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At least 1,315 records · Page 73Linked to original sources
PubMed1995

Role of gut-derived endotoxaemia and bacterial translocation in rats after thermal injury: effects of selective decontamination of the digestive tract.

This study was performed to investigate: (1) the role of gut-derived endotoxin/bacterial translocation in the pathogenesis of sepsis, and (2) the possible effects of selective decontamination of the digestive tract (SDD) on mortality in rats following 40 per cent full-thickness scald injury. In the SDD-treated group, Enterobacteriaceae and yeasts were eradicated from the caecal mucosa, while the mucosal flora consisting of mainly anaerobes was well preserved, within 3 days. The incidence of bacterial translocation to the mesenteric lymph nodes (MLN) and viscerae was significantly lowered on postburn days 1, 3 and 5 (P < 0.05-0.01). Meanwhile, pretreatment with SDD resulted in reductions of the faecal endotoxin levels in different segments of intestinal tract to less than 0.5 per cent (0.04-0.45 per cent) of the untreated control; there was also a significant attenuation of the elevation of endotoxin concentrations in both portal and systemic blood. Intestinal diamine oxidase (DAO) activity returned to baseline on day 5 in rats receiving SDD but not in controls. The 5-day survival rate in the SDD-treated group was elevated by 26.7 per cent as compared with controls (P < 0.05). These data suggested that endotoxin/bacterial translocation took place early and commonly, which in turn contributed to postburn sepsis and mortality. SDD was effective in preventing gut origin endotoxaemia and bacterial translocation, and improving the survival rate in rats following severe thermal injuries.

Amine Oxidase (Copper-Containing)↗
PubMed1996

Hot spring burns.

This case report describes a woman who, while visiting a hot spring, received partial- and full-thickness immersion scald burns of both ankles and heels. The prevention of such accidents is most important; efforts should be made to educate guides and tourists about the potential hazards inherent in these resorts.

Accidental Falls↗
PubMed1996

Epidemiological survey of childhood burn injuries in France.

Among domestic injuries in children, skin burns deserve special attention because they can lead to severe residual lesions. Their frequency has been reported to range from 3 to 8 per cent of all childhood injuries, but few epidemiological data have been collected in France. This study was undertaken to improve our knowledge of this public-health problem. A 20-item epidemiological questionnaire developed by the SFETB was used to collect prospective data on childhood burn injuries managed over a 12-month period in 14 burn centres and 18 paediatric surgery units in France. Of the 937 patients included in the study, 606 were contributed by burn centres and 331 by paediatric surgery units. Descriptive analysis and tests for correlations between several parameters showed that the typical burn-injury patient was a boy (61.6 per cent) with a mean age of 47 months, who suffered a scald burn (64.1 per cent) in the kitchen (56.2 per cent). The bathroom (13.6 per cent) was found to be an especially dangerous room because of the presence of hot water taps (shower, bathtub) and the high risk of an immersion injury. Burns due to ignition of volatile substances (16.95 per cent) were less common, but caused seven of the 11 deaths recorded in this survey. Most burn injuries were superficial lesions (59 per cent) covering less than 10 per cent of the body surface (56.2 per cent). However, grafting was required in 35 per cent of patients. Epidemiological surveys provide objective information on hazardous agents and on the settings in which burns are most likely to occur. They are essential for the development of appropriate preventive strategies, which are still receiving insufficient emphasis in the European Economic Community (EEC).

Accidents, Home↗
PubMed1996

Epidemiology of childhood burns at the Burn Centre in Brno, Czech Republic.

Three hundred and ninety-four children were admitted to the burn centre in Brno over a 3-year period. The overall incidence was 31 children per 100,000 children aged 0-14 years. The majority of patients were aged 1-3 years and almost 80 per cent of them were scalded. Proportionally more boys than girls were injured, in most cases at home in the presence of one or both parents. The highest risk time for injuries was between 16.00 and 18.00 h. Seasonal variations had no significant influence on the increased number of admissions to the burn centre. Sixty-six per cent of the children had minor burns. Four children died of the consequences of burns during the period studied. Social and economic factors had a significant influence on the incidence of childhood burns.

Adolescent↗
PubMed1996

Markedly increased lymphatic removal of hyaluronan from skin after major thermal injury.

Hyaluronam (HYA) (formerly hyaluronic acid) is an important constituent of the interstitial matrix in skin. Following major burn injury plasma HYA is known to increase markedly. The present study investigated to what extent the lymphatic removal of HYA from skin is affected following major burn injuries. Under ketamine anaesthesia a 30 per cent full thickness scald injury was inflicted on sheep previously provided with a chronic prefemoral lymph fistula. Animals were resuscitated for 24 h using lactated Ringer's infusion as needed to restore and maintain cardiac output within +/- 10 per cent of baseline. Following burn injury, lymph flow from thermally injured tissue gradually increased to 10-25 times above baseline. The baseline HYA concentration in lymph was 4.3 +/- 1.1 micrograms/ml; the HYA concentration in lymph was not significantly altered postinjury. The lymphatic HYA flux (flow x concentration) increased postinjury to 5-30 times control. The HYA concentration in plasma was 162 +/- 12 ng/ml at baseline; postinjury plasma HYA peaked at two to three times baseline at 4-8 h after the injury. At 24 h postinjury plasma HYA was reduced compared to baseline. In conclusion, after major burn injury the lymphatic transport of HYA from the injured area into the systemic circulation increased markedly, leading to elevated plasma concentrations of this high molecular weight connective tissue component.

Animals↗
PubMed1996

Eight years experience of a regional burns unit in Saudi Arabia: clinical and epidemiological aspects.

A retrospective analysis of 435 consecutive admissions to a regional burns unit over an 8-year period is presented. The majority were domestic accidents, while a few were suicidal and two were due to child abuse. Scalds were commoner than flame burns, 70.6 per cent were children under 12 years, 12.4 per cent had > 40 per cent TBSA affected, 66.9 per cent were deep partial or full thickness burns, 24.4 per cent had signs of shock on admission, 13.6 per cent had smoke inhalation injury. In spite of these known adverse factors the overall outcome was satisfactory, with a case fatality rate of 7.4 per cent and a residual disability rate of 10.8 per cent. Good initial resuscitation, a low infection rate (18.4 per cent) and the ready availability of appropriate surgical intervention (35.6 per cent), with good intensive care support, could account for the satisfactory outcome.

Adolescent↗
PubMed1995

Reducing the burn risk to elderly persons living in residential care.

A 45-month retrospective analysis of 70 geriatric burn admissions to the Welsh Regional Burns and Plastics Unit highlighted 13 (18.6 per cent) injuries that occurred whilst the patient was in residential care (six residential care homes, seven nursing homes). The mean age overall was 83 years. The residential care patients had a TBSA of 12.5 per cent with a mortality of 46 per cent, whilst the group living in the community had a TBSA of 8.63 per cent with a mortality of 14 per cent. These results were not statistically comparable due to the unequal population grouping. The cause of injury in the residential group included five hot water scalds, six radiator contact burns, one flame burn and one flash burn. All 13 patients were found to have such severe dementia that they were unable to give a reliable history. In the majority of patients a lack of supervision was in part responsible. Some basic measures are presented that could reduce the incidence of accidental burn injury in this vulnerable group of the population.

Aged↗
PubMed1995

Childhood burns in Ghana: epidemiological characteristics and home-based treatment.

The objectives of this research were to study the epidemiological characteristics and home-based treatment of childhood burns in the Ashanti Region of Ghana. Children aged 0-5 years with a burn history were identified through a community-based, multisite survey. A standard questionnaire was administered to mothers of 630 of these children to elicit information on their sociodemographic characteristics and the circumstances of the burn event. Ninety-two per cent of the burns occurred in the home, particularly in the kitchen (51 per cent) and the house yard (36 per cent), with most of them happening in the late morning and around the evening meal. The main causes of the burns were scalds (45 per cent), contact with a hot object (34 per cent) and flame (20 per cent). 'Cool' water was applied to the burned area in 30 per cent of cases. Otherwise, treatment with a traditional preparation was the most popular first-aid choice. Since a considerable proportion of burns happened between meals when children 'play with fire' in the house yard, the provision of alternative play activities and community play areas may reduce the incidence of burns to these children. Secondly, we recommend that education on first-aid management of burns be intensified, with special emphasis on alternatives to the use of traditional preparations.

Age Distribution↗
PubMed1995

Intraosseous infusion for burns resuscitation.

Two examples of resuscitation of a scalded child by intraosseous infusion, following failed peripheral venous cannulation, are presented. The technique of intraosseous infusion is reviewed and it is concluded that this technique provides a valuable second-line technique for establishing emergency venous access in children. It is quick, reliable and enables the rapid infusion of intravenous fluids and drugs into the systemic venous system. Complications are rare but can be serious and close observation of the infusion site is advisable.

Burns↗
PubMed1996

Epidemiology of burns in a district hospital in western India.

In a prospective study, data on 175 patients treated between June 1993 and February 1994 has been analysed. In this series, adolescents and young adults (11-40 years) comprised 79.4 per cent of the patients. Males formed 43 per cent and females 57 per cent of the total burns 92 per cent of the burns occurred at home. 86.8 per cent of the patients belonged to low socioeconomic groups. 47.4 per cent of them were housewives or housemaids. 44.6 per cent of burns occurred during the morning hours from 6 a.m. to 12 noon. 79.4 per cent of the burns were accidental in nature. Flame burns accounted for 92 per cent, scalds for 5.7 per cent of the total. 64.5 per cent of the patients were admitted within 4 h of injury. The overall mortality rate was 56.5 per cent, below 40 per cent surface area burned (%BSAB) it was 6.1 per cent and above 70 per cent it was 100 per cent. Flame burns resulted in maximum deaths (86.1 per cent). 40 per cent of the patients had more than 70 per cent BSAB burns in this series, which accounts for the high mortality.

Adolescent↗
PubMed1989

Stimulus specificity of peripherally evoked substance P release from the rabbit dorsal horn in situ.

Characteristics of in situ substance P release from the lumbar dorsal horn were investigated in decerebrated rabbits. Noxious mechanical stimuli produced by pinching the skin of a hind leg ipsilateral to the perfusion site remarkably and significantly increased the release of immunoreactive substance P, which was identified as substance P itself, using separation with high-performance liquid chromatography and radioimmunoassay. The noxious pinch did not affect the release of immunoreactive substance P, when applied to the contralateral hind leg. Both the basal and pinch-evoked release of immunoreactive substance P were largest in the dorsolateral part of the dorsal horn. The pinch-evoked release of immunoreactive substance P was abolished when the dorsal horn was perfused with a Ca2+-free medium containing 7 mM Mg2+ or with a medium with 10 microM tetrodotoxin added. The evoked release of immunoreactive substance P was also abolished following pretreatment of a stimulated region with the local anesthetic dibucaine, a procedure which inhibited the pinch-evoked aversive behavior in freely-moving rabbits. Among a variety of natural stimuli applied to the hind leg, noxious pinch and a subcutaneous injection of formaldehyde solution significantly evoked the release of immunoreactive substance P from the dorsal horn. The most intense heat or scalding stimulation increased the immunoreactive substance P release in two out of five experiments. However, other natural stimuli such as ice-cold, warm, noxious heat and innocuous mechanical stimuli produced no apparent changes in the release of immunoreactive substance P. These results suggest that among the noxious stimuli, only mechanical and inflammatory but not thermal stimuli lead to a release of substance P from the primary afferent terminals in the dorsal horn. The present findings suggest that, at least in rabbits, substance P-containing primary afferents have high-threshold mechanoreceptors. Substance P may participate in the transmission of information related to noxious mechanical and inflammatory stimulation from the periphery to the dorsal horn.

Animals↗
PubMed1986

Hypothalamic neuroendocrine correlates of cutaneous burn injury in the rat: I. Scanning electron microscopy.

Rats were given a standard scald burn on 60% of the body surface or only a sham burn and were sacrificed at intervals from 6 hr to 14 days later. Serum thyroxine (T4), free thyroxine index (FT4I) and triiodothyronine (T3) were depressed compared to values in respective shams as early as 6 hr post-burn. T4 and FT4I were less depressed on post-burn days (PBD) 2-3 than on PBD 1 and then exhibited a further fall. T3 remained depressed through PBD 14. Pineal melatonin content was elevated at 6 hr and fell to the normal daytime range in subsequent samples. The ventral portion of the diencephalon was prepared for scanning electron microscopy. Only in the burned rats and beginning on PBD 2, large numbers of supraependymal neurons (SEN) appeared in the ventricular space attached to the inferior walls and floor of the third cerebral ventricle. Transmission electron microscopy was used to confirm the neuronal nature of the SEN. Viewed by scanning electron microscopy, these persisted through PBD 14. SEN were interconnected by cables of their neurites exhibiting varicosities on individual neurites as they passed over perikarya of other SEN. Some SEN were seen to be only partially emerged from the underlying tissue and others were seen to send a thick process into the hypothalamic tissue. These observations indicate that after peripheral injury there is marked plasticity of the brain in an area thought to control the endocrine systems that show abnormalities after such a peripheral injury. The timing, location and nature of these anatomic changes indicate the possibility that at least some aspects of central nervous orchestration of the endocrine metabolic response to injury may be related to the emergence of a neuronal system receiving or sending messages through the cerebrospinal fluid and/or through new neurite circuits along the surface of the third ventricular wall. These structures may appear in response to initial primary hormonal changes and/or may play a role in maintaining the post-injury hormonal milieu manifested in part by a subsequent second fall in serum T4.

Animals↗
PubMed1995

Determining the true cause of death in a dermatological disaster.

Adverse drug reactions that result in patient death warrant special consideration to determine if the outcome was preventable. We report the results of an investigation into the cause of death of a 63 year old male who was thought to have phenytoin-induced toxic epidermal necrolysis (TEN). Most dermatological reactions from drugs are minor and resolve without sequelae once the drug is discontinued. In some cases, reactions are severe and can be life threatening. The patient arrived at the emergency department with extensive exfolative dermatitis. The differential diagnosis included phenytoin-induced TEN, scalded skin syndrome, and phenytoin hypersensitivity. After he was admitted his clinical status deteriorated and he died 13 days after admission. Autopsy findings were significant for necrotizing dermatitis, necrotizing pneumonia, multiple herpetic ulcerations, multisystem organ failure and blood cultures grew Staphylococcus aureus (TSS toxin positive). Findings that indicate a cause of death other than a drug-induced dermatological reaction are presented as well as an overview of the patients' medical history. The differential diagnosis of drug induced skin lesions are also discussed.

Journal Article↗
PubMed2003

Burn-induced red blood cell deformability and shape changes are modulated by sex hormones.

BACKGROUND: Burns are known to cause changes in red blood cell (RBC) deformability and resting shape. However, it is unclear whether sex and sex hormones can influence the severity of these alterations. METHODS: Red blood cell deformability and shape were examined in proestrus and diestrus female rats, ovariectomized female rats, as well as castrated and non-castrated male rats (6 animals per group) subjected to scald burn. Red blood cell deformability was measured by laser ektacytometry and erythrocyte shape was evaluated by scanning electron microscopy. RESULTS: Burn-induced RBC deformability changes (decrease in elongation index) and shape alterations (increase in the percentage of reversibly and irreversibly changed cells) were less severe in proestrus females than in diestrus females or males. Ovariectomized rats demonstrated more severe RBC changes than non-ovariectomized ones. The degree of RBC damage was the same in castrated and non-castrated males. CONCLUSIONS: Removal of female sex hormones increases the severity of burn-induced RBC, indicating that female sex hormones protect against burn-induced RBC dysfunction. In contrast, male sex hormones do not appear to modulate burn-induced RBC dysfunction.

Animals↗
PubMed2004

Inhibition of T cell MAPKs (Erk 1/2, p38) with thermal injury is related to down-regulation of Ca2+ signaling.

We evaluated MAPK (Erk 1/2 and p38) signaling mechanisms of altered T-cell-mediated immune responses in thermal injury condition. Rats were subjected to 30% body surface scald burn, and their mesenteric lymph node (MLN) and Peyer's patch (PP) T cells were purified using nylon wool method. Activation of MAPKs, Erk 1/2 and p38 was assessed in T cells by determining its phosphorylation using immunoblot analysis, intracellular immunostaining and confocal microscopy. The results showed a down-regulation of Erk 1/2 and p38 activation in anti-CD3-stimulated T cells from thermally injured animals, compared to Erk 1/2 and p38 in sham rat T cells. The down-regulation of MAPKs in T cells was reversed by treatment of T cells with calcium agonist, ionomycin. These data indicate that attenuated MAPKs (Erk 1/2, p38) activation in thermally injured animals' T cells could result from derangement of Ca(2+) mobilization. This finding suggests that T cell signaling derangements with thermal injury involve an altered cross-talk between Ca(2+) mobilization and MAPK signaling mechanisms.

Animals↗
PubMed2005

Antigen presenting cells (APCs) from thermally injured and/or septic rats modulate CD4+ T cell responses of naive rat.

Regulation of immune response is marked by complex interactions among the cells that recognize and present antigens. Antigen presenting cells (APCs), the antigen presenting cell component of the innate immune response plays an important role in effector CD4+ T cell response. Thermal injury and/or superimposed sepsis in rats' leads to suppressed CD4+ T cell functions. We investigated modulations of CD4+ T cell function by APCs (purified non-T cells) from thermally injured and/or septic rats. Rats were subjected to 30% total body surface area scald burn or exposed to 37 degrees C water (Sham burn) and sepsis was induced by cecal-ligation and puncture (CLP) method. At day 3 post-injury animals were sacrificed and CD4+ T cells and APCs from mesenteric lymph nodes (MLN) were obtained using magnetic microbead isolation procedure. APCs from injured rats were co-cultured with sham rat MLN CD4+ T cells and proliferative responses (thymidine incorporation), phenotypic changes (Flow cytometry), IL-2 production (ELISA) and CTLA-4 mRNA (RT-PCR) were determined in naive rat CD4+ T cells. The data indicate that APCs from thermally injured and/or septic rats when co-cultured with CD4+ T cells suppressed CD4+ T cell effector functions. This lack of CD4+ T cell activation was accompanied with altered co-stimulatory molecules, i.e., CD28 and/or CTLA-4 (CD152). In conclusion, our studies indicated that defective APCs from thermally injured and/or septic rats modulate CD4+ T cell functions via changes in co-stimulatory molecules expressed on naive CD4+ T cells. This altered APC: CD4+ T cell interaction leads to suppressed CD4+ T cell activation of healthy animals.

Animals↗
PubMed2004

2-Mercaptoethane sulfonate (MESNA) protects against burn-induced renal injury in rats.

Animal models of thermal injury implicate oxygen radicals as causative agents in local wound response and distant organ injury following burn. In this study we investigated the putative protective effects of 2-mercaptoethane sulfonate (MESNA) against oxidative kidney damage in rats with thermal injury. Under ether anaesthesia, shaved dorsum of the rats was exposed to 90 degrees C bath for 10s to induce burn injury. Rats were decapitated either 6 or 24h after burn injury. MESNA was administered i.p. immediately after burn injury. MESNA injections were repeated once more 12h after the first injection in the 24h burn group. In the control group the same protocol was applied except that the dorsum was dipped in a 25 degrees C water bath for 10s. Kidney tissues were taken for the determination of malondialdehyde (MDA) and glutathione (GSH) levels, protein oxidation (PO), myeloperoxidase (MPO) activity and collagen contents. Creatinine, urea concentrations (BUN) and lactate dehydrogenase (LDH) in blood were measured for the evaluation of renal functions and tissue damage, respectively. Tissues were also examined microscopically. Severe skin scald injury (30% of total body surface area) caused significant decrease in GSH level, significant increase in MDA level, protein oxidation (PO), MPO activity and collagen content of renal tissue. Serum creatinine was slightly increased at the early phase of thermal trauma but not changed in 24h groups. On the other hand BUN and LDH were significantly elevated by thermal trauma in both 6 and 24h of burn groups. Treatment of rats with MESNA significantly increased the GSH level and decreased the MDA level, PO, MPO activity, collagen contents, BUN and LDH. Since MESNA reversed the oxidant responses seen in burn injury, it seems likely that MESNA could protect against thermal trauma-induced renal damage.

Animals↗
PubMed2005

Burn epidemiology in the Brisbane and Queensland area.

AIM: The aim was to evaluate changes in patterns of injury and whether mortality rates have decreased. METHOD: The database over 20 years from 1982 to 2002 and the 6 years 1997 to 2003 was studied. RESULTS: 4523 admissions. 73.7% males, 26.3% females. Monthly and seasonal admissions showed little fluctuation. 52.8% in the 21-40 years age group, 19.7% under 20 years, 19.4% in the 41-60 years group and 8.1% over 60 years. TBSA: 80.4% under 20%, 12.6-21% to 40%, 3.3-41% to 60% and 3.4% were over 61%. Causes: flame 56%, scalds 26%, contact 9%, chemical 5%, electrical 2%, friction 1% flash burns 1%. Fifty five percent at home, 20% work, 13% motor vehicles and 11% leisure. Fifteen percent had significant inhalation injuries and 81% required intubation. Mortality rate for 6 years was 2.1%. In 1972-1996 of 4096 burns was 3.6% and 3.4% in 1993-1996. CONCLUSION: Little change in patterns of injury. Burns less than 20% predominate. The majority were under 40 years. Inhalation injury, large burns and elderly were major causes of morbidity and mortality. Mortality rate is falling.

Accidents, Occupational↗