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PubMed1982

Altered muscle metabolism in rats after thermal injury.

Burn injury is associated with an elevation in total body oxygen consumption, increased hepatic alanine uptake and conversion to glucose, and a negative nitrogen balance. The primary source of the alanine used for gluconeogenesis by the liver and of the nitrogen lost as urea is believed to be from skeletal muscle. Selected muscle regulatory enzymes and pyruvate and oleate oxidation rates were assayed for maximal activity during the postburn period. Male Sprague-Dawley rats that received 50% total body surface scald burns on the dorsum and abdomen were examined for citrate synthase (CS), phosphofructokinase (PFK), and glutamate-pyruvate transaminase (GPT) activity in uninjured muscle at 3, 7, 13, and 20 days postburn, and the ability of muscle to oxidize pyruvate and oleate was measured at 3 and 13 days after injury. Cs, PFK, and GPT activities increased significantly (p less than 0.05) by 13-20 days after injury in the soleus and diaphragm. The epitrochlearis showed no change in CS, but PFK and GPT were elevated within this time frame. The gastrocnemius muscle showed an elevated oleate oxidation rate at 13 days after injury, but no change at 3 days postburn. Pyruvate oxidation rates were unaltered. The results of this study indicate that during the postburn period several metabolic alterations occur in muscle. These adaptations include: (1) elevated CS activity which may be associated with increased oxidative capacity,, (2) increased PFK activity which implies that more substrate is being shuttled through the glycolytic pathway, (3) increased GPT activity which may reflect increased pyruvate conversion to alanine, and (4) increased oleate oxidation rates which demonstrate that muscle is utilizing more fatty acid substrates during the postburn period.

Adaptation, Physiological↗
PubMed1984

Structured medium-chain and long-chain triglyceride emulsions are superior to physical mixtures in sparing body protein in the burned rat.

The present study was undertaken to compare the effectiveness of a physical mixture of long-chain and medium-chain triglycerides with an emulsion consisting of chemically synthesized triglycerides composed of medium-chain and long-chain fatty acids in similar proportions. Sprague-Dawley rats received a 25% body surface area full-thickness scald burn on the dorsum. For the next three days, all rats received 300 kcal/kg/day as 160 kcal/kg/day glucose, 50 kcal/kg/day amino acid, and an additional 90 kcal/kg/day lipid emulsion as either long-chain triglyceride, medium-chain triglyceride, a 1:1 physical mix of medium-chain and long-chain triglycerides or a chemically structured triglyceride made up of 60% medium-chain fatty acid and a 40% safflower oil. Rats receiving the chemically structured lipid emulsion showed the greatest gain in body weight, the greatest positive nitrogen balance, and the highest serum albumin concentration, outstripping rats receiving the long-chain triglyceride, medium-chain triglyceride, and even the physical mixture long-chain and medium-chain triglycerides (P less than 0.01). A 30% increase in oxygen consumption and 35% increase in energy expenditure in rats given the medium-chain triglyceride emulsion alone (P less than 0.01) was observed. This study confirms that the metabolism of chemically structured triglycerides composed of medium-chain and long-chain fatty acids markedly differs from similar physical mixtures. For these reasons, the new structured lipid emulsions may prove advantageous in feeding the severely injured patient.

Amino Acids↗
PubMed1985

Effect of inhibitors of proteolysis and arachidonic acid metabolism on burn-induced protein breakdown.

A rat model has been developed to study the local effects of burn injury on the underlying muscle tissue. Protein turnover was measured in soleus muscle incubated in vitro in which both tyrosine release and protein synthesis was measured. A scald injury (3 seconds) to a small area of one hindlimb produces an increase in muscle proteolysis and is without effect on the soleus muscle of the contralateral leg. A very high concentration of indomethacin (40 mumol/L) had no effect on proteolysis in the control muscle but specifically inhibited burn-induced protein breakdown. However, since other cyclooxygenase inhibitors (aspirin and ibuprofen), lipoxygenase inhibitors (ETYA, NDGA, and esculetin), and mepacrine (a phospholipase inhibitor) had no effect on protein breakdown, it is unlikely that a product of arachidonic acid metabolism maintains the increased proteolysis in vitro. In addition, endogenous production of prostaglandin E2 (PGE2) was not different in muscles from burned and control legs. Probes of the proteolytic pathway using inhibitors show that the burn-induced stimulation of proteolysis is consistent with the stimulation of lysosomal protease activity. These results are supported by the observation of increased acid protease activity in muscle homogenates from the burned leg. The best hypothesis that explains these data is that a lysosomal pathway of protein degradation may be enhanced by burn. Products of arachidonic acid metabolism do not appear to maintain burn-induced proteolysis in muscle, although their role in initiating the pathological changes in vivo cannot be excluded.

Animals↗
PubMed1991

Persistence of metabolic effects after long-term oral feeding of a structured triglyceride derived from medium-chain triglyceride and fish oil in burned and normal rats.

The persistence of metabolic effects following long-term oral feeding of a structured triglyceride rich in omega-3 fatty acids was studied in burned and normal rats, and compared with controls fed safflower oil, a long-chain triglyceride high in omega-6 fatty acid content. Male Sprague-Dawley rats were pair-fed a high fat diet as either structured triglyceride or safflower oil for 42 days. On day 43, a jugular catheter was placed, and rats received either a dorsal surface scald or sham injury. Following a 48-hour fast, body weight, nitrogen loss, energy metabolism, and liver weight were measured, and whole-body and tissue-specific protein kinetics were studied by constant intravenous infusion of [1-14C]leucine. Plasma albumin, free fatty acids, glucose, insulin, and triglyceride fatty acid composition were determined. Urinary nitrogen loss, energy expenditure, and plasma leucine concentration were elevated in burned rats, confirming the presence of an injury response. Rats previously fed structured triglyceride had greater liver weight, total liver protein, and percentage of leucine flux oxidized, and plasma levels of glucose and insulin were increased. Plasma leucine concentration was decreased in rats previously fed structured triglyceride. Plasma triglyceride and phospholipid fatty acid analysis showed a reduction in arachidonic acid and an increase in omega-3 fatty acids in rats previously fed structured triglyceride. Long-term feeding of structured triglyceride induced major systemic metabolic changes related to the dietary fatty acid composition that persist after the diet is discontinued.

Administration, Oral↗
PubMed1975

Acute (toxic) epidermal necrolysis. Report of a case.

A case of acute (toxic) epidermal necrolysis is reported in the dental literature for the first time. This severe, life-threatening mucocutaneous syndrome resembles severely scalded skin. Sloughing vesiculobullous oral lesions are a frequent component. Staphylococcus aureus and drug reactions may cause separate entities presenting clinically as acute epidermal necrolysis. This case of drug-induced epidermal necrolysis ina child was successfully treated with methicillin and hydrocortisone.

Child, Preschool↗
PubMed1993

Burn injury decreased splanchnic PGI2 release is restored by treatment with lazaroid.

This study examined the hypothesis that burn injury inhibits the release of splanchnic PGI2, a potent endogenous vasodilator of the splanchnic vascular bed. Male Hartley Guinea Pigs (350 grams) were anesthetized, shaved and subjected to a full thickness scald burn comprising 45% of the total body surface area (or sham burn). The animals were treated with intravenous or topical lazaroid, a 21-aminosteroid U75412E. After recovery for 24 hours, the animals were anesthetized, and the superior mesenteric artery was cannulated and removed with its intact intestine (SV + SI). The SV + SI was perfused in vitro with oxygenated Krebs buffer. The venous effluent was assayed for 6-keto-PGF1 alpha, PGE2 and thromboxane B2 by enzyme immunoassay. Acute burn injury decreased SV + SI release of 6-keto-PGF1 alpha by 57% but did not alter release of PGE2 or thromboxane B2. Treatment of the animals with topical lazaroid and not intravenous lazaroid restored SV+SI 6-keto-PGF1 alpha release to control levels. These data showed that topical lazaroid therapy maintained endogenous splanchnic PGI2 release following acute burn injury. Maintaining endogenous splanchnic PGI2 release by topical lazaroid treatment may be one strategy to avoid splanchnic ischemia following acute thermal injury.

6-Ketoprostaglandin F1 alpha↗
PubMed1982

Determinants of foster care placement for the maltreated child.

This study examined the records of the North Carolina Central Registry of Child Abuse and Neglect to determine which social, family, and child characteristics were most influential in the decision to place a child in foster care. These records contained all theoretically relevant factors as well as demographic data. Analysis included the computation of odds ratios for foster care for each of 250 variables. A maximum likelihood logistic regression model was constructed to obtain the independent and cumulative contribution of each factor. Some expected variables such as parental stress factors (substance abuse) and types of abuse (burns and scalds) placed a child at a significant risk for placement in foster care (p less than 0.01). However, less obvious factors such as referral source (law enforcement agencies) or geographic area also placed children at risk. Overall, the model explained little of the variance of these decisions (R2 = 0.168) and poorly predicted placement (sensitivity 66.3 per cent, specificity 74.6 per cent). Using existing data, we were unable to adequately describe the decision process in selecting foster care.

Adolescent↗
PubMed1987

The untreatable family.

The untreatable family is defined as one in which it is unsafe to permit an abused child to live. Despite the fact that many families turn out to be resistive to treatment, they have received very little attention. In the field of physical abuse, 16-60% of parents reabuse their children following the initial incident. Sexual reabuse is estimated to occur in 16% of cases. Treatment of abusive families also aims to alter family functioning. From studies in physical abuse we find 20-87% of families are unchanged or worse at the end of treatment. In sexual abuse the equivalent figures are 16-38%. Parental factors associated with a poor outcome include parental history of severe childhood abuse, persistent denial of abusive behavior, refusal to accept help, severe personality disorder, mental handicap complicated by personality disorder, parental psychosis with delusions involving the child, and alcohol/drug abuse. Parents lack empathy for their child and fail to see the child's needs as separate from their own. Severe forms of abuse (fractures, burns, scalds, premeditated infliction of pain, vaginal intercourse or sexual sadism) are more likely to prove untreatable. Munchausen by proxy, nonaccidental poisoning, and severe forms of nonorganic failure to thrive are similarly resistant. An early recognition of untreatability may help to reduce burnout by diverting precious resources from the untreatable to the families for whom there is relatively more hope.

Child↗
PubMed1995

Pattern of intentional burns to children in Ghana.

Intentional (inflicted) injury to children through burns has been studied and mentioned extensively in the literature, although much less so in developing countries. A community-based survey of children aged 0-5 years in the Ashanti Region of Ghana found that of 650 childhood burns, 35 (5.4%) were purposefully inflicted. The perpetrators were mostly friends (43%) and siblings (37%) of the victims, and traditional healers (6%) who inflicted these burns to children who were comatose after convulsions. Intentional burns were more likely to be inflicted by flame (OR = 3.87, 95% CI = 1.52-10.0), and contact with a hot object (OR = 1.66, 95% CI = .62-4.44) than through scalding, the most common cause of burns in this region. Other patterns of intentional burns included the absence of any adult, burns covering < 3-5% of body surface area, and increased rate of wound infection. These findings contrast with the pattern of intentional burns seen in other countries, notably developed ones. Even though these inflicted burns were minor, it is important that doctors working in this setting become aware of their presence and that traditional healers and the general public be educated about the appropriate treatment for childhood convulsions.

Burns↗
PubMed1988

Detection of Listeria spp. in faeces from animals, in feeds, and in raw foods of animal origin.

Thirty-nine samples of feeds and 79 faecal samples were collected at seven different dairy farms, at some of which the cows were suffering from Listeria mastitis. Faecal samples were also collected from poultry on a dairy farm and from cages used for transportation of poultry to slaughter. Also neck-skin samples were taken from 17 carcasses of dressed poultry, and five samples of scalding and chilling water at a poultry slaughterhouse. Finally, 67 samples of minced beef were collected from retail shops. The overall results show that approximately 82% of the feed samples harboured Listeria spp. and 62% Listeria monocytogenes. The faecal samples showed that 67% harboured Listeria spp. and 51% L. monocytogenes. In the minced beef samples, Listeria spp. could be demonstrated in 67% and L. monocytogenes in 28%. Of the faecal samples from poultry, 33% harboured Listeria spp. and also 33% L. monocytogenes. Listeria spp. were detected in 94% of the poultry neck-skin samples, and L. monocytogenes in 47%. Almost all L. monocytogenes from faeces and feeds agglutinated Listeria antisera against serotypes 1-4, while only 71% of the strains from minced beef agglutinated the same antisera. The high prevalence of positive findings indicates that the isolation method used is suitable for detection of Listeria spp. in heavily contaminated material as well as in foods with low bacterial counts.

Abattoirs↗
PubMed1992

The contamination of pork with spoilage bacteria during commercial dressing, chilling and cutting of pig carcasses.

Swab samples from the surfaces of carcasses and cuts were obtained at various stages of the dressing, chilling and cutting operations in three pig processing plants. The aerobic microflora obtained from those swabs were enumerated and characterized. The flora on the skins of carcasses exiting the scalding tanks were dominated by Gram-positive organisms, with numbers about 10(3)/cm2. After dehairing, numbers were about 10(4)/cm2 with major fractions of Gram-negative organisms. Flora numbers and compositions were largely unaltered after the singeing operations, but lesser numbers were recovered after the carcasses were polished. Carcass dressing did not change the numbers on the skin. During the chilling of carcasses, the flora at two large plants altered little, but drying of the carcass surfaces at a smaller plant reduced the Gram-negative fraction of the flora. Numbers on serous and fat surfaces exposed during the dressing and cutting of carcasses were initially about 10(2)/cm2. That number was approximately maintained on finished skinned cuts produced at the smaller plant, but further contamination with lactobacilli and Brochothrix thermosphacta occurred during cutting. At the larger plants, the flora on skinned cuts were similar to those on skins, although further contamination with B. thermosphacta occurred at one plant.

Abattoirs↗
PubMed1996

Hazard identification in swine slaughter with respect to foodborne bacteria.

Swine slaughter is an open process with many opportunities for the contamination of the pork carcass with potentially pathogenic bacteria; however, it does not contain any point where hazards are completely eliminated. Data on the prevalence of various pathogenic bacteria (Aeromonas hydrophila, Campylobacter coli/jejuni, Listeria monocytogenes, Salmonella spp., Staphylococcus aureus and Yersinia enterocolitica) in pigs, their growth and survival characteristics and ability to become established on the slaughter line are presented. The presentation covers the processing steps from lairage to chilling and is based on swine slaughter practices in Denmark, Norway and Sweden. The major contamination points during swine slaughter are pig-related, such as faecal and pharyngeal, and environmental. HACCP (Hazard Analysis Critical Control Point) and GMP (Good Manufacturing Practice) in swine slaughter must be focused on limiting this spread. The pathogenic bacteria show differences in their general mechanism of distribution. The major contamination source of Campylobacter spp., Salmonella spp. and Y. enterocolitica is the pig, and the contamination of carcasses with these bacteria may be limited, provided that only strict slaughtering procedures are used. Other organisms such as Aeromonas spp., L. moncytogenes/Listeria spp. and S. aureus can be endemic in the processing environment. Since endemic bacteria can be controlled by proper cleaning and disinfection, these organisms are useful as indicators for the success of GMP rules. The following affiliation to CPs or CCPs made for specific steps during slaughter and dressing may serve as a guidance: (i) lairage (CP), (ii) killing (CP), (iii) scalding (CP), (iv) dehairing (CP), (v) singeing/flaming (CP), (vi) polishing (CP), (vii) circumanal incision and removal of the intestines (CCP), (viii) excision of the tongue, pharynx, and in particular the tonsils (CCP), (ix) splitting (CP), (x) post mortem inspection procedures (CCP) and (xi) deboning of the head (CCP).

Abattoirs↗
PubMed1990

Beta-lactamase-negative, methicillin-resistant Staphylococcus aureus in a newborn nursery: report of an outbreak and laboratory investigations.

An outbreak of skin infection caused by a beta-lactamase-negative strain of methicillin-resistant Staphylococcus aureus (MRSA) occurred during a five-week period in a newborn nursery. Twelve babies, two mothers and two members of staff were involved. One baby had a diagnosis of staphylococcal scalded skin syndrome and two others required treatment with antibiotics. The infecting strain produced exfoliative toxin A. It was thought that it had been introduced from a different maternity unit by a nasal carrier. Laboratory investigations tended to support this hypothesis.

Bacteriophage Typing↗
PubMed1992

Toxicity of the anticancer folate antagonist trimetrexate in rats.

Trimetrexate is a nonclassical folate antagonist that is active against a number of experimental murine and human tumor cell lines. To assess its toxicity, rats were administered single or repeated (daily x5) doses by either the oral or the intravenous route. Oral doses were 0, 90, 180, 295, and 375 mg/kg (single dose) and 0, 32, 65, and 80 mg/kg (daily x5). Intravenous doses were 0, 6, 20, and 60 mg/kg (single dose) and 0, 10, 20, and 30 mg/kg (daily x5). In the oral studies, signs of toxicity first appeared 2 to 3 days after initiation of dosing. Clinical signs included hypoactivity, diarrhea, urine scald, rhinorrhea, emaciation, and death. Significant pathologic findings were degenerative enteropathy in small and large intestines, bone marrow hypocellularity, decreased WBCs (neutrophils, lymphocytes), generalized lymphoid depletion, and testicular tubular degeneration. Except for the testicular changes, these effects were most severe in animals dosed at 65 and 80 mg/kg in the oral x5 study (65-70% mortality). Repeated oral doses at 32 mg/kg and single oral doses through 375 mg/kg caused only mild to moderate effects and less than 5% mortality. In contrast, single intravenous doses at 60 mg/kg resulted in immediate death (20% mortality) due to apparent CNS toxicity. Intravenous doses below 60 mg/kg were essentially asymptomatic. Toxicity in the intravenous studies was limited to decreased WBCs, splenic and thymic lymphoid depletion (repeated dosing), and testicular tubular degeneration and/or atrophy. Except for the testicular lesions, most of the effects in the oral and intravenous studies were reversible within 4 weeks. The results show that the acute toxicity of trimetrexate in rats is somewhat dependent on its route of administration, although the spectrum of effects is qualitatively similar to that observed in other species and with other folate antagonists. The dose-limiting toxicity of trimetrexate in rats common to both routes of administration is myelosuppression.

Administration, Oral↗
PubMed1993

Inhibition of the renal uptake of p-aminohippurate and tetraethylammonium by the antioxidant ethoxyquin in the rat.

Ethoxyquin (6-ethoxy-2,2,4-trimethyl-1,2-dihydroquinolein, EQ) is an antioxidant used in animal foodstuffs and to prevent superficial scalding in some fruits. In renal cortical slices prepared from male rats that had consumed a diet containing EQ, EQ inhibited the specific uptake of 14C-labelled p-aminohippurate ([14C]PAH) and tetraethylammonium ([14C]TEA), markers of organic anion and cation tubular secretion, respectively. The specific uptake of [14C]TEA was five-fold more sensitive to EQ than [14C]PAH uptake (IC50 0.33 and 1.51 mM, respectively). EQ (1 mM) decreased Na+/K(+)-ATPase activity from 1.58 to 1.0 mumol inorganic phosphate/mg protein/min in renal microsomes. The activity of this enzyme provides the energy for the function of both secretory systems. These results suggest that the mechanisms by which EQ inhibits both anion and cation tubular secretion involves a decrease in the Na+/K(+)-ATPase activity. This effect leads to interference with the energy supply required for these tubular secretory mechanisms. Our results indicate that the exposure of animals or humans to high concentrations of ethoxyquin should be avoided.

Administration, Oral↗
PubMed1990

Occupational injuries to dental personnel.

Occupational injuries to dental hospital personnel over 9 years (1980-1988 inclusive) were studied. Some 300 accidents were reported. Over one-half were sharps injuries. Over one-quarter were falls or collisions. Eye injuries accounted for some 10 per cent of incidents, burns and scalds the remainder. Serious complications were rare, but many of the injuries could have been avoided.

Accidents, Occupational↗
PubMed1986

Interactions between local and generalised burn edema.

In judging the infusion therapy of burn injuries, not only the circulatory and pulmonary effects are considered but also the local effect on burned tissue. Local edema leads to hypoxia as well as to the burn-specific sludge phenomenon. Microcirculation and edema are often adversely influenced by our therapeutic efforts. Therapeutic proteinase inhibition, for example, has a beneficial effect on edema formation but reduces spontaneous fibrinolytic activity and thus increases the sludge phenomenon. Standardized experimental scalds of 30% of the body surface in rabbits increased density of the lungs, as determined by computed tomography. Colloidal infusion therapy was found to diminish fluid shift into the lung more than crystalloid infusion therapy. However, all tested infusion regimens, using identical quantity, increased edema formation in the burned skin. Biseco (natural serum proteins containing igG, igA and igM; Fa. Biotest, Frankfurt, F.R.G.) and Solcoseryl (a protein-free extract of calf blood stimulating the oxygen efficiency; Fa. Solco Basel) were demonstrated to diminish local edema formation as well as lung edema secondary to burn injuries.

Actihaemyl↗
PubMed1983

Thermal trauma-induced changes in the synthesis of rat serum proteins.

Infliction of non-lethal scalding was found to cause an increase in the rate of incorporation of 35S-methionine into albumin and globulin fractions of rat serum proteins, the the increase being remarkably higher for alpha- and beta-globulins than for albumin and gamma-globulins The most pronounced enhancement was associated with the 60- and 70-kd constituents of beta-globulins, the 34-, 55- and 136-kd polypeptides of alpha-2-globulins and the 50-, 60-, 125- and 145-kd polypeptides of alpha-1-globulins. The response of serum proteins to the heat shock was similar, though the changes were significantly less pronounced.

Alpha-Globulins↗