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PubMed2004

[Results of vacuum therapy (v.a.C.) of superficial and deep dermal burns].

BASIS: This prospective multi-centre study in co-operation with the Wake Forrest University covered the area of applications for treatment of fresh, superficial and deep dermal burns and scalds (grade II a-b). The micro-circulation relationships, wound healing time, extent of germ settlement and the connective tissue edema were of particular interest (together with the increase or decrease in burn depth). Moreover, the economical aspects were compared with conservative therapy. MATERIAL AND METHODS: his study was carried out on our intensive care ward on 11 patients suffering from burn injuries and we took the healing process as the basis (2001-2003). Inclusion criteria for the study were burns on both hands, degree II a-b, occurring trauma less than 6 hours ago and a treatment period of minimum 48 hours. In any case the hands inflicted with deeper and extensive burns (assessment by 2 experienced, independent appraising plastic surgeons) were subject to V.A.C. therapy. The standard conventional, conservative therapy applied to the other hand was taken for comparison or control purposes to determine the success. Since October 2001 we use the IC-View perfusography with ICG colouring (ICG pulsion, PULSION Medical Systems AG, Munich, Germany) for objective findings both previously and during the course of treatment. A respective quantitative analysis and assessment of the recorded video sequences were made with the help of special software (IC-CALC, PULSION Medical Systems AG, Munich, Germany). Here too, the intensity of the fluorescence indicated the blood circulation through the connective tissue and is on the same level. Basis for this method of study was the work of Holm et al. in our department. RESULTS: Above all, the results of our study revealed a significant reduction or prophylaxis of the connective tissue edema. Due to improvement in the micro-circulation, also supported by dynamic IC-View laser-fluorescence videography it could be determined that the wound healing process was quicker and without complication in the majority of cases. This was all the more true, although even when the extent of the deep dermal hand burns treated by V.A.C. therapy was greater than on the hand taken for comparison. Extending the therapy applied to the hand to the entire extremity could contribute to avoiding operative stress (escharotomy) in selected cases. Troublesome supporting of the hands and the ergotherapeutic use of splints were not necessary because of the exact fixation of the extremities ensured by the vacuum method. The advantage became more obvious when both the cost factor and time expenditure were considered and compared with previous conservative therapy. CONCLUSIONS: In the near future the treatment of superficial and deep dermal burns/scalds by V.A.C. therapy can help in reducing the expenditure in time, material and personnel when treating large area wounds. A further advantage is not only to be seen in the optimised healing process in the case of superficial and deep dermal burn wounds but also in the reduction or even avoidance of extensive escharotomy with the accompanying operation trauma. In this respect close mesh control of the blood circulating conditions appeared to us to be important and as a result of our study V.A.C. therapy was approved in December 2002 for the treatment of superficial and deep dermal burns by FDA (Dept. of Health and Human Services).

Burns↗
PubMed2006

[Epidemiological Analysis of Injuries Among Children under 15 Years of Age in Germany--The Starting Point for Injury Prevention].

OBJECTIVE: The epidemiological analysis of injury circumstances can play an important role in implementing targeted injury prevention measures. The data available in Germany are being compiled in order to define risk groups, risk factors and the main accident causes. METHOD: A descriptive epidemiological analysis of injuries among children according to severity (fatality or hospitalization rate), frequency, age group, location, product involvement, ethnic background and social risk factors was carried out. The following data sources were drawn upon for the epidemiological analysis: official statistics, surveys on home and leisure accidents, social status data from school beginners' medical examinations in the federal states of Brandenburg and Schleswig-Holstein as well as population-based injury monitoring in the city of Delmenhorst (1998 - 2002). RESULTS: Since 1990, total injury mortality among children under 15 years has declined by more than two-thirds in Germany (from 10.2 to 3.0 per 100,000 during the period 1990 - 2004). This is true both for road traffic accidents and for home and leisure accidents. There is an age-specific distribution in terms of fatal accident causes: suffocation, drowning, falls and burns are the most common among the under 5-year-olds, while in school-age children road traffic accidents and drowning predominate. For several years, infants and toddlers have been the groups most at risk and hospitalisation figures for these groups are still sharply increasing. In the under 5-year-old group, accidents happen mainly in and around the home, whereas among school children (5 - 14 years) they occur most frequently at school, at home and during leisure activities, and on the roads. Accidents are often environment- and product-related. Children from ethnic minorities and low status families are the groups most at risk in terms of road traffic accidents and scalds. CONCLUSION: The epidemiological analysis of childrens' injuries should be the starting point for age- and environment-specific and product-related interventions. Intervention strategies should take into account parents' ethnic background as well as potential language barriers.

Accidents↗
PubMed1994

[Ototoxicity of locally administered aminoglycoside antibiotics].

In 7 children impairment of hearing was observed after local therapy with neomycin and gentamicin because of scalding wounds. In all cases the hearing loss depends on the duration of treatment with the aminoglycoside antibiotics. Deep and well vascularised wounds strikingly enhance the absorption rates of the ototoxic drugs. 3 adults locally treated with aminoglycoside antibiotics (neomycin, framycetin, gentamicin) for ulcera cruris displayed a delayed development of hearing loss. The hearing impairment occurs several weeks after therapy and leads to deafness in severe cases even if the treatment had been discontinued a long time ago. The most relevant factors in preventing such damage are: strictest possible indication, taking into account all contraindications, as well as shortest possible duration of therapy.

Administration, Topical↗
PubMed1992

Current concepts in pediatric burn care: general management of severe burns.

Severe burns and scalds are still frequent. If the burn victim is a child, it should ideally be taken care of in a pediatric burn center, where both the burn and child-related needs are specifically met. The goals of burn care are to preserve life, to preserve function, to limit physical and psychological sequelae and to provide social reintegration. The system of burn care essentially consists of adequate initial resuscitation followed by early surgery aimed at rapid and definitive wound closure. Vigorous nutritional support as well as early rehabilitation and continuous psychosocial care are of paramount importance. The paper summarizes the essentials of pediatric burn care (burn surgery excluded).

Burn Units↗
PubMedDate not supplied

Burns caused by medical therapy.

A burn injury may occur as an unexpected consequence of medical treatment. We examined the burn prevention implications of injuries received in a medical treatment facility or as a direct result of medical care. The records of 4510 consecutive admissions to 1 burn center between January 1978 and July 1997 were retrospectively reviewed. A cohort of 54 patients burned as a result of medical therapy was identified and stratified by location (home vs medical facility) and by mechanism of injury. Twenty-two patients were burned in a medical treatment facility, including 12 patients who were burned as a result of careless or unsupervised use of tobacco products. Thirty-two patients were burned as a result of home medical therapy, including 9 patients who had scald injuries from vaporizers, 8 patients who were burned by simultaneous use of cigarettes and home nasal oxygen therapy, and 11 patients who were burned by therapeutic application of heat. In contrast to previous studies, no patient was burned by the use of medical laser devices. To further decrease burn risk from medical therapy we advocate the prohibition of cigarette smoking in any medical facility. Continued tobacco use may represent a contraindication to home oxygen therapy. Given the lack of proof of efficacy combined with the potential for burn injury, the use of vaporizers to treat upper respiratory symptoms should be discouraged. Patients with diminished sensation or altered mental status are at increased risk of burn injury from bathing or topical heat application and merit closer monitoring during these activities.

Adolescent↗
PubMedDate not supplied

Polyclonal antibodies to rat interleukin-6 attenuate fever in rats after burn injuries: a preliminary report.

Rats with 50% total body surface area full-thickness burn injuries have sustained increases in body temperature without evidence of sepsis. In this animal model, the only known endogenous pyrogen consistently present in plasma is interleukin-6 (IL-6). We investigated the hypothesis that IL-6 acts as an endogenous pyrogen and produces the observed increase in body temperature. Body temperature and activity index were recorded every 5 minutes for control rats and rats with burns (50% total body surface area scald burns) for a period before the burn injuries and through the eighth day after the burn injuries. On the fifth day after the burn injuries, between 8 and 9 AM, control animals and animals with burns were given an intra-arterial dose of IL-6 polyclonal neutralizing antibody (IL-6 pAb) that was equivalent to one half of the neutralizing dose of IL-6 pAb. This calculation was based on plasma levels of IL-6 obtained from rats with burns in previous studies and on the neutralizing capability of the IL-6 used. On the sixth and seventh days after the burn injuries, a full neutralizing dose of IL-6 pAb was given. Blood samples were obtained for IL-6 assays at baseline and after treatment with IL-6 pAb but were lost because of the failure of an ultracold freezer. A one half neutralizing dose of IL-6 pAb produced no discernible effect on the body temperature of the control animals or of the animals with burns. On the sixth and seventh days after the burn injury, IL-6 pAb produced 45% and 34% respective decreases in body temperature compared with the animals with burns that received saline solution (P < .05 for both comparisons). On the eighth day after the burn injuries, the effect had completely dissipated. We concluded that our results support the idea that increased circulating levels of IL-6 may be causally related to fever that occurs in nonseptic rats with large burn wounds.

Animals↗
PubMed1997

The gene for albicidin detoxification from Pantoea dispersa encodes an esterase and attenuates pathogenicity of Xanthomonas albilineans to sugarcane.

Albicidin phytotoxins are pathogenicity factors in a devastating disease of sugarcane known as leaf scald, caused by Xanthomonas albilineans. A gene (albD) from Pantoea dispersa has been cloned and sequenced and been shown to code for a peptide of 235 amino acids that detoxifies albicidin. The gene shows no significant homology at the DNA or protein level to any known sequence, but the gene product contains a GxSxG motif that is conserved in serine hydrolases. The AlbD protein, purified to homogeneity by means of a glutathione S-transferase gene fusion system, showed strong esterase activity on p-nitrophenyl butyrate and released hydrophilic products during detoxification of albicidins. AlbD hydrolysis of p-nitrophenyl butyrate and detoxification of albicidins required no complex cofactors. Both processes were strongly inhibited by phenylmethylsulfonyl fluoride, a serine enzyme inhibitor. These data strongly suggest that AlbD is an albicidin hydrolase. The enzyme detoxifies albicidins efficiently over a pH range from 5.8 to 8.0, with a broad temperature optimum from 15 to 35 degrees C. Expression of albD in transformed X. albilineans strains abolished the capacity to release albicidin toxins and to incite disease symptoms in sugarcane. The gene is a promising candidate for transfer into sugarcane to confer a form of disease resistance.

Amino Acid Sequence↗
PubMed2004

Diet, nutrition and the prevention of cancer.

OBJECTIVE: To assess the epidemiological evidence on diet and cancer and make public health recommendations. DESIGN: Review of published studies, concentrating on recent systematic reviews, meta-analyses and large prospective studies. CONCLUSIONS AND RECOMMENDATIONS: Overweight/obesity increases the risk for cancers of the oesophagus (adenocarcinoma), colorectum, breast (postmenopausal), endometrium and kidney; body weight should be maintained in the body mass index range of 18.5-25 kg/m(2), and weight gain in adulthood avoided. Alcohol causes cancers of the oral cavity, pharynx, oesophagus and liver, and a small increase in the risk for breast cancer; if consumed, alcohol intake should not exceed 2 units/d. Aflatoxin in foods causes liver cancer, although its importance in the absence of hepatitis virus infections is not clear; exposure to aflatoxin in foods should be minimised. Chinese-style salted fish increases the risk for nasopharyngeal cancer, particularly if eaten during childhood, and should be eaten only in moderation. Fruits and vegetables probably reduce the risk for cancers of the oral cavity, oesophagus, stomach and colorectum, and diets should include at least 400 g/d of total fruits and vegetables. Preserved meat and red meat probably increase the risk for colorectal cancer; if eaten, consumption of these foods should be moderate. Salt preserved foods and high salt intake probably increase the risk for stomach cancer; overall consumption of salt preserved foods and salt should be moderate. Very hot drinks and foods probably increase the risk for cancers of the oral cavity, pharynx and oesophagus; drinks and foods should not be consumed when they are scalding hot. Physical activity, the main determinant of energy expenditure, reduces the risk for colorectal cancer and probably reduces the risk for breast cancer; regular physical activity should be taken.

Alcohol Drinking↗
PubMed2003

Microbial cross-contamination by airborne dispersion and contagion during defeathering of poultry.

1. A readily identifiable strain of Escherichia coli K12 was used as a 'marker' organism to determine the sources, routes and patterns of microbial cross-contamination during mechanical defeathering of broiler chicken carcases. 2. Inoculation of scald water with the marker organism led to a relatively even pattern of carcase contamination during subsequent defeathering. Microbial cross-contamination was greater by this route of inoculation than by either surface inoculation of a 'seeder' carcase or oral inoculation of a live bird one day before slaughter. 3. Dispersal of the marker organism was strongly influenced by the mechanical action of the defeathering machines. Forward transmission of the marker occurred by aerosol or large airborne droplets and particulates such as feathers. Moving carcases through the defeathering machines when these were non-operational clearly reduced backward transmission of the marker. 4. Although microbial dispersal was unaffected by increasing the spacing between individual carcases or installing a water curtain at the entry and exit of the defeathering machines, shielding of carcases with aluminium baffles reduced counts of the marker organism from contaminated carcases by > 90%. 5. The results imply that microbial cross-contamination of broiler chicken carcases during defeathering occurs mainly via the airborne route, which could be contained by physical means.

Abattoirs↗
PubMed2005

Risk factors associated with Salmonella enterica subsp. enterica contamination of chicken carcases in Senegal.

This study was to identify the risk factors for Salmonella spp. contamination of Senegalese chicken carcases during slaughtering. One hundred and twenty traditional slaughterhouses were studied from January 2000 to December 2002 in and around Dakar. A questionnaire was answered by the slaughterers, and samples of breast skin were taken to assess the Salmonella status of chicken carcases. Results showed that 43.3% of the batches were contaminated with Salmonella, indicating Salmonella Hadar and Salmonella Brancaster as the two main serovars. Salmonella contamination of the carcases after slaughtering was related to contamination of the live birds. Feed withdrawal before slaughtering and thorough cleaning and disinfection procedures decreased the risk of contamination. One individual worker for each slaughtering stage was also associated with a decreasing risk of contamination. Using scalding water for plucking the chicken carcases increased contamination risk. These results will help slaughters to produce safer products for local consumers.

Abattoirs↗
PubMed2005

Risk factors associated with Salmonella enterica subsp. enterica contamination of chicken carcases in Senegal.

The objective of this study was to identify the risk factors for Salmonella spp. contamination of Senegalese chicken carcases during slaughtering. One hundred and twenty traditional slaughterhouses were studied from January 2000 to December 2002 in and around Dakar. A questionnaire was administered to the slaughterers and samples of breast skin were taken to assess the Salmonella spp. status of chicken carcases. Results showed that 43.3% of the chicken batches were contaminated with Salmonella spp., with Salmonella Hadar and Salmonella Brancaster as the two main serovars. Salmonella spp. contamination of the live birds before slaughtering was related to contamination of the carcases after slaughtering. Feed withdrawal before slaughtering and thorough cleaning and disinfection procedures decreased the risk of Salmonella contamination. One individual worker for each slaughtering stage was also associated with a decreased risk of Salmonella contamination. Using scalding water for plucking increased the risk of contamination. These results will help slaughterers to produce safer products for local consumers.

Abattoirs↗
PubMed1975

Heat destruction of some bacterial strains attached to broiler skin.

1. Heat destruction of bacteria attached to the skin did not occur at a logarithmic rate provided the temperature was above 51 degrees C. 2. It was concluded that the bacteria are protected by their location in the skin surface rather than by polymers produced during attachment. 3. An analogous process is considered to take place during the scalding of broilers, since bacteria which survived were difficult to remove from the carcasses during further processing.

Animals↗
PubMed1993

Microbiological survey of five poultry processing plants in the UK.

1. Neck skin samples were taken from chickens and turkeys at all the main stages of processing to monitor changes in total viable count (TVC) and counts of coliforms and pseudomonads. 2. Processing reduced TVC by up to 100-fold. Geometric mean counts after packaging were log10 4.4 to 5.3 CFU/g whilst corresponding counts of coliforms were 2.7 to 3.8 CFU/g. 3. Increases in mean TVC or coliforms as a result of either defeathering or evisceration did not exceed 0.6 log. 4. Pseudomonads represented only a minor fraction of the initial microflora of the bird and were often reduced by scalding to a figure which could not be detected by direct plating of samples; however, subsequent contamination resulted in means between log10 2.9 and 4.0 CFU/g for packaged carcases. 5. Although Staphylococcus aureus was readily isolated from defeathering equipment, mean counts from defeathered carcases were always below log10 3.0 CFU/g.

Animals↗
PubMedDate not supplied

Formation of sulphate ion during the dehydration of sulphited vegetables.

A reverse isotope dilution procedure was used to measure the formation of sulphate ion during the air dehydration of sulphited cabbage, carrot and potato at 80 degrees C. The conversion of sulphite to sulphate was found to be of first order with respect to sulphite. The formation of sulphate in the vegetables during dehydration accounts for only part of the sulphate in the dehydrated products; the remainder comes from the scald liquor. The technique for sulphate determination is critically evaluated and the observed yields discussed.

Crystallization↗
PubMed1996

Burns in children under 3 years of age: the Zaria experience.

This is a retrospective study of 84 children aged 36 months and less who were admitted for burns care from January 1980 to December 1989. Fifty-four (64%) had scalds, 28 (33%) had flame burns and in two children the cause was not known. The upper extremities were most commonly involved. Sixty-five per cent of the children were admitted during the cool, dry Harmattan season. Associated factors included cooking at floor level, bedside fires, epileptic fits in the mothers and general architectural factors. Wound infection was the commonest complication. The overall mortality rate was 27.4%. Burns prevention demands improvement in the design of houses, cooking methods, treatment of epilepsy and abandoning puerperal bathing by mothers.

Burns↗
PubMed1998

Early dermabrasion of deep dermal burns with sandpaper. Case reports.

Deep dermal burns are initially difficult to evaluate, and they sometimes heal spontaneously. We present our experience of dermabrasion with sandpaper in four patients. It is a useful alternative to early excision of the scar. Skin grafts are not always required and the aesthetic results are excellent. Dermabrasion should be considered routinely for all deep dermal burns and particularly for facial burns and those caused by scalds.

Adult↗
PubMed2000

[Emergence of drug-resistant gram-positive pathogenic bacteria].

Staphylococcus aureus is a common cause of soft tissue infection, e.g. impetigo, cellulitis, or wound infection, and causes osteomyelitis, arthritis, bacteremia with metastatic infection, and scalded skin and toxic shock syndromes. Coagulase-negative staphylococci have become increasingly important causes of nosocomial bacteremia associated with invasive monitoring, intravascular catheters and prosthetic heart valves or joints. Most staphylococci produce blactamase and are resistant to penicillin. An increasing proportion of S. aureus have intrinsic resistance to methicillin (MRSA) and present major problems in hospitals for the control of cross infection. The glycopeptides, teicoplanin and vancomycin, are the antibiotics of first choice for treatment of these infections. After the first report describing a Japanese clinical isolate of vancomycin-resistant S. aureus (VRSA), several papers have documented the emergence of these microorganisms. Since the development and spreading of this phenomenon which is perceived as a fearsome threat to the already difficult therapy of nosocomial infections due to the prevalence of heterogeneous vancomycin resistance, we found the incidence of MRSA exceeds 35% in our hospital. Out of 179 methicillin-resistant S. aureus isolated during 1997-1998, two strains (1.1%) gave subclones with vancomycin MICs of 8 mg/L. PFGE showed identical restriction patterns for both isolates, suggesting transfer of a single clone between two different patients.

Cross Infection↗
PubMed2002

Clonal association of Staphylococcus aureus causing bullous impetigo and the emergence of new methicillin-resistant clonal groups in Kansai district in Japan.

A molecular epidemiological analysis was performed to reveal the clonal association of Staphylococcus aureus strains isolated from patients with bullous impetigo. Pulsed-field gel electrophoresis with cluster analysis, genetic and phenotypic characterizations, and antimicrobial susceptibility profiling of 88 S. aureus strains isolated from outpatients at 4 hospitals in the Kansai district in Japan were undertaken. Three distinct clonal groups were identified: 2 of them carried the exfoliative toxin (ET) A gene (eta), and the other carried the ETB gene (etb). The former groups represent 2 eta-positive clonal groups that have not been described previously. All the strains in the more dominant eta-positive clonal group and some of the strains in the etb-positive clonal group were methicillin-resistant S. aureus (MRSA) showing borderline-to-moderate resistance to beta-lactams. These MRSA strains appear to be emerging clonal groups that have not been considered in previous epidemiological studies of ET-producing S. aureus in Japan and thus pose a significant threat for future treatment of patients with bullous impetigo and/or staphylococcal scalded-skin syndrome.

Blister↗