenhouse gases emitted by biomass burning is directly proportional, through individual emission factors, to the biomass actually burned. This chapter evaluates the biomass annually burned on the African continent as a result of the three main burning processes previously mentioned

  8. Quality of life and mediating role of patient scar assessment in burn patients.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2017-09-01

    In this study, we examined the plausibility of the mediating effect of the levels of patient scar assessment on the relationship between burn severity measured with total body surface area and burn-specific health-related quality of life (HRQL) among patients with burns in South Korea. In this cross sectional descriptive study, we collected data from 100 burn patients in three burn centers specializing in burn care in South Korea. Patient scar assessment, burn specific HRQL, and burn-related characteristics were self-reported with anonymous, paper-based surveys. The findings showed a positive correlation between burn severity, patient scar assessment, and HRQL in burn patients. The evidence of this paper is that quality of life after burns more determined by scar characteristics than burn severity. In the light of the poor HRQL in burn patients, the results of this study support that improving scar status could improve patients' HRQL. Health care providers should keep in mind that patients' perspectives of their scars would be a great indicator of their HRQL, so the providers' focus should be on intensive scar management intervention in their care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  9. In-situ burning of spilled oil

    International Nuclear Information System (INIS)

    Tennyson, E.J.

    1992-01-01

    This presentation provided an overview of results from the Minerals Management Service's (MMS) funded research on in situ burning of spilled oil. The program began in 1983 to determine the limitations of this innovative response strategies. Specific physical variables evaluated were slick thickness, degree of weathering (sparging), sea state, wind velocities, air and water temperatures, degrees of emulsification and degree of ice-coverage. All of the oils tested burned with 50 to 95 percent removal ratios as long as emulsification had not occurred. Slick thickness of 3mm or thicker were required to sustain ignition and extinguishment occurred when the slick reached approximately 1mm thick. The next phase of the research involved quantitative analysis of the pollutants created by in situ burning including chemical composition of the parent oil, burn residue, and airborne constituents. These studies were conducted at the National Institute of Standards and Technology (NIST) with emphasis on particulate, and gaseous components created by the burning process. Research efforts over several years, and a variety of crude oils, yielded data which indicated that aldehydes ketones, dioxans, furans, and polyaromatic compounds (PAHS) were not formed in the burning process. The airborne pollutants reflected similar concentrations of these compounds that were present in the parent oil. Lighter molecular weight PAHs tended to be converted to higher molecular weight compounds. Heavier molecular weight compounds are considered less acutely toxic than lighter molecular weight PAHS. Predominant burn products released into the air were by weight: 75% carbon dioxide, 12% water vapor, 10% soot, 3% carbon monoxide and 0.2% other products including those listed above

  10. [Fat grafting in facial burns sequelae].

    Science.gov (United States)

    Viard, R; Bouguila, J; Voulliaume, D; Comparin, J-P; Dionyssopoulos, A; Foyatier, J-L

    2012-06-01

    Fat graft is now part of the armamentarium in face plastic surgery. It is successfully used in burn scars. The aim of our study is the discussion of the value of this technique in optimizing cosmetic result of burns face sequelae. Fifteen adult patients (10 females and five males) with scars resulting from severe burns 2 to 9 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two to three injections were administered at the dermohypodermal junction. Ages, sexes, aetiology of burn, facial burn sequelae, recipient sites, quantity of fat injected, aesthetic results are discussed. Patient age ranged from 21 to 55 years (average: 38). The mean follow-up of the study was 66 months (23-118). Patients received 7.5 (5-11) facial restorative surgeries before fat graft. Patients underwent two sessions of fat transfer, 33cc average per session. We did not report any complications. The clinical appearance, discussed by three surgeons and subjective patient feelings, after a 6-month follow-up period, suggests considerable improvement in the mimic features, skin texture, and thickness. The result is good in 86% of cases and acceptable in the other cases. Burns sequelae offer local conditions which justify special cannula can cross fibrosis and explaining the value of multiplying the sessions. Indications for lipostructure include four distinct nosological situations, sometimes combined. Lipostructure can restore a missing relief, filling a localized depression, reshape a lack of face volume or smooth a scarring skin. Fat graft seems to complete and improve the results of the standard surgical approach in burned face. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  11. [Surgical treatment of burns : Special aspects of pediatric burns].

    Science.gov (United States)

    Bührer, G; Beier, J P; Horch, R E; Arkudas, A

    2017-05-01

    Treatment of pediatric burn patients is very important because of the sheer frequency of burn wounds and the possible long-term ramifications. Extensive burns need special care and are treated in specialized burn centers. The goal of this work is to present current standards in burn therapy and important innovations in the treatment of burns in children so that the common and small area burn wounds and scalds in pediatric patients in day-to-day dermatological practice can be adequately treated. Analysis of current literature, discussion of reviews, incorporation of current guidelines. Burns in pediatric patients are common. Improvement of survival can be achieved by treatment in burn centers. The assessment of burn depth and area is an important factor for proper treatment. We give an overview for outpatient treatment of partial thickness burns. New methods may result in better long-term outcome. Adequate treatment of burn injuries considering current literature and guidelines improves patient outcome. Rational implementation of new methods is recommended.

  12. TRIGA criticality experiment for testing burn-up calculations

    International Nuclear Information System (INIS)

    Persic, Andreja; Ravnik, Matjaz; Zagar, Tomaz

    1999-01-01

    A criticality experiment with partly burned TRIGA fuel is described. 20 wt % enriched standard TRIGA fuel elements initially containing 12 wt % U are used. Their average burn-up is 1.4 MWd. Fuel element burn-up is calculated in 2-D four group diffusion approximation using TRIGLAV code. The burn-up of several fuel elements is also measured by reactivity method. The excess reactivity of several critical and subcritical core configurations is measured. Two core configurations contain the same fuel elements in the same arrangement as were used in the fresh TRIGA fuel criticality experiment performed in 1991. The results of the experiment may be applied for testing the computer codes used for fuel burn-up calculations. (author)

  13. Burning plasmas in ITER for energy source

    International Nuclear Information System (INIS)

    Inoue, Nobuyuki

    2002-01-01

    Fusion research and development has two aspects. One is an academic research on science and technology, i.e., discovery and understanding of unexpected phenomena and, development of innovative technology, respectively. The other is energy source development to realize fusion as a viable energy future. Fusion research has been made remarkable progress in the past several decades, and ITER will soon realize burning plasma that is essential for both academic research and energy development. With ITER, scientific research on unknown phenomena such as self-organization of the plasma in burning state will become possible and it contributes to create a variety of academic outcome. Fusion researchers will have a responsibility to generate actual energy, and electricity generation immediately after the success of burning plasma control experiment in ITER is the next important step that has to be discussed seriously. (author)

  14. Burning plasmas in ITER for energy source

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Nobuyuki [Atomic Energy Commission, Tokyo (Japan)

    2002-10-01

    Fusion research and development has two aspects. One is an academic research on science and technology, i.e., discovery and understanding of unexpected phenomena and, development of innovative technology, respectively. The other is energy source development to realize fusion as a viable energy future. Fusion research has been made remarkable progress in the past several decades, and ITER will soon realize burning plasma that is essential for both academic research and energy development. With ITER, scientific research on unknown phenomena such as self-organization of the plasma in burning state will become possible and it contributes to create a variety of academic outcome. Fusion researchers will have a responsibility to generate actual energy, and electricity generation immediately after the success of burning plasma control experiment in ITER is the next important step that has to be discussed seriously. (author)

  15. [Lymphocyte metabolism in children with extensive burns].

    Science.gov (United States)

    Artem'ev, S A; Nazarov, I P; Kamzalakova, N I; Bulygin, G V

    2009-01-01

    The results of the study lead to the conclusion that the development of burn disease in children is accompanied by significant lymphocytic structural metabolic changes that determine the functional capabilities of cells and the immune system as a whole. There is an evident activation of the glutathione antioxidant system, a drastic activation of enzymes that ensure Krebs cycle reactions, as well as activation of anaerobic processes. The above changes are mainly caused by the activated sympathoadrenal system that is characteristic of stresses. The knowledge about the metabolic mechanisms responsible for the development of cellular reactions to burn shock and burn disease permits specification of the elements of the pathogenesis of these severe conditions and substantiation of the possibility of using metabolic correction in the complex treatment of children with the above pathology.

  16. Minor burn - first aid - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100213.htm Minor burn - first aid - series—Procedure, part 1 To use ... out of 2 Overview To treat a minor burn, run cool water over the area of the ...

  17. [Burns in adolescents].

    Science.gov (United States)

    Ortiz Rodríguez, R; Domínguez Amillo, E; Soto Beauregard, C; Díaz González, M; López Gutiérrez, J C; Ros Mar, Z; Tovar Larrucea, J A

    2012-04-01

    The aim of this study was to know the epidemiology of burns in teenagers. Burn patients over 11 years old admitted in our Institution in the last 10 years were included. Etiology, burn size, hospital stay, quirurgical interventions and long term sequelae were registered. One thousand and eight patients were admitted, 89 were over 11 years (8.8%), 70.7% were boys and 29.3% girls. Fire was the principal agent in 58 cases (65.1%), due to fireworks in 13 (22.4%), alcohol in 7 (12%), explosion of flammable containers (spray) in 4 (6.8%) and gasoline in 3 (5.2%). Fireworks injuries and spray explosions affected face and hand in 88% cases. The median hospital stay was 8 days after admission (1 to 90). 83.1% required surgical treatment with mean of 1.8 +/- 1.4 interventions and 21.3% had long-term sequelaes that required at least one surgical intervention. Fire is the main cause of burns in adolescents. Fireworks injuries represented a quarter of that lesions, and highlights paint spray explosions as new causative agents. Considering the high morbidity in this age group, with permanent functional and aesthetic sequelae, prevention campaigns are needed to reduce such accidents.

  18. Electrical Burns: First Aid

    Science.gov (United States)

    ... local emergency number if the source of the burn is a high-voltage wire or lightning. Don't get near high-voltage ... 20 feet (about 6 meters) away — farther if wires are jumping and sparking. Don't move a person with ... breathing Heart rhythm problems (arrhythmias) Cardiac ...

  19. Burns - Multiple Languages

    Science.gov (United States)

    ... Translations Russian (Русский) Expand Section Burn Care - Русский (Russian) Bilingual ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  20. One Burn, One Standard

    Science.gov (United States)

    2014-09-01

    PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Giretzlehner M., Haller H. L., Faucher L. D., Pressman M. A., Salinas J., Jeng J. C., 5d. PROJECT NUMBER 5e...AUVA Linz, Austria Lee D. Faucher, MD University of Wisconsin Madison, Wisconsin Melissa A. Pressman , PhD Arizona Burn Center Phoenix

  1. 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.

  2. Mineralogical and micromorphological modifications in soil affected by slash pile burn

    Science.gov (United States)

    M. M. Nobles; W. J. Massman; M. Mbila; G. Butters

    2010-01-01

    Silvicultural practices, such as slash pile burning, are commonly used for fire and ecosystem management. This management technique can drastically alter chemical, physical and biological soil properties due to the high temperatures achieved during the prolonged severe burn. Little is known, however, about the impact of high-temperature slash pile burning on soil...

  3. Burn Wise Educational Materials for Businesses

    Science.gov (United States)

    Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

  4. Repeated Prescribed Burning in Aspen

    Science.gov (United States)

    Donald A. Perala

    1974-01-01

    Infrequent burning weather, low flammability of the aspen-hardwood association, and prolific sprouting and seeding of shrubs and hardwoods made repeated dormant season burning a poor tool to convert good site aspen to conifers. Repeat fall burns for wildlife habitat maintenance is workable if species composition changes are not important.

  5. Air-Freshener Burns: A New Paradigm in Burns Etiology?

    OpenAIRE

    Sarwar, Umran; Nicolaou, M.; Khan, M. S.; Tiernan, E.

    2011-01-01

    Objectives: We report a rare case of burns following the use of automated air-fresheners. Methods: We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. Results: A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms re...

  6. Air-freshener burns: a new paradigm in burns etiology?

    Science.gov (United States)

    Sarwar, Umran; Nicolaou, M; Khan, M S; Tiernan, E

    2011-10-01

    We report a rare case of burns following the use of automated air-fresheners. We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms resulting in a seven-day hospital admission. The burns were treated conservatively. To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale.

  7. Current issues in burn wound infections.

    Science.gov (United States)

    Dodd, D; Stutman, H R

    1991-01-01

    As we have emphasized, the diagnosis of burn wound infections in the high-risk burned child can be difficult and depends on a very high degree of suspicion and daily clinical evaluation of the burn wound site by consistent observers. Appropriate precautions include meticulous hand-washing and the use of gloves when handling the wound site and prophylactic application of a topical antibacterial agent such as SSD cream. Wound therapy should include routine vigorous surgical débridement. Surveillance wound cultures should be done weekly to determine the emergency of colonization and aid in the selection of empiric antimicrobial regimens when these are appropriate. Wound biopsy for histological examination and quantitative culture is highly recommended in the severely ill child with an unclear etiology or site of infection. If, despite these measures, sepsis ensues, then systemic antibiotics must be started empirically as an adjuctive therapy to surgical débridement. Knowledge of the organisms colonizing a wound will prove useful in choosing an antibiotic regimen while awaiting definitive results of blood and wound biopsy cultures. Without this information, early burn sepsis therapy should focus on gram-positive organisms, while infection later in the course should raise suspicion of nosocomial pathogens such as P. aeruginosa, other enteric bacilli, and C. albicans. An initial regimen might include nafcillin plus ceftazidime or an aminoglycoside, with anaerobic coverage depending on considerations noted previously. Once the causative agent is identified, therapy must be modified accordingly. Amphotericin B and acyclovir use should be guided by positive cultures from the burn wound site along with systemic evidence of dissemination. Available studies do not yet make clear the role of empiric immunotherapy with intravenous gamma globulin in the burned child. Therefore, its use cannot be recommended at the present time, although the development of specific

  8. 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.

  9. ANFO truck burn trials

    Energy Technology Data Exchange (ETDEWEB)

    Rosen von, B.; Contestabile, E. [Natural Resources Canada, CANMET Canadian Explosives Research Laboratory, Ottawa, ON (Canada)

    2003-10-01

    This report describes the investigation of a tractor-trailer explosion. A truck loaded with 18,000 kg of commercial explosives, of which 13,000 kg was ammonium nitrate with fuel oil (ANFO), caught fire when it struck a rockcut near Walden, Ontario on August 5, 1998. The fire resulted in the detonation of the load. The Canadian Explosives Research Laboratory (CERL) conducted a test program to examine the suitability of existing explosive transportation regulations. Unconfined burns of ANFO were performed. The accident was recreated in two burn trials in an attempt to identify the mechanism that led from fire to detonation. Two full-scale tests were conducted using complete tractor-trailers, each in a jack-knifed position with most of the explosives placed on the ground in front of the trailer. ANFO was used in the first test to determine its response to thermal stimulus and the likelihood of detonation or explosion. The second test involved ANFO, a slurry and an emulsion. Thermocouples and video cameras were used to observe the burning characteristics of the explosives, the truck and its components. The explosives burned steadily for 80 minutes in each test. Many truck components, such as tires, spring brake chambers and the fuel tank ruptured violently due to the heat. Although no detonation occurred in the test trials, it was concluded that under favourable conditions, many truck components, might produce fragments with enough energy to initiate heat-sensitized explosives. It was suggested that a fragment impact caused the detonation at Walden. 4 refs., 7 tabs., 8 figs.

  10. Fungal Burn Wound Infection

    Science.gov (United States)

    1991-01-01

    Aspergillus), Blasto- T he use of effective topical chemotherapeutic agents to myces (Candida), and Zygomycetes ( Mucor , Rhizopus).6 reduce...species, 18%; Mucor species and Rhizopus species, acetate in the morning and silver sulfadiazine in the evening. Prophy- 9.1%; and Microspora species and...sensitivity reports, and the patient’s sue, including one patient who required a hip disarticulation response. to control an invasive Mucor burn wound

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

    Science.gov (United States)

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

    2016-01-01

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

  12. 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.

  13. Radioisotopic studies on pulmonary function in experimental burn shock

    International Nuclear Information System (INIS)

    Lambrecht, W.; Barcikowski, S.; Maziarz, Z.; Zajgner, J.; Markiewicz, A.

    1980-01-01

    Disturbances in pulmonary ventilation and perfusion, which can initiate severe complications, often lead to many therapeutic failures in burn shock. Early recognition of respiratory disturbances is often required to improve results of treatment of burn shock. The authors investigated changes in pulmonary ventilation and perfusion in napalm-burnt rabbits using 133 Xe. Simultaneously, they determined effect of treatment with cytochrome C on pulmonary ventilation and perfusion in animals burnt with napalm. It was found that in napalm-burnt rabbits burn shock was accompanied by a significant deterioration in pulmonary ventilation and perfusion. The most marked changes were observed one and two days after burn. It was also found a beneficial effect of treatment with cytochrome C on alveolar ventilation. The authors pointed out the usefulness of radioisotopic investigations of pulmonary ventilation and perfusion in burn shock. (author)

  14. [Factor XIII deficiency in burns].

    Science.gov (United States)

    Burkhardt, H; Zellner, P R; Möller, I

    1977-08-01

    In 34 patients with severe burn injuries platelets, fibrinogen, prothrombin time, partial thromboplastin time, thrombin time and factor XIII were measured daily. Half of the patients were administered 15 000 IE of heparin per 24 hours. In the first 4 days there was a rapid fall of factor XIII to a value of approximately 30%. Values remained very low during the whole observation period of up to 20 days. However, in patients treated with heparin, values tended to be 10--15% higher. After an initial decline on the tenth day, the platelets had risen to the lowest normal level. Platelets were identical in both groups. The causes for the changes in these haemostasis parameters, their significance, and possible consequences of therapy are discussed.

  15. Impact of pediatric burn camps on participants' self esteem and body image: an empirical study.

    Science.gov (United States)

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

    2011-12-01

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

  16. The Effect of Prescribed Burns and Wildfire on Vegetation in Bastrop State Park, TX

    Science.gov (United States)

    Justice, C. J.

    2014-12-01

    In 2011, central Texas had its worst drought since the 1950's. This, in conjunction with the strong winds produced by Tropical Storm Lee created conditions that made possible the Bastrop County Complex Fire in September 2011. These record-breaking wildfires burned over 95% of the 6,565-acre Bastrop State Park (BSP). Since 2003, BSP had been using prescribed burns as a management practice to reduce fuel load and prevent high severity wildfires. Although these prescribed fires did not prevent the 2011 wildfires they may have mitigated their effects. This study considered the effect of prescribed burn history and wildfire burn severity on vegetation recovery in BSP since the 2011 wildfire. The hypotheses of this study are that prescribed burn history and wildfire burn severity separately and jointly have affected post wildfire vegetation. To test these hypotheses, data were collected in 2013 from 46 plots across BSP using the Fire Effects Monitoring and Inventory (FIREMON) protocol to determine herbaceous plant density, shrub density, overstory density, and midstory tree density. Data were analyzed using analyses of variance (ANOVA) to determine the effects of prescribed fire and wildfire severity on these vegetation measurements. It was found that more severely burned plots had more herbaceous plants, fewer midstory trees, and lower shrub densities than less severely burned plots. Contrary to an initial hypotheses, there were few relationships between prescribed burn history and wildfire effects. The only significant effect detected for prescribed burning was the positive effect of prescribed fire on midstory tree density, but only for plots that were not severely burned in the wildfire. In this system, burn severity had a greater effect on post-wildfire vegetation than prescribed burns.

  17. Foot burns: epidemiology and management.

    Science.gov (United States)

    Hemington-Gorse, S; Pellard, S; Wilson-Jones, N; Potokar, T

    2007-12-01

    This is a retrospective study of the epidemiology and management of isolated foot burns presenting to the Welsh Centre for Burns from January 1998 to December 2002. A total of 289 were treated of which 233 were included in this study. Approximately 40% were in the paediatric age group and the gender distribution varied dramatically for adults and children. In the adult group the male:female ratio was 3.5:1, however in the paediatric group the male:female ratio was more equal (1.6:1). Scald burns (65%) formed the largest group in children and scald (35%) and chemical burns (32%) in adults. Foot burns have a complication rate of 18% and prolonged hospital stay. Complications include hypertrophic scarring, graft loss/delayed healing and wound infection. Although isolated foot burns represent a small body surface area, over half require treatment as in patients to allow for initial aggressive conservative management of elevation and regular wound cleansing to avoid complications. This study suggests a protocol for the initial acute management of foot burns. This protocol states immediate referral of all foot burns to a burn centre, admission of these burns for 24-48 h for elevation, regular wound cleansing with change of dressings and prophylactic antibiotics.

  18. BAMS: A Tool for Supervised Burned Area Mapping Using Landsat Data

    Directory of Open Access Journals (Sweden)

    Aitor Bastarrika

    2014-12-01

    Full Text Available A new supervised burned area mapping software named BAMS (Burned Area Mapping Software is presented in this paper. The tool was built from standard ArcGISTM libraries. It computes several of the spectral indexes most commonly used in burned area detection and implements a two-phase supervised strategy to map areas burned between two Landsat multitemporal images. The only input required from the user is the visual delimitation of a few burned areas, from which burned perimeters are extracted. After the discrimination of burned patches, the user can visually assess the results, and iteratively select additional sampling burned areas to improve the extent of the burned patches. The final result of the BAMS program is a polygon vector layer containing three categories: (a burned perimeters, (b unburned areas, and (c non-observed areas. The latter refer to clouds or sensor observation errors. Outputs of the BAMS code meet the requirements of file formats and structure of standard validation protocols. This paper presents the tool’s structure and technical basis. The program has been tested in six areas located in the United States, for various ecosystems and land covers, and then compared against the National Monitoring Trends in Burn Severity (MTBS Burned Area Boundaries Dataset.

  19. Protocol for a systematic review of quantitative burn wound microbiology in the management of burns patients.

    Science.gov (United States)

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

    2015-11-06

    Sepsis from burn injuries can result from colonisation of burn wounds, especially in large surface area burns. Reducing bacterial infection will reduce morbidity and mortality, and mortality for severe burns can be as high as 15 %. There are various quantitative and semi-quantitative techniques to monitor bacterial load on wounds. In the UK, burn wounds are typically monitored for the presence or absence of bacteria through the collection and culture of swabs, but no absolute count is obtained. Quantitative burn wound culture provides a measure of bacterial count and is gaining increased popularity in some countries. It is however more resource intensive, and evidence for its utility appears to be inconsistent. This systematic review therefore aims to assess the evidence on the utility and reliability of different quantitative microbiology techniques in terms of diagnosing or predicting clinical outcomes. Standard systematic review methods aimed at minimising bias will be employed for study identification, selection and data extraction. Bibliographic databases and ongoing trial registers will be searched and conference abstracts screened. Studies will be eligible if they are prospective studies or systematic reviews of burn patients (any age) for whom quantitative microbiology has been performed, whether it is compared to another method. Quality assessment will be based on quality assessment tools for diagnostic and prognostic studies and tailored to the review as necessary. Synthesis is likely to be primarily narrative, but meta-analysis may be considered where clinical and methodological homogeneity exists. Given the increasing use of quantitative methods, this is a timely systematic review, which will attempt to clarify the evidence base. As far as the authors are aware, it will be the first to address this topic. PROSPERO, CRD42015023903.

  20. Explanatory Model of Resilience in Pediatric Burn Survivors.

    Science.gov (United States)

    Quezada, Lucía; González, Mónica T; Mecott, Gabriel A

    2016-01-01

    Identifying factors of adjustment in pediatric burn patients may facilitate appropriate mental health interventions postinjury. The aim of this is study was to explore the roles of both the patient's and caregivers' resilience and posttraumatic stress in pediatric burn survivor adjustment. For the purposes of the study, "51 patient-parent/guardian" dyads participated. Patients answered the Resilience Questionnaire for Children and Adolescents, and caregivers answered the Mexican Resilience Scale and the Davidson Trauma Scale. The roles of patient age, time since the burn, and size of burn injury were also considered. Statistical analyses included Spearman's ρ for correlations and structural equation modeling. P less than .05 was considered significant. Patients and caregivers reported high levels of resilience, and the majority of caregivers reported low severity of posttraumatic stress disorder symptoms. Pediatric burn survivors' resilience was associated with being younger at the time of the burn and less severity of intrusive and avoidance symptoms in caregivers; it was also associated with a higher resilience in caregivers. It can be concluded that psychological responses of caregivers of pediatric burn survivors affect the well being and positive adjustment of patients; thus psychological services for caregivers would likely have a double benefit for both caregivers and patients.

  1. Healing of cornea following an electric burn.

    Science.gov (United States)

    Chaudhry, Tanveer Anjum; Shaikh, Farheen; Ahmad, Khabir

    2012-08-01

    Electrical injuries have become a significant health problem in developing countries because of increase in access to electricity in the last few decades and lack of adequate safety measures. Electrical injuries of eyes are relatively uncommon. A case report of a rapid and complete corneal healing accompanied by satisfactory visual recovery after an electric burn event in a 20-year-old male is reported. The patient had accidental exposure to high voltage live wire while he was repairing it, resulting in severe ocular and superficial body burn. He was not wearing any protective equipment at the time of injury. On examination, the best-corrected visual acuity was counting fingers in the left eye with severe corneal epithelial loss and diffuse corneal oedema. The patient was treated medically, with a rapid corneal healing and resolution of oedema over the next few days. Visual acuity in the worse eye (left) improved to 20/25 from counting fingers.

  2. Actinide burning and waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Pigford, T H [University of California, Berkeley, CA (United States)

    1990-07-01

    Here we review technical and economic features of a new proposal for a synergistic waste-management system involving reprocessing the spent fuel otherwise destined for a U.S. high-level waste repository and transmuting the recovered actinides in a fast reactor. The proposal would require a U.S. fuel reprocessing plant, capable of recovering and recycling all actinides, including neptunium americium, and curium, from LWR spent fuel, at recoveries of 99.9% to 99.999%. The recovered transuranics would fuel the annual introduction of 14 GWe of actinide-burning liquid-metal fast reactors (ALMRs), beginning in the period 2005 to 2012. The new ALMRs would be accompanied by pyrochemical reprocessing facilities to recover and recycle all actinides from discharged ALMR fuel. By the year 2045 all of the LWR spent fuel now destined f a geologic repository would be reprocessed. Costs of constructing and operating these new reprocessing and reactor facilities would be borne by U.S. industry, from the sale of electrical energy produced. The ALMR program expects that ALMRs that burn actinides from LWR spent fuel will be more economical power producers than LWRs as early as 2005 to 2012, so that they can be prudently selected by electric utility companies for new construction of nuclear power plants in that era. Some leaders of DOE and its contractors argue that recovering actinides from spent fuel waste and burning them in fast reactors would reduce the life of the remaining waste to about 200-300 years, instead of 00,000 years. The waste could then be stored above ground until it dies out. Some argue that no geologic repositories would be needed. The current view expressed within the ALMR program is that actinide recycle technology would not replace the need for a geologic repository, but that removing actinides from the waste for even the first repository would simplify design and licensing of that repository. A second geologic repository would not be needed. Waste now planned

  3. Actinide burning and waste disposal

    International Nuclear Information System (INIS)

    Pigford, T.H.

    1990-01-01

    Here we review technical and economic features of a new proposal for a synergistic waste-management system involving reprocessing the spent fuel otherwise destined for a U.S. high-level waste repository and transmuting the recovered actinides in a fast reactor. The proposal would require a U.S. fuel reprocessing plant, capable of recovering and recycling all actinides, including neptunium americium, and curium, from LWR spent fuel, at recoveries of 99.9% to 99.999%. The recovered transuranics would fuel the annual introduction of 14 GWe of actinide-burning liquid-metal fast reactors (ALMRs), beginning in the period 2005 to 2012. The new ALMRs would be accompanied by pyrochemical reprocessing facilities to recover and recycle all actinides from discharged ALMR fuel. By the year 2045 all of the LWR spent fuel now destined f a geologic repository would be reprocessed. Costs of constructing and operating these new reprocessing and reactor facilities would be borne by U.S. industry, from the sale of electrical energy produced. The ALMR program expects that ALMRs that burn actinides from LWR spent fuel will be more economical power producers than LWRs as early as 2005 to 2012, so that they can be prudently selected by electric utility companies for new construction of nuclear power plants in that era. Some leaders of DOE and its contractors argue that recovering actinides from spent fuel waste and burning them in fast reactors would reduce the life of the remaining waste to about 200-300 years, instead of 00,000 years. The waste could then be stored above ground until it dies out. Some argue that no geologic repositories would be needed. The current view expressed within the ALMR program is that actinide recycle technology would not replace the need for a geologic repository, but that removing actinides from the waste for even the first repository would simplify design and licensing of that repository. A second geologic repository would not be needed. Waste now planned

  4. Burning mouth syndrome: An update

    OpenAIRE

    Vijay Kumar Ambaldhage; Jaishankar Homberhalli Puttabuddi; Purnachandrarao Naik Nunsavath

    2015-01-01

    Burning mouth syndrome (BMS) is characterized by an oral burning sensation in the absence of any organic disorders of the oral cavity. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. It is observed principally in middle-aged patients and postmenopausal women and is characterized by an intense burning type of pain, preferably on the tongue and in other areas of the ...

  5. Burning mouth syndrome: Present perspective

    OpenAIRE

    Ramesh Parajuli

    2015-01-01

    Introduction: Burning mouth syndrome is characterized by chronic oral pain or burning sensation affecting the oral mucosa in the absence of obvious visible mucosal lesions. Patient presenting with the burning mouth sensation or pain is frequently encountered in clinical practice which poses a challenge to the treating clinician. Its exact etiology remains unknown which probably has multifactorial origin. It often affects middle or old age women and it may be accompanied by xerostomia and alte...

  6. Pumice stones as potential in-situ burning enhancer

    DEFF Research Database (Denmark)

    Rojas Alva, U.; Andersen, Bjørn Skjønning; Jomaas, Grunde

    2018-01-01

    Small-scale and mid-scale experiments were conducted in order to evaluate pumice stones as a potential enhancement for in-situ burning (ISB). Four oil types, several emulsification degrees of one crude oil were studied. In general, it was observed that the pumice stones did not improve the burning...... and after the burn, thus bringing the oil into the water column. Finally, the species production of CO and CO2 was not reduced. Based on the presented results, pumice stones have a negative impact on the efficiency of ISB, and they are ruled out as an ISB enhancer and should not be used in relation to ISB....

  7. Ice & Fire: the Burning Question

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Jomaas, Grunde

    2017-01-01

    With the Arctic opening up to new shipping routes and increased oil exploration and production due to climate change, the risk of an Arctic oil spill is increasing. Of the classic oil spill response methods (mechanical recovery, dispersants and in-situ burning), in-situ burning is considered...... to be particularly a suitable response method in the Arctic. In-situ burning aims to remove the oil from the marine environment by burning it from the water surface. A recent Ph.D. thesis from the Technical University of Denmark has provided some new insights with respect to the fire science behind this response...

  8. Novel burn device for rapid, reproducible burn wound generation.

    Science.gov (United States)

    Kim, J Y; Dunham, D M; Supp, D M; Sen, C K; Powell, H M

    2016-03-01

    Scarring following full thickness burns leads to significant reductions in range of motion and quality of life for burn patients. To effectively study scar development and the efficacy of anti-scarring treatments in a large animal model (female red Duroc pigs), reproducible, uniform, full-thickness, burn wounds are needed to reduce variability in observed results that occur with burn depth. Prior studies have proposed that initial temperature of the burner, contact time with skin, thermal capacity of burner material, and the amount of pressure applied to the skin need to be strictly controlled to ensure reproducibility. The purpose of this study was to develop a new burner that enables temperature and pressure to be digitally controlled and monitored in real-time throughout burn wound creation and compare it to a standard burn device. A custom burn device was manufactured with an electrically heated burn stylus and a temperature control feedback loop via an electronic microstat. Pressure monitoring was controlled by incorporation of a digital scale into the device, which measured downward force. The standard device was comprised of a heat resistant handle with a long rod connected to the burn stylus, which was heated using a hot plate. To quantify skin surface temperature and internal stylus temperature as a function of contact time, the burners were heated to the target temperature (200±5°C) and pressed into the skin for 40s to create the thermal injuries. Time to reach target temperature and elapsed time between burns were recorded. In addition, each unit was evaluated for reproducibility within and across three independent users by generating burn wounds at contact times spanning from 5 to 40s at a constant pressure and at pressures of 1 or 3lbs with a constant contact time of 40s. Biopsies were collected for histological analysis and burn depth quantification using digital image analysis (ImageJ). The custom burn device maintained both its internal

  9. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

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

  10. Methylated spirit burns following traditional hair dressing practice.

    Science.gov (United States)

    Michael, Afieharo I; Iyun, Ayodele O

    2018-02-01

    Methylated spirit burns have been reported following domestic uses such as igniting fondues. It has also been used as an accelerant for self-immolation. We report the first documented case of severe methylated spirit burns sustained during traditional hair dressing. Increased awareness on the dangers of methylated spirit as well as making it less readily available for domestic use is warranted. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. Burning mouth syndrome: a review on diagnosis and treatment.

    Science.gov (United States)

    Coculescu, E C; Radu, A; Coculescu, B I

    2014-01-01

    Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in the clinically healthy oral mucosa. It is difficult to diagnose BMS because there is a discrepancy between the severity, extensive objective pain felt by the patient and the absence of any clinical changes of the oral mucosa. This review presents some aspects of BMS, including its clinical diagnosis, classification, differential diagnosis, general treatment, evolution and prognosis.

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

    Science.gov (United States)

    2016-10-01

    able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E

  13. [Heat stroke and burns resulting from use of sauna

    DEFF Research Database (Denmark)

    Runitz, K.; Jensen, T.H.

    2009-01-01

    We describe a case of severe heat stroke resulting from exposure to extreme heat in a sauna for an unknown period of time. The patient sustained 20% 2nd degree burns. On arrival at the emergency department, the patient's temperature was 40.5 degrees C. At the critical care unit, the patient devel...... developed severe multi-organ failure and critical polyneuropathy. Severe heat stroke is a rare diagnosis in Denmark. The treatment is symptomatic and the prognosis is grave, especially in combination with severe burns Udgivelsesdato: 2009/1/26......We describe a case of severe heat stroke resulting from exposure to extreme heat in a sauna for an unknown period of time. The patient sustained 20% 2nd degree burns. On arrival at the emergency department, the patient's temperature was 40.5 degrees C. At the critical care unit, the patient...

  14. Clinical outcome of patients with self-inflicted burns.

    Science.gov (United States)

    Cornet, P A; Niemeijer, A S; Figaroa, G D; van Daalen, M A; Broersma, T W; van Baar, M E; Beerthuizen, G I J M; Nieuwenhuis, M K

    2017-06-01

    Patients with self-inflicted burns (SIB) are thought to have a longer length of stay compared to patients with accidental burns. However, other predictors for a longer length of stay are often not taken into account, e.g. percentage of the body surface area burned, age or comorbidities. Therefore, we wanted to study the outcome of patients with SIB at our burn center. A retrospective, observational study was conducted. All adult patients with acute burns admitted to the burn center of the Martini Hospital Groningen, between January 1, 2009 and December 31, 2013 were included. Data on characteristics of the patient, injury, and outcome (LOS, mortality, discharge destination) were collected. In patients with SIB, suicide attempts (SA) were distinguished from self-harm without the intention to die (non-suicidal self-injury, NSSI). To evaluate differences in outcome, each patient with SIB was matched on variables and total score of the Abbreviated Burn Severity Index (ABSI) to a patient with accidental burns (AB). In total 29 admissions (21 SA and 8 NSSI) were due to SIB and 528 due to accidents. Overall, when compared to AB, there were significant differences with respect to mortality and LOS for SA and/or NSSI. Mortality was higher in the SA group, while the LOS was higher in both the SA and NSSI groups compared to the AB group. However, after matching on ABSI, no statistical significant differences between the SA and SA-match or the NSSI and NSSI-match group were found. With the right and timely treatment, differences in mortality rate or length of stay in hospital could all be explained by the severity of the burn and the intention of the patient. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  15. In-situ burning of Orimulsion : small scale burns

    International Nuclear Information System (INIS)

    Fingas, M.F.

    2002-01-01

    This study examined the feasibility of burning Orimulsion. In-situ burning has always been a viable method for cleaning oil spills on water because it can effectively reduce the amount of spilled oil and eliminate the need to collect, store, transport and dispose of recovered oil. Orimulsion, however, behaves very differently from conventional oil when it is spilled because of its composition of 70 per cent bitumen in 30 per cent water. In-situ burning of this surfactant-stablized oil-in-water emulsion has never been seriously considered because of the perception that Orimulsion could not be ignited, and if it could, ignition would not be sustained. In this study, burn tests were conducted on 3 scales in a Cleveland Open Cup apparatus of 5 cm, 10 cm and 50 cm diameters. Larger scale burns were conducted in specially built pans. All tests were conducted on salt water which caused the bitumen to separate from the water. The objective was to determine if sufficient vapours could be generated to ignite the Orimulsion. The study also measured if a sustained flame would result in successful combustion. Both objectives were successfully accomplished. Diesel fuel was used to ignite the Orimulsion in the specially designed pan for large scale combustion. Quantitative removal of Orimulsion was achieved in all cases, but in some burns it was necessary to re-ignite the Orimulsion. It was noted that when Orimulsion burns, some trapped water droplets in the bitumen explode with enough force to extinguish a small flame. This did not occur on large-scale burns. It was concluded that the potential for successful in-situ burning increases with size. It was determined that approximately 1 mm in thickness of diesel fuel is needed to ignite a burn. 5 refs., 3 tabs., 4 figs

  16. Electroacupuncture improves burn-induced impairment in gastric motility mediated via the vagal mechanism in rats.

    Science.gov (United States)

    Song, J; Yin, J; Sallam, H S; Bai, T; Chen, Y; Chen, J D Z

    2013-10-01

    Delayed gastric emptying (GE) is common in patients with severe burns. This study was designed to investigate effects and mechanisms of electroacupuncture (EA) on gastric motility in rats with burns. Male rats (intact and vagotomized) were implanted with gastric electrodes, chest and abdominal wall electrodes for investigating the effects of EA at ST-36 (stomach-36 or Zusanli) on GE, gastric slow waves, autonomic functions, and plasma interleukin 6 (IL-6) 6 and 24 h post severe burns. (i) Burn delayed GE (P Electroacupuncture improved GE 6 and 24 h post burn (P Electroacupuncture improved burn-induced gastric dysrhythmia. The percentage of normal slow waves was increased with EA 6 and 24 h post burn (P = 0.02). (iii) Electroacupuncture increased vagal activity assessed by the spectral analysis of heart rate variability (HRV). The high-frequency component reflecting vagal component was increased with EA 6 (P = 0.004) and 24 h post burn (P = 0.03, vs sham-EA). (iv) Electroacupuncture attenuated burn-induced increase in plasma IL-6 at both 6 (P = 0.03) and 24 h post burn (P = 0.003). Electroacupuncture at ST-36 improves gastric dysrhythmia and accelerates GE in rats with burns. The improvement seems to be mediated via the vagal pathway involving the inflammatory cytokine IL-6. © 2013 John Wiley & Sons Ltd.

  17. Psychosocial needs of burns nurses: a descriptive phenomenological inquiry.

    Science.gov (United States)

    Kornhaber, Rachel Anne; Wilson, Anne

    2011-01-01

    The purpose of this qualitative study was to explore the psychosocial needs of nurses who care for patients with severe burn injuries. Burns nurses work in an emotionally challenging and confronting environment, for which they are in need of emotional and clinical support. Exposure to such high levels of stress in this occupational environment has implications for nurses' health and psychosocial well-being. Seven burns nurses were recruited in 2009 from a severe burn injury unit in New South Wales, Australia. A qualitative phenomenological methodology was used to construct themes depicting nurses' experiences. Participants were selected through purposeful sampling, and data were collected through in-depth individual semistructured interviews using open-ended questions. Data were analyzed with Colaizzi's phenomenological method of data analysis. The psychosocial needs of burns nurses were identified and organized into five categories: peer nursing support, informal support, lack of support, multidisciplinary team collaboration, and professional support. The findings clearly demonstrate that support and unity within the workplace are fundamental factors for the psychosocial well-being of nurses caring for patients who have sustained a severe burn injury. Support for nurses in the form of regular professional or collegial debriefing sessions and utilization of employee assistance programs could ease the impact of the stressful environment in which they operate, and could influence staff retention. However, a supportive workplace culture is necessary to encourage nurses to access these services.

  18. Care for the Critically Injured Burn Patient Modulation of Burn Scars Through Laser Deliver of Stem Cells

    Science.gov (United States)

    2013-10-01

    Miller School of Medicine and the USAISR. To obtain ADSCs, a sample of adipose tissue was surgically removed from the back (front shoulder) region... center of the animal and resulted in better overall similarity in clinical scar morphology. Histologic evaluation of wounds 70 days after burn...isolate and grow tissue fibroblast from the treated and control burn scars. Tissue samples (3 per time point) were decontaminated using several

  19. 30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

  20. Stem Cells in Burn Eschar

    NARCIS (Netherlands)

    van der Veen, V. C.; Vlig, M.; van Milligen-Kummer, F.J.; de Vries, S.I.; Middelkoop, E.; Ulrich, M.

    2012-01-01

    This study compares mesenchymal cells isolated from excised burn wound eschar with adipose-derived stem cells (ASCs) and dermal fibroblasts in their ability to conform to the requirements for multipotent mesenchymal stem cells (MSCs). A population of multipotent stem cells in burn eschar could be an

  1. Burn mortality in patients with preexisting cardiovascular disease.

    Science.gov (United States)

    Knowlin, Laquanda; Reid, Trista; Williams, Felicia; Cairns, Bruce; Charles, Anthony

    2017-08-01

    Burn shock, a complex process, which develops following burn leads to severe and unique derangement of cardiovascular function. Patients with preexisting comorbidities such as cardiovascular diseases may be more susceptible. We therefore sought to examine the impact of preexisting cardiovascular disease on burn outcomes. A retrospective analysis of patients admitted to a regional burn center from 2002 to 2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA, pre-existing comorbidities, and length of ICU/hospital stay. Bivariate analysis was performed and Poisson regression modeling was utilized to estimate the incidence of being in the ICU and mortality. There were a total of 5332 adult patients admitted over the study period. 6% (n=428) had a preexisting cardiovascular disease. Cardiovascular disease patients had a higher mortality rate (16%) compared to those without cardiovascular disease (3%, pwill likely be a greater number of individuals at risk for worse outcomes following burn. This knowledge can help with burn prognostication. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  2. Use of telemedicine to improve burn care in Ukraine.

    Science.gov (United States)

    Fuzaylov, Gennadiy; Knittel, Justin; Driscoll, Daniel N

    2013-01-01

    Global burn injuries have been described as the "forgotten public health crises" by the World Health Organization. Nearly 11 million people a year suffer burns severe enough to require medical attention; more people are burned each year than are infected with human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis combined. Telemedicine has the potential to link experts in specialized fields, such as burn care, to regions of the world that have limited or no access to such specialized care. A multilevel telemedicine program was developed between Massachusetts General Hospital/Shriners Hospital in Boston, Massachusetts, and City Hospital #8 in Lviv, Ukraine. The program should lead to a sustainable improvement in the care of burn victims in Ukraine. The authors helped establish a Learning Center at City Hospital #8 in Lviv, Ukraine, through which they were able to consult from Shriners Hospital in Boston, on a total of 14 acute burn patients in Ukraine. This article discusses two case reports with the use of telemedicine and how it has allowed the authors to provide not only acute care consultation on an international scale, but also to arrange for direct expert examination and international transport to their specialized burn center in the United States. The authors have established a program through doctors from Massachusetts General Hospital/Shriner's Hospital in Boston, which works with a hospital in Ukraine and has provided acute consultation, as well as patient transportation to the United States for treatment and direct assessment.

  3. Burning mouth syndrome: An update

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Ambaldhage

    2015-01-01

    Full Text Available Burning mouth syndrome (BMS is characterized by an oral burning sensation in the absence of any organic disorders of the oral cavity. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. It is observed principally in middle-aged patients and postmenopausal women and is characterized by an intense burning type of pain, preferably on the tongue and in other areas of the oral mucosa. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. This article provides an overview of the literature on this syndrome with special reference to the etiological factors, clinical aspects, diagnostic criteria that should be followed and the therapeutic management with reference to the most recent studies.

  4. Fuel burning and climate

    International Nuclear Information System (INIS)

    Aunan, Kristin

    2004-01-01

    Emission of soot particles and other air pollution indoors constitutes a considerable health hazard for a major part of the population in many developing countries, one of them being China. In these countries problems relating to poverty are the most important risk factors, undernourishment being the dominating reason. Number four on the list of the most serious health hazards is indoor air pollution caused by burning of coal and biomass in the households. Very high levels of soot particles occur indoors because of incomplete combustion in old-fashioned stoves and by use of low quality fuel such as sticks and twigs and straw and other waste from agriculture. This leads to an increase in a series of acute and chronic respiratory diseases, including lung cancer. It has been pointed out in recent years that emissions due to incomplete combustion of coal and biomass can contribute considerably to climate changes

  5. Pediatric burns: Kids' Inpatient Database vs the National Burn Repository.

    Science.gov (United States)

    Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hartman, Brett C; Hadad, Ivan; Tholpady, Sunil S

    2016-04-01

    Burn injuries are one of the leading causes of morbidity and mortality in young children. The Kids' Inpatient Database (KID) and National Burn Repository (NBR) are two large national databases that can be used to evaluate outcomes and help quality improvement in burn care. Differences in the design of the KID and NBR could lead to differing results affecting resultant conclusions and quality improvement programs. This study was designed to validate the use of KID for burn epidemiologic studies, as an adjunct to the NBR. Using the KID (2003, 2006, and 2009), a total of 17,300 nonelective burn patients younger than 20 y old were identified. Data from 13,828 similar patients were collected from the NBR. Outcome variables were compared between the two databases. Comparisons revealed similar patient distribution by gender, race, and burn size. Inhalation injury was more common among the NBR patients and was associated with increased mortality. The rates of respiratory failure, wound infection, cellulitis, sepsis, and urinary tract infection were higher in the KID. Multiple regression analysis adjusting for potential confounders demonstrated similar mortality rate but significantly longer length of stay for patients in the NBR. Despite differences in the design and sampling of the KID and NBR, the overall demographic and mortality results are similar. The differences in complication rate and length of stay should be explored by further studies to clarify underlying causes. Investigations into these differences should also better inform strategies to improve burn prevention and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility.

    Science.gov (United States)

    Patel, Dipen D; Rosenberg, Marta; Rosenberg, Laura; Foncerrada, Guillermo; Andersen, Clark R; Capek, Karel D; Leal, Jesus; Lee, Jong O; Jimenez, Carlos; Branski, Ludwik; Meyer, Walter J; Herndon, David N

    2018-03-07

    Children 5 and younger are at risk for sustaining serious burn injuries. The causes of burns vary depending on demographic, cultural and socioeconomic variables. At this pediatric burn center we provided medical care to children from Mexico with severe injuries. The purpose of this study was to understand the impact of demographic distribution and modifiable risk factors of burns in young children to help guide prevention. A retrospective chart review was performed with children 5 and younger from Mexico who were injured from 2000-2013. The medical records of 447 acute patients were reviewed. Frequency counts and percentages were used to identify geographic distribution and calculate incidence of burns. Microsoft Powermap software was used to create a geographical map of Mexico based on types of burns. A binomial logistic regression was used to model the incidence of flame burns as opposed to scald burns in each state with relation to population density and poverty percentage. In all statistical tests, alpha=0.05 for a 95% level of confidence. Burns were primarily caused by flame and scald injuries. Admissions from flame injuries were mainly from explosions of propane tanks and gas lines and house fires. Flame injuries were predominantly from the states of Jalisco, Chihuahua, and Distrito Federal. Scalds were attributed to falling in large containers of hot water or food on the ground, and spills of hot liquids. Scald injuries were largely from the states of Oaxaca, Distrito Federal, and Hidalgo. The odds of a patient having flame burns were significantly associated with poverty percentage (ppoverty led to decrease in odds of a flame burn, but an increase in the odds of scald burns. Similarly, we found that increasing population density led to a decrease in the odds of a flame burn, but an increase in the odds of a scald burn. Burns in young children from Mexico who received medical care at this pediatric burn center were attributed to flame and scalds. Potential

  7. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection

    DEFF Research Database (Denmark)

    Calum, H.; Moser, C.; Jensen, P. O.

    2009-01-01

    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 burn...... injury was induced in mice with a hot-air blower. The third-degree burn was confirmed histologically. The mice were allocated into five groups: control, shave, burn, infection and burn infection group. 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...

  8. Instant hot noodles: do they need to burn?

    Science.gov (United States)

    Wu, C; Tan, A L; Maze, D A E; Holland, A J A

    2013-03-01

    Scalds and contact burns in children may occur as the result of spillage of hot food and drinks, including instant hot noodles. This study sought to determine the frequency of noodle burns in children and investigate the thermal properties of instant hot noodles. Data on instant hot noodle burns in children were retrieved from the New South Wales Severe Burn Injury Database between 2005 and 2010. Five widely available brands of instant hot noodles, including three cup and two packet varieties, were prepared following the manufacturer's instructions. For each preparation the initial temperature after cooking was recorded, together with the time to cool to 50°C. 291 children sustained instant hot noodle burns over the 6 year study period, representing 5.4% of all children referred to our burns unit. Over a third received inadequate first aid. Cup noodles cooked with boiling water reached the highest temperature of over 80°C and took the longest time to cool to 50°C: on average 52.3 min. Cup noodles in smaller, narrower containers achieved higher post-cooking temperatures compared to noodles in wider, bowel shaped containers. Packet noodles cooked in a Microwave oven attained lower peak temperatures and shorter cooling times compared to cup noodles. Although relatively uncommon in children, instant hot noodle burns often received inadequate first aid. When cooked according to manufacturer's instructions, noodles generally exceeded temperatures sufficient to cause a burn. Consumers and parents need to be aware of the risks of burn when preparing these foods. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  9. Assault by burning in Jordan

    Science.gov (United States)

    Haddadin, W.

    2012-01-01

    Summary Criminal attacks by burns on women in Jordan are highlighted in this retrospective study carried out of all proved cases of criminal burns in female patients treated at the burn unit of the Royal Rehabilitation Center in Jordan between January 2005 and June 2012. Thirteen patients were included in our study, out of a total of 550 patients admitted, all in the age range of 16-45 yr. Of these 13 women, six were burned by acid throwing, five by hot water, and two by direct flames from fuel thrown over them. Burn percentage ranged from 15 to 75% of the total body surface area, with involvement in most cases of the face and upper trunk. The mean hospital stay was 33 days and the mortality rate was 3/13, i.e. 23%. Violence against women exists in Jordanian society, yet burning assaults are rare. Of these, burning by throwing acid is the most common and most disfiguring act, with a higher mortality rate in domestic environments. PMID:23766757

  10. The evidence-based topical therapies for management of minor burns in outpatient clinic

    Directory of Open Access Journals (Sweden)

    Siphora Dien

    2015-08-01

    Full Text Available Burns are often seen in clinics or hospitals. Majority of burns are minor burns, which can be managed in outpatient setting with satisfactory result. The healing outcome depends on physician’s knowledge and competencies in burn pathogenesis and basic principles of burn care. Initial treatment of burns consists of emergency evaluation, assessment of depth and severity of burns and considerations for referral. The principles of minor wound therapy include cooling, cleansing, pain management, and topical therapy. Recently, many topical agents are available and indicated for first to second degree burn. Silver sulfadiazine (SSD is the standard treatment; however, it has some limitations. Scientific evidences showed that topical antibiotics do not reduce the incidence of local infection, invasive infection, and mortality of infection. Burns heal faster with hydrogel dressings and some other dressings compared to SSD. There are insufficient evidences to support the use of aloe vera, honey, and negative pressure wound therapy in burns. Moist exposed burn ointment (MEBO® has been demonstrated to have equal efficacy to SSD.

  11. Hair bleaching and skin burning

    OpenAIRE

    Forster, K.; Lingitz, R.; Prattes, G.; Schneider, G.; Sutter, S.; Schintler, M.; Trop, M.

    2012-01-01

    Hairdressing-related burns are preventable and therefore each case is one too many. We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond and placed under a dryer to accelerate the highlighting procedure. The wound on the nape of the neck required surgical debridement and skin grafting. The grafted area resulted in subsequent scar formation.

  12. Burns injury in children: Is antibiotic prophylaxis recommended?

    Directory of Open Access Journals (Sweden)

    Jamila Chahed

    2014-01-01

    Full Text Available Background: Wound infection is the most frequent complication in burn patients. There is a lack of guidelines on the use of systemic antibiotics in children to prevent this complication. Patients and Methods: A prospective study is carried out on 80 patients to evaluate the role of antibiotic prophylaxis in the control of infections. Results: The mean age was 34 months (9 months to 8 years. There was a male predominance with sex ratio of 1.66. The mean burn surface size burn was 26.5% with total burn surface area ranging from 5% to 33%, respectively. According to American Burn Association 37% (30/80 were severe burns with second and third degree burns >10% of the total surface body area in children aged <10 years old. Scalds represented 76.2% (61/80 of the burns. Burns by hot oil were 11 cases (13.7%, while 8 cases (10% were flame burns. The random distribution of the groups was as follow: Group A (amoxicilline + clavulanic acid = 25 cases, Group B (oxacilline = 20 cases and Group C (no antibiotics = 35 cases. Total infection rate was 20% (16/80, distributed as follow: 8 cases (50% in Group C, 5 cases (31.2% in Group A and 3 cases in Group B (18.7%. Infection rate in each individual group was: 22.9% (8 cases/35 in Group C, 20% (5 cases/25 in Group A and 15% (3 cases/20 in Group B (P = 0.7. They were distributed as follow: Septicaemia 12 cases/16 (75%, wound infection 4 cases/16 (25%. Bacteria isolated were with a decreasing order: Staphylococcus aureus (36.3%, Pseudomonas (27.2%, Escherichia coli (18.1%, Klebsiella (9% and Enterobacteria (9%. There is a tendency to a delayed cicatrisation (P = 0.07 in case of hot oil burns (65.18 ± 120 days than by flame (54.33 ± 19.8 days than by hot water (29.55 ± 26.2 days. Otherwise no toxic shock syndrome was recorded in this study. Conclusion: It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are

  13. 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

  14. A burning question

    International Nuclear Information System (INIS)

    Lamb, Garth

    2010-01-01

    Converting unwanted biomass to fuel pellets four times denser than wood has local companies in Queensland, Australia excited. The well-tested 'old technology' of burning wood is going through a renaissance. There is a growing focus on producing high- density biomass pellets from feedstock that would otherwise be considered waste. Their uniform size reduces transport costs, the energy content varies, about 4-5MWh/tonne, compared to 2.8MWh/t for brown coal or 8.3MWh/t for black coal. The biomass estimates from sugarcane, other agricultural wastes and wood wastes suggest Australia has huge biomass resources, but whether or not Australia's political settings see the potential fulfilled is yet to be seen. Altus Renewables recently disclosed plans to build a biofuel pelletisation plant at Queensland's largest sawmill. Altus are very interested in the European market, the world's leading pellet consuming region, where according to the IEA, biomass represents 65% of the renewables. Cheap power provided by waste biomass could potentially power biomass converters, desalination plants, or even pump water inland to arid regions.

  15. Burning mouth syndrome.

    Science.gov (United States)

    Jääskeläinen, Satu K; Woda, Alain

    2017-06-01

    Objective To review the clinical entity of primary burning mouth syndrome (BMS), its pathophysiological mechanisms, accurate new diagnostic methods and evidence-based treatment options, and to describe novel lines for future research regarding aetiology, pathophysiology, and new therapeutic strategies. Description Primary BMS is a chronic neuropathic intraoral pain condition that despite typical symptoms lacks clear clinical signs of neuropathic involvement. With advanced diagnostic methods, such as quantitative sensory testing of small somatosensory and taste afferents, neurophysiological recordings of the trigeminal system, and peripheral nerve blocks, most BMS patients can be classified into the peripheral or central type of neuropathic pain. These two types differ regarding pathophysiological mechanisms, efficacy of available treatments, and psychiatric comorbidity. The two types may overlap in individual patients. BMS is most frequent in postmenopausal women, with general population prevalence of around 1%. Treatment of BMS is difficult; best evidence exists for efficacy of topical and systemic clonazepam. Hormonal substitution, dopaminergic medications, and therapeutic non-invasive neuromodulation may provide efficient mechanism-based treatments for BMS in the future. Conclusion We present a novel comprehensive hypothesis of primary BMS, gathering the hormonal, neuropathic, and genetic factors presumably required in the genesis of the condition. This will aid in future research on pathophysiology and risk factors of BMS, and boost treatment trials taking into account individual mechanism profiles and subgroup-clusters.

  16. [Ischemic cholangiopathy induced by extended burns].

    Science.gov (United States)

    Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

    2013-04-01

    Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Biomass Burning: Major Uncertainties, Advances, and Opportunities

    Science.gov (United States)

    Yokelson, R. J.; Stockwell, C.; Veres, P. R.; Hatch, L. E.; Barsanti, K. C.; Liu, X.; Huey, L. G.; Ryerson, T. B.; Dibb, J. E.; Wisthaler, A.; Müller, M.; Alvarado, M. J.; Kreidenweis, S. M.; Robinson, A. L.; Toon, O. B.; Peischl, J.; Pollack, I. B.

    2014-12-01

    Domestic and open biomass burning are poorly-understood, major influences on Earth's atmosphere composed of countless individual fires that (along with their products) are difficult to quantify spatially and temporally. Each fire is a minimally-controlled complex phenomenon producing a diverse suite of gases and aerosols that experience many different atmospheric processing scenarios. New lab, airborne, and space-based observations along with model and algorithm development are significantly improving our knowledge of biomass burning. Several campaigns provided new detailed emissions profiles for previously undersampled fire types; including wildfires, cooking fires, peat fires, and agricultural burning; which may increase in importance with climate change and rising population. Multiple campaigns have better characterized black and brown carbon and used new instruments such as high resolution PTR-TOF-MS and 2D-GC/TOF-MS to improve quantification of semi-volatile precursors to aerosol and ozone. The aerosol evolution and formation of PAN and ozone, within hours after emission, have now been measured extensively. The NASA DC-8 sampled smoke before and after cloud-processing in two campaigns. The DC-8 performed continuous intensive sampling of a wildfire plume from the source in California to Canada probing multi-day aerosol and trace gas aging. Night-time plume chemistry has now been measured in detail. Fire inventories are being compared and improved, as is modeling of mass transfer between phases and sub-grid photochemistry for global models.

  18. Lawn mower-related burns.

    Science.gov (United States)

    Still, J; Orlet, H; Law, E; Gertler, C

    2000-01-01

    Lawn mower-related injuries are fairly common and are usually caused by the mower blades. Burns may also be associated with the use of power lawn mowers. We describe 27 lawn mower-related burn injuries of 24 male patients and 3 female patients. Three of the patients with burn injuries were children. Burn sizes ranged from 1% to 99% of the total body surface area (mean, 18.1%). Two of the patients died. The hospital stay ranged from 1 day to 45 days. Twenty-six injuries involved gasoline, which is frequently associated with refueling accidents. Safety measures should involve keeping children away from lawn mowers that are being used. The proper use and storage of gasoline is stressed.

  19. Modern management of paediatric burns

    African Journals Online (AJOL)

    2010-03-01

    Mar 1, 2010 ... an area of stasis where sluggish circulation and release of inflammatory mediators will .... way to estimate medium to large burns in patients older than 10 .... on day 1 decreases stress hormone release, improves nitrogen ...

  20. Preventing Burns in Your Home

    Science.gov (United States)

    ... clothing when you handle chemicals. Store chemicals, including gasoline, out of the reach of children. To prevent ... mild burn? What is the treatment for smoke inhalation? Resources American Red Cross, Home Fire Safety Centers ...

  1. Multi-Accuracy-Level Burning Plasma Simulations

    International Nuclear Information System (INIS)

    Artaud, J. F.; Basiuk, V.; Garcia, J.; Giruzzi, G.; Huynh, P.; Huysmans, G.; Imbeaux, F.; Johner, J.; Scheider, M.

    2007-01-01

    The design of a reactor grade tokamak is based on a hierarchy of tools. We present here three codes that are presently used for the simulations of burning plasmas. At the first level there is a 0-dimensional code that allows to choose a reasonable range of global parameters; in our case the HELIOS code was used for this task. For the second level we have developed a mixed 0-D / 1-D code called METIS that allows to study the main properties of a burning plasma, including profiles and all heat and current sources, but always under the constraint of energy and other empirical scaling laws. METIS is a fast code that permits to perform a large number of runs (a run takes about one minute) and design the main features of a scenario, or validate the results of the 0-D code on a full time evolution. At the top level, we used the full 1D1/2 suite of codes CRONOS that gives access to a detailed study of the plasma profiles evolution. CRONOS can use a variety of modules for source terms and transport coefficients computation with different level of complexity and accuracy: from simple estimators to highly sophisticated physics calculations. Thus it is possible to vary the accuracy of burning plasma simulations, as a trade-off with computation time. A wide range of scenario studies can thus be made with CRONOS and then validated with post-processing tools like MHD stability analysis. We will present in this paper results of this multi-level analysis applied to the ITER hybrid scenario. This specific example will illustrate the importance of having several tools for the study of burning plasma scenarios, especially in a domain that present devices cannot access experimentally. (Author)

  2. Burning mouth syndrome: Clinical dilemma?

    OpenAIRE

    Kanchan R Patil; R S Sathawane

    2008-01-01

    Burning Mouth Syndrome (BMS) is a chronic orofacial burning pain condition usually in the absence of clinical and laboratory findings that affects many adults worldwide, yet its etiology and treatment remain poorly understood. Though it has been associated with numerous oral and systemic conditions, there has been no clear consensus on its etiology, pathogenesis and treatment. As a result, patients with inexplicable oral complaints are often referred from one health care professional to anoth...

  3. 21 CFR 880.5180 - Burn sheet.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

  4. In-situ burning of oil spills: Review and research properties

    International Nuclear Information System (INIS)

    Fingas, M.

    1992-01-01

    In-situ burning of oil spills has been tried over the past thirty years but has never been fully-accepted as an oil-spill cleanup option - largely because of the lack of understanding of the combustion products and the principles governing the combustibility of oil-on-water. Extensive research is currently underway to understand the many facets of burning oil. A consortium of over 15 agencies in the United States and Canada have joined forces to study burning and to conduct large scale experiments. This effort will result in data which should lead to broader acceptance of in-situ burning as an acceptable spill countermeasures alternative. Burning has distinct advantages over other counter-measures. First and foremost, it offers the potential to rapidly remove large quantities of oil. In-situ burning has the potential to remove as much oil in one day as several mechanical devices could in one month. Application of in-situ burning could prevent a large amount of shoreline contamination and damage to biota by removing oil before it spreads and moves to other areas. Secondly, in-situ burning requires minimal equipment and much less labor than any other technique. It can be applied in areas where other methods cannot be used because of distances and lack of infra-structure. Thirdly, burning of oil is a final solution compared to mechanical recovery. When oil is recovered mechanically it still has to be transported, stored and disposed of. Fourth and finally, burning may be the only option available in certain situations. Oil amongst ice and on ice are examples of situations where practical alternatives to burning do not exist. There are disadvantages to burning. The first and most visible disadvantage is the large black smoke plume that burning oil produces. The second disadvantage is that the oil must be a minimum thickness to burn

  5. Functional Group Analysis of Biomass Burning Particles Using Infrared Spectroscopy

    Science.gov (United States)

    Horrell, K.; Lau, A.; Bond, T.; Iraci, L. T.

    2008-12-01

    Biomass burning is a significant source of particulate organic carbon in the atmosphere. These particles affect the energy balance of the atmosphere directly by absorbing and scattering solar radiation, and indirectly through their ability to act as cloud condensation nuclei (CCN). The chemical composition of biomass burning particles influences their ability to act as CCN, thus understanding the chemistry of these particles is required for understanding their effects on climate and air quality. As climate change influences the frequency and severity of boreal forest fires, the influence of biomass burning aerosols on the atmosphere may become significantly greater. Only a small portion of the organic carbon (OC) fraction of these particles has been identified at the molecular level, although several studies have explored the general chemical classes found in biomass burning smoke. To complement those studies and provide additional information about the reactive functional groups present, we are developing a method for polarity-based separation of compound classes found in the OC fraction, followed by infrared (IR) spectroscopic analysis of each polarity fraction. It is our goal to find a simple, relatively low-tech method which will provide a moderate chemical understanding of the entire suite of compounds present in the OC fraction of biomass burning particles. Here we present preliminary results from pine and oak samples representative of Midwestern United States forests burned at several different temperatures. Wood type and combustion temperature are both seen to affect the composition of the particles. The latter seems to affect relative contributions of certain functional groups, while oak demonstrates at least one additional chemical class of compounds, particularly at lower burning temperatures, where gradual solid-gas phase reactions can produce relatively large amounts of incompletely oxidized products.

  6. DIFFERENTIATING PERIMORTEM AND POSTMORTEM BURNING

    Directory of Open Access Journals (Sweden)

    Brahmaji Master

    2015-01-01

    Full Text Available One of the most challenging cases in forensic medicine is ascertaining the cause of death of burnt bodies under suspicious circumstances. The key questions that arise at the time of investigation include: 1  Was the person alive or dead prior to fire accident?  Did the victim die because of burn?  If death was not related to burns, could burns play a role in causing death?  Were the burns sustained accidentally, did the person commit suicide or was the person murdered?  Are the circumstances suggesting an attempt to conceal crime?  How was the fire started?  How was the victim identified?  In case of mass fatalities, who died first? Postmortem burning of corpses is supposed to be one of the ways to hide a crime. Differentiating the actual cause of death in burn patients is therefore important. Medical examiners usually focus on the defining the changes that occur in tissues while forensic anthropologists deal with the changes related to the bone with or without any the influence of other tissues. Under the circumstances of fire, differentiating the perimortem trauma from that of postmortem cause of bone fractures is vital in determining the cause and motive of death

  7. Treatment of Palm Burns in Children

    OpenAIRE

    Argirova, M.; Hadzhiyski, O.

    2005-01-01

    The timing and methods of treatment of palm burns in children vary widely. From January 2002 to November 2004, 492 children with burns - 125 of them with hand burns or other body burns - were hospitalized and treated at the N.I. Pirogov Clinic for Burns and Plastic Surgery in Bulgaria. Fifty-four children (for a total of 73 burned hands) presented isolated palm burns.Twenty-two hands were operated on. In this review we present the incidence, causes, treatment methods, functional results, and ...

  8. Burn injury reduces neutrophil directional migration speed in microfluidic devices.

    Directory of Open Access Journals (Sweden)

    Kathryn L Butler

    2010-07-01

    Full Text Available Thermal injury triggers a fulminant inflammatory cascade that heralds shock, end-organ failure, and ultimately sepsis and death. Emerging evidence points to a critical role for the innate immune system, and several studies had documented concurrent impairment in neutrophil chemotaxis with these post-burn inflammatory changes. While a few studies suggest that a link between neutrophil motility and patient mortality might exist, so far, cumbersome assays have prohibited exploration of the prognostic and diagnostic significance of chemotaxis after burn injury. To address this need, we developed a microfluidic device that is simple to operate and allows for precise and robust measurements of chemotaxis speed and persistence characteristics at single-cell resolution. Using this assay, we established a reference set of migration speed values for neutrophils from healthy subjects. Comparisons with samples from burn patients revealed impaired directional migration speed starting as early as 24 hours after burn injury, reaching a minimum at 72-120 hours, correlated to the size of the burn injury and potentially serving as an early indicator for concurrent infections. Further characterization of neutrophil chemotaxis using this new assay may have important diagnostic implications not only for burn patients but also for patients afflicted by other diseases that compromise neutrophil functions.

  9. An Examination of a Yoga Intervention With Pediatric Burn Survivors.

    Science.gov (United States)

    Conn, Amy S; Hall, Morgan S; Quinn, Kristen; Wiggins, Bradley; Memmott, Carolyn; Brusseau, Timothy A

    Burn injuries have a major influence on the survivors' physical and psychological functioning. In pediatric burns, the consequences persist long after the injury. The objective of this study is to evaluate an existing yoga kids program to gain better understanding of the physical and psychosocial effects of a yoga practice among children with burn injuries. Thirty campers participated in a series of four (1 hour) yoga sessions during the summer of 2014. Nationally trained Instructors had taught children's yoga in the Southwestern United States for at least 10 years. A Yoga Evaluation Questionnaire, designed for children, was used to evaluate perceptions of somatic and cognitive anxiety before and after each Yoga session. Camper's age ranged from 6 to 12 years old with burn severities ranging from 5 to 75%. A dependent samples t-test was used to test for differences between composite pre- and postintervention scores for both somatic and cognitive anxiety. Significant effects emerged for somatic anxiety t(29) = -4.24, P Yoga program may lower perceptions of cognitive and somatic anxiety in pediatric burn survivors. Further, Yoga is one technique that may compliment the short- and long-term treatment of burn injuries.

  10. 30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

  11. Burns From Hot Wheat Bags: A Public Safety Issue

    Science.gov (United States)

    Collins, Anna; Amprayil, Mathew; Solanki, Nicholas S.; Greenwood, John Edward

    2011-01-01

    Introduction: Wheat bags are therapeutic devices that are heated in microwaves and commonly used to provide relief from muscle and joint pain. The Royal Adelaide Hospital Burns Unit has observed a number of patients with significant burn injuries resulting from their use. Despite their dangers, the products come with limited safety information. Methods: Data were collected from the Burns Unit database for all patients admitted with burns due to hot wheat bags from 2004 to 2009. This was analyzed to determine the severity of the burn injury and identify any predisposing factors. An experimental study was performed to measure the temperature of wheat bags when heated to determine their potential for causing thermal injury. Results: 11 patients were admitted with burns due to hot wheat bags. The median age was 52 years and the mean total body surface area was 1.1%. All burns were either deep dermal (45.5%) or full thickness (54.5%). Ten patients required operative management. Predisposing factors (eg, neuropathy) to thermal injury were identified in 7 patients. The experimental study showed that hot wheat bags reached temperatures of 57.3°C (135.1°F) when heated according to instructions, 63.3°C (145.9°F) in a 1000 W microwave and 69.6°C (157.3°F) on reheating. Conclusions: Hot wheat bags cause serious burn injury. When heated improperly, they can reach temperatures high enough to cause epidermal necrosis in a short period of time. Patients with impaired temperature sensation are particularly at risk. There should be greater public awareness of the dangers of wheat bag use and more specific safety warnings on the products. PMID:21915357

  12. Determination of nuclear fuel burn-up

    International Nuclear Information System (INIS)

    Kristak, J.; Vobecky, M.

    1973-01-01

    Samples containing a known content of 235 U were irradiated with several different neutron doses and activities were determined of radionuclides including 125 Sb, 144 Ce, 134 Cs, 154 Eu, 103 Ru, 95 Zr. The values thus obtained were divided by the 137 Cs activity value. The resulting neutron dose-dependent value is plotted into a calibration graph. The degree of nuclear fuel burn-up is obtained from the graph using an experimentally determined ratio of the activities of the above radionuclides. (B.S.)

  13. Effect of piracetam and nimodipine on full-thickness skin burns in rabbits.

    Science.gov (United States)

    Sari, Elif; Dincel, Gungor C

    2016-08-01

    The potential of several drugs for full-thickness skin burns has been investigated, but the treatment of such burns remains a challenge in plastic surgery. The present study was designed to determine the effect of systemic and topical administration of piracetam and nimodipine on full-thickness skin burn wound healing. A total of 36 New Zealand male rabbits were divided into six groups. Full-thickness skin burns were produced in all the groups, except the control group. Piracetam was administered systemically (piracetam-IV) and topically (piracetam-C) for 14 days, and nimodipine was administered systemically (nimodipine-IV) and topically (nimodipine-C) over the burn wounds for 14 days. The sham group underwent burn injury but was not administered any drug. After 21 days, gross examination and histopathological analysis were performed and the results were compared statistically. Nimodipine-C and nimodipine-IV had no effect on burn wound healing. However, both piracetam-IV and piracetam-C significantly enhanced the healing of the full-thickness skin burn wounds, although the latter was more effective, useful and practical in burn wound healing. The histopathological features of the wounds in the piracetam-C group were closer to those of the control group than those of the other groups. Piracetam-C rather than piracetam-IV may promote full-thickness burn wound healing in rabbits. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  14. The epidemiology of burns in young children from Mexico treated at a U.S. hospital.

    Science.gov (United States)

    Patel, Dipen D; Rosenberg, Laura; Rosenberg, Marta; Leal, Jesus; Andersen, Clark R; Foncerrada, Guillermo; Lee, Jong O; Jimenez, Carlos J; Branski, Ludwik; Meyer, Walter J; Herndon, David N

    2016-12-01

    Young children are the most vulnerable for sustaining burns. At this pediatric burn hospital we have provided medical care to young children with severe burns from Mexico for many years. This study identified modifiable risk factors that could be used to assist in prevention of burns in this age group. A retrospective chart review was performed with children Mexico who were injured from 2000 to 2013. The medical records of 447 acute patients were reviewed. There were 187 females and 260 males with large burns >20% total body surface area (TBSA) burned. Primary causes of burns were flame and scalds. Children with flame injuries were older (3.0±1.5 years of age) than those with scalds (2.6±1.2 years of age). Admissions attributed to flame burns were largely from explosions by propane tanks, gas line leaks, and house fires. Most admissions for scalds were predominantly from falling in large containers of hot water, food, or grease; and fewer were attributed to spills from hot liquids. Most cases reported to a social service agency were to find resources for families. Mortality rate for flame and scald burns was low. It is important take into account demographic, cultural, and socioeconomic variables when developing and implementing prevention programs. Burn prevention instruction for parents is crucial. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  15. Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

    Science.gov (United States)

    Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

    2016-03-01

    This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

  16. Infection in burn patients in a referral center in Colombia.

    Science.gov (United States)

    Ramirez-Blanco, Carlos Enrique; Ramirez-Rivero, Carlos Enrique; Diaz-Martinez, Luis Alfonso; Sosa-Avila, Luis Miguel

    2017-05-01

    Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS). Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established. 402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics. Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most

  17. Long term mortality in critically ill burn survivors.

    Science.gov (United States)

    Nitzschke, Stephanie; Offodile, Anaeze C; Cauley, Ryan P; Frankel, Jason E; Beam, Andrew; Elias, Kevin M; Gibbons, Fiona K; Salim, Ali; Christopher, Kenneth B

    2017-09-01

    , showed that major burn was predictive of lower mortality following hospital admission [HR=0.34 (95% CI 0.15-0.76; P=0.009)]. The modified Baux score was not predictive for mortality following hospital discharge [OR 5year post-discharge mortality=1.00 (95%CI 0.99-1.02; P=0.74); HR for post-discharge mortality=1.00 (95% CI 0.99-1.02; P=0.55)]. Critically ill patients with major burns who survive to hospital discharge have decreased 5year mortality compared to those with less severe burns. ICU Burn unit patients who survive to hospital discharge are younger with less comorbidities. The observed relationship is likely due to the relatively higher physiological reserve present in those who survive a Burn ICU course which may provide for a survival advantage during recovery after major burn. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  18. Burns resulting from spontaneous combustion of electronic cigarettes: a case series.

    Science.gov (United States)

    Sheckter, Clifford; Chattopadhyay, Arhana; Paro, John; Karanas, Yvonne

    2016-01-01

    Electronic cigarette (e-cigarette) sales have grown rapidly in recent years, coinciding with a public perception that they are a safer alternative to traditional cigarettes. However, there have been numerous media reports of fires associated with e-cigarette spontaneous combustion. Three severe burns caused by spontaneous combustion of e-cigarettes within a 6-month period were treated at the Santa Clara Valley Medical Center Burn Unit. Patients sustained partial and full-thickness burns. Two required hospitalization and surgical treatment. E-cigarettes are dangerous devices and have the potential to cause significant burns. Consumers and the general public should be made aware of these life-threatening devices.

  19. Inducible satellite cell depletion attenuates skeletal muscle regrowth following a scald-burn injury.

    Science.gov (United States)

    Finnerty, Celeste C; McKenna, Colleen F; Cambias, Lauren A; Brightwell, Camille R; Prasai, Anesh; Wang, Ye; El Ayadi, Amina; Herndon, David N; Suman, Oscar E; Fry, Christopher S

    2017-11-01

    Severe burns result in significant skeletal muscle cachexia that impedes recovery. Activity of satellite cells, skeletal muscle stem cells, is altered following a burn injury and likely hinders regrowth of muscle. Severe burn injury induces satellite cell proliferation and fusion into myofibres with greater activity in muscles proximal to the injury site. Conditional depletion of satellite cells attenuates recovery of myofibre area and volume following a scald burn injury in mice. Skeletal muscle regrowth following a burn injury requires satellite cell activity, underscoring the therapeutic potential of satellite cells in the prevention of prolonged frailty in burn survivors. Severe burns result in profound skeletal muscle atrophy; persistent muscle atrophy and weakness are major complications that hamper recovery from burn injury. Many factors contribute to the erosion of muscle mass following burn trauma, and we have previously shown concurrent activation and apoptosis of muscle satellite cells following a burn injury in paediatric patients. To determine the necessity of satellite cells during muscle recovery following a burn injury, we utilized a genetically modified mouse model (Pax7 CreER -DTA) that allows for the conditional depletion of satellite cells in skeletal muscle. Additionally, mice were provided 5-ethynyl-2'-deoxyuridine to determine satellite cell proliferation, activation and fusion. Juvenile satellite cell-wild-type (SC-WT) and satellite cell-depleted (SC-Dep) mice (8 weeks of age) were randomized to sham or burn injury consisting of a dorsal scald burn injury covering 30% of total body surface area. Both hindlimb and dorsal muscles were studied at 7, 14 and 21 days post-burn. SC-Dep mice had >93% depletion of satellite cells compared to SC-WT (P satellite cell proliferation and fusion. Depletion of satellite cells impaired post-burn recovery of both muscle fibre cross-sectional area and volume (P satellite cells in the aetiology of lean

  20. Prestudy of burn control in NET

    International Nuclear Information System (INIS)

    Anderson, D.; Hamnen, H.; Lisak, M.

    1990-02-01

    The present report describes our ongoing work on a number of selected topics, and the plans for the nearest future. In chapter 2 we have specialized the system of the previous report to form an easily tractable, second-order system. In this case one can give an explicit, analytical condition for stability. A code providing quick answers regarding stability, time scales and eigenvectors has been written and tested. The zerodimensional modelling of a burning plasma described by space dependent equations is often done in a heuristic way, with no clear relation between the two systems of equations. We have tried to put the approximation procedure involved in the transition to 0-D models on a more formal basis. This is the topic of chapter 3. The 1-D equilibrium solution is also investigated with respect to its stability properties, which are shown to be the same as those derived from the simplest 0-D space averaged model. Chapter 4 contains a few emerging thoughts on burn control. First, the limited swing of the auxiliary heating gives rise to limitations on the possibilities to intervene against temperature excursions by an auxiliary heating modulation. This problem becomes severe when one operates at high Q values. Another analysis concerns the problem of selecting a proper control action when a temperature profile differs from the equilibrium shape. A couple of alternative schemes for burn control, minor radius alterations and dynamic stabilization are tentatively discussed; no definite answers on their feasibility are obtained. The problem of diagnosing the plasma with respect to burn conditions is the topic of chapter 5. The influence on the energy distribution of control actions and the reliability of neutron measurements are discussed, and the question of how to handle sawteeth is briefly revisited. Chapter 6 is a description of process identification and how it could be used for burn control. A particular advantage is that it can be combined with physical

  1. Third Degree Skin Burns Caused by an MRI Compatible Electrocardiographic Monitoring System

    DEFF Research Database (Denmark)

    Brix, Lau; Isaksen, Christin Rosendahl Graff; Kristensen, Birgitte Hornbæk

    of the assigned compatibility specifications of the leads due to the use of TFE sequences with high SAR values. MRI compatible monitoring systems are only safe when used with proper care. The presented burn cases may have been avoided if space had been provided between the ECG leads and the skin using a cloth....... This holds true even in cases in which the devices are MRI compatible and therefore safe in specified MRI environments. Of particular interest to this case report is skin burns caused by the ECG monitoring equipment. In this context, several cases of ECG electrode related burns have been reported, while...... burns caused by the ECG cables are less common [1]. This case report presents two unusual cases of skin burns which were caused by MRI safe ECG leads during scanning. Cases:Two patients suffered third degree burns using MRI approved ECG leads (Medrad® Veris MR Monitor system) in a Siemens Skyra 3...

  2. Case study of water-soluble metal containing organic constituents of biomass burning aerosol

    Science.gov (United States)

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

    2011-01-01

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

  3. Art Therapy on a Hospital Burn Unit: A Step towards Healing and Recovery.

    Science.gov (United States)

    Russel, Johanna

    1995-01-01

    Describes how art therapy can benefit patients hospitalized due to severe burns, who suffer psychological as well as physical trauma. Outlines the psychological phases, identifies how burn patients typically experience their healing process, and discusses how art therapy can assist the patient at each stage of the recovery process. (JPS)

  4. Burning mouth syndrome: Current concepts

    Directory of Open Access Journals (Sweden)

    Cibele Nasri-Heir

    2015-01-01

    Full Text Available Burning mouth syndrome (BMS is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM. The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients.

  5. Burning mouth syndrome: Current concepts.

    Science.gov (United States)

    Nasri-Heir, Cibele; Zagury, Julyana Gomes; Thomas, Davis; Ananthan, Sowmya

    2015-01-01

    Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM). The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients.

  6. Telemedicine and burns: an overview.

    Science.gov (United States)

    Atiyeh, B; Dibo, S A; Janom, H H

    2014-06-30

    Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

  7. Introduction to burning plasma physics

    International Nuclear Information System (INIS)

    Momota, Hiromu

    1982-01-01

    The free energy of fusion-produced charged particles, the critical plasma Q-value for the thermal instability, and the Cherenkov's emission are discussed. The free energy of fusion-produced charged particles is large even in DT burning plasma. The primary role of fusion-produced energetic charged particles is the heating of fuel plasma. If the charged particle heating is large, burning may be thermally unstable. A zero dimensional analysis shows that the critical plasma Q-values for this thermal instability are nearly 5 for DT burning plasma of 14 keV and 1.6 for D-He 3 burning plasma of 60 keV. These critical plasma Q-values are small as compared to that required for commercial reactors. Then, some methods of burning-control should be introduced to fusion plasma. Another feature of energetic charged particles may be Cherenkov's emission of various waves in fusion plasma. The relationship between this micro-instability and transport phenomena may be the important problem to be clarified. The fusion-produced energetic charged particles have large Larmor radii, and they may have effects on balooning mode instability. (Kato, T.)

  8. Fusarium spp infections in a pediatric burn unit: nine years of experience.

    Science.gov (United States)

    Rosanova, María Teresa; Brizuela, Martín; Villasboas, Mabel; Guarracino, Fabian; Alvarez, Veronica; Santos, Patricia; Finquelievich, Jorge

    2016-01-01

    Fusarium spp are ubiquitous fungi recognized as opportunistic agents of human infections, and can produce severe infections in burn patients. The literature on Fusarium spp infections in pediatric burn patients is scarce. To describe the clinical and epidemiological features as well as outcome of Fusarium spp infections in pediatric burn patients. Retrospective, descriptive study of Fusarium spp infections in a specialized intensive care burn unit. In 15 patients Fusarium spp infections were diagnosed. Median age was 48 months. Direct fire injury was observed in ten patients. The median affected burn surface area was 45%. Twelve patients had a full thickness burn. Fourteen patients had a Garces Index ≥3. Fungal infection developed at a median of 11 days after burn injury. Fungi were isolated from burn wound in 14 patients and from the bone in one patient. Amphotericin B was the drug of choice for treatment followed by voriconazole. Median time of treatment completion was 23 days. One patient (7%) died of fungal infection-related causes. In our series Fusarium spp was an uncommon pathogen in severely burnt patients. The burn wound was the most common site of infection and mortality was low. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Josef Mordechai Haik

    2015-03-01

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

  10. Effects of burn location and investigator on burn depth in a porcine model.

    Science.gov (United States)

    Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

    2016-02-01

    In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (Plocations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  11. Improving global fire carbon emissions estimates by combining moderate resolution burned area and active fire observations

    Science.gov (United States)

    Randerson, J. T.; Chen, Y.; Giglio, L.; Rogers, B. M.; van der Werf, G.

    2011-12-01

    In several important biomes, including croplands and tropical forests, many small fires exist that have sizes that are well below the detection limit for the current generation of burned area products derived from moderate resolution spectroradiometers. These fires likely have important effects on greenhouse gas and aerosol emissions and regional air quality. Here we developed an approach for combining 1km thermal anomalies (active fires; MOD14A2) and 500m burned area observations (MCD64A1) to estimate the prevalence of these fires and their likely contribution to burned area and carbon emissions. We first estimated active fires within and outside of 500m burn scars in 0.5 degree grid cells during 2001-2010 for which MCD64A1 burned area observations were available. For these two sets of active fires we then examined mean fire radiative power (FRP) and changes in enhanced vegetation index (EVI) derived from 16-day intervals immediately before and after each active fire observation. To estimate the burned area associated with sub-500m fires, we first applied burned area to active fire ratios derived solely from within burned area perimeters to active fires outside of burn perimeters. In a second step, we further modified our sub-500m burned area estimates using EVI changes from active fires outside and within of burned areas (after subtracting EVI changes derived from control regions). We found that in northern and southern Africa savanna regions and in Central and South America dry forest regions, the number of active fires outside of MCD64A1 burned areas increased considerably towards the end of the fire season. EVI changes for active fires outside of burn perimeters were, on average, considerably smaller than EVI changes associated with active fires inside burn scars, providing evidence for burn scars that were substantially smaller than the 25 ha area of a single 500m pixel. FRP estimates also were lower for active fires outside of burn perimeters. In our

  12. Prehospital treatment of burns: a qualitative study of experiences, perceptions and reactions of victims.

    Science.gov (United States)

    Sadeghi Bazargani, H; Fouladi, N; Alimohammadi, H; Sadeghieh Ahari, S; Agamohammadi, M; Mohamadi, R

    2013-08-01

    The manner in which burns are initially managed, at an incident scene, can affect the extent and depth of burn wounds and their final prognosis. The aim of this study was to understand people's experiences, perceptions and reactions towards the initial management of burns and fire accidents in Ardabil Province, Iran. In a qualitative study, 48 burn victims accompanied by their caregivers were enrolled. Focus group discussion (FGD) was used to collect data. All the interviews were recorded, transcribed and analysed using content analysis method. Four categories of information were retrieved in this study, including fire control, scald and burn wound management, seeking medical consultation and severity indicators. Uncertainty regarding what to do when someone catches fire was an evident finding that was explored through the discussions. The results revealed that transferring the patient to the hospital most often takes place after initial treatments administered at home. People believed that cooling a burn wound for a time longer than a few seconds may harm the wound. A strong belief in the efficacy of traditional remedies was disclosed when the statements of participants revealed that traditional or home-made remedies were widely used either to control pain immediately after burn and later during the wound repair process to accelerate the repair or to control the infection and prevent oedema and scar. Among these remedies, pennyroyal and grated potatoes seemed to be the most popular ones. Pennyroyal was thought to prevent infection and potatoes were used to relieve pain. People doubted the capability of health-care workers who work in rural health houses. People considered electrical burns and burns on the chest to be the most severe types of burns. Inappropriate perceptions regarding initial management of burns existed among the participants that should be addressed in future quantitative research or through developing programmes on secondary prevention of burns

  13. Chemistry of burning the forest floor during the FROSTFIRE experimental burn, interior Alaska, 1999

    Science.gov (United States)

    Harden, J.W.; Neff, J.C.; Sandberg, D.V.; Turetsky, M.R.; Ottmar, R.; Gleixner, G.; Fries, T.L.; Manies, K.L.

    2004-01-01

    Wildfires represent one of the most common disturbances in boreal regions, and have the potential to reduce C, N, and Hg stocks in soils while contributing to atmospheric emissions. Organic soil layers of the forest floor were sampled before and after the FROSTFIRE experimental burn in interior Alaska, and were analyzed for bulk density, major and trace elements, and organic compounds. Concentrations of carbon, nutrients, and several major and trace elements were significantly altered by the burn. Emissions of C, N, and Hg, estimated from chemical mass balance equations using Fe, Al, and Si as stable constituents, indicated that 500 to 900 g C and up to 0 to 4 ?? 10-4 g Hg/M2 were lost from the site. Calculations of nitrogen loss range from -4 to +6 g/m2 but were highly variable (standard deviation 19), with some samples showing increased N concentrations post-burn potentially from canopy ash. Noncombustible major nutrients such as Ca and K also were inherited from canopy ash. Thermogravimetry indicates a loss of thermally labile C and increase of lignin-like C in char and ash relative to unburned counterparts. Overall, atmospheric impacts of boreal fires include large emissions of C, N and Hg that vary greatly as a function of severe fire weather and its access to deep organic layers rich in C, N, and Hg. In terrestrial systems, burning rearranges the vertical distribution of nutrients in fuels and soils, the proximity of nutrients and permafrost to surface biota, and the chemical composition of soil including its nutrient and organic constituents, all of which impact C cycling. Copyright 2004 by the American Geophysical Union.

  14. Advanced tokamak burning plasma experiment

    International Nuclear Information System (INIS)

    Porkolab, M.; Bonoli, P.T.; Ramos, J.; Schultz, J.; Nevins, W.N.

    2001-01-01

    A new reduced size ITER-RC superconducting tokamak concept is proposed with the goals of studying burn physics either in an inductively driven standard tokamak (ST) mode of operation, or in a quasi-steady state advanced tokamak (AT) mode sustained by non-inductive means. This is achieved by reducing the radiation shield thickness protecting the superconducting magnet by 0.34 m relative to ITER and limiting the burn mode of operation to pulse lengths as allowed by the TF coil warming up to the current sharing temperature. High gain (Q≅10) burn physics studies in a reversed shear equilibrium, sustained by RF and NB current drive techniques, may be obtained. (author)

  15. Wood-burning stoves worldwide

    DEFF Research Database (Denmark)

    Luis Teles de Carvalho, Ricardo

    global environmental health risk, since these sources are important contributors to fine particulate matter (PM2.5) in the ambient air that increase climate and health risks. This thesis explores the social-technical dimensions of both the use of wood-burning stoves (WBSs) and transition to the use......More than any time in our history, the wood-burning stove continues to be the most popular technology used for cooking and heating worldwide. According to the World Health Organization and recent scientific studies, the inefficient use of solid-fuels in traditional stoves constitutes the major...... systems, improved efficient retrofits and advanced stove innovations. In chapter 3, four popular wood-burning practices found in five countries were singled-out to be examined closely in four case studies: “cooking in Brazil”, “cooking and heating in Peru”, “heating in Portugal” and “recreational heat...

  16. Burns during Easter festivities in Greece.

    Science.gov (United States)

    Pallantzas, A; Kourakos, P; Stampolidis, N; Papagianni, E; Balagoura, A; Stathopoulos, A; Polizoi, A; Emvalomata, A; Evaggelopoulou, M; Castana, O

    2012-12-31

    Easter is the most important holiday for the Greek Church. It is rich in traditions and rituals but during the Greek Easter festivities, especially at midnight Mass on Easter Saturday night, it is customary to throw fireworks around. These fireworks are not part of the true Easter tradition and they are potentially fatal. Unfortunately, in the past few years, the custom has become more and more popular in Greece. There are some local variations, mainly in the Aegean islands, where homemade rockets are used to have a "rocket war". The rockets consist of wooden sticks loaded with an explosive mixture containing gunpowder and launched from special platforms. Many severe injuries involving loss of sight and limbs as well as major burns are also caused by the use of illegal fireworks at Easter. Every year numerous burn victims are hospitalized. The most affected areas are the face, the upper extremities, and the chest, often in association with slight or severe wounds and injuries. This study presents our department's experience with incidents due to the use of fireworks during Easter festivities.

  17. Burning mouth syndrome: Current concepts

    OpenAIRE

    Nasri-Heir, Cibele; Zagury, Julyana Gomes; Thomas, Davis; Ananthan, Sowmya

    2015-01-01

    Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also rep...

  18. Principles of Burn Pain Management.

    Science.gov (United States)

    James, Dominika Lipowska; Jowza, Maryam

    2017-10-01

    This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options. A brief synopsis of the principles of outpatient pain management is provided. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Experience and outcomes of micrografting for major paediatric burns.

    Science.gov (United States)

    Rode, H; Martinez, R; Potgieter, D; Adams, S; Rogers, A D

    2017-08-01

    The deficit of donor sites in major burns over 50% of the total body surface area has necessitated the application of methods besides traditional meshed autografting to achieve definitive skin cover. The Meek micrografting technique was introduced at this hospital in 2011, especially in the absence of a reliable source of deceased donor allograft skin. The purpose of this study was to evaluate this strategy with reference to its technical execution, efficacy and indications in the context of major paediatric burn surgery. A cohort study was performed of all paediatric patients with major burn who underwent Meek micrografting at a dedicated paediatric burn centre in a developing country over a five year period. Demographics, details of their burns, operative management and clinical course and outcomes were collected from patient records and operative notes and analysed. Thirty-five patients were managed using the micrografting technique during the study period. The mean patient age was 4.1 years (range 3 months-11 years) and their mean total body surface area (TBSA) burn was 49.7% (range 15-86%). Eleven patients sustained inhalation injuries and five developed a re-feeding syndrome on account of delayed referral. The mean abbreviated burn severity index (ABSI) was 8.5 (range 2-13). The hospital length of stay in the 27 survivors was a mean of 75.5 days, equating to 1.4 days per percentage burn. Eight patients died during the course of treatment, with a mean TBSA burn of 67.75% (range 38-86%). Graft take one month after surgery was documented to be more than 90% in 24 patients, of whom 3 subsequently died. Eleven patients had less than 90% graft take at this time, of whom 5 died. There is a considerable 'learning curve' associated with this technique. In order to achieve success one must ensure a completely viable, non-infected bed, obtained by tangential or fascial excision, followed by allografting as temporary coverage and to 'test the wound bed' for definitive

  20. Case report: Some pitfalls in burns management: illustrative case ...

    African Journals Online (AJOL)

    We present two females with severe, mainly full thickness burns, who have developed gross deformities due to inadequate treatment of their bums. Early referral to major centres with the technical expertise and material resources to manage such complicated injuries will help to minimise the degree of deformity and ...

  1. An evaluation of nutritional practice in a paediatric burns unit ...

    African Journals Online (AJOL)

    was correct in only 39 of 211 days. Conclusion. Adequate nutrition is essential for burns patients, but several factors can lead to either under- or over-feeding. A daily dietary consumption chart and evaluation of compliance are essential for each patient. There should be greater acceptability of tube enteral feeding. S Afr Med ...

  2. Introducing banked allograft skin to burn surgery in South Africa

    African Journals Online (AJOL)

    Burn injury remains a severely neglected epidemic in South Africa. (SA), despite the magnitude of the problem. This has been described by a number of authors, and there is a shift towards addressing the deficits.[1-6] The recent establishment of the first allograft skin bank in SA is potentially a tremendous stride towards ...

  3. Air-freshener burns: A new paradigm in burns etiology?

    Directory of Open Access Journals (Sweden)

    Umran Sarwar

    2011-01-01

    Conclusions: To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale.

  4. Epidemiology of Burn Injury and Demography of Burn Care Facilities

    Science.gov (United States)

    1990-06-01

    epidemiologic surveillance, vide the nursing care required by an exten- microbiology support is required for diagno-v sively burned patient is one of the...MA. Pittsburgh bur study. 28. Purdue GF, Hunt JL, Prescott PR. Child abuse bynig an iandnci o, suspiciro JA Traumarg 1988 t Pittsburgh and Allegheny

  5. Role of burning season on initial understory vegetation response to prescribed fire in a mixed conifer forest

    Science.gov (United States)

    Knapp, E.E.; Schwilk, D.W.; Kane, J.M.; Keeley, J.E.

    2007-01-01

    Although the majority of fires in the western United States historically occurred during the late summer or early fall when fuels were dry and plants were dormant or nearly so, early-season prescribed burns are often ignited when fuels are still moist and plants are actively growing. The purpose of this study was to determine if burn season influences postfire vegetation recovery. Replicated early-season burn, late-season burn, and unburned control units were established in a mixed conifer forest, and understory vegetation was evaluated before and after treatment. Vegetation generally recovered rapidly after prescribed burning. However, late-season burns resulted in a temporary but significant drop in cover and a decline in species richness at the 1 m 2 scale in the following year. For two of the several taxa that were negatively affected by burning, the reduction in frequency was greater after late-season than early-season burns. Early-season burns may have moderated the effect of fire by consuming less fuel and lessening the amount of soil heating. Our results suggest that, when burned under high fuel loading conditions, many plant species respond more strongly to differences in fire intensity and severity than to timing of the burn relative to stage of plant growth. ?? 2007 NRC.

  6. Potential health impacts of burning coal beds and waste banks

    Science.gov (United States)

    Finkelman, R.B.

    2004-01-01

    Uncontrolled release of pollutants from burning coal beds and waste banks presents potential environmental and human health hazards. On a global scale, the emissions of large volumes of greenhouse gases from burning coal beds may contribute to climate change that alters ecosystems and patterns of disease occurrence. On regional and local scales, the emissions from burning coal beds and waste banks of acidic gases, particulates, organic compounds, and trace elements can contribute to a range of respiratory and other human health problems. Although there are few published reports of health problems caused by these emissions, the potential for problems can be significant. In India, large numbers of people have been displaced from their homes because of health problems caused by emissions from burning coal beds. Volatile elements such as arsenic, fluorine, mercury, and selenium are commonly enriched in coal deposits. Burning coal beds can volatilize these elements, which then can be inhaled, or adsorbed on crops and foods, taken up by livestock or bioaccumulated in birds and fish. Some of these elements can condense on dust particles that can be inhaled or ingested. In addition, selenium, arsenic, lead, tin, bismuth, fluorine, and other elements condense where the hot gaseous emissions come in contact with ambient air, forming mats of concentrated efflorescent minerals on the surface of the ground. These mats can be leached by rainwater and washed into local water bodies providing other potential routes of exposure. Although there are little data linking burning coal beds and waste banks to known health problems, a possibly analogous situation exists in rural China where mineralized coal burned in a residential environment has caused widespread and severe health problems such as fluorosis and arseniasis. ?? 2004 Elsevier B.V. All rights reserved.

  7. Burns related to electrosurgery - Report of two cases

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    Full Text Available Abstract Electrosurgery is a technology developed over the last few years and has become a very important tool in modern surgery. Most of the equipment is considered safe, although there are risks related to its use. Several lesions may be caused by electrocautery, and burns are the most common and feared. We report two cases of burns related to use of electrocautery and promote a literature review, because knowledge of electrosurgery fundamentals, its correct use, the choice of a safety device, constant monitoring, and immediate investigation before any suspicions surely can improve the operational experience for both surgeon and patient.

  8. Burn and they will come! The western regional birds and burns study examines bird responses to prescribed fire

    Science.gov (United States)

    Jonathan Thompson; John Lehmkuhl

    2008-01-01

    Although prescribed fire is increasingly being used in ponderosa pine forests as a management tool to reduce the risk of future high-severity wildfire, its effects on wildlife habitat have rarely been examined. The Birds and Burns Network was created to assist managers in planning prescribed fire projects that will reduce fuels and enhance bird habitat. Researchers...

  9. Wood would burn

    International Nuclear Information System (INIS)

    Swithenbank, Jim; Chen, Qun; Zhang, Xiaohui; Sharifi, Vida; Pourkashanian, Mohamed

    2011-01-01

    Absract: In view of the world-wide problem of energy sustainability and greenhouse gas production (carbon dioxide), it is timely to review the issues involved in generating heat and power from all fuels and especially new (to the UK) solid fuels, including high moisture fuels such as wood, SRF, oil shale, tar sands and brown coal, which will become major international fuels as oil and gas become depleted. The combustion properties of some of these materials are significantly different from traditional coal, oil and gas fuels, however the technology proposed herein is also applicable to these conventional fuels. This paper presents some innovative combustion system options and the associated technical factors that must be considered for their implementation. For clarity of understanding, the novel concepts will be largely presented in terms of a currently developing solid fuel market; biomass wood chips. One of the most important characteristics of many solid fuels to be used in the future (including oil shale and brown coal) is their high moisture content of up to 60%. This could be removed by utilising low grade waste heat that is widely available in industry to dry the fuel and thus reduce transport costs. Burning such dried wood for power generation also increases the energy available from combustion and thus acts as a thermal transformer by upgrading the low grade heat to heat available at combustion temperatures. The alternative approach presented here is to recover the latent heat by condensing the extrinsic moisture and the water formed during combustion. For atmospheric combustion, the temperature of the condensed combustion products is below the dew point at about 55-65 o C and is only suitable for recovery in an efficient district heating system. However, in order to generate power from the latent heat, the condensation temperature must be increased to the level where the heat can be used in the thermodynamic power cycle. This can be achieved by

  10. Treatment and follow-up results of children with electrical burn who observed in burn intensive care unit

    Directory of Open Access Journals (Sweden)

    Çiğdem Aliosmanoğlu

    2011-06-01

    Full Text Available Electrical burns are infrequent relative to other injuries, but they are associated with high morbidity and mortality. The aim of this study was to assess management and follow-up results of pediatric patients’ who observed in intensive care unit and also review the precautions for preventing electrical burns.Materials and methods: Totally 22 patients aged under 17 years who were observed in the burn intensive care unit of Şanlıurfa Education and Research Hospital during the period between July 2009-October 2010. Cases were investigated retrospectively. The patients’ age, gender, total burn surface area, length of stay in hospital, musculo-skeletal system complication, cardiovascular system complication, kidney damage and attempts were recorded.Results: Of the 22 cases, 19 (86.3% were male and 3 (13.7% were female. The mean age of the patients was 11.5 years. In 10 (45.4% children burns were occurred in workplace and working area and 12 (54.6% were occurred in the home environment. Depth of burns were third degree in 10 (45.4% children and second degree in 12 (54.6%. The mean percentage of burn surface area was 25.9%. The mean length of stay in hospital was 17 days. Debridement and grafting were performed to 12 (54.6% cases and 10 (45.4% children were treated with dressings. No patient had increased creatinine kinase levels, oliguria, myoglobuinuria and arrhythmia. The mean hospitalization time was 17 days.Conclusion: Nearly half of patients underwent debridement plus grafting. None of our patients developed renal failure other severe system dysfunction.

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

    Directory of Open Access Journals (Sweden)

    F SHAKIBAEI

    2002-03-01

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

  12. Astronaut observations of global biomass burning

    International Nuclear Information System (INIS)

    Wood, C.A.; Nelson, R.

    1991-01-01

    One of the most fundamental inputs for understanding and modeling possible effects of biomass burning is knowledge of the size of the area burned. Because the burns are often very large and occur on all continents (except Antarctica), observations from space are essential. Information is presented in this chapter on another method for monitoring biomass burning, including immediate and long-term effects. Examples of astronaut photography of burning during one year give a perspective of the widespread occurrence of burning and the variety of biological materials that are consumed. The growth of burning in the Amazon region is presented over 15 years using smoke as a proxy for actual burning. Possible climate effects of smoke palls are also discussed

  13. Reliability enhancement through optimal burn-in

    Science.gov (United States)

    Kuo, W.

    1984-06-01

    A numerical reliability and cost model is defined for production line burn-in tests of electronic components. The necessity of burn-in is governed by upper and lower bounds: burn-in is mandatory for operation-critical or nonreparable component; no burn-in is needed when failure effects are insignificant or easily repairable. The model considers electronic systems in terms of a series of components connected by a single black box. The infant mortality rate is described with a Weibull distribution. Performance reaches a steady state after burn-in, and the cost of burn-in is a linear function for each component. A minimum cost is calculated among the costs and total time of burn-in, shop repair, and field repair, with attention given to possible losses in future sales from inadequate burn-in testing.

  14. Protect the Ones You Love: Burns Safety

    Science.gov (United States)

    ... Submit Search The CDC Protect the Ones You Love: Child Injuries are Preventable Note: Javascript is disabled ... ways you can help protect the children you love from burns. Key Prevention Tips To prevent burns ...

  15. EPIDEMOLOGY OF BURNS IN ENUGU, NIGERIA

    African Journals Online (AJOL)

    JIBURUM

    community is encouraged to study the epidemiology of burns since this important ... CONCLUSION The incidence and mortality of burn injury has remained high in this .... they are a group at risk. ... epidemiology and the compliance factors in.

  16. The Burning Truth(s)

    African Journals Online (AJOL)

    Surgical procedures in acute burns can be broadly divided into four groups: ablative (tangential or fascial ... tissue oedema due to extravasation of plasma into the interstitium. Fluid replacement will worsen the oedema, ... include airway distortion, pulmonary dysfunction, difficult vascular access, rapid blood loss, problematic ...

  17. Burning mouth syndrome and menopause

    Directory of Open Access Journals (Sweden)

    Parveen Dahiya

    2013-01-01

    Full Text Available Menopause is a physiological process typically occurring in the fifth decade of life. One of the most annoying oral symptoms in this age group is the burning mouth syndrome (BMS, which may be defined as an intraoral burning sensation occurring in the absence of identifiable oral lesion or laboratory findings. Pain in burning mouth syndrome may be described as burning, tender, tingling, hot, scalding, and numb sensation in the oral mucosa. Multiple oral sites may be involved, but the anterior two-third part and the tip of tongue are most commonly affected site. There is no definite etiology for BMS other than the precipitating causative factors, and it is still considered idiopathic. Various treatment options like use of benzodiazepine, anti-depressants, analgesics, capsaicin, alpha lipoic acids, and cognitive behavioral therapy are found to be effective, but definite treatment is still unknown. The present article discusses some of the recent concepts of etiopathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder.

  18. Burning Mouth Syndrome and Menopause

    Science.gov (United States)

    Dahiya, Parveen; Kamal, Reet; Kumar, Mukesh; Niti; Gupta, Rajan; Chaudhary, Karun

    2013-01-01

    Menopause is a physiological process typically occurring in the fifth decade of life. One of the most annoying oral symptoms in this age group is the burning mouth syndrome (BMS), which may be defined as an intraoral burning sensation occurring in the absence of identifiable oral lesion or laboratory findings. Pain in burning mouth syndrome may be described as burning, tender, tingling, hot, scalding, and numb sensation in the oral mucosa. Multiple oral sites may be involved, but the anterior two-third part and the tip of tongue are most commonly affected site. There is no definite etiology for BMS other than the precipitating causative factors, and it is still considered idiopathic. Various treatment options like use of benzodiazepine, anti-depressants, analgesics, capsaicin, alpha lipoic acids, and cognitive behavioral therapy are found to be effective, but definite treatment is still unknown. The present article discusses some of the recent concepts of etiopathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder. PMID:23411996

  19. Burning effigies with Bakhtinian laughter

    NARCIS (Netherlands)

    Göttke, F.

    2015-01-01

    The hanging or burning of effigies as an expression of dissent is a well-established genre of playful political protest. It is enacted in a variety of ways, accessing the conventions of various traditional rituals and social practices, and can function either as a progressive force demanding change,

  20. Prescribed burning for understory restoration

    Science.gov (United States)

    Kenneth W. Outcalt

    2006-01-01

    Because the longleaf ecosystem evolved with and is adapted to frequent fire, every 2 to 8 years, prescribed burning is often useful for restoring understory communities to a diverse ground layer of grasses, herbs, and small shrubs. This restoration provides habitat for a number of plant and animal species that are restricted to or found mostly in longleaf pine...

  1. Increased chromium uptake in polymorphonuclear leukocytes from burned patients

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  2. Trauma mechanisms and injury patterns in pediatric burn patients.

    Science.gov (United States)

    Moehrlen, Theres; Szucs, Thomas; Landolt, Markus A; Meuli, Martin; Schiestl, Clemens; Moehrlen, Ueli

    2018-03-01

    The objective of this study was to evaluate the frequency, severity, exact patterns and mechanisms of burn injuries in children. The patient records of children with acute burns admitted to the University Children's Hospital of Zurich were retrospectively reviewed over an 11year period. The age group with the highest risk, were children under the age of five (69%). Boys were overrepresented in all age groups, but the gender imbalance increased with age. Infants and toddlers were mainly injured by scalds and contact burns. Conversely, almost three quarters of injuries over the age of 9 were caused by flame. The majority of scald injuries was a result of pulling down hot liquids. The typical distribution of this accident scenario involved mainly the face, trunk and arms. More than half of all flame injuries occurred due to fire accelerants. 55% of children were passively involved while other children throwing flammable substances into a fire. Most of these injuries involved the face and arms. This study shows that burn etiology is age dependent. Additionally, our results demonstrate the diversity of burn accidents and their resulting injuries. These findings may help better specify target groups and subjects for prevention. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  3. Comparison of mortality prediction models and validation of SAPS II in critically ill burns patients.

    Science.gov (United States)

    Pantet, O; Faouzi, M; Brusselaers, N; Vernay, A; Berger, M M

    2016-06-30

    Specific burn outcome prediction scores such as the Abbreviated Burn Severity Index (ABSI), Ryan, Belgian Outcome of Burn Injury (BOBI) and revised Baux scores have been extensively studied. Validation studies of the critical care score SAPS II (Simplified Acute Physiology Score) have included burns patients but not addressed them as a cohort. The study aimed at comparing their performance in a Swiss burns intensive care unit (ICU) and to observe whether they were affected by a standardized definition of inhalation injury. We conducted a retrospective cohort study, including all consecutive ICU burn admissions (n=492) between 1996 and 2013: 5 epochs were defined by protocol changes. As required for SAPS II calculation, stays burned (TBSA) and inhalation injury (systematic standardized diagnosis since 2006). Study epochs were compared (χ2 test, ANOVA). Score performance was assessed by receiver operating characteristic curve analysis. SAPS II performed well (AUC 0.89), particularly in burns burns <40% TBSA. Ryan and BOBI scores were least accurate, as they heavily weight inhalation injury.

  4. Burn up physics

    International Nuclear Information System (INIS)

    Tretiakoff, O.

    1964-01-01

    The present communication is devoted to a body of theoretical and experimental work carried out at the C.E.A. with the aim of adding to the current knowledge on the evolution of the reactivity (during fuel irradiation) in natural or slightly enriched Uranium reactors. The difficulties of performing direct experiments on large amounts of irradiated fuels are reviewed - especially in operating power reactors - and the necessity is underlined for fundamental research in two directions: on one hand, the change in the composition of the fuels (chains of heavy nuclei, fission products), and on the other hand the effect of changes in composition on the neutron balance. Before presenting three types of experiments which have been carried out, the importance of the problems associated with the neutron spectra is stressed and the practical methods used for the calculations are briefly described. The systematic irradiation of several types of fuel, followed by their chemical and isotopic analysis has been going on for several years. An outline of the experimental programme is given with a description of the methods employed: α, β, γ chain for the preparation of samples determination of the plutonium content by coulometry and double isotopic dilution, separation of Boron used in some cases for the measurement of integrated neutron densities. The interpretation of the measurements is discussed with some examples. A second and more recent series of experiments deals with the investigation of lattices, using synthetic fuels (Uranium-Plutonium alloys) as compared to slightly depleted or enriched Uranium Various experiments are considered on heavy water and on cold graphite, then on graphite heated up to 500 C Some results already obtained are listed. These experiments, requiring nearly a metric ton of each type of fuel cannot be pursued in a systematic manner. This is why is developed since several years a method of differential measurement by oscillation, which requires

  5. Beneficial effects of hydrogen-rich saline on early burn-wound progression in rats.

    Directory of Open Access Journals (Sweden)

    Song Xue Guo

    Full Text Available Deep burn wounds undergo a dynamic process known as wound progression that results in a deepening and extension of the initial burn area. The zone of stasis is more likely to develop more severe during wound progression in the presence of hypoperfusion. Hydrogen has been reported to alleviate injury triggered by ischaemia/reperfusion and burns in various organs by selectively quenching oxygen free radicals. The aim of this study was to investigate the possible protective effects of hydrogen against early burn-wound progression.Deep-burn models were established through contact with a boiled, rectangular, brass comb for 20 s. Fifty-six Sprague-Dawley rats were randomly divided into sham, burn plus saline, and burn plus hydrogen-rich saline (HS groups with sacrifice and analysis at various time windows (6 h, 24 h, 48 h post burn. Indexes of oxidative stress, apoptosis and autophagy were measured in each group. The zone of stasis was evaluated using immunofluorescence staining, ELISA, and Western blot to explore the underlying effects and mechanisms post burn.The burn-induced increase in malondialdehyde was markedly reduced with HS, while the activities of endogenous antioxidant enzymes were significantly increased. Moreover, HS treatment attenuated increases in apoptosis and autophagy postburn in wounds, according to the TUNEL staining results and the expression analysis of Bax, Bcl-2, caspase-3, Beclin-1 and Atg-5 proteins. Additionally, HS lowered the level of myeloperoxidase and expression of TNF-α, IL-1β, and IL-6 in the zone of stasis while augmenting IL-10. The elevated levels of Akt phosphorylation and NF-κB p65 expression post burn were also downregulated by HS management.Hydrogen can attenuate early wound progression following deep burn injury. The beneficial effect of hydrogen was mediated by attenuating oxidative stress, which inhibited apoptosis and inflammation, and the Akt/NF-κB signalling pathway may be involved in regulating the

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

    International Nuclear Information System (INIS)

    Tang Zhongyi; Lu Xingan; Jing Ling; Qi Qiang

    1994-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Elevated thrombopoietin in plasma of burned patients without and with sepsis enhances platelet activation.

    Science.gov (United States)

    Lupia, E; Bosco, O; Mariano, F; Dondi, A E; Goffi, A; Spatola, T; Cuccurullo, A; Tizzani, P; Brondino, G; Stella, M; Montrucchio, G

    2009-06-01

    Thrombopoietin (TPO) is a humoral growth factor that does not induce platelet aggregation per se, but enhances platelet activation in response to several agonists. Circulating levels of TPO are increased in patients with sepsis and are mainly related to sepsis severity. To investigate the potential contribution of elevated TPO levels in platelet activation during burn injury complicated or not by sepsis. We studied 22 burned patients, 10 without and 12 with sepsis, and 10 healthy subjects. We measured plasma levels of TPO, as well as leukocyte-platelet binding and P-selectin expression. The priming activity of plasma from burned patients or healthy subjects on platelet aggregation and leukocyte-platelet binding, and the role of TPO in these effects were also studied in vitro. Burned patients without and with sepsis showed higher circulating TPO levels and increased monocyte-platelet binding compared with healthy subjects. Moreover, TPO levels, monocyte-platelet binding and P-selectin expression were significantly higher in burned patients with sepsis than in burned patients without sepsis. In vitro, plasma from burned patients without and with sepsis, but not from healthy subjects, primed platelet aggregation, monocyte-platelet binding and platelet P-selectin expression. The effect of plasma from burned patients with sepsis was significantly higher than that of plasma from burned patients without sepsis. An inhibitor of TPO prevented the priming effect of plasma from burned patients. Increased TPO levels may enhance platelet activation during burn injury and sepsis, potentially participating in the pathogenesis of multi-organ failure in these diseases.

  9. Burn Prevention for Families with Children with Special Needs

    Medline Plus

    Full Text Available ... Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch this video to learn ... know about burn prevention if you have a child with special needs. Read our burn prevention tips | ...

  10. Car radiator burns: a prevention issue.

    Science.gov (United States)

    Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W

    2004-01-01

    Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

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

    Directory of Open Access Journals (Sweden)

    Edrisa Sanyang

    2017-07-01

    rural location (aOR = 9.23, 95% CI = 2.30–37.12 or by fire or flames (aOR = 6.09, 95% CI = 1.55–23.97 were more likely to die. Children 0–5 years or 5–18 years (aOR = 0.2, 95% CI = 0.03–1.18; aOR = 0.38; 95% CI = 0.11–1.570, respectively were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group.

  12. [Nitrogen balance assessment in burn patients].

    Science.gov (United States)

    Beça, Andreia; Egipto, Paula; Carvalho, Davide; Correia, Flora; Oliveira, Bruno; Rodrigues, Acácio; Amarante, José; Medina, J Luís

    2010-01-01

    The burn injury probably represents the largest stimulus for muscle protein catabolism. This state is characterized by an accelerated catabolism of the lean or skeletal mass that results in a clinical negative balance of nitrogen and muscle wasting. The determination of an appropriate value for protein intake is essential, since it is positively related to the nitrogen balance (NB) and accordingly several authors argue that a positive NB is the key parameter associated with nutritional improvement of a burn patient. Evaluation of the degree of protein catabolism by assessment of the Nitrogen Balance; Defining of nutritional support (protein needs) to implement in patients with burned surface area (BSA) = 10%. We prospectively evaluated the clinical files and scrutinized the clinical variables of interest. The NB was estimated according to three formulae. Each gram of nitrogen calculated by the NB was then converted into grams of protein, subtracted or added to protein intake (or administered enteric or parenterically) and divided by kg of reference Weight (kg Rweight), in an attempt to estimate the daily protein needs. The cohort consisted of 10 patients, 6 females, with average age of 58(23) years old, a mean of BSA of 21.4(8.4)%, ranging from a minimum of 10.0% and máximum of 35.0%. On average, patients were 58 (23) years old. The average number of days of hospitalization in the burn unit was 64.8(36.5) days. We observed significant differences between the 3 methods used for calculating the NB (p = 0.004), on average the NB was positive. When the formula A was used the average value of NB was higher. Regarding the attempt to estimate the needs of g prot/kg Rweight/day most of the values did not exceed, on average, 2.6 g Prot/kg Rweight/day and no significant differences between patients with a BSA% of 10-20% and with BSA% > 20% were found. Despite being able to estimate the protein catabolism through these formulas and verifying that most values were above zero

  13. Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2016-05-01

    The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  14. Mortality pattern of burn patients admitted in S. G. M. Hospital Rewa: A teaching institute of central India

    Directory of Open Access Journals (Sweden)

    S Lal

    2012-01-01

    Full Text Available Background: Burn injuries rank among the most severe types of injuries suffered by the human body with an attendant high mortality and morbidity rate. In previous studies, incidence, severity and deaths due to burn were found higher in young married women in India. Study to find out mortality pattern in burn patient was not carried out in this part of country. Objective: To identify demographic and sociocultural factors, type, modes, causes and risk factors for burn injuries and their gender-wise association. Materials and Methods: It was a retrospective study. Data were collected from all burn patients who admitted and died while on the treatment from 2004 to 2009. A total of 586 patients were included in this study. Data were gathered from hospital records and entered in the excel sheet. Analysis of data was done by using SPSS version 17 statistical software. Results: The mean age of patients was 22.66 years (range 1 m to 80 years. Episodes of burn were 4.63 times common in female (82.25% than in male (17.75%. It was statistically significant in females of age group 21-30 years (93.93% vs. 15.33% P < 0.0001. Married females (86.80% burned more commonly than married males (13.19% P < 0.0001. Flame burn was the major cause of death (95.56%. Kerosene was the most common (69% source of flame burn. Clothes caught fire while working on Chullha were 25% cases ( P < 0.0001. Accidental (86.44% burn was the most common intention of injury. The majority of burn deaths (68% occurred within one week of the incident due to septicemia (57%. Conclusion: Factors associated with an increase in mortality were accidental burns, burn size, young age, married women, and flame burns. For planning and implementing prevention programs, the approach has to be multidisciplinary and coordinated.

  15. Local cooling does not prevent hyperalgesia following burn injury in humans

    DEFF Research Database (Denmark)

    Werner, Mads U; Lassen, Birgit Vibeke; Pedersen, Juri L

    2002-01-01

    One of the oldest methods of pain relief following a burn injury is local application of ice or cold water. Experimental data indicate that cooling may also reduce the severity of tissue injury and promote wound healing, but there are no controlled studies in humans evaluating the anti-inflammato......One of the oldest methods of pain relief following a burn injury is local application of ice or cold water. Experimental data indicate that cooling may also reduce the severity of tissue injury and promote wound healing, but there are no controlled studies in humans evaluating the anti...... and mechanical detection thresholds, thermal and mechanical pain responses, area of secondary hyperalgesia), first degree burn injuries were induced on both calves by contact thermodes (12.5 cm(2), 47 degrees C for 7 min). Eight minutes after the burn injury, contact thermodes (12.5 cm(2)) were again applied...... on the burns. One of the thermodes cooled the burn (8 degrees C for 30 min) whereas the other thermode was a non-active dummy on the control burn. Inflammatory and sensory variables were followed for 160 min after end of the cooling procedure. The burn injury induced significant increases in skin temperature...

  16. From traditional biochemical signals to molecular markers for detection of sepsis after burn injuries.

    Science.gov (United States)

    Muñoz, Balam; Suárez-Sánchez, Rocío; Hernández-Hernández, Oscar; Franco-Cendejas, Rafael; Cortés, Hernán; Magaña, Jonathan J

    2018-05-22

    Sepsis is a life-threatening organ-dysfunction condition caused by a dysregulated response to an infectious condition that can cause complications in patients with major trauma. Burns are one of the most destructive forms of trauma; despite the improvements in medical care, infections remain an important cause of burn injury-related mortality and morbidity, and complicated sepsis predisposes patients to diverse complications such as organ failure, lengthening of hospital stays, and increased costs. Accurate diagnosis and early treatment of sepsis may have a beneficial impact on clinical outcome of burn-injured patients. In this review, we offer a comprehensive description of the current and traditional markers used as indicative of sepsis in burned patients. However, although these are markers of the inflammatory post-burn response, they usually fail to predict sepsis in severely burned patients due to that they do not reflect the severity of the infection. Identification and measurement of biomarkers in early stages of infection is important in order to provide timely response and effective treatment of burned patients. Therefore, we compiled important experimental evidence, demonstrating novel biomarkers, including molecular markers such as genomic DNA variations, alterations of transcriptome profiling (mRNA, miRNAs, lncRNAs and circRNAs), epigenetic markers, and advances in proteomics and metabolomics. Finally, this review summarizes next-generation technologies for the identification of markers for detection of sepsis after burn injuries. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

  17. Proposed neutral-beam diagnostics for fast confined alpha particles in a burning plasma

    International Nuclear Information System (INIS)

    Schlachter, A.S.; Cooper, W.S.

    1986-10-01

    Diagnostic methods for fast confined alpha particles are essential for a burning plasma experiment. Several methods which use energetic neutral beams have been proposed. We review these methods and discuss system considerations for their implementation

  18. Incidence and characteristics of chemical burns.

    Science.gov (United States)

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

    2017-05-01

    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  19. [To see the future development of burn medicine from the view of holistic integrative medicine].

    Science.gov (United States)

    Hu, D H; Tao, K

    2017-04-20

    The therapeutic methods and effects have been improved greatly in the past few decades for burn care and management with several important advancements which have resulted in more effective patient stabilization and significantly decreased mortality in China. However, the challenges still exist, such as how to further improve the recovery of the patients' appearance and function, and how to advance the treatment of severe deep extensive burn injury, etc. The theory of holistic integrative medicine (HIM) provides a new opportunity for the development of clinical medicine. This article emphasizes the important roles of HIM in exploration of burn medicine, considering the advanced development of modern life sciences and relevant techniques.

  20. Silicon Burning. II. Quasi-Equilibrium and Explosive Burning

    International Nuclear Information System (INIS)

    Hix, W.R.; Thielemann, F.

    1999-01-01

    Having examined the application of quasi-equilibrium to hydrostatic silicon burning in Paper I of this series, we now turn our attention to explosive silicon burning. Previous authors have shown that for material that is heated to high temperature by a passing shock and then cooled by adiabatic expansion, the results can be divided into three broad categories, incomplete burning, normal freezeout, and α-rich freezeout, with the outcome depending on the temperature, density, and cooling timescale. In all three cases, we find that the important abundances obey quasi-equilibrium for temperatures greater than approximately 3x10 9 K, with relatively little nucleosynthesis occurring following the breakdown of quasi-equilibrium. We will show that quasi-equilibrium provides better abundance estimates than global nuclear statistical equilibrium, even for normal freezeout, and particularly for α-rich freezeout. We will also examine the accuracy with which the final nuclear abundances can be estimated from quasi-equilibrium. copyright copyright 1999. The American Astronomical Society

  1. Global biomass burning: Atmospheric, climatic, and biospheric implications

    International Nuclear Information System (INIS)

    Levine, J.S.

    1991-01-01

    As a significant source of atmospheric gases, biomass burning must be addressed as a major environmental problem. Biomass burning includes burning forests and savanna grasslands for land clearing and conversion, burning agricultural stubble and waste after harvesting, and burning biomass fuels. The editor discusses the history of biomass burning and provides an overview of the individual chapters

  2. In view of standardization Part 2: Management of challenges in the initial treatment of burn patients in Burn Centers in Germany, Austria and Switzerland.

    Science.gov (United States)

    Ziegler, Benjamin; Hirche, Christoph; Horter, Johannes; Kiefer, Jurij; Grützner, Paul Alfred; Kremer, Thomas; Kneser, Ulrich; Münzberg, Matthias

    2017-03-01

    Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland. The survey included standards of airway management and ventilation, fluid management and circulation, body temperature monitoring and management, topical burn wound treatment and a microbiological surveillance. Additionally, the distribution of standardized course systems was covered. 17 out of 22 questionnaires (77%) were returned completed. Regarding volume resuscitation, results showed a similar approach in estimating initial fluid while discrepancies persisted in the use of colloidal fluid and human albumin. Elective tracheostomy and the need for bronchoscopy with suspected inhalation injury were the most controversial issues revealed by the survey. Topical treatment of burned body surface also followed different principles regarding the use of synthetic epidermal skin substitutes or enzymatic wound debridement. Less discrepancy was found in basic diagnostic measures, body temperature management, estimation of the extent of burns and microbiological surveillance. While many burn-related issues are clearly not questionable and managed in a similar way in most participating facilities, we were able to show that the most contentious issues in burn trauma management involve initial volume resuscitation, management of inhalation trauma and topical burn wound treatment. Further research is required to address these topics and evaluate a potential superiority of a regime in order to increase the level of

  3. Management of post burn hand deformities

    Directory of Open Access Journals (Sweden)

    Sabapathy S

    2010-10-01

    Full Text Available The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor.

  4. Modeling of multi-strata forest fire severity using Landsat TM data

    Science.gov (United States)

    Q. Meng; R.K. Meentemeyer

    2011-01-01

    Most of fire severity studies use field measures of composite burn index (CBI) to represent forest fire severity and fit the relationships between CBI and Landsat imagery derived differenced normalized burn ratio (dNBR) to predict and map fire severity at unsampled locations. However, less attention has been paid on the multi-strata forest fire severity, which...

  5. Okanagan indoor wood burning appliance inventory survey

    International Nuclear Information System (INIS)

    2001-01-01

    A survey was conducted to determine the usage and nature of wood burning appliances used by residents in British Columbia's Okanagan region. The objective was to better understand this source of air quality concern and to facilitate strategic planning, guidelines and legislation. The survey also provides a baseline to track the effectiveness of any reduction strategies. It identifies the different types of wood burning appliances used in the community and presents residential options about potential bylaws to protect air quality. The receptivity of households to switch to more efficient wood burning appliances was also examined. The survey completes a portion of an overall emissions inventory for the Okanagan Valley. Environment Canada uses the particulate loading results to model the air quality in the airshed. Results showed that approximately 21 per cent of the households in the Okanagan use indoor wood burning appliances, and burn an average of 2.3 cords of wood each year. Only 11 per cent of the appliances are considered to have advanced burning technology. It is projected that the use of wood burning appliances in the Okanagan will increase by 5 to 7 per cent in the next 2 years. Most residents have good burning habits, but some improvements can still be made. Many residents are considering exchanging old wood burning appliances for clean burning technology appliances for environmental and health reasons. Most households would support a bylaw to control nuisance amounts of smoke from wood burning appliances. 20 tabs., 5 figs

  6. [Burns care following a nuclear incident].

    Science.gov (United States)

    Bargues, L; Donat, N; Jault, P; Leclerc, T

    2010-09-30

    Radiation injuries are usually caused by radioactive isotopes in industry. Detonations of nuclear reactors, the use of military nuclear weapons, and terrorist attacks represent a risk of mass burn casualties. Ionizing radiation creates thermal burns, acute radiation syndrome with pancytopenia, and a delayed cutaneous syndrome. After a latency period, skin symptoms appear and the depth of tissue damages increase with dose exposure. The usual burn resuscitation protocols have to be applied. Care of these victims also requires assessment of the level of radiation, plus decontamination by an experienced team. In nuclear disasters, the priority is to optimize the available resources and reserve treatment to patients with the highest probability of survival. After localized nuclear injury, assessment of burn depth and surgical techniques of skin coverage are the main difficulties in a burn centre. Training in medical facilities and burn centres is necessary in the preparation for management of the different types of burn injuries.

  7. Method for burning radioactive wastes

    International Nuclear Information System (INIS)

    Hattori, Akinori; Tejima, Takaya.

    1987-01-01

    Purpose: To completely process less combustible radioactive wastes with no excess loads on discharge gas processing systems and without causing corrosions to furnace walls. Method: Among combustible radioactive wastes, chlorine-containing less combustible wastes such as chlorine-containing rubbers and vinyl chlorides, and highly heat generating wastes not containing chloride such as polyethylene are selectively packed into packages. While on the other hand, packages of less combustible wastes are charged into a water-cooled jacket type incinerator intermittently while controlling the amount and the interval of charging so that the temperature in the furnace will be kept to lower than 850 deg C for burning treatment. Directly after the completion of the burning, the packed highly heat calorie producing wastes are charged and subjected to combustion treatment. (Yoshihara, H.)

  8. Burning mouth syndrome: A review

    Directory of Open Access Journals (Sweden)

    Rajendra G Patil

    2017-01-01

    Full Text Available Burning mouth syndrome is a condition characterized by chronic orofacial pain without any mucosal abnormalities or other organic disease. There are numerous synonyms for this ailment such as stomatodynia, stomatopyrosis, glossodynia, glossopyrosis, sore mouth, sore tongue, oral dysesthesia, and scalding mouth syndrome. Patients usually present with burning, stinging, or numbness on the tongue or other areas of oral mucosa. The complex etiology and lack of characteristic signs and symptoms makes the diagnosis difficult. As a result of which managing such patients become a herculean task. Moreover, lack of understanding of the disease leads to misdiagnosis and unnecessary referral of patients. In this article, the authors have described the etiopathogenesis, diagnostic algorithm and management of this confusing ailment.

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Burning Phosphorus under Water Safely

    Science.gov (United States)

    Taylor, Larry C.

    1997-09-01

    A safer method for demonstrating the burning of white phosphorous under water is described. This demonstration uses 3% hydrogen peroxide solution and manganese dioxide as the oxygen source, eliminating the use of potentially explosive potassium chlorate. The oxygen generation is manually controlled by means of a stopcock on the dropping funnel. The apparatus has been designed to provide a most spectacular display, especially in the dark, lasting an hour or longer if desired, and eliminates the noxious phosphorous odor.

  11. Partial-thickness burn wounds healing by topical treatment

    Science.gov (United States)

    Saeidinia, Amin; Keihanian, Faeze; Lashkari, Ardalan Pasdaran; Lahiji, Hossein Ghavvami; Mobayyen, Mohammadreza; Heidarzade, Abtin; Golchai, Javad

    2017-01-01

    Abstract Background: Burns are common event and associated with a high incidence of death, disability, and high costs. Centella asiatica (L.) is a medicinal herb, commonly growing in humid areas in several tropical countries that improve wound healing. On the basis of previous studies, we compared the efficacy of Centiderm versus silver sulfadiazine (SSD) in partial thickness burning patients. Methods: Study population comprised burn victims referred to Velayat Burning Hospital at Rasht, Iran. The intervention group received Centiderm and control group SSD cream. Burn wounds were treated once daily at home. All of the wounds were evaluated till complete healing occurred and at the admission, days 3, 7, 14 objective signs; visual acuity score (VAS) and subjective signs were recorded. Re-epithelialization time and complete healing days were recorded. We used random fixed block for randomization. The randomization sequence was created using the computer. Patients and burning specialist physician were blinded. Results: Seventy-five patients randomized into 2 groups; (40 patients: Centiderm group; 35 patients: SSD group). The mean age of them was 30.67 ± 9.91 years and 19 of them were male (31.7%). Thirty patients in Centiderm and 30 patients in SSD group were analyzed. All of objective and subjective signs and mean of re-epithelialization and complete healing were significantly better in Centiderm group rather than SSD group (P < 0.05). There was no infection in Centiderm group. Conclusions: We showed that use of Centiderm ointment not only improved the objective and subjective signs in less than 3 days, but also the re-epithelialization and complete healing rather than SSD without any infection in the subjects. PMID:28248871

  12. Prescribed burning supports grassland biodiversity - A multi-species study

    Science.gov (United States)

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

    2017-04-01

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

  13. Method of burning petrochemical products

    Energy Technology Data Exchange (ETDEWEB)

    Sado, I

    1973-01-12

    This invention concerns a method of burning wastes such as polyvinyl chloride or other synthetic resin products and rubbers, in which wastes are burned in a nearly smokeless and odorless state. The method is characterized by a process by which petrochemical waste products are subjected to a spontaneous combustion in a casserole state in a closed combustion room in such a way that no air is supplied whatever, and subsequently the gas so generated is sent successively in an adequate amount into a separately installed second combustion room where it is reburnt at a high temperature of more than 1000 C by a jet flame from the oil burners mounted inside the combustion room. Usually, petrochemical products emanate black smoke of Ringelmann concentration of more than five and a strong odor, but in this method, particularly in the case of polyvinyl chloride the exhaust smoke has a Ringelmann smoke concentration of less than one and is almost odorless because the plastic is completely gasified by the spontaneous combustion and completely burned at 1300 to 1400/sup 0/C with oil and air in the second combustion room. When the exhaust smoke is passed through a neutralization tank to remove the chloride compounds in the smoke, the damaging contribution of the exhaust gas or smoke to the secondary pollution can be completely eliminated.

  14. Radioactive implications from coal burning

    International Nuclear Information System (INIS)

    Papastefanou, C.; Manolopoulou, M.; Charalambous, S.

    1989-01-01

    Lignites burning in the Greek Coal Power Plants (CPP) contain naturally occurring radionuclides mainly arising from the uranium series. Radium-226 concentrations in lignites burning in the three Coal Power Plants of the 3.02 GW energy centre, the greatest in Greece (Valley of Ptolemais, North Greece), varied from about 30 to 132 Bq kg -1 (average 65.5 Bq kg -1 . About 1.3 % of 226 Ra is discharged to the environment in particulate form - fly ash - by the stacks of thermal power stations, burning coal at a rate 14.3 Mt (GH y) -1 . The collective effective dose equivalent (EDE) commitment to the population 44400 living in the region of these plants, due to inhalation was estimated to be 0.13 man Sv y -1 , that is an order of magnitude higher than that recommended for such a population. Doses from inhaled radon and radon progeny might cause an excess of 3-7 cancer deaths this year. (author)

  15. [Psychiatric co-morbidity, body image problems and psychotherapeutic interventions for burn survivors: a review].

    Science.gov (United States)

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

    2013-11-01

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

  16. OPTIMIZATION OF RESULTS AND TREATMENT TIMING OF DEEP DERMAL BURNS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Konstantin Aleksandrovich Afonichev

    2014-06-01

    Full Text Available Untreated deep dermal burns in children are the cause of long-term treatment and severe cicatricial deformities, resulting in poor cosmetic results and greatly impairing functional outcome. The problem of optimizing the results and timing of treatment of deep burns in children in recent years has become particularly urgent. We observed 1853 children with III-A degree burns. Some of the children's burns healed spontaneously, which led to the development of scar deformities during the first six months after injury. Risk factors for their development, depending on the patient's age and location of the lesion, are pointed out. Other children underwent early tangential excision of eschar. The analysis of the treatment results showed that the use of early surgery in children with deep dermal burns can reduce treatment time, as well as significantly to improve the cosmetic and functional outcomes of trauma.

  17. Fire hazard after prescribed burning in a gorse shrubland: implications for fuel management.

    Science.gov (United States)

    Marino, Eva; Guijarro, Mercedes; Hernando, Carmen; Madrigal, Javier; Díez, Carmen

    2011-03-01

    Prescribed burning is commonly used to prevent accumulation of biomass in fire-prone shrubland in NW Spain. However, there is a lack of knowledge about the efficacy of the technique in reducing fire hazard in these ecosystems. Fire hazard in burned shrubland areas will depend on the initial capacity of woody vegetation to recover and on the fine ground fuels existing after fire. To explore the effect that time since burning has on fire hazard, experimental tests were performed with two fuel complexes (fine ground fuels and regenerated shrubs) resulting from previous prescribed burnings conducted in a gorse shrubland (Ulex europaeus L.) one, three and five years earlier. A point-ignition source was used in burning experiments to assess ignition and initial propagation success separately for each fuel complex. The effect of wind speed was also studied for shrub fuels, and several flammability parameters were measured. Results showed that both ignition and initial propagation success of fine ground fuels mainly depended on fuel depth and were independent of time since burning, although flammability parameters indicated higher fire hazard three years after burning. In contrast, time since burning increased ignition and initial propagation success of regenerated shrub fuels, as well as the flammability parameters assessed, but wind speed had no significant effect. The combination of results of fire hazard for fine ground fuels and regenerated shrubs according to the variation in relative coverage of each fuel type after prescribed burning enabled an assessment of integrated fire hazard in treated areas. The present results suggest that prescribed burning is a very effective technique to reduce fire hazard in the study area, but that fire hazard will be significantly increased by the third year after burning. These results are valuable for fire prevention and fuel management planning in gorse shrubland areas. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Perceptions of prescribed burning in a local forest community in Victoria, Australia.

    Science.gov (United States)

    Bell, Tina; Oliveras, Immaculada

    2006-11-01

    The general perceptions of prescribed burning were elicited from forest users for an area that has been subject to this form of land management for at least 20 years. The largest group consisted of local residents living in and around the Wombat State Forest with two smaller groups of students from a nearby university campus and local professional land managers. A questionnaire was given to each participant in order to explore how the forest was used, to determine the level of knowledge of burning in the targeted forest and Victoria and the perception of the appearance, effectiveness of protection, and accessibility to the forest after prescribed burning. Generally all groups had similar responses with community members having stronger views on the effectiveness and practicalities of prescribed burning, whereas students were more neutral in their opinions. All participants claimed knowledge of prescribed burning activities within Victoria, but fewer had experience of planned fires in the Wombat State Forest. All groups agreed that areas that had not been recently burned had a better appearance than those that had, but this result may have included a range of value judgments. Land managers had a greater understanding of the ecological importance of season and timing of burning; however, some students and community members were equally knowledgeable. Prescribed burning did not impede access to the forest, nor did smoke from prescribed burns pose any great problem. The majority of the participants felt that the amount of prescribed burning done in the forest was adequate for engendering a feeling of protection to life and property, yet many were still suspicious of this management practice. These initial findings indicate several areas in which further research would be useful including the efficacy of education programs for community members and improved communication of burn plans by land managers.

  19. Emissions from Biomass Burning in the Yucatan

    Science.gov (United States)

    Yokelson, R.; Crounse, J. D.; DeCarlo, P. F.; Karl, T.; Urbanski, S.; Atlas, E.; Campos, T.; Shinozuka, Y.; Kapustin, V.; Clarke, A. D.; hide

    2009-01-01

    In March 2006 two instrumented aircraft made the first detailed field measurements of biomass burning (BB) emissions in the Northern Hemisphere tropics as part of the MILAGRO project. The aircraft were the National Center for Atmospheric Research C-130 and a University of Montana/US Forest Service Twin Otter. The initial emissions of up to 49 trace gas or particle species were measured from 20 deforestation and crop residue fires on the Yucatan peninsula. This included two trace gases useful as indicaters of BB (HCN and acetonitrile) and several rarely, or never before, measured species: OH, peroxyacetic acid, propanoic acid, hydrogen peroxide, methane sulfonic acid, and sulfuric acid. Crop residue fires emitted more organic acids and ammonia than deforestation fires, but the emissions from the main fire types were otherwise fairly similar. The Yucatan fires emitted unusually amounts of SO2 and particle chloride, likely due to a strong marine influence on the peninsula.

  20. Factors affecting the prevalence of foot pad dermatitis, hock burn and breast burn in broiler chicken.

    Science.gov (United States)

    Haslam, S M; Knowles, T G; Brown, S N; Wilkins, L J; Kestin, S C; Warriss, P D; Nicol, C J

    2007-06-01

    1. Standardised data on flock husbandry were recorded on 149 broiler farms during the 4 d prior to slaughter. 2. Birds were examined at the slaughterhouse for contact dermatitis lesions. Foot pad dermatitis score (FPDS) and hock burn score (HBS) were measured on five point scales. Carcase rejection data were also collected. 3. The mean percentage of birds in each flock with: moderate or severe foot lesions was 11.1% (range 0-71.5%); moderate or severe hock burn was 1.3% (range 0-33.3%); and, breast burn was 0.02%. 4. A general linear model was developed to examine factors associated with mean flock FPDS. Assuming a linear relationship, within the range of data collected and with all other factors remaining the same, every 1% increase in the proportion of Genotype A birds in the flock was associated with an increase in mean FPDS of 0.003, every one-point increase in litter score was associated with a 0.326 increase in mean FPDS and every one-point increase in flock mean HBS was associated with a 0.411 increase in mean FPDS. Flock mean FPDS was associated with feed supplier and was higher in winter. 5. The general linear model developed for flock mean HBS, found that every one-point increase in mean FPDS increased mean HBS by 0.090, every one-point increase in litter score increased HBS by 0.119 and, every 1% increase in small/emaciated birds decreased mean HBS by 0.333. Reduced HBS was also associated with increased final litter depth, younger slaughter age and an increased percentage of dietary wheat. For every 1% increase in Genotype A birds, a decrease in flock mean HBS of 0.003 would be expected. 6. An effect of hatchery was also identified.

  1. Fire severity classification: Uses and abuses

    Science.gov (United States)

    Theresa B. Jain; Russell T. Graham

    2003-01-01

    Burn severity (also referred to as fire severity) is not a single definition, but rather a concept and its classification is a function of the measured units unique to the system of interest. The systems include: flora and fauna, soil microbiology and hydrologic processes, atmospheric inputs, fire management, and society. Depending on the particular system of interest...

  2. Supporting biodiversity by prescribed burning in grasslands - A multi-taxa approach.

    Science.gov (United States)

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

    2016-12-01

    There are contrasting opinions on the use of prescribed burning management in European grasslands. On the one hand, prescribed burning can be effectively used for the management of open landscapes, controlling dominant species, reducing accumulated litter or decreasing wildfire risk. On the other hand burning can have a detrimental impact on grassland biodiversity by supporting competitor grasses and by threatening several rare and endangered species, especially arthropods. We studied the effects of prescribed burning in alkaline grasslands of high conservation interest. Our aim was to test whether dormant-season prescribed burning can be an alternative conservation measure in these grasslands. We selected six sites in East-Hungary: in three sites, a prescribed fire was applied in November 2011, while three sites remained unburnt. We studied the effects of burning on soil characteristics, plant biomass and on the composition of vegetation and arthropod assemblages (isopods, spiders, ground beetles and rove beetles). Soil pH, organic matter, potassium and phosphorous did not change, but soluble salt content increased significantly in the burnt sites. Prescribed burning had several positive effects from the nature conservation viewpoint. Shannon diversity and the number of flowering shoots were higher, and the cover of the dominant grass Festuca pseudovina was lower in the burnt sites. Graminoid biomass was lower, while total, green and forb biomass were higher in the burnt plots compared to the control. The key finding of our study was that prescribed burning did not decrease the abundance and diversity of arthropod taxa. Species-level analyses showed that out of the most abundant invertebrate species, 10 were not affected, 1 was negatively and 1 was positively affected by burning. Moreover, our results suggest that prescribed burning leaving unburnt patches can be a viable management tool in open landscapes, because it supports plant diversity and does not threaten

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

    Directory of Open Access Journals (Sweden)

    Terence J Coderre

    2000-01-01

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

  4. Temporal effects of prescribed burning on terpene production in Mediterranean pines.

    Science.gov (United States)

    Valor, Teresa; Ormeño, Elena; Casals, Pere

    2017-12-01

    Prescribed burning is used to reduce fuel hazard but underburning can damage standing trees. The effect of burning on needle terpene storage, a proxy for secondary metabolism, in fire-damaged pines is poorly understood despite the protection terpenes confer against biotic and abiotic stressors. We investigated variation in needle terpene storage after burning in three Mediterranean pine species featuring different adaptations to fire regimes. In two pure-stands of Pinus halepensis Mill. and two mixed-stands of Pinus sylvestris L. and Pinus nigra ssp. salzmanni (Dunal) Franco, we compared 24 h and 1 year post-burning concentrations with pre-burning concentrations in 20 trees per species, and evaluated the relative contribution of tree fire severity and physiological condition (δ13C and N concentration) on temporal terpene dynamics (for mono- sesqui- and diterpenes). Twenty-four hours post-burning, monoterpene concentrations were slightly higher in P. halepensis than at pre-burning, while values were similar in P. sylvestris. Differently, in the more fire-resistant P. nigra monoterpene concentrations were lower at 24 h, compared with pre-burning. One year post-burning, concentrations were always lower compared with pre- or 24 h post-burning, regardless of the terpene group. Mono- and sesquiterpene variations were negatively related to pre-burning δ13C, while diterpene variations were associated with fire-induced changes in needle δ13C and N concentration. At both post-burning times, mono- and diterpene concentrations increased significantly with crown scorch volume in all species. Differences in post-burning terpene contents as a function of the pine species' sensitivity to fire suggest that terpenic metabolites could have adaptive importance in fire-prone ecosystems in terms of flammability or defence against biotic agents post-burning. One year post-burning, our results suggest that in a context of fire-induced resource availability, pines likely prioritize

  5. A review of treatment strategies for hydrofluoric acid burns: current status and future prospects.

    Science.gov (United States)

    Wang, Xingang; Zhang, Yuanhai; Ni, Liangfang; You, Chuangang; Ye, Chunjiang; Jiang, Ruiming; Liu, Liping; Liu, Jia; Han, Chunmao

    2014-12-01

    Hydrofluoric acid (HF), a dangerous inorganic acid, can cause severe corrosive effects and systemic toxicity. HF enters the human body via where it contacts, such as skin and mucosa, alimentary and respiratory tracts, and ocular surfaces. In the recent years, the incidence of HF burn has tended to increase over time. The injury mechanism of HF is associated primarily with the massive absorption of HF and the release of hydrogen ions. Correct diagnosis and timely treatment are especially important for HF burns. The critical procedure to treat HF burn is to prevent on-going HF absorption, and block the progressive destruction caused by fluoride ions. Due to the distinct characteristics of HF burns, the topical treatment, as well as systemic support, has been emphasised. Whereas, management of patients with HF burns remains a great challenge in some situations. To date, there has been no widely accepted protocol for the rescue of HF burns, partly due to the diversity of HF burns. This paper overviews the current status and problems of treatment strategies for HF burns, for the purpose of promoting the future researches and improvement. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  6. Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects

    Directory of Open Access Journals (Sweden)

    Elton Mathias

    2017-12-01

    Full Text Available Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population. The pain management of the children with major burns challenges the skills of the personnel of every unit. Managing these wounds requires intensive therapeutic treatment for multi-organ dysfunction, and surgical treatment to prevent sepsis and other complications that further delay wound closure. Alternatives to the practice of donor site harvest and autografting for the treatment of severe burns and other complex skin defects are urgently needed for both adult and pediatric populations. This review article focuses on thermal burn pathophysiology and pain management and provides an overview of currently approved products used for the treatment of pediatric burn wounds. A new promising approach has been presented as a first-line therapy in the treatment of burns to reduce surgical autografting in pediatric patients.

  7. Characterization of Phenolic Compounds in Pinus laricio Needles and Their Responses to Prescribed Burnings

    Directory of Open Access Journals (Sweden)

    Lila Ferrat

    2007-07-01

    Full Text Available Fire is a dominant ecological factor in Mediterranean-type ecosystems. Management strategies include prescribed (controlled burning, which has been used in the management of several species, such as Pinus nigra ssp laricio var. Corsicana, a pine endemic to Corsica of great ecological and economic importance. The effects of prescribed burning on Pinus laricio have been little studied. The first aim of this study was to characterize total and simple phenolic compounds in Pinus laricio. The second aim was to understand: i the short term (one to three months and medium term (three years effects of prescribed burning, and ii the effects of periodic prescribed burning on the production of phenolic compounds in Pinus laricio. The first result of this study is the presence of total and simple phenolic compounds in the needles of Pinus laricio. 3-Vanillyl propanol is the major compound. After a prescribed burning, the synthesis of total phenolic compounds increases in Pinus laricio for a period of three months. Total phenolic compounds could be used as bioindicators for the short-term response of Pinus laricio needles to prescribed burning. Simple phenolic compounds do not seem to be good indicators of the impact of prescribed burning because prescribed burnings are low in intensity.

  8. Factors related to child maltreatment in children presenting with burn injuries.

    Science.gov (United States)

    Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye

    2014-01-01

    The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. Pmaltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.

  9. Characterization of phenolic compounds in Pinus laricio needles and their responses to prescribed burnings.

    Science.gov (United States)

    Cannac, Magali; Pasqualini, Vanina; Greff, Stéphane; Fernandez, Catherine; Ferrat, Lila

    2007-07-30

    Fire is a dominant ecological factor in Mediterranean-type ecosystems. Management strategies include prescribed (controlled) burning, which has been used in the management of several species, such as Pinus nigra ssp laricio var. Corsicana, a pine endemic to Corsica of great ecological and economic importance. The effects of prescribed burning on Pinus laricio have been little studied. The first aim of this study was to characterize total and simple phenolic compounds in Pinus laricio. The second aim was to understand: i) the short term (one to three months) and medium term (three years) effects of prescribed burning, and ii) the effects of periodic prescribed burning on the production of phenolic compounds in Pinus laricio. The first result of this study is the presence of total and simple phenolic compounds in the needles of Pinus laricio. 3-Vanillyl propanol is the major compound. After a prescribed burning, the synthesis of total phenolic compounds increases in Pinus laricio for a period of three months. Total phenolic compounds could be used as bioindicators for the short-term response of Pinus laricio needles to prescribed burning. Simple phenolic compounds do not seem to be good indicators of the impact of prescribed burning because prescribed burnings are low in intensity.

  10. Development of continuous energy Monte Carlo burn-up calculation code MVP-BURN

    International Nuclear Information System (INIS)

    Okumura, Keisuke; Nakagawa, Masayuki; Sasaki, Makoto

    2001-01-01

    Burn-up calculations based on the continuous energy Monte Carlo method became possible by development of MVP-BURN. To confirm the reliably of MVP-BURN, it was applied to the two numerical benchmark problems; cell burn-up calculations for High Conversion LWR lattice and BWR lattice with burnable poison rods. Major burn-up parameters have shown good agreements with the results obtained by a deterministic code (SRAC95). Furthermore, spent fuel composition calculated by MVP-BURN was compared with measured one. Atomic number densities of major actinides at 34 GWd/t could be predicted within 10% accuracy. (author)

  11. 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

  12. Myosin Light Chain Kinase Mediates Intestinal Barrier Disruption following Burn Injury

    Science.gov (United States)

    Chen, Chuanli; Wang, Pei; Su, Qin; Wang, Shiliang; Wang, Fengjun

    2012-01-01

    Background Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC) phosphorylation mediated by MLC kinase (MLCK) is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. Methodology/Principal Findings Male balb/c mice were assigned randomly to either sham burn (control) or 30% total body surface area (TBSA) full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg), an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC)-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. Conclusions/Significance The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury. PMID:22529961

  13. Myosin light chain kinase mediates intestinal barrier disruption following burn injury.

    Directory of Open Access Journals (Sweden)

    Chuanli Chen

    Full Text Available BACKGROUND: Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC phosphorylation mediated by MLC kinase (MLCK is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. METHODOLOGY/PRINCIPAL FINDINGS: Male balb/c mice were assigned randomly to either sham burn (control or 30% total body surface area (TBSA full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg, an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. CONCLUSIONS/SIGNIFICANCE: The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury.

  14. Review of the use of povidone-iodine (PVP-I) in the treatment of burns.

    Science.gov (United States)

    Steen, M

    1993-01-01

    Local infection and burn wound sepsis are one of the most severe problems in the treatment of thermally injured patients. Early surgical treatment and the use of topical antiseptics led to a decrease in the infection rate and significantly improved the survival rate of burns patients within the last twenty-five years. Many antiseptics are used in the treatment of burns. Silver nitrate, silver sulphadiazine, sulfamylon and povidone-iodine (PVP-I) are the most common substances used worldwide in burn care facilities. Clinical studies demonstrate that treatment with PVP-I is the most effective against bacterial and fungal infection. Several methodological problems however arise from direct comparison between these antiseptics, and local and systemic adverse effects can make the right choice difficult. Some case reports documented possible side effects in the treatment of patients with PVP-I, leading to general concerns about this treatment. Absorption of iodine and possible changes in thyroid hormones are well known, but evaluation of the clinical consequences is controversial. Reports of severe metabolic acidosis and renal insufficiency with lethal results have condemned the use of PVP-I in the treatment of extensive burns. The case reports, however, dealt with patients suffering from general morbidity and sepsis and therefore these single reports may not be generally valid. Local treatment of burns may cause further problems. The beneficial effect of a decrease of bacterial counts in deeper tissue may be confounded by other effects delaying wound healing, as shown in some experimental studies. Controlled clinical investigations on burn patients however are still missing. The paper will discuss these topics in detail referring to the treatment of burns with PVP-I. It is based on a critical review of the literature and the author's own experience in burns therapy.

  15. Burns

    Science.gov (United States)

    ... regularly. Teach children about fire safety and the danger of matches and fireworks. Keep children from climbing ... injuries of the lungs. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

  16. Burns

    Science.gov (United States)

    ... putting a child in the bathtub. Cover unused electric outlets with safety caps, and replace damaged, frayed or brittle electrical cords. Keep fire extinguishers on every floor of your house, especially in the kitchen, and know how to use them. Do not ...

  17. Acute Kidney Injury: It's not just the 'big' burns.

    Science.gov (United States)

    Kimmel, L A; Wilson, S; Walker, R G; Singer, Y; Cleland, H

    2018-02-01

    Acute Kidney Injury (AKI) complicates the management of at least 25% of patients with severe burns and is associated with long term complications. Most research focuses on the patients with more severe burns, and whether the same factors are associated with the development of AKI in patients with burns between 10 and 19% total body surface area (TBSA) is unknown. The aims of this study were to examine the incidence of, and factors associated with, the development of AKI in patients with %TBSA≥10, as well as the relationship with hospital metrics such as length of stay (LOS). Retrospective medical record review of consecutive burns patients admitted to The Alfred Hospital, the major adult burns centre in Victoria, Australia. Demographic and injury details were recorded. Factors associated with AKI were determined using multiple logistic regression. Between 2010 and June 2014, 300 patients were admitted with burn injury and data on 267 patients was available for analysis. Median age was 54.5 years with 78% being male. Median %TBSA was 15 (IQR 12, 20). The AKI incidence, as measured by the RIFLE criteria, was 22.5%, including 15% (27/184) in patients with %TBSA 10-19. Factors associated with AKI included increasing age and %TBSA (OR 1.05 p<0.001) as well as increased surgeries (p<0.041) and a cardiac comorbidity (p<0.01). All patients with renal comorbidity developed AKI. In the %TBSA 10-19 cohort, only increasing age (OR 1.05 p<0.001) was associated with AKI. After accounting for confounding factors, the probability of discharge from hospital in Non-AKI group was greater than for the AKI patients at all time points (P<0.001). This is the first study to show an association between patients with %TBSA 10-19 and AKI. Given the association between AKI and complications, prospective research is needed to further understand AKI in burns with the aim of risk reduction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Childhood burns in south eastern Nigeria.

    Science.gov (United States)

    Archibong, A E; Antia, U E; Udosen, J

    1997-06-01

    In a ten year retrospective study of burns in children in University of Calabar Teaching Hospital (UCTH), Calabar, the main causes were hot water, hot soup or oil (56.6%) involving children mostly in the one to three year age group. The relative safety of the home environment seen in other forms of paediatric trauma is not observed in burns in children. A changing pattern of burns in children has emerged within the region with naked flames/bush fire coming second and affecting 22.7% of the children. Chemical burns hitherto a rare occurrence is now frequent because of the storage of caustic soda and acids in living rooms by soap making parents. Burns affecting the perineum, axilla and buttocks are difficult to keep clean and frequently lead to infections, with associated increased morbidity. Causes of childhood burns are largely preventable requiring active social/medical education and public enlightenment campaigns on the various methods of prevention.

  19. Maternal burn-out: an exploratory study.

    Science.gov (United States)

    Séjourné, N; Sanchez-Rodriguez, R; Leboullenger, A; Callahan, S

    2018-02-21

    Maternal burn-out is a psychological, emotional and physiological condition resulting from the accumulation of various stressors characterised by a moderate but also a chronic and repetitive dimension. Little research has focused on this syndrome. The current study aims to assess maternal burn-out rate and to identify factors associated with this state of exhaustion. 263 French mothers aged between 20 and 49 years answered five scales quantifying maternal burn-out, perceived social support, parental stress, depression and anxiety symptoms and history of postnatal depression. About 20% of mothers were affected by maternal burn-out. The main factors related to maternal burn-out were having a child perceived as difficult, history of postnatal depression, anxiety, satisfaction of a balance between professional and personal life and parental stress. This research shows the need for further work on maternal burn-out to better understand and prevent this syndrome.

  20. Moderate glycemic control safe in critically ill adult burn patients: A 15 year cohort study.

    Science.gov (United States)

    Stoecklin, Patricia; Delodder, Frederik; Pantet, Olivier; Berger, Mette M

    2016-02-01

    Hyperglycemia is a metabolic alteration in major burn patients associated with complications. The study aimed at evaluating the safety of general ICU glucose control protocols applied in major burns receiving prolonged ICU treatment. 15 year retrospective analysis of consecutive, adult burn patients admitted to a single specialized centre. death or length of stay burned surface (TBSA), severity scores, infections, ICU stay, outcome. Metabolic variables: total energy, carbohydrate and insulin delivery/24h, arterial blood glucose and CRP values. Analysis of 4 periods: 1, before protocol; 2, tight doctor driven; 3, tight nurse driven; 4, moderate nurse driven. 229 patients, aged 45 ± 20 years (mean ± SD), burned 32 ± 20% TBSA were analyzed. SAPSII was 35 ± 13. TBSA, Ryan and ABSI remained stable. Inhalation injury increased. A total of 28,690 blood glucose samples were analyzed: the median value remained unchanged with a narrower distribution over time. After the protocol initiation, the normoglycemic values increased from 34.7% to 65.9%, with a reduction of hypoglycaemic events (no extreme hypoglycemia in period 4). Severe hyperglycemia persisted throughout with a decrease in period 4 (9.25% in period 4). Energy and glucose deliveries decreased in periods 3 and 4 (pprotocol improved the glycemic control in adult burn patients, reducing glucose variability. Moderate glycemic control in burns was safe specifically related to hypoglycemia, reducing the incidence of hypoglycaemic events compared to the period before. Hyperglycemia persisted at a lower level. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  1. Integra artificial skin dermal regeneration templates in burn scar surgery

    International Nuclear Information System (INIS)

    Rexon Ngim

    1999-01-01

    Integra artificial skin is a porous matrix used as a permanent dermal replacement. Developed in the 1970's, it has been used successfully in the treatment of acute bums requiring full or deep partial thickness skin replacement. Three patients with burn scars received Integra Artificial Skin to resurface various areas of burn scars and also contractures. The first was a 24-year-old woman who had two pieces of Integra to resurface a forearm/elbow/wrist defect. The second was a 28-year-old woman who had two pieces of Integra to resurface a neck contracture. The third was a 44 year-old woman who had two pieces to correct severe burn contractures/ scars of her hands. The results of these three patients, probably the first time Integra was used for bum scar and contracture revision, indicate that there is a place for Integra in Burn Scar surgery. However, the basic principle of its application must be adhered to. These include excision to remove the complete scar, recreation of original size of skin defect and meticulous application of the Artificial Skin and its care post-operatively. Details of its application will be highlighted

  2. Fluid resuscitation for major burn patients with the TMMU protocol.

    Science.gov (United States)

    Luo, Gaoxing; Peng, Yizhi; Yuan, Zhiqiang; Cheng, Wenguang; Wu, Jun; Tang, Jin; Huang, Yuesheng; Fitzgerald, Mark

    2009-12-01

    Fluid resuscitation is one of the critical treatments for the major burn patient in the early phases after injury. We evaluated the practice of fluid resuscitation for severely burned patients with the Third Military Medical University (TMMU) protocol, which is most widely used in many regions of China. Patients with major burns (>30% total body surface area (TBSA)) presenting to Southwest Hospital, Third Military Medical University, between January 2005 and October 2007, were included in this study. Fluid resuscitation was initiated by the TMMU protocol. A total of 71 patients were (46 adults and 25 children) included in this study. All patients survived the first 48 h after injury smoothly and none developed abdominal compartment syndrome or other recognised complications associated with fluid resuscitation. The average quantity of fluid infused was 3.3-61.33% more than that calculated based on the TMMU protocol in both adult and paediatric groups. The average urine output during the first 24h after injury was about 1.2 ml per kg body weight per hour in the two groups, but reached 1.2 ml and 1.7 ml during the second 24h in adult and pediatric groups, respectively. This study indicates that the TMMU protocol for fluid resuscitation is a feasible option for burn patients. Individualised resuscitation - guided by the physiological response to fluid administration - is still important as in other protocols.

  3. [Electrical burns in children. 3 years of case histories].

    Science.gov (United States)

    Caneira, E; Serafim, Z; Duarte, R; Leal, M J

    1996-01-01

    The Burn Unit of Dona Estefânia Hospital admitted a total of 454 patients from January 1992 to January 1995, 24 of these patients suffered from electric shock. Of these 24 patients 3 suffered burns in the mouth, 15 in one or both hands and 6 multiple burns. In 19 patients the burns were up to 1%. A description is made of 5 cases, male children between the ages of 9 and 13 years, which were deemed severe. The incidents occurred outdoors with different voltages and in activities considered of ludic or experimental nature: two on the roof of a house, two with railway cables and one with an electrical cable in a port zone. The burnt areas vary between 4% and 70%, all of them 2nd and 3rd degree, with hospitalization lasting from 36 to 116 days. In addition to early and coordinated medical and rehabilitative treatment, according to individual needs, a description is also made of the cutaneous sequelae (deforming cicatrices, bridles), neurologic and psychologic sequelae, with emphasis on a patient who underwent amputation of the lower left leg and 4th and 5th ranges of the right foot. It was concluded that measures should be taken in education and legislation to prevent these accidents. Relevance is given to the need for a multidisciplinary team and specialized center for the treatment of these patients.

  4. Burn patient care lost in good manufacturing practices?

    Science.gov (United States)

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

    2016-01-01

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

  5. Biomass Burning Observation Project (BBOP) Final Campaign Report

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, LI [Brookhaven National Lab. (BNL), Upton, NY (United States); Sedlacek, A. J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-01-01

    The Biomass Burning Observation Project (BBOP) was conducted to obtain a better understanding of how aerosols generated from biomass fires affect the atmosphere and climate. It is estimated that 40% of carbonaceous aerosol produced originates from biomass burning—enough to affect regional and global climate. Several biomass-burning studies have focused on tropical climates; however, few campaigns have been conducted within the United States, where millions of acres are burned each year, trending to higher values and greater climate impacts because of droughts in the West. Using the Atmospheric Radiation Measurement (ARM) Aerial Facility (AAF), the BBOP deployed the Gulfstream-1 (G-1) aircraft over smoke plumes from active wildfire and agricultural burns to help identify the impact of these events and how impacts evolve with time. BBOP was one of very few studies that targeted the near-field time evolution of aerosols and aimed to obtain a process-level understanding of the large changes that occur within a few hours of atmospheric processing.

  6. Explosive hydrogen burning in novae

    International Nuclear Information System (INIS)

    Wiescher, M.; Goerres, J.; Thielemann, F.K.; Ritter, H.

    1986-01-01

    Recent observations (nova CrA 81 and Aql 82) reported large enhancements of element abundances beyond CNO nuclei in nova ejecta, which still wait for a clear theoretical explanation. Attempts to interprete these findings include scenarios like nova events on a O-Ne-Mg white dwarf or nuclear processing which enables the transfer of CNO material to heavier nuclei. In the present study we included all available nuclear information on proton-rich unstable nuclei, to update thermo-nuclear reaction rates in explosive hydrogen burning. They are applied in a systematic analysis of explosive hydrogen burning for a variety of temperature conditions, appropriate to nova explosions. We find that (a) for temperatures T>2 10 8 K, pre-existing material in Ne, Al, or Mg can be transferred to heavier nuclei following the flow pattern of a r(apid) p(roton-capture) process (b) for T> or approx.3.5 10 8 K CNO matter can be processed to heavier nuclei (in accordance with previous findings). On the basis of these results it seems unlikely that nova Aql 82 (which shows strong carbon and oxygen enrichment together with heavier elements) can be explained by a nova event on a bare O-Ne-Mg white dwarf but is rather a result of burning with T> or approx.3.5 10 8 K. An application to existing nova models shows a reduced 26 Al production, when compared to earlier predictions. Both conclusions, however, have to be verified by complete nova calculations which include the improved nuclear physics input, presented here. (orig.)

  7. Vitamin E Supplementation in Burn Patients

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-12-1-0429 TITLE: Vitamin E Supplementation in Burn Patients PRINCIPAL INVESTIGATOR: Perenlei Enkhbaatar, MD., PhD...NOTES 14. ABSTRACT Our recent findings demonstrate that burn injury significantly depleted stores of vitamin E in adipose tissue of children by nearly...oxidative stress. The objectives of our proposal were to a) attenuate alpha-tocopherol depletion in burn patients by vitamin E supplementation, b) to

  8. In-Situ Burn Gaps Analysis

    Science.gov (United States)

    2015-02-01

    This Report) UNCLAS//Public 20. Security Class (This Page) UNCLAS//Public 21. No of Pages 76 22. Price UNCLAS//Public | CG-926 RDC | Merrick...surveillance and spotting techniques/equipment to keep responders in the heaviest oil concentrations where their operation to skim , burn, or disperse...Offshore Oil Skim And Burn System For Use With Vessels Of Opportunity. UNCLAS//Public | CG-926 RDC | Merrick, et al. Public | June 2015 In-Situ Burn Gaps

  9. Fire-fighting burning oil wells

    International Nuclear Information System (INIS)

    Newbury, Herbert; Risk, Stewart.

    1993-01-01

    A method of extinguishing burning oil wells is presented which involves dispensing liquid nitrogen to the burning site to prevent or inhibit oxygen from fuelling the flames. To carry out the method a remotely operated vehicle is described which is provided with a source of liquid nitrogen and an articulated deployment boom capable of supplying the liquid nitrogen to the site of a burning oil well. (Author)

  10. Long-term RF burn-in effects on dielectric charging of MEMS capacitive switches

    KAUST Repository

    Molinero, David G.; Luo, Xi; Shen, Chao; Palego, Cristiano; Hwang, James; Goldsmith, Charles L.

    2013-01-01

    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.

  11. Effects of vegetation burning on the atmospheric chemistry of the Venezuelan savanna

    International Nuclear Information System (INIS)

    Sanhueza, E.

    1991-01-01

    Biomass burning in tropical savanna and rainforest regions is an important factor in the chemical composition of the atmosphere. On the global scale, burning of savanna grass procedures three to four times greater emission of trace gases than deforestation processes of tropical rainforest. As part of a comprehensive study of the Venezuelan savanna atmosphere, measurements of gases and particles, chemical composition of rain, and biogenic soil emission were made during burning and nonburning periods at several rural savanna sites. A review of the most significant findings is presented in this chapter, and their regional and global implications are discussed

  12. Idiopathic burning mouth syndrome: a common treatment-refractory somatoform condition responsive to ECT.

    Science.gov (United States)

    McGirr, Alexander; Davis, Lindsay; Vila-Rodriguez, Fidel

    2014-04-30

    Somatic symptom disorders are common causes of disability and suffering, and can pose significant management challenges. Idiopathic burning mouth syndrome is a challenging somatic symptom disorder with relatively high prevalence, particularly among post-menopausal women. Here, we present the case of a woman with severe treatment refractory idiopathic burning mouth syndrome and comorbid major depressive disorder, who was successfully treated with bitemporal electroconvulsive therapy. This case highlights the potential effectiveness of electroconvulsive therapy in idiopathic burning mouth syndrome when other treatment options have been exhausted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. 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.

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

    NARCIS (Netherlands)

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

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

  15. EFFECT OF POLYMYXIN-B ON INTESTINAL BACTERIAL TRANSLOCATION IN PSEUDOMONAS-AERUGINOSA WOUND-COLONIZED BURNED MICE

    NARCIS (Netherlands)

    DIJKSTRA, HM; MANSON, WL; KLASEN, HJ; VANDERWAAIJ, D

    1992-01-01

    Bacterial translocation (BT) from the gastrointestinal tract has been proposed to play a role in the pathogenesis of septic complications in severely burned patients. In a burn model the effect of a subtherapeutic dose of polymyxin B-sulfate (PB) at BT was examined in Escherichia coli-monoassociated

  16. Microbial community structure and activity in a Colorado Rocky Mountain forest soil scarred by slash pile burning

    Science.gov (United States)

    Aida E. Jimenez Esquilin; Mary E. Stromberger; William J. Massman; John M. Frank; Wayne D. Shepperd

    2007-01-01

    Tree thinning and harvesting produces large amounts of slash material which are typically disposed of by burning, often resulting in severe soil heating. We measured soil chemical properties and microbial community structure and function over time to determine effects of slash pile burning in a ponderosa pine forest soil. Real time data were collected for soil...

  17. Prescribed burning and mastication effects on surface fuels in southern pine beetle-killed loblolly pine plantations

    Science.gov (United States)

    Aaron D. Stottlemyer; Thomas A. Waldrop; G. Geoff Wang

    2015-01-01

    Surface fuels were characterized in loblolly pine (Pinus taeda L.) plantations severely impacted by southern pine beetle (Dendroctonus frontalis Ehrh.) (SPB) outbreaks in the upper South Carolina Piedmont. Prescribed burning and mastication were then tested as fuel reduction treatments in these areas. Prescribed burning reduced...

  18. Rapid optimization of multiple-burn rocket flights.

    Science.gov (United States)

    Brown, K. R.; Harrold, E. F.; Johnson, G. W.

    1972-01-01

    Different formulations of the fuel optimization problem for multiple burn trajectories are considered. It is shown that certain customary idealizing assumptions lead to an ill-posed optimization problem for which no solution exists. Several ways are discussed for avoiding such difficulties by more realistic problem statements. An iterative solution of the boundary value problem is presented together with efficient coast arc computations, the right end conditions for various orbital missions, and some test results.

  19. Contact Burn with Blister Formation in Children Treated with Sennosides.

    Science.gov (United States)

    Cogley, Kimberly; Echevarria, Andrea; Correa, Catalina; De la Torre-Mondragón, Luis

    2017-03-01

    Eight children treated for severe constipation with sennosides unexpectedly developed contact burns with blisters secondary to the use of these laxatives. All patients wore diapers, and the injuries occurred overnight. To avoid this side effect, we recommend that patients treated with sennosides, especially those in diapers, receive the medication at a time that allows for bowel movements to occur during the day and not overnight. © 2017 Wiley Periodicals, Inc.

  20. Evaluation of the breed/burn fast reactor concept

    International Nuclear Information System (INIS)

    Atefi, B.; Driscoll, M.J.; Lanning, D.D.

    1979-12-01

    A core design concept and fuel management strategy, designated breed/burn, has been evaluated for heterogeneous fast breeder reactors. In this concept internal blanket assemblies after fissile material is bred in over several incore cycles, are shuffled into a moderated radial blanket and/or central island. The most promising materials combination identified used thorium in the internal blankets (due to the superior performance of epithermal Th-U233 systems) and zirconium hydride (ZrH 16 ) as the moderator