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Biomedical subjects

H Slater

Publications and source records attributed to H Slater.

70 records · Page 4Linked to original sources
PubMedDate not supplied

Sildimac: a new delivery system for silver sulfadiazine in the treatment of full-thickness burn injuries.

Wound care is painful for the patient with a burn injury and tedious for the burn unit staff but necessary to remove exudates and debris and to limit infections. In an effort to circumvent daily dressing changes while ensuring optimal wound protection, Sildimac (Marion Laboratories, Kansas City, Mo.), a new drug delivery system for silver sulfadiazine, was developed. When silver sulfadiazine, a topical antimicrobial commonly used for the treatment of burns, is incorporated into the delivery system, the drug is released in a sustained fashion. We report here the results of a multicenter evaluation of the safety and efficiency of Sildimac for treatment of full-thickness burn wounds. Sildimac, when left in place for up to 4 days, appears to be as effective as twice-daily wound cleansing and application of Silvadene cream 1% (Marion Laboratories, Kansas City, Mo.) for the treatment of full-thickness burns.

Acrylates↗
PubMedDate not supplied

Survey of treatment modalities for the prevention of hypertrophic facial scars.

The application of pressure to facial burns as a means of preventing or treating hypertrophic scar formation constitutes a major clinical challenge. Success depends on the experience of the therapist, choice of the pressure treatment, proper measurement technique, and adequate duration of therapy. A mail survey of therapists involved in the use of the various pressure modalities reveals a common trend with respect to the type of device used and the duration of therapy. The majority of therapists report that no one treatment produces uniformly excellent results.

Burns↗
PubMedDate not supplied

Bad advice; bad burn: a new problem in burn prevention.

Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.

Burns↗
PubMedDate not supplied

Inhalation injury: a decade without progress.

Despite major advances in the management of patients with critical burn injuries, inhalation injury continues to be a major determinant of death resulting from burn injuries. Two cohort groups of victims with burn and inhalation injuries, separated by a decade, were retrospectively reviewed in an effort to determine the impact of newer treatment modalities. Patients were categorized as being at "high" or "low" risk on the basis of primary and secondary diagnostic criteria. Despite a statistically significant decrease in the percent of total body surface injury, no change in mortality rate was noted between the two groups. The advent of sophisticated diagnostic and management techniques does not appear to have decreased the mortality rate associated with inhalation injury.

Adolescent↗
PubMedDate not supplied

Experience with patients with burns who refuse blood transfusion for religious reasons.

Patients with extensive full-thickness burns who refuse blood transfusion present a challenge to the burn team. We have recently treated four such patients, and we achieved a successful outcome in three. Staged excision and skin graft operations with minimal blood loss were performed. Two patients were treated with erythropoietin. Patient autonomy should be accepted by the burn team, but opportunity should exist for reassessment of treatment plans.

Adult↗
PubMedDate not supplied

Wound healing in partial-thickness burn wounds treated with collagenase ointment versus silver sulfadiazine cream.

During burn care the wounds must be repeatedly debrided of adherent and loose debris until the decision is made to surgically excise and graft the wound or to await epithelialization. Though native proteolytic enzymes in the skin or those produced by colonizing bacteria can speed eschar separation, the use of exogenous enzymes for wound debridement may accelerate wound cleaning and healing. Collagenase digests native and denatured collagen in necrotic tissue. This multicenter trial of 79 patients with partial-thickness wounds compared the efficacy of collagenase ointment applied with polymyxin B sulfate/bacitracin powder with the efficacy of standard topical antimicrobial therapy (control) in which silver sulfadiazine cream (1%) was used to debride paired burn sites. Patients selected for the study had two noncontiguous, partial-thickness, comparably sized, and anatomically similar burn wounds. Ages of patients ranged from 5 to 60 years (mean 33 years). The total body surface area burned ranged from 2% to 30% (mean 13.6%). Mean burn sizes used for study treatment were 366 cm2 (26 to 2310 cm2) for collagenase sites and 355 cm2 (26 to 2394 cm2) for control sites. Sites on each patient were randomly assigned to treatment with either collagenase or control. Endpoints were time to clean wound bed (absence of retained debris) and time to healing (complete epithelialization). The sites treated with collagenase cleaned in less time (mean 9.3 days) than the control sites (mean 11.6 days). Similarly the collagenase sites healed faster than the control sites (mean 19 vs 22.1 days).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMedDate not supplied

Use of a token reinforcement system to promote appropriate behavior at a pediatric burn summer camp.

Child behavior management can be an important concern in conducting summer camps for pediatric burn patients, because many of these patients have a history of significant behavioral difficulties. To be efficient, a flexible camp-wide behavior management system, such as a token economy, would be ideal. In this article we discuss the concept and principles of a token reinforcement system and outline how this intervention was applied to our pediatric burn summer camp across 2 consecutive years. We also provide a description of modifications made for the second camp, based on counselor ratings of and our experience with the token system during the first camp. Results from counselor assessments indicated that after using the token system, counselors' perceptions of its utility (eg, effective in decreasing problem behavior in campers, useful in making behavior management easier) increased significantly across both years.

Behavior Therapy↗
PubMedDate not supplied

An assessment of burn prevention knowledge in a high burn-risk environment: restaurants.

Our facility has seen an increase in the number of cases of children burned in restaurants. Fieldwork has revealed many unsafe serving practices in restaurants in our tristate area. The current research targets what appears to be an underexamined burn-risk environment, restaurants, to examine server knowledge about burn prevention and burn care with customers. Participants included 71 local restaurant servers and 53 servers from various restaurants who were recruited from undergraduate courses. All participants completed a brief demographic form as well as a Burn Knowledge Questionnaire. It was found that server knowledge was low (ie, less than 50% accuracy). Yet, most servers reported that they felt customer burn safety was important enough to change the way that they serve. Additionally, it was found that length of time employed as a server was a significant predictor of servers' burn knowledge (ie, more years serving associated with higher knowledge). Finally, individual items were examined to identify potential targets for developing prevention programs.

Adolescent↗
PubMedDate not supplied

Preinjury behavioral and emotional problems among pediatric burn patients.

Standardized behavior rating scales have been used in the routine care of children during medical visits because they provide an objective, norm-based index for the child's behavioral functioning. The purpose of this study was to examine behavior problems among children (aged 2.5-18 years) with burn injuries using the Behavioral Assessment System for Children, a multi-informant system of standardized rating scales that assesses clinical and adaptive behavior areas. Parents and youth (ages 8-18) completed the Behavioral Assessment System for Children with reference to the pediatric patient's behavioral functioning before hospital admission for a burn injury. In total, data were collected on 94 children. Results suggested that a substantial portion of the sample endorsed significantly elevated levels of behavioral difficulties across a broad range of problem behaviors. On the basis of parent report, preschoolers exhibited concerns related to hyperactivity, anxiety, aggression, and attention problems, whereas school-aged children were reported to have these same concerns as well as depression and conduct problems. Twenty percent of our adolescent sample (ages 12-18 years) were described to be experiencing even more internalizing and externalizing behavior problems relative to the two groups of their younger counterparts. Boys were found to contribute to the cause of their burn injury significantly more often than girls. The strengths, limitations, and clinical implications of our findings are discussed.

Adolescent↗
PubMedDate not supplied

Discharge videotaping: a means of augmenting occupational and physical therapy.

Regional burn centers commonly receive patients from medical facilities that are geographically distant. Logistic problems that may hamper follow-up care in the burn center can lead to a decrease in function as a result of contractures and hypertrophic scar formation. Inexperience on the part of therapists at community facilities serves to intensify this problem. Discharge videotaping, with respect to physical and occupational therapy programs, is a means of documenting range of motion at the time of discharge and providing visual documentation of the therapy program to be followed on an outpatient basis. The video tapes are forwarded to the outlying community hospital's therapy department in order to accomplish these goals.

Burns↗
PubMedDate not supplied

Burned children: a socioeconomic profile for focused prevention programs.

A review of 197 consecutive admissions of children 16 years of age and under to the Western Pennsylvania Hospital Burn/Trauma Center during a 28-month period (January 1984-April 1986) found that the majority of these children came from economically disadvantaged homes and that scalding was the most frequent mechanism of injury. Black children, poor children, and children of single parents were disproportionally represented in the study population compared with a similar-aged population in the hospital's referral area. By identifying a specific group of children who are at highest risk of being burned, and by determining the burn injuries these children are most likely to sustain, the study makes it possible to realistically tailor burn prevention programs to meet the specific social and economic characteristics of the group at highest risk.

Adolescent↗
PubMedDate not supplied

Coexistent T-cell lymphoblastic lymphoma and an atypical myeloproliferative disorder associated with t(8;13)(p21;q14).

This report describes a neoplasm exhibiting both lymphoid and myeloid differentiation associated with an acquired balanced translocation between chromosomes 8 and 13 occurring in a 10-year-old boy. Serial lymph node biopsies revealed the presence of both lymphoblastic lymphoma and an atypical myeloproliferative disorder within the same node. Immunophenotyping was consistent with the presence of an immature T-cell population within the nodal biopsy specimens. Cytogenetic analysis of the bone marrow and lymph node biopsy specimens revealed a unique translocation, t(8;13) (p21;q14). Molecular analysis revealed rearrangement of the immunoglobulin heavy chain gene and germline configuration of the T-cell receptor gene. The patient had a poor response to classical T-cell acute lymphocytic leukemia/lymphoma therapy and was changed to a myeloid leukemia protocol with good response. He underwent bone marrow transplantation but died soon after of overwhelming graft-versus-host disease. We found five similar cases in the literature, suggesting the existence of a subset of mixed lymphoid/myeloid disorders with 8p;13q translocations, in which the clinical picture is dictated by the myeloid element.

Child↗