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At least 973 records · Page 54Linked to original sources
PubMed1989

Hyperglycaemia after burn injury.

The effect of burn injury on blood sugar levels, serum insulin levels and glucose tolerance was studied in male rats. In the burned group (following 50 per cent surface burn injury), the blood sugar level was significantly increased after burn injury in comparison with control uninjured rats. Hyperglycaemia was blocked by injection of phentolamine (10 mg/kg) for 24 h or propranolol (50 micrograms/kg) 30 min before burn or if the animals were adrenalectomized 4 days before injury. Serum insulin levels were significantly decreased in the scalded rats and their glucose tolerance was impaired. Early hyperglycaemia probably arises as a result of adrenal medullary hyperactivity. The initial rise in blood glucose probably arises from glycogen breakdown, followed later by increased hepatic production of glucose. The 50 per cent body surface scald injury is followed, acutely, by a period of glucose intolerance. In part, this intolerance may be due to decreased serum levels of insulin. The inadequate response of insulin secretion in response to glucose loading may be due to inhibition of insulin secretion by pancreatic beta cells caused by elevated catecholamine levels, possibly in combination with the action of antagonists such as glucagon, which may be secreted in excess as a result of stimulation by catecholamines.

Adrenalectomy↗
PubMed1992

Profile of the paediatric burn patient in a Canadian burn centre.

Five hundred and eighty-three children (0-18 years old), consisting of 33.4 per cent of all burn inpatients, were admitted to the University of Alberta Hospitals over an 11-year period (January 1978 to December 1988). Demographic and outcome variables, in addition to aetiological factors, were examined. 48.4 per cent of burns occurred in children less than 4 years of age, with males predominating in every age group (P less than 0.001). Children had smaller burns, a higher incidence of scalds, less inhalation injuries and a lower mortality compared to adult burn patients admitted over the same time period (P less than 0.05). There was a low incidence of confirmed child abuse by burns (1.4 per cent). High-risk environments identified were the home (74.6 per cent of burns) and recreational settings (12.4 per cent of burns), mainly occurring around campfires. Native children were overrepresented in the burn population compared to the general population by a factor of approximately 10:1. Scald prevention, high-risk environments (home and recreational), high-risk populations (male and natives) and unsafe practices with flammable liquids (petrol in particular) should be emphasized in paediatric burn prevention programmes.

Accidents, Home↗
PubMed1993

Burn injuries in the elderly.

This study has shown that elderly males were more likely to be admitted to the Royal Brisbane Hospital Burns Unit than females. No high-risk period of the day, week or year could be identified for this group. Flame burns and scalds were most common as was the association with cooking and bathing activities. Predisposing factors were found to be common in the elderly burn population. Prevention programmes need to be directed to the home with safer cooking facilities and lower temperature or temperature outlet controls to lessen bathing scalds, as these patients found it difficult to escape a hot bath. Mortality rates were related to the percentage total body surface area burned and inhalation injury, and were well predicted by the Burn Severity Index. Complications were mainly pneumonias and venous thrombosis and reflect the need in this age group of maintaining active mobility and a quick resolution of the burn injury. Good nutrition, often lacking in this age group, must be maintained, along with meticulous wound care if infection is to be prevented. Early wound coverage is vital to prevent sepsis. Our approach is towards an early skin grafting programme while the patient is fit. This is aggressive, with as much skin coverage as possible, before the patient's condition deteriorates. Every effort is made to maintain the patient's health as near normal as possible. However, if deterioration occurs, then the patient is supported and grafting delayed until the patient is again fit for surgery. When this study was undertaken, it was hoped that an answer to the controversial subject of early versus late surgery could be answered.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Prevention of hot tap water burns--a comparative study of three types of automatic mixing valve.

To prevent fatal outbreaks of Legionnaires' disease, particularly in hospitals and other health-care premises, building services engineers are recommended to store and operate hot water systems at a temperature of 60 degrees C. However, water at this temperature can cause serious scalding. It is therefore advised that mixing valves be installed in the hot water supply pipework to provide hot water at safe temperatures for washing and bathing. Electricity Association Technology Ltd (EATL) investigated the performance of three makes of automatic mixing valve. Tests showed that with constant supply conditions there was little difference in performance between the three valves when blending hot and cold water. However, the ability of the valves to respond to the loss of the cold water supply was quite valve was able, consistently, to shut the hot water off in the event of cold water failure. These results suggest that where it is necessary to safeguard people or patients against any risk of scalding, e.g. young children and handicapped patients, a quality thermostatic valve should be installed rather than a cheaper tempering valve.

Burns↗
PubMed1995

The Harstad Injury Prevention Study: prevention of burns in small children by a community-based intervention.

Burns are known to cause considerable morbidity and mortality, and scalding is the most common type of burn injury in small children. A community-based injury prevention programme was initiated in the Norwegian city of Harstad (22,000 inhabitants) in 1987 and evaluated by means of data from a hospital-based injury recording system. One part of the programme aimed at reducing burns in children below 5 years of age. Accident analyses based on the local database revealed coffee to be the most frequent liquid causing scalds, which mostly occurred in the kitchen. Sixty-six per cent of the injured were boys and two-thirds were below 2 years of age. The prevention study was divided in a baseline period (19.5 months) with no local intervention-and a succeeding 7-year period containing a wide range of active and passive prevention strategies. From the first to the second period the mean burn injury rate decreased 52.9 per cent, from 52.4 to 24.7 per 10,000 person years (P < 0.05). In a reference city located 1,000 km away, the rates increased from 61.9 to 68.0 per 10,000 person years (NS). The burn injury rate reduction was considered mainly attributable to the strengthening of public participation and the enhancement of community empowerment achieved by recording and actively using the local burn injury data.

Burns↗
PubMed1994

Epidemiology, morbidity, mortality and treatment of burn injuries--a study in a peripheral industrial hospital.

This is a retrospective study of 348 patients with burn injuries admitted to a peripheral industrial hospital over a period of 10 years. The patients were from all walks of life. The study compared the incidence of burns occurring in various industries and those in other situations, assessed the morbidity and mortality profile of burn injuries treated in a hospital devoid of a modern burn care unit and presents ways of improving the treatment of burn injuries. Out of the 348 patients 42.5 per cent had major burns and 57.5 per cent had minor burns. Children mostly received minor burns, females between the ages of 20 and 40 years commonly received major burns. Flame burns due to kerosene stoves, open flames and fireworks were the commonest causative agent (60.3 per cent). Scalds comprised 28.7 per cent of the injuries, the remainder being due to chemicals, electricity and lighting. Eighty-five per cent of the burns occurred in households; 12 per cent were industrial burns and rest were due to road traffic accidents and lightning. Out of 42 industrial burns, only two cases were of major severity. Most of the industrial burns were scalds. The overall mortality was 18.3 per cent. The average hospital stay was 17.5 days. The treatment given to the patients is briefly discussed and the importance of the introduction of modern methods of burn management in our hospital is also emphasized.

Accidents, Occupational↗
PubMed1996

Bacterial translocation in D-galactosamine-treated rats in a burn model.

Bacteria and endotoxins can pass through the gut barrier under certain conditions. This process of bacterial translocation (BT) may occur after thermal injury in animals and is thought to play a role in the pathogenesis of septic complications in severely burned patients. The current study was performed to determine the role of endotoxin-related cytokines in the pathogenesis of burn-induced BT. Wistar rats were used in which enhanced sensitivity to TNF/LPS reactions was achieved by treatment with galactosamine (GalN). The GI tracts of these rats were antibiotic decontaminated with oral bacitracin and neomycin and were colonized with a neomycin resistant (NR)-Escherichia coli strain. The rats were divided into four groups, 30 per cent TBSA scald with GalN (Burn+GalN) pretreatment; 30 per cent TBSA scald without GalN (Burn); or sham injury with (GalN) and without GalN (Sham) pretreatment. On day 2, the animals were killed and liver, spleen, lung, heart and the peritoneal cavity were cultured. Blood samples were taken and the concentrations of LPS, TNF, IL-6 and ALAT were determined. Mortality was significantly increased in the Burn+GalN group compared to the other groups. In all groups, the incidences of BT were increased compared to the sham-treated group, although BT was most pronounced in the Burn+GalN group. In the latter group it was accompanied by highly elevated IL-6 and ALAT levels. The results of this study suggest that endotoxin mediators like TNF and IL-6 could play a role in the phenomenon of BT and that the function of the liver is an important clearing mechanism.

Alanine Transaminase↗
PubMed1995

Bilateral amputations following hydrotherapy tank burns in a paraplegic patient.

Hydrotherapy is an important part of wound care and physical therapy. The benefits of hydrotherapy are derived from water's cleansing ability, buoyancy, drag, inertia and temperature. If the temperature of the water is not adequately controlled, an immersion scald burn can occur. A paraplegic patient who was receiving hydrotherapy for treatment of his malleolar ulcers sustained immersion scald burns that ultimately necessitated below-the-knee amputations.

Adult↗
PubMed1995

Death in the bathtub involving children.

Retrospective analysis of 215 deaths in the bathtub (Institute of Forensic Medicine, University of Cologne, 1980-1993) revealed 12 fatalities involving children, seven boys and five girls, aged from 9 months to 13 years. The manner and cause of death was seven accidents (five by drowning, two by scalding burns), two natural deaths (epilepsy, heart failure due to Hurler's syndrome), one homicide (stabbing) and two undetermined cases (one probable seizure, one subdural hematoma associated with signs of maltreatment). Seven children < 4 years old died without exception from accidental drowning or scalding. Three toddlers had been left alone and unattended in the bathtub for a 'short time' (< or = 15 min) and two in the care of elder siblings. The immersion time and the amount of water required to cause lethal drowning are expressed in the terms of pathophysiology.

Accidents, Home↗
PubMed2004

Incidence and patterns of childhood burn injuries in the Western Cape, South Africa.

The current study describes the epidemiology and patterns of moderate to severe childhood burn injuries in the Western Cape province in South Africa. Burn injuries sustained by children aged 12 years and younger and registered over January 1999 to December 2000 at the Red Cross Children's Hospital in the Western Cape are analysed (n=1201). Differences in risk distribution between different segments of the population are measured and typical injury patterns are identified. The results show that burn injury incidence is particularly high for toddlers (15.8/10000 child-years/c-y) and infants (14.6/10000 c-y) for boys (7.0/10000 c-y), and for African children (11.4/10000 c-y). Burn injury incidence is highest in winter (1.7/10000 c-y) but only significantly greater than the rate in summer (1.3/10000 c-y). Further, four burn injury patterns are identified, and labeled 'infant scalding', 'toddler scalding', 'injuries among older children with an over-representation of flame-related burns' and 'other causes of burns sustained to the head and neck region'. In sum, the risk of burn injury is higher in younger children. Differences between genders were more pronounced among younger and older age groups. Differences between population groups are more important in magnitude than in nature. The patterns identified can stimulate further research and development into the household product and environmental contributors to childhood burn injury.

Age Distribution↗
PubMed2005

Application of tissue ultrasound palpation system (TUPS) in objective scar evaluation.

One of the characteristics of hypertrophic scarring is its raised appearance. Its maturation often results in increased thickness. Therapists usually rely on subjective observation and palpation to document scar thickness. The result of these subjective assessments may reflect only the superficial scar thickness but is unable to measure the whole scar volume and thickness under the skin surface. Measurement of scar thickness using ultrasound imaging has been previously reported, but has not been commonly used in clinics due to its complex operation method and high cost. In this study, we have adopted a newly developed and user-friendly Tissue ultrasound palpation system (TUPS) for the assessment of scar thickness. It consists of a finger size palpation probe, connected to an ultrasound transducer and an in-series load cell to measure the thickness of the soft tissue over the human body. The method of operation is easy and it can be used to measure skin thickness on various parts of the body, thus reflecting the skin thickness. The reliability of the TUPS in clinical application was tested on 30 subjects with a hypertrophic scar at a local hospital. Three raters implemented two assessments on each subject to study its test-retest and inter-rater reliabilities. It was then used to assess 100 subjects with various severity of hypertrophic scar caused by trauma, scald, burn or surgery. They were assessed using TUPS as well as the Vancouver Scar Scale (VSS) for rating scar thickness, pliability, pigmentation and vascularity. Two-way mixed intra-class correlation showed a high test-retest reliability with Intraclass Correlation Coefficient (ICC)=0.98 and inter-rater reliability ICC=0.84. Fair positive correlations with VSS thickness score and VSS total score r=0.34 (p<0.05) and 0.42 (p<0.05), respectively. A significant difference between two scar type groups (50 burn scald scars and 50 surgical scars) was demonstrated (d.f.=52.94, t=3.99, p<0.01). TUPS was proved to have high inter-rater, test-retest reliability and it had a moderate correlation with the VSS that clinicians used for assessment of the scar. This system is recommended for clinical assessment of scar thickness.

Adolescent↗
PubMed2005

Epidemiology of burn injuries in Singapore from 1997 to 2003.

The Singapore General Hospital (SGH) Burn Centre receives more than 93% of burn cases occurring in Singapore. The Centre also received patients from the Southeast Asian region. The collection and analysis of burn epidemiology data in recent years from Singapore would provide insights into new prevention/management strategies in terms of population profile and economic activities. Data pertaining to burn patients admitted to SGH Burn Centre between January 1997 and December 2003 were studied retrospectively in terms of admissions' demographics, extent of burn (TBSA), causes of burns, length of hospital stay (LOS) and mortality. A total of 2019 burn patients were admitted with an annual admission of 288. This presented an incidence rate for burn injury (with admission) of 0.07 per 1000 general population. The male to female ratio is 2.2:1 and the mean age of admission is 32.5years. The mean extent of burn was 11.5% and patients with burn size 10% TBSA and less made up the majority of admissions at 70.7% while patients with burn size 30% TBSA and more made up 8.2%. The most common cause of burn injury is scald at 45.6% followed by flame at 35.2%. The overall mean LOS and mortality are 10.8days and 4.61%, respectively. An annual trend of falling mortality rate for admissions with burn size >30% TBSA was observed-60% in year 2000 to 30% in 2003. This is a result of massive early excision and grafting of severe burn patients. 17.6% of patients were children of 12years and below, showing a 11.9% reduction from previous study in the 80s. This is consistent with the city's demographics of falling fertility rate and improved living and social conditions. Occupational burn admissions account for 33.4% of total admissions, a reduction of 11.6% from a study in the early 90s. Occurrence of occupational flame burns decreased by 9.5% due to an improvement in fire prevention and management of the industrial sectors. However, chemical burns increased by 12.6% as the chemical sector in Singapore grew at a rate of 10% from year 1995 to 2000. Singapore has also derived much experience from the management of mass casualties resulting from SQ006 plane crash and bomb blasts in Bali as well as in Jakarta. In total, 315 victims were treated (4 from SQ006, 16 from Bali and 15 from Jakarta) with 1 mortality. The burns admissions in Singapore has a profile consistent with population demographics. Scald is the major cause of burns and most of these injuries are preventable. While the industries have made inroads into good fire prevention and management, management of chemical burns and other occupational hazards will continue to be scrutinized and advice given in terms of regulations, work processes and personal protective gears.

Adolescent↗
PubMed2005

A seven-year epidemiology study of 12,381 admitted burn patients in Taiwan--using the Internet registration system of the Childhood Burn Foundation.

This study described the epidemiological characteristics of the 12,381 admitted burn patients in Taiwan. The data was from 43 contracted hospitals of the Childhood Burn Foundation, in the years from 1997 to 2003. This descriptive study included 8172 males and 4206 females, with a male to female ratio of 1.94 and an average age of 29.3 years. There were 3993 (33.4%) patients under 18 years old; and 26.4% of the patients were children under 7 years old. First and second years of life were the peak of incidence. The mean extent of burn was 14.0% total body surface area with 950 patients (7.7%) suffering from a burn extent >/=40% TBSA. Scalds resulted in 5085 admissions (43.2%) and flame burns accounted for 3825 admissions (32.5%). In patient group under 18 years old, 76.8% were scald burn and 14.1% were flame burn. The majority of the burn injuries (53.3%) occurred in the dwelling place; 1122 patients had inhalation injuries and required admission to the burn center for pulmonary support. In addition, suicide attempts were recorded in 2.4% (300 cases) of all burn patients with a mean burn size of 40.7% total body surface and mortality rate of 29.3%. The overall mortality rate is 381 out of 12,381 patients (3.1%). The LA(50) was around 80% TBSA. The significant effects of risk factors, such as old age, large burn extent, combined inhalation injury and suicide were demonstrated. Adequate first aid by water cooling affected the outcome of the patient group with burn extent less than 30% TBSA, which was shown by the decrease of length of stay. These results showed some unique distributions that reflected certain socio-economic and cultural background of Taiwan.

Accidents, Home↗
PubMed2005

Etiology and outcome of pediatric burns in Tabriz, Iran.

A 3-year prospective study of burn victims hospitalized at a major burn center was conducted to determine the etiology and outcome of pediatric burns. One thousand one hundred sixty patients under the age of 14 years identified and stratified by age, sex, burn size, presence or absence of inhalation injury, and cause of burn. The mean patient age was 2.2 years, and the male:female ratio was 1.6:1. There were 74 deaths overall (6.4%), the majority of which (44) were among children under 5 years of age. Except for burn incidence, there were no significant differences between males and females. The mean burn size was 19%, and was significantly larger for nonsurvivors than survivors (50.3% versus 16.8%; P<0.001). Inhalation injuries were strongly associated with large burns, and were present in all flame-burn fatalities. Scalds were the most common type of burn among children under 5 years of age; flame burns predominated in older children. There were 39 deaths related to scalds. Large burn size was the strongest predictor of mortality followed by the presence of inhalation injury and the length of time to intravenous access.

Adolescent↗
PubMed2005

Hot oil burns--a study of predisposing factors, clinical course and prevention strategies.

A 10-year retrospective study of hot oil scalds was conducted at the Yorkshire Regional Burns Centre from the years 1995-2004. The number of admissions was noted to have increased over this period. Peak occurrence was noted in the 1-5 and the 30-40-year-old age groups. The peak occurrence in adults was significantly older than that previously reported. Ninety-two percent of injuries in the 1-6-year-old age group were due to pulling a handle or cord of a container of hot oil. Older children had similar mechanisms of injury as adults. Injuries due to epilepsy, intoxication or assaults, were seen exclusively in the fourth to seventh decades of life. The total body surface area of adults and children were similar, i.e. 7.15 +/- 5.49% versus 7.23 +/- 6.87%. However, the incidence of full thickness injury in adults was over twice that observed in children, i.e. 67% versus 26%. Prevention of hot oil scalds requires adult supervision of young children. Product modification for fryers is helpful, but is not a substitute for adult supervision. Prevention of injury in adults requires the placement of adequate warning labels on hot oil cooking appliances as well as containers of cooking oil. In addition, adults should refrain from the consumption of alcoholic beverages when using hot oil cooking appliances or deep-frying.

Accidents, Home↗
PubMed2006

Paediatric burns in Kuwait: incidence, causes and mortality.

From a prospective study on burn patients admitted at the Burn Center in Kuwait during 1993-2001, 826 paediatric burn cases, in 0-14 years age group, were retrieved to study incidence, causes, and mortality among children. The demographic characteristics, clinical features, and outcome constituted our data file in Statistical Software, SPSS. Overall incidence rate was 17.5/100,000 children aged 0-14 years, being almost twice (34/100,000) among those between 0 and 4 years, constituting 70.8% of all paediatric burns. Scald was the main cause of burn (67%), followed by flame (23%). Mean age (6.4 years) of children with flame burns, was significantly higher (p < 0.001) than those with scalds, or other causes. A positive significant correlation existed between duration of hospital stay and TBSA% (r = 0.56, p < 0.001). Overall mortality rate was 0.23/100,000 children, maximum (0.52/100,000) being in children below 5 years. Among 11 (1.3%) non-survivors, flame burns caused nine fatalities. Multiple logistic regression mooring predicted children aged < 5 years, flame burns and TBSA >or= 70%, (OR = 29.2, p < 0.001), as main contributing factors to fatal outcome among children. Gender and nationality had no influence on incidence or mortality. These findings will hopefully stimulate development of targeted and sustainable interventions for reducing burns occurrence among identified paediatric high-risk groups.

Adolescent↗
PubMed2006

Prevention oriented epidemiologic study of accidental burns in rural areas of Ardabil, Iran.

PURPOSE OF STUDY: Burns are one of the leading causes of injury-related deaths in Iran. We conducted a study to investigate features of burns in rural areas of Ardabil Province from October 2004 through March 2005, with an aim to providing content for effective prevention programs. BASIC PROCEDURES: This study employed longitudinal prospective methodology. The study population included all patients presenting with burns to local health care facilities during the study period. MAIN FINDINGS: A total of 1179 cases were studied. Most of the cases (59.4%) were females. Mean of age of victims was 22.3+/-19 years in females and 13.6+/-17 years in males. The vast majority (91.2%) of burns occurred at home. More than two-thirds of burns were because of hot liquids or steam. The majority of scald burns resulted during use of heating devices such as samovars, gas stoves, valors and picnic gas stoves. Overturning and spilling of hot liquids were the most common injury mechanisms. PRINCIPLE CONCLUSIONS: Prevention programs should focus on children and adult women. Prevention efforts should target home environments and focus on prevention of scalding burns.

Accidents, Home↗
PubMed2006

Characteristics of 1494 pediatric burn patients in Shanghai.

To analyze the epidemiological characteristics of pediatric burn patients in Shanghai and to determine the targets for a pediatric burn prevention program, a retrospective review of all medical records of acute pediatric burn patients (age</=14 years old) admitted to the Burn Center of the Ruijin Hospital between January 1980 and December 2002 was performed. Patient demographics, etiology of burn, mechanism of injury, extent and anatomical areas burned, number of operations, and length of hospital stay were recorded. A total of 1494 pediatric burn patients were admitted. Six hundred eighty-seven (46%) patients were from the migrant population (non-registered population of temporary workers from rural areas outside of Shanghai). Scalding was the main cause of pediatric burns in the age groups. Children 0-3-year-old were the most common victims of scalding, chemical burns, and contact burns. Domestic burns resulted in 1293 (86.5%) injuries followed by burns occurring while playing in public. The incidence of domestic burns has increased since the beginning of the study period, while the incidence of burns while playing in public has decreased. The median total body surface area was 4% for mild burns, 10% for moderate burns, and 18% for extensive burns. Predominant areas involved were the head, neck, anterior trunk, and right lower limb. Most children received conservative treatment, and their mean hospital stay was 16.1+/-12.2 days. There were 17 (1.1%) deaths, mostly due to sepsis (82.4%). Migrant children are the majority of burn victims since 1996. The education of burn prevention should focus on the migrant population in an industrializing city.

Adolescent↗