Science.gov

Sample records for abbreviated burn severity

  1. Several Flame Balls Burning

    NASA Technical Reports Server (NTRS)

    2003-01-01

    The Structure of Flameballs at Low Lewis Numbers (SOFBALL) experiments aboard the space shuttle in 1997 a series of sturningly successful burns. This sequence was taken during STS-94, July 12, 1997, MET:10/08:18 (approximate). It was thought these extremely dim flameballs (1/20 the power of a kitchen match) could last up to 200 seconds -- in fact, they can last for at least 500 seconds. This has ramifications in fuel-spray design in combustion engines, as well as fire safety in space. The SOFBALL principal investigator was Paul Ronney, University of Southern California, Los Angeles. The experiment was part of the space research investigations conducted during the Microgravity Science Laboratory-1R mission (STS-94, July 1-17 1997). Advanced combustion experiments will be a part of investigations planned for the International Space Station. (925KB, 9-second MPEG spanning 10 minutes, screen 320 x 240 pixels; downlinked video, higher quality not available) A still JPG composite of this movie is available at http://mix.msfc.nasa.gov/ABSTRACTS/MSFC-0300186.html.

  2. Is proportion burned severely related to daily area burned?

    NASA Astrophysics Data System (ADS)

    Birch, Donovan S.; Morgan, Penelope; Kolden, Crystal A.; Hudak, Andrew T.; Smith, Alistair M. S.

    2014-05-01

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day.

  3. Do standard burn mortality formulae work on a population of severely burned children and adults?

    PubMed

    Tsurumi, Amy; Que, Yok-Ai; Yan, Shuangchun; Tompkins, Ronald G; Rahme, Laurence G; Ryan, Colleen M

    2015-08-01

    Accurate prediction of mortality following burns is useful as an audit tool, and for providing treatment plan and resource allocation criteria. Common burn formulae (Ryan Score, Abbreviated Burn Severity Index (ABSI), classic and revised Baux) have not been compared with the standard Acute Physiology and Chronic Health Evaluation II (APACHEII) or re-validated in a severely (≥20% total burn surface area) burned population. Furthermore, the revised Baux (R-Baux) has been externally validated thoroughly only once and the pediatric Baux (P-Baux) has yet to be. Using 522 severely burned patients, we show that burn formulae (ABSI, Baux, revised Baux) outperform APACHEII among adults (AUROC increase p<0.001 adults; p>0.5 children). The Ryan Score performs well especially among the most at-risk populations (estimated mortality [90% CI] original versus current study: 33% [26-41%] versus 30.18% [24.25-36.86%] for Ryan Score 2; 87% [78-93%] versus 66.48% [51.31-78.87%] for Ryan Score 3). The R-Baux shows accurate discrimination (AUROC 0.908 [0.869-0.947]) and is well-calibrated. However, the ABSI and P-Baux, although showing high measures of discrimination (AUROC 0.826 [0.737-0.916] and 0.848 [0.758-0.938]) in children), exceedingly overestimates mortality, indicating poor calibration. We highlight challenges in designing and employing scores that are applicable to a wide range of populations.

  4. Burn Severity Mapping in Australia 2009

    NASA Astrophysics Data System (ADS)

    McKinley, R.; Clark, J.; Lecker, J.

    2012-07-01

    In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER) teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS) and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC) aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR) algorithm.

  5. [Invasive yeast infections in severely burned patients].

    PubMed

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective.

  6. [Invasive yeast infections in severely burned patients].

    PubMed

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective. PMID:27395025

  7. Infection control in severely burned patients

    PubMed Central

    Coban, Yusuf Kenan

    2012-01-01

    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag (Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help the control of infection in these immunocomprimised patients. Strict infection control practices (physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms. PMID:24701406

  8. Attitudes toward Children with Severe Burns.

    ERIC Educational Resources Information Center

    Holaday, Margot; Wolfson, Aaron

    1997-01-01

    Examined reasons for negative attitudes toward children with severe burns by surveying 226 counseling and rehabilitation students. Results suggest that pessimistic expectations and negative attitudes built on conjecture are due to four sources: social standards of beauty, emotionality of the observer, reminders of personal vulnerability, and…

  9. Assessing burn severity using satellite time series

    NASA Astrophysics Data System (ADS)

    Veraverbeke, Sander; Lhermitte, Stefaan; Verstraeten, Willem; Goossens, Rudi

    2010-05-01

    In this study a multi-temporal differenced Normalized Burn Ratio (dNBRMT) is presented to assess burn severity of the 2007 Peloponnese (Greece) wildfires. 8-day composites were created using the daily near infrared (NIR) and mid infrared (MIR) reflectance products of the Moderate Resolution Imaging Spectroradiometer (MODIS). Prior to the calculation of the dNBRMT a pixel-based control plot selection procedure was initiated for each burned pixel based on time series similarity of the pre-fire year 2006 to estimate the spatio-temporal NBR dynamics in the case that no fire event would have occurred. The dNBRMT is defined as the one-year post-fire integrated difference between the NBR values of the control and focal pixels. Results reveal the temporal dependency of the absolute values of bi-temporal dNBR maps as the mean temporal standard deviation of the one-year post-fire bi-temporal dNBR time series equaled 0.14 (standard deviation of 0.04). The dNBRMT's integration of temporal variability into one value potentially enhances the comparability of fires across space and time. In addition, the dNBRMT is robust to random noise thanks to the averaging effect. The dNBRMT, based on coarse resolution imagery with high temporal frequency, has the potential to become either a valuable complement to fine resolution Landsat dNBR mapping or an imperative option for assessing burn severity at a continental to global scale.

  10. Analysis of Alaskan burn severity patterns using remotely sensed data

    USGS Publications Warehouse

    Duffy, P.A.; Epting, J.; Graham, J.M.; Rupp, T.S.; McGuire, A.D.

    2007-01-01

    Wildland fire is the dominant large-scale disturbance mechanism in the Alaskan boreal forest, and it strongly influences forest structure and function. In this research, patterns of burn severity in the Alaskan boreal forest are characterised using 24 fires. First, the relationship between burn severity and area burned is quantified using a linear regression. Second, the spatial correlation of burn severity as a function of topography is modelled using a variogram analysis. Finally, the relationship between vegetation type and spatial patterns of burn severity is quantified using linear models where variograms account for spatial correlation. These results show that: 1) average burn severity increases with the natural logarithm of the area of the wildfire, 2) burn severity is more variable in topographically complex landscapes than in flat landscapes, and 3) there is a significant relationship between burn severity and vegetation type in flat landscapes but not in topographically complex landscapes. These results strengthen the argument that differential flammability of vegetation exists in some boreal landscapes of Alaska. Additionally, these results suggest that through feedbacks between vegetation and burn severity, the distribution of forest vegetation through time is likely more stable in flat terrain than it is in areas with more complex topography. ?? IAWF 2007.

  11. Do burns increase the severity of terror injuries?

    PubMed

    Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef

    2008-01-01

    The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score

  12. Severe burn on 81% of body surface after sun tanning.

    PubMed

    Sforza, Marcos; Andjelkov, Katarina; Zaccheddu, Renato

    2013-07-01

    We report herein the case of a 42-year-old woman who presented to the Burns Unit with 81% of her body surface severely burned following sun bathing, after applying fig leaf tea as a tanning agent. The patient was hospitalized for 13 days in a Burns Intensive Care Unit, and was discharged for an ambulatory follow-up. The treatment of such burns does not differ from any conventional treatment for heat- induced second-degree burns. The physiopathology of the phytophotodermatitis induced by such homemade tanning solutions rich in psoralen is discussed in detail.

  13. Coping with severe burns in the early stage after burn injury.

    PubMed

    Bras, Marijana; Loncar, Zoran; Brajković, Lovorka; Gregurek, Rudolf; Micković, Vlatko

    2007-03-01

    This study examined the relationship between coping strategies, anxiety and depression levels and burn injury characteristics in the early phase of the treatment in burn-injured patients. Seventy patients with severe burns were interviewed within two weeks of their burn trauma. Coping strategies were measured by the coping with burns questionnaire (CBQ). Anxiety and depression levels were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. There were no statistically significant gender differences in various coping strategies. Avoidance was associated with higher levels of anxiety, depression and hopelessness. The percentage of total body surface area (TBSA) and localization of burns were not associated with coping patterns. Implications for the assessment and management of burn injured patients were discussed.

  14. Predictors of Muscle Protein Synthesis after Severe Pediatric Burns

    PubMed Central

    Diaz, Eva C.; Herndon, David N.; Lee, Jinhyung; Porter, Craig; Cotter, Matthew; Suman, Oscar E.; Sidossis, Labros S.; Børsheim, Elisabet

    2015-01-01

    Background Following a major burn, skeletal muscle protein synthesis rate increases, but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months post-injury, and identify predictors that influence this response. Study design 87 children with ≥40% total body surface area (TBSA) burn were included. Patients participated in stable isotope infusion studies at 1, 2 and ~ 4 weeks post-burn, and at 6, 12 and 24 months post-injury to determine skeletal muscle fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. Results Patients (8±6 years) had large (62, 51–72% TBSA) and deep (47±21% TBSA third degree) burns. Muscle fractional synthesis rate was elevated throughout the first 12 months post-burn compared to established values from healthy young adults. Muscle fractional synthesis rate was lower in boys, children >3 years old, and when burns were >80% TBSA. Conclusions Muscle protein synthesis is elevated for at least one year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiological response to burn trauma. Muscle protein synthesis is highly affected by gender, age and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn victims. PMID:25807408

  15. Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

    PubMed Central

    Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard

    2013-01-01

    Abstract. Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns. PMID:23764696

  16. Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

    NASA Astrophysics Data System (ADS)

    Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard; Durkin, Anthony J.

    2013-06-01

    Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns.

  17. Does fire severity influence shrub resprouting after spring prescribed burning?

    NASA Astrophysics Data System (ADS)

    Fernández, Cristina; Vega, José A.; Fonturbel, Teresa

    2013-04-01

    Prescribed burning is commonly used to reduce the risk of severe wildfire. However, further information about the associated environmental effects is required to help forest managers select the most appropriate treatment. To address this question, we evaluated if fire severity during spring prescribed burning significantly affects the resprouting ability of two common shrub species in shrubland under a Mediterranean climate in NW Spain. Fire behaviour and temperatures were recorded in tagged individuals of Erica australis and Pterospartum tridentatum during prescribed burning. The number and length of resprouted shoots were measured three times (6, 12 and 18 months) after the prescribed burning. The influence of a series of fire severity indicators on some plant resprouting vigour parameters was tested by canonical correlation analysis. Six months and one year after prescribed burning, soil burn severity (measured by the absolute reduction in depth of the organic soil layer, maximum temperatures in the organic soil layer and the mineral soil surface during burning and the post-fire depth of the organic soil layer) reduced the resprouting vigour of E. australis and P. tridentatum. In contrast, direct measurements of fire effects on plants (minimum branch diameter, duration of temperatures above 300 °C in the shrub crown and fireline intensity) did not affect the post-fire plant vigour. Soil burn severity during spring prescribed burning significantly affected the short-term resprouting vigour in a mixed heathland in Galicia. The lack of effects eighteen months after prescribed burning indicates the high resilience of these species and illustrates the need to conciliate fire prevention and conservation goals.

  18. Severe pyoderma gangrenosum in association with a flame burn

    PubMed Central

    Matsuda, Kaho; Okamoto, Osamu; Sato, Seiichi; Gamachi, Ayako; Hashimoto, Hiroyuki

    2016-01-01

    Abstract We herein report a severe case of pyoderma gangrenosum occurring in a burn patient and discuss the possibility of occult complications of this pathological state in daily treatment. PMID:27583260

  19. Update on the critical care management of severe burns.

    PubMed

    Kasten, Kevin R; Makley, Amy T; Kagan, Richard J

    2011-01-01

    Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population.

  20. Epidemiology of severe burn injuries in a Tertiary Burn Centre in Tehran, Iran

    PubMed Central

    Mohammadi-Barzelighi, H.; Alaghehbandan, R.; Motevallian, A.; Alinejad, F.; Soleimanzadeh-Moghadam, S.; Sattari, M.; Lari, A.R.

    2011-01-01

    Summary The aim of the study was to examine the epidemiological characteristics of hospitalized burn patients in a tertiary burn centre in Tehran, Iran. A hospital-based cross-sectional study of all hospitalized patients with burn injuries was conducted in Motahari Burn and Reconstruction Center in Tehran from August to December 2010. Medical records of all hospitalized burn patients were reviewed and pertinent information was captured. A total of 135 patients with severe burns requiring hospitalization were identified during the study period (68.9% males, mean age 33 yr). The most common cause of burns was flammable materials/ liquids (e.g. kerosene and gasoline) (56/135, 41.5%). Binary logistic regression analysis showed that sex (female) and total body surface area (TBSA) burned were the strongest predictors of survival in this cohort. Our findings showed that burn injury continued to be a significant public health problem in Iran, young people (26-35 yr) being the most affected. TBSA and sex (female) were found to be the most predictive factors of patient survival. PMID:22262960

  1. Epidemiology of severe burn injuries in a Tertiary Burn Centre in Tehran, Iran.

    PubMed

    Mohammadi-Barzelighi, H; Alaghehbandan, R; Motevallian, A; Alinejad, F; Soleimanzadeh-Moghadam, S; Sattari, M; Lari, A R

    2011-06-30

    The aim of the study was to examine the epidemiological characteristics of hospitalized burn patients in a tertiary burn centre in Tehran, Iran. A hospital-based cross-sectional study of all hospitalized patients with burn injuries was conducted in Motahari Burn and Reconstruction Center in Tehran from August to December 2010. Medical records of all hospitalized burn patients were reviewed and pertinent information was captured. A total of 135 patients with severe burns requiring hospitalization were identified during the study period (68.9% males, mean age 33 yr). The most common cause of burns was flammable materials/ liquids (e.g. kerosene and gasoline) (56/135, 41.5%). Binary logistic regression analysis showed that sex (female) and total body surface area (TBSA) burned were the strongest predictors of survival in this cohort. Our findings showed that burn injury continued to be a significant public health problem in Iran, young people (26-35 yr) being the most affected. TBSA and sex (female) were found to be the most predictive factors of patient survival. PMID:22262960

  2. Postfire soil burn severity mapping with hyperspectral image unmixing

    USGS Publications Warehouse

    Robichaud, P.R.; Lewis, S.A.; Laes, D.Y.M.; Hudak, A.T.; Kokaly, R.F.; Zamudio, J.A.

    2007-01-01

    Burn severity is mapped after wildfires to evaluate immediate and long-term fire effects on the landscape. Remotely sensed hyperspectral imagery has the potential to provide important information about fine-scale ground cover components that are indicative of burn severity after large wildland fires. Airborne hyperspectral imagery and ground data were collected after the 2002 Hayman Fire in Colorado to assess the application of high resolution imagery for burn severity mapping and to compare it to standard burn severity mapping methods. Mixture Tuned Matched Filtering (MTMF), a partial spectral unmixing algorithm, was used to identify the spectral abundance of ash, soil, and scorched and green vegetation in the burned area. The overall performance of the MTMF for predicting the ground cover components was satisfactory (r2 = 0.21 to 0.48) based on a comparison to fractional ash, soil, and vegetation cover measured on ground validation plots. The relationship between Landsat-derived differenced Normalized Burn Ratio (dNBR) values and the ground data was also evaluated (r2 = 0.20 to 0.58) and found to be comparable to the MTMF. However, the quantitative information provided by the fine-scale hyperspectral imagery makes it possible to more accurately assess the effects of the fire on the soil surface by identifying discrete ground cover characteristics. These surface effects, especially soil and ash cover and the lack of any remaining vegetative cover, directly relate to potential postfire watershed response processes. ?? 2006 Elsevier Inc. All rights reserved.

  3. Determination of resting energy expenditure after severe burn.

    PubMed

    Shields, Beth A; Doty, Kevin A; Chung, Kevin K; Wade, Charles E; Aden, James K; Wolf, Steven E

    2013-01-01

    The purpose of this study was to evaluate the accuracy of nine predictive equations for calculating energy expenditure in severely burned adult subjects. The selected equations have been reported as commonly used or determined to be the most accurate. This prospective, observational study was conducted on adult subjects admitted between October 2007 and July 2010 with ≥ 20% TBSA full-thickness burns (excluding electrical burns or severe head injury). Indirect calorimetry measurements were conducted as a convenience sample during the first 30 days after injury. Demographic data were collected, and resting energy expenditure was calculated using the nine selected predictive equations and compared to measured energy expenditure (MEE) using descriptive and comparative statistics. Data were collected on 31 subjects with an average age of 46 ± 19 years and %TBSA burn of 48 ± 21%. For all equations, slopes and intercepts were significantly different from the line of identity when compared with MEE. A calorie-dependent bias was present for all equations, in that lower calorie range was overestimated and the higher calorie range was underestimated. Only the Carlson and Milner equations had results that were not significantly different from the MEE and mean differences that were not significant in all burn size ranges. None of the equations had a strong correlation with MEE. Of the equations available, the Milner and Carlson equations are the most satisfactory in predicting resting energy expenditure in severely burned adults when indirect calorimetry is unavailable. PMID:22868454

  4. A project for monitoring trends in burn severity

    USGS Publications Warehouse

    Eidenshink, Jeffery C.; Schwind, Brian; Brewer, Ken; Zhu, Zhu-Liang; Quayle, Brad; Howard, Stephen M.

    2007-01-01

    Jeff Eidenshink, Brian Schwind, Ken Brewer, Zhi-Liang Zhu, Brad Quayle, and Elected officials and leaders of environmental agencies need information about the effects of large wildfires in order to set policy and make management decisions. Recently, the Wildland Fire Leadership Council (WFLC), which implements and coordinates the National Fire Plan (NFP) and Federal Wildland Fire Management Policies (National Fire Plan 2004), adopted a strategy to monitor the effectiveness of the National Fire Plan and the Healthy Forests Restoration Act (HFRA). One component of this strategy is to assess the environmental impacts of large wildland fires and identify the trends of burn severity on all lands across the United States. To that end, WFLC has sponsored a six-year project, Monitoring Trends in Burn Severity (MTBS), which requires the U.S. Department of Agriculture Forest Service (USDA-FS) and the U.S. Geological Survey (USGS) to map and assess the burn severity for all large current and historical fires. Using Landsat data and the differenced Normalized Burn Ratio (dNBR) algorithm, the USGS Center for Earth Resources Observation and Science (EROS) and USDA-FS Remote Sensing Applications Center will map burn severity of all fires since 1984 greater than 202 ha (500ac) in the east, and 404 ha (1,000 ac) in the west. The number of historical fires from this period combined with current fires occurring during the course of the project will exceed 9,000. The MTBS project will generate burn severity data, maps, and reports, which will be available for use at local, state, and national levels to evaluate trends in burn severity and help develop and assess the effectiveness of land management decisions. Additionally, the information developed will provide a baseline from which to monitor the recovery and health of fire-affected landscapes over time. Spatial and tabular data quantifying burn severity will augment existing information used to estimate risk associated with a range

  5. Linking runoff response to burn severity after a wildfire

    USGS Publications Warehouse

    Moody, J.A.; Martin, D.A.; Haire, S.L.; Kinner, D.A.

    2008-01-01

    Extreme floods often follow wildfire in mountainous watersheds. However, a quantitative relation between the runoff response and burn severity at the watershed scale has not been established. Runoff response was measured as the runoff coefficient C, which is equal to the peak discharge per unit drainage area divided by the average maximum 30 min rainfall intensity during each rain storm. The magnitude of the bum severity was expressed as the change in the normalized burn ratio. A new burn severity variable, hydraulic functional connectivity ?? was developed and incorporates both the magnitude of the burn severity and the spatial sequence of the bum severity along hillslope flow paths. The runoff response and the burn severity were measured in seven subwatersheds (0.24 to 0.85 km2) in the upper part of Rendija Canyon burned by the 2000 Cerro Grande Fire Dear Los Alamos, New Mexico, USA. A rainfall-discharge relation was determined for four of the subwatersheds with nearly the same bum severity. The peak discharge per unit drainage area Qupeak was a linear function of the maximum 30 min rainfall intensity I30. This function predicted a rainfall intensity threshold of 8.5 mm h-1 below which no runoff was generated. The runoff coefficient C = Qupeak/I30 was a linear function of the mean hydraulic functional connectivity of the subwatersheds. Moreover, the variability of the mean hydraulic functional connectivity was related to the variability of the mean runoff coefficient, and this relation provides physical insight into why the runoff response from the same subwatershed can vary for different rainstorms with the same rainfall intensity. Published in 2007 by John Wiley & Sons, Ltd.

  6. Survival from acute renal failure after severe burns.

    PubMed

    Sawada, Y; Momma, S; Takamizawa, A; Nishida, S

    1984-12-01

    We describe a patient with 50 per cent, third degree flame burns who had a history of paint thinner inhalation for over 10 years. Moreover, chlorpromazine had been administered for the treatment of insomnia caused by chronic thinner intoxication. He developed oliguric acute renal failure soon after the burn injury, although adequate resuscitation therapy was given, and survived following frequent haemodialysis. Although survival from acute renal failure after severe burns is rare, once the diagnosis of acute renal failure has been made, haemodialysis should be instituted as early as possible. Furthermore, in a severely burnt patient with episodes of chronic and acute intoxication from organic chemicals or drugs which may have caused renal damage, acute renal failure may occur, so that careful observation is advised. PMID:6525538

  7. Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

    PubMed

    van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p < 0.001) improvement in scar quality at 12 months compared with the 3- and 6-month data. Predictors for severe scarring are depth of the wound (p < 0.001) and total body surface area burned (p < 0.001). Etiology (p = 0.753) and age (p > 0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively.

  8. [Integration of burn treatment and rehabilitation for a child with extremely severe burn].

    PubMed

    Li, Hongming; Zhang, Jiaping; Chen, Jian; Song, Huapei; Liu, Qiushi; Fan, Xin; Peng, Yizhi; Wu, Jun

    2015-04-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and

  9. 1984–2010 trends in fire burn severity and area for the conterminous US

    USGS Publications Warehouse

    Picotte, Joshua J.; Peterson, Birgit E.; Meier, Gretchen; Howard, Stephen M.

    2016-01-01

    Burn severity products created by the Monitoring Trends in Burn Severity (MTBS) project were used to analyse historical trends in burn severity. Using a severity metric calculated by modelling the cumulative distribution of differenced Normalized Burn Ratio (dNBR) and Relativized dNBR (RdNBR) data, we examined burn area and burn severity of 4893 historical fires (1984–2010) distributed across the conterminous US (CONUS) and mapped by MTBS. Yearly mean burn severity values (weighted by area), maximum burn severity metric values, mean area of burn, maximum burn area and total burn area were evaluated within 27 US National Vegetation Classification macrogroups. Time series assessments of burned area and severity were performed using Mann–Kendall tests. Burned area and severity varied by vegetation classification, but most vegetation groups showed no detectable change during the 1984–2010 period. Of the 27 analysed vegetation groups, trend analysis revealed burned area increased in eight, and burn severity has increased in seven. This study suggests that burned area and severity, as measured by the severity metric based on dNBR or RdNBR, have not changed substantially for most vegetation groups evaluated within CONUS.

  10. Mapping burned areas and burn severity patterns across the Mediterranean region

    NASA Astrophysics Data System (ADS)

    Kalogeropoulos, Christos; Amatulli, Giuseppe; Kempeneers, Pieter; Sedano, Fernando; San Miguel-Ayanz, Jesus; Camia, Andrea

    2010-05-01

    The Mediterranean region is highly susceptible to wildfires. On average, about 60,000 fires take place in this region every year, burning on average half a million hectares of forests and natural vegetation. Wildfires cause environmental degradation and affect the lives of thousands of people in the region. In order to minimize the consequences of these catastrophic events, fire managers and national authorities need to have in their disposal accurate and updated spatial information concerning the size of the burned area as well as the burn severity patterns. Mapping burned areas and burn severity patterns is necessary to effectively support the decision-making process in what concerns strategic (long-term) planning with the definition of post-fire actions at European and national scales. Although a comprehensive archive of burnt areas exists at the European Forest Fire Information System, the analysis of the severity of the areas affected by forest fires in the region is not yet available. Fire severity is influenced by many variables, including fuel type, topography and meteorological conditions before and during the fire. The analysis of fire severity is essential to determine the socio-economic impact of forest fires, to assess fire impacts, and to determine the need of post-fire rehabilitation measures. Moreover, fire severity is linked to forest fire emissions and determines the rate of recovery of the vegetation after the fire. Satellite imagery can give important insights about the conditions of the live fuel moisture content and can be used to assess changes on vegetation structure and vitality after forest fires. Fire events occurred in Greece, Portugal and Spain during the fire season of 2009 were recorded and analyzed in a GIS environment. The Normalized Difference Vegetation Index (NDVI), the Enhanced Vegetation Index (EVI) and the Normalized Burn Ratio (NBR) were calculated from 8-days composites MODIS/TERRA imagery from March to October 2009. In

  11. TNF-α/IL-10 Ratio Correlates with Burn Severity and May Serve as a Risk Predictor of Increased Susceptibility to Infections

    PubMed Central

    Tsurumi, Amy; Que, Yok-Ai; Ryan, Colleen M.; Tompkins, Ronald G.; Rahme, Laurence G.

    2016-01-01

    Severe burn injury renders patients susceptible to multiple infection episodes; however, identifying specific patient groups at high risk remains challenging. Burn-induced inflammatory response dramatically modifies the levels of various cytokines. Whether these changes could predict susceptibility to infections remains unknown. The aim of this study was to determine the early changes in the pro- to anti-inflammatory cytokine ratio and investigate its ability to predict susceptibility to repeated infections after severe burn trauma. The patient population consisted of 34 adult patients having early (≤48 h since injury) blood draws following severe (≥20% total burn surface area (TBSA)) burn injury and suffering from a first infection episode at least 1 day after blood collection. Plasma TNF-α and IL-10 levels were measured to explore the association between the TNF-α/IL-10 ratio, hypersusceptibility to infections, burn size (TBSA), and common severity scores (Acute Physiology and Chronic Health Evaluation II (APACHEII), Baux, modified Baux (R-Baux), Ryan Score, and Abbreviated Burn Severity Index (ABSI)). TNF-α/IL10 plasma ratio measured shortly after burn trauma was inversely correlated with burn size and the injury severity scores investigated, and was predictive of repeated infections (≥3 infection episodes) outcome (AUROC [95%CI] of 0.80 [0.63–0.93]). Early measures of circulating TNF-α/IL10 ratio may be a previously unidentified biomarker associated with burn injury severity and predictive of the risk of hypersusceptibility to repeated infections. PMID:27761434

  12. The use of exenatide in severely burned pediatric patients

    PubMed Central

    2010-01-01

    Introduction Intensive insulin treatment (IIT) has been shown to improve outcomes post-burn in severely burnt patients. However, it increases the incidence of hypoglycemia and is associated with risks and complications. We hypothesized that exenatide would decrease plasma glucose levels post-burn to levels similar to those achieved with IIT, and reduce the amount of exogenous insulin administered. Methods This open-label study included 24 severely burned pediatric patients. Six were randomized to receive exenatide, and 18 received IIT during acute hospitalization (block randomization). Exenatide and insulin were administered to maintain glucose levels between 80 and 140 mg/dl. We determined 6 AM, daily average, maximum and minimum glucose levels. Variability was determined using mean amplitude of glucose excursions (MAGE) and percentage of coefficient of variability. The amount of administered insulin was compared in both groups. Results Glucose values and variability were similar in both groups: Daily average was 130 ± 28 mg/dl in the intervention group and 138 ± 25 mg/dl in the control group (P = 0.31), MAGE 41 ± 6 vs. 45 ± 12 (respectively). However, administered insulin was significantly lower in the exenatide group than in the IIT group: 22 ± 14 IU patients/day in the intervention group and 76 ± 11 IU patients/day in the control group (P = 0.01). The incidence rate of hypoglycemia was similar in both groups (0.38 events/patient-month). Conclusions Patients receiving exenatide received significantly lower amounts of exogenous insulin to control plasma glucose levels. Exenatide was well tolerated and potentially represents a novel agent to attenuate hyperglycemia in the critical care setting. Trial registration NCT00673309. PMID:20701787

  13. Fire intensity, fire severity and burn severity: A brief review and suggested usage

    USGS Publications Warehouse

    Keeley, J.E.

    2009-01-01

    Several recent papers have suggested replacing the terminology of fire intensity and fire severity. Part of the problem with fire intensity is that it is sometimes used incorrectly to describe fire effects, when in fact it is justifiably restricted to measures of energy output. Increasingly, the term has created confusion because some authors have restricted its usage to a single measure of energy output referred to as fireline intensity. This metric is most useful in understanding fire behavior in forests, but is too narrow to fully capture the multitude of ways fire energy affects ecosystems. Fire intensity represents the energy released during various phases of a fire, and different metrics such as reaction intensity, fireline intensity, temperature, heating duration and radiant energy are useful for different purposes. Fire severity, and the related term burn severity, have created considerable confusion because of recent changes in their usage. Some authors have justified this by contending that fire severity is defined broadly as ecosystem impacts from fire and thus is open to individual interpretation. However, empirical studies have defined fire severity operationally as the loss of or change in organic matter aboveground and belowground, although the precise metric varies with management needs. Confusion arises because fire or burn severity is sometimes defined so that it also includes ecosystem responses. Ecosystem responses include soil erosion, vegetation regeneration, restoration of community structure, faunal recolonization, and a plethora of related response variables. Although some ecosystem responses are correlated with measures of fire or burn severity, many important ecosystem processes have either not been demonstrated to be predicted by severity indices or have been shown in some vegetation types to be unrelated to severity. This is a critical issue because fire or burn severity are readily measurable parameters, both on the ground and with

  14. Early and Late Acute Kidney Injury in Severely Burned Patients

    PubMed Central

    Witkowski, Wojciech; Kawecki, Marek; Surowiecka-Pastewka, Agnieszka; Klimm, Wojciech; Szamotulska, Katarzyna; Niemczyk, Stanisław

    2016-01-01

    Background This study evaluated factors influencing early and late occurrence of AKI in severely burned patients and assessed the relationship between time of occurrence of AKI and mortality of AKI patients. Material/Methods Renal function was evaluated at 3 time points: at admission, at the critical point or middle point of hospitalization, and at the endpoint for which death or a discharge from the center was considered. AKI criteria were: decrease in GFR of less than 60 ml/min at admission, decrease in GFR of more than 75% compared to baseline, and decrease in the daily diuresis of less than 500 ml/24 h. Results At admission, 15.1% of the patients had eGFR <60 ml/min. AKI occurred in 38.5% of cases. The occurrence of AKI was associated with: elderly age (p<0.001), female sex (p=0.017), overweight and obesity (p=0.055); extent and depth of burns, respiratory failure, low protein concentration (for all p<0.001), low blood pressure (p=0.014), and high WBC (p=0.010). Early AKI was detected in 28% of patients. Mortality was 100% with the initial GFR ≥60, 100% with the initial GFR <60 and early deterioration of renal function, 80% with the initial GFR <60 and late worsening, and 60% with the initial GFR <60 and no worsening. Late AKI was observed in 10% of patients and mortality in this group was 79.2%. Mortality in the entire group with AKI was 88.0% versus 24.5%. Conclusions The frequent occurrence of AKI, especially early, worsens the prognosis for survival. Assessment of renal function should be included in the prognostic scales for burned patients. PMID:27746455

  15. [Studying of cytokine dynamics in injured persons with severe burns for estimation of severity and prognosis].

    PubMed

    Kovalenko, O M; Mal'tsev, D V; Kazmirchuk, V Ie; Kovalenko, A O

    2014-02-01

    Dynamics of a blood serum concentration of tumor necrosis factor-alpha (TNF- alpha), interleukines (IL-1beta, IL-10) in 35 patients, suffering severe burn, and possibility of application of these indices as biomarkers of the severity state and the complications prognosis, were studied. During the investigation there was established, that TNF-alpha concentration on the 8 - 10th and 19 - 21th day after trauma does the best for characterization of a burn total area, while the IL-1beta concentration on the 8 - 10th day after trauma - the deep affections severity and the IL-10 concentration on the 19 - 21th day after trauma - the deep affections severity. Hyperreactivity, caused by enhanced production of TNF-alpha, IL-1beta and IL-10, witnesses the raised risk of development of the organs complications. And adversely, hypo- and areactivity in extended and deep burns witnesses about enhanced risk of lethality. The blood serum concentration of TNF-alpha, IL-1beta and IL-10 is expedient to use as a biomarkers of the patients state severity and for the course prognosis of pathological process.

  16. [Severe ocular burns by calcium carbide in a speleologist: a case report].

    PubMed

    Testud, F; Voegtlé, R; Nordmann, J P; Descotes, J

    2002-03-01

    A case of severe ocular burns in an amateur speleologist is reported. The explosion of his acetylene lamp caused the projection of calcium carbide particles, which induced burning of the cornea and conjunctiva in both eyes. He slowly recovered in several months. The pathophysiology of the burns, linked to the in situ production of lime, and their management are discussed.

  17. Burn severity estimation using GeoEye imagery, object-based image analysis (OBIA), and Composite Burn Index (CBI) measurements

    NASA Astrophysics Data System (ADS)

    Dragozi, E.; Gitas, Ioannis Z.; Stavrakoudis, Dimitris G.; Minakou, C.

    2015-06-01

    Forest fires greatly influence the stability and functions of the forest ecosystems. The ever increasing need for accurate and detailed information regarding post-fire effects (burn severity) has led to several studies on the matter. In this study the combined use of Very High Resolution (VHR) satellite data (GeoEye), Objectbased image analysis (OBIA) and Composite Burn Index (CBI) measurements in estimating burn severity, at two different time points (2011 and 2012) is assessed. The accuracy of the produced maps was assessed and changes in burn severity between the two dates were detected using the post classification comparison approach. It was found that the produced burn severity map for 2011 was approximately 10% more accurate than that of 2012. This was mainly attributed to the increased heterogeneity of the study area in the second year, which led to an increased number of mixed class objects and consequently made it more difficult to spectrally discriminate between the severity classes. Following the post-classification analysis, the severity class changes were mainly attributed to the trees' ability to survive severe fire damage and sprout new leaves. Moreover, the results of the study suggest that when classifying CBI-based burn severity using VHR imagery it would be preferable to use images captured soon after the fire.

  18. Predictors of muscle protein synthesis after severe pediatric burns

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objectives: Following a major burn, muscle protein synthesis rate increases but in most patients, this response is not sufficient to compensate the also elevated protein breakdown. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that skeletal muscle prot...

  19. Severe adult burn survivors. What information about skin allografts?

    PubMed Central

    Gaucher, Sonia; Duchange, Nathalie; Jarraya, Mohamed; Magne, Jocelyne; Rochet, Jean-Michel; Stéphanazzi, Jean; Hervé, Christian; Moutel, Grégoire

    2013-01-01

    Background and objective During the acute phase of a severe burn, surgery is an emergency. In this situation, human skin allografts constitute an effective temporary skin substitute. However, information about the use of human tissue can not be given to the patients because most of the allografted patients are unconscious due to their injury. Objective This study explored the restitution of information on skin donation to patients who have been skin allografted and who have survived their injury. Method A qualitative study was conducted due to the limited number of patients in ability to be interviewed according to our medical and psychological criteria. Results and discussion Twelve patients who had been treated between 2002 and 2008 were interviewed. Our results show that 10 of them ignored that they had received skin allografts. One of the two patients who knew that they had received allografts knew that skin had been harvested from deceased donor. All patients expressed that there is no information that should not be delivered. They also expressed their relief to have had the opportunity to discuss their case and at being informed during their interview. Their own experience impacted their view in favor of organ and tissue donation. PMID:23229877

  20. MILD OBESITY IS PROTECTIVE AFTER SEVERE BURN INJURY

    PubMed Central

    Jeschke, Marc G.; Finnerty, Celeste C.; Emdad, Fatemeh; Rivero, Haidy G.; Kraft, Robert; Williams, Felicia N; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective To assess the impact of obesity on morbidity and mortality in severely burned patients. Background Despite the increasing number of people with obesity, little is known about the impact of obesity on postburn outcomes. Methods A total of 405 patients were prospectively enrolled as part of the multicenter trial Inflammation and the Host Response to Injury Glue Grant with the following inclusion criteria: 0 to 89 years of age, admitted within 96 hours after injury, and more than 20% total body surface area burn requiring at least 1 surgical intervention. Body mass index was used in adult patients to stratify according to World Health Organization definitions: less than 18.5 (underweight), 18.5 to 29.9 (normal weight), 30 to 34.9 (obese I), 35 to 39.9 (obese II), and body mass index more than 40 (obese III). Pediatric patients (2 to ≤18 years of age) were stratified by using the Centers for Disease Control and Prevention and World Health Organization body mass index-for-age growth charts to obtain a percentile ranking and then grouped as underweight (<5th percentile), normal weight (5th percentile to <95th percentile), and obese (≥95th percentile). The primary outcome was mortality and secondary outcomes were clinical markers of patient recovery, for example, multiorgan function, infections, sepsis, and length of stay. Results A total of 273 patients had normal weight, 116 were obese, and 16 were underweight; underweight patients were excluded from the analyses because of insufficient patient numbers. There were no differences in primary and secondary outcomes when normal weight patients were compared with obese patients. Further stratification in pediatric and adult patients showed similar results. However, when adult patients were stratified in obesity categories, log-rank analysis showed improved survival in the obese I group and higher mortality in the obese III group compared with obese I group (P < 0.05). Conclusions Overall, obesity was not

  1. [Emphasize the diagnosis and treatment of infective endocarditis in patients with severe burn].

    PubMed

    Huan, Jingning

    2016-02-01

    The incidence and mortality of infective endocarditis (IE) in patients with severe burn remain high, which are attributed to invasive procedures, bacteremia, and wound infection after burns. Clinical clues for IE in burns are usually masked by burn-related manifestations, so the diagnosis of IE may be delayed or missed. For burned patients with persistent bacteremia of unknown source, especially Staphylococcus aureus-induced bacteremia, the diagnosis of IE should be considered according to the Duke criteria, and early echocardiography performance is particularly important. Antibiotic therapy is the mainstay initial management, and early surgical intervention is strongly recommended once IE is clearly diagnosed in patients with burns. In order to lower the incidence and mortality of IE in burns, it is very important to take prophylactic procedures along with the whole course of burn management. PMID:26902272

  2. Improved survival with an innovative approach to the treatment of severely burned patients: development of a burn treatment manual.

    PubMed

    Morisada, S; Nosaka, N; Tsukahara, K; Ugawa, T; Sato, K; Ujike, Y

    2015-09-30

    The management of severely burned patients remains a major issue worldwide as indicated by the high incidence of permanent debilitating complications and poor survival rates. In April 2012, the Advanced Emergency & Critical Care Medical Center of the Okayama University Hospital began implementing guidelines for severely burned patients, distributed as a standard burn treatment manual. The protocol, developed in-house, was validated by comparing the outcomes of patients with severe extensive burns (SEB) treated before and after implementation of these new guidelines at this institution. The patients included in this study had a burn index (BI) ≥30 or a prognostic burn index (PBI = BI + patient's age) ≥100. The survival rate of the patients with BI ≥30 was 65.2% with the traditional treatment and 100% with the new guidelines. Likewise, the survival rate of the patients with PBI ≥100 was 61.1% with the traditional treatment compared to 100% with the new guidelines. Together, these data demonstrate that the new treatment guidelines dramatically improved the treatment outcome and survival of SEB patients.

  3. Autoextraction of Permanent Incisors and Self-Inflicted Orodental Trauma in a Severely Burned Child

    PubMed Central

    Keles, Sultan; Dogusal, Gülçin; Sönmez, Işıl

    2015-01-01

    Autoextraction is one type of self-injurious behaviour. In the literature, self-injurious behaviours are observed in syndromes and genetic conditions. However, to the best of our knowledge, SIB and autoextraction in a severely burned patient have not been reported to date. This report describes the self-inflicted trauma and autoextraction in a severely burned child, and the management of the child during and after burn treatment. PMID:26843993

  4. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    PubMed Central

    Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Suman, Oscar E.; Mlcak, Ronald P.; Herndon, David N.

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. Methodology/Principal Findings Patients: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. Conclusions Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for

  5. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    PubMed

    Jeschke, Marc G; Finnerty, Celeste C; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an extensive literature search to identify models that other groups have developed to determine the effects of CRP levels postburn to assess the value of these parameters as predictors of sepsis or severe infection. Statistical analysis was performed using ANOVA and regression analysis where appropriate. Three-hundred fifteen female and 603 male pediatric patients were enrolled in this study. Average total body surface area (TBSA) burn was 45±23%, with full thickness burn over 32±27% TBSA, and patients were 7±6 years old. CRP values significantly correlated with burn size, survival and gender. Significantly higher levels of CRP were found in large burns, in non-survivors, and in females, p<0.05. Using various described models to determine whether CRP levels change before and after an event can predict sepsis or severe infection, we found that CRP cannot predict severe infection or sepsis. Although CRP is a marker of the inflammatory response postburn, CRP fails to predict infection or sepsis in severely burn patients.

  6. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    PubMed Central

    Jeschke, Marc G; Finnerty, Celeste C; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an extensive literature search to identify models that other groups have developed to determine the effects of CRP levels postburn to assess the value of these parameters as predictors of sepsis or severe infection. Statistical analysis was performed using ANOVA and regression analysis where appropriate. Three-hundred fifteen female and 603 male pediatric patients were enrolled in this study. Average total body surface area (TBSA) burn was 45±23%, with full thickness burn over 32±27% TBSA, and patients were 7±6 years old. CRP values significantly correlated with burn size, survival and gender. Significantly higher levels of CRP were found in large burns, in non-survivors, and in females, p<0.05. Using various described models to determine whether CRP levels change before and after an event can predict sepsis or severe infection, we found that CRP cannot predict severe infection or sepsis. Although CRP is a marker of the inflammatory response postburn, CRP fails to predict infection or sepsis in severely burn patients. PMID:23875119

  7. Hot soup! Correlating the severity of liquid scald burns to fluid and biomedical properties.

    PubMed

    Loller, Cameron; Buxton, Gavin A; Kerzmann, Tony L

    2016-05-01

    Burns caused by hot drinks and soups can be both debilitating and costly, especially to pediatric and geriatric patients. This research is aimed at better understanding the fluid properties that can influence the severity of skin burns. We use a standard model which combines heat transfer and biomedical equations to predict burn severity. In particular, experimental data from a physical model serves as the input to our numerical model to determine the severity of scald burns as a consequence of actual fluid flows. This technique enables us to numerically predict the heat transfer from the hot soup into the skin, without the need to numerically estimate the complex fluid mechanics and thermodynamics of the potentially highly viscous and heterogeneous soup. While the temperature of the soup is obviously is the most important fact in determining the degree of burn, we also find that more viscous fluids result in more severe burns, as the slower flowing thicker fluids remain in contact with the skin for longer. Furthermore, other factors can also increase the severity of burn such as a higher initial fluid temperature, a greater fluid thermal conductivity, or a higher thermal capacity of the fluid. Our combined experimental and numerical investigation finds that for average skin properties a very viscous fluid at 100°C, the fluid must be in contact with the skin for around 15-20s to cause second degree burns, and more than 80s to cause a third degree burn.

  8. Burns

    MedlinePlus

    ... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, call 911 or your local ... the power source has been turned off. For chemical burns: Dry chemicals should be brushed off the ...

  9. Burn severity and areas of daily fire growth for 42 forest fires in Idaho and Montana, 2005 - 2011

    NASA Astrophysics Data System (ADS)

    Birch, Donovan Shayne

    This work consisted of two studies of burn severity using infrared perimeter maps and satellite-inferred burn severity data, differenced Normalized Burn Ratio, from 42 wildland fires from central Idaho and western Montana from 2005 to 2007, and 2011. Study 1 examined the proportion of burn severity categories for individual daily areas burned. We defined 2,697 areas, from which we calculated the proportion of three burn severity classes. The proportion of high severity was weakly correlated with size of area burned. Large areas burned do not consistently produced larger proportions of high severity. Study 2 analyzed burn severity relative to 20 environmental variables using the Random Forest machine learning algorithm. We used ten daily weather observations, eight 34-yr climate percentiles, seven topographical index measurements, and four vegetation characteristics from 10,819 randomly located points. We found that higher percentage existing vegetation cover had larger influences on changes in burn severity.

  10. Burn Severity Assessment in the Okanogan-Wenatchee Forest Using NASA Satellite Missions

    NASA Astrophysics Data System (ADS)

    Schiffman, B.; Newcomer, M.; Delgado, D.; Gantenbein, C.; Wang, T.; Prichard, S.; Schmidt, C.; Skiles, J.

    2008-12-01

    Fire severity is an increasingly critical issue for forest managers. A long history of fire suppression has led to millions of acres of dry western forests and a buildup of hazardous fuels. Satellite imagery offers a cost- effective and feasible tool for fire severity assessment and can provide near real-time data for mitigation measures. This study focused on the Tripod Complex Fire that burned more than 175,000 acres of the Okanogan-Wenatchee Forest in Washington in 2006. Field data were collected in order to calculate the Composite Burn Index (CBI), a ground-based measurement of burn severity which can directly correlate with satellite measurements. These in-situ data were used to calibrate the satellite data from the Landsat TM5 sensor and the MODIS sensor on the NASA TERRA satellite. The satellite data were used to calculate the differenced Normalized Burn Ratio (dNBR) and the relative rNBR. These algorithms use the relationship between the near infrared and the shortwave infrared pixel values to quantify burn severity. After comparing these two algorithms, it was determined that there was no significant difference between dNBR and rNBR. Using the burn severity map created with the dNBR data, an analysis was performed to examine the relationship between burn severity and variables such as slope, aspect, and vegetation type. The results showed that there was no relationship between burn severity and any of the variables in the Tripod Complex Fire.

  11. Cryoamputation as a temporizing measure in severe burn injury.

    PubMed

    Pennington, J Daniel; Wall, Anji E; Schlesinger, Joseph J; Higdon, Kent K; Weavind, Liza

    2014-01-01

    Cryoamputation, or physiologic amputation, is a well-described procedure typically used to amputate gangrenous lower extremities. In such cases the patient is too unstable for transport to the operating room, so cryoamputation using dry ice or other refrigerant allows for immediate bedside intervention and later operative amputation when the patient is more stable. In this study the authors describe the use of cryoamputation to stabilize a burn patient with a nonviable upper extremity considered to be contributing significantly to his metabolic acidosis. This experience suggests that cryoamputation may be a reasonable technique to consider when a burn patient presents with a nonviable extremity but is too unstable for immediate operative amputation. PMID:24978024

  12. Determining relative contributions of vegetation and topography to burn severity from LANDSAT imagery.

    PubMed

    Wu, Zhiwei; He, Hong S; Liang, Yu; Cai, Longyan; Lewis, Bernard J

    2013-10-01

    Fire is a dominant process in boreal forest landscapes and creates a spatial patch mosaic with different burn severities and age classes. Quantifying effects of vegetation and topography on burn severity provides a scientific basis on which forest fire management plans are developed to reduce catastrophic fires. However, the relative contribution of vegetation and topography to burn severity is highly debated especially under extreme weather conditions. In this study, we hypothesized that relationships of vegetation and topography to burn severity vary with fire size. We examined this hypothesis in a boreal forest landscape of northeastern China by computing the burn severity of 24 fire patches as the difference between the pre- and post-fire Normalized Difference Vegetation Index obtained from two Landsat TM images. The vegetation and topography to burn severity relationships were evaluated at three fire-size levels of small (<100 ha, n = 12), moderate (100-1,000 ha, n = 9), and large (>1,000 ha, n = 3). Our results showed that vegetation and topography to burn severity relationships were fire-size-dependent. The burn severity of small fires was primary controlled by vegetation conditions (e.g., understory cover), and the burn severity of large fires was strongly influenced by topographic conditions (e.g., elevation). For moderate fires, the relationships were complex and indistinguishable. Our results also indicated that the pattern trends of relative importance for both vegetation and topography factors were not dependent on fire size. Our study can help managers to design fire management plans according to vegetation characteristics that are found important in controlling burn severity and prioritize management locations based on the relative importance of vegetation and topography.

  13. Applying Spatial Statistics to Isolate the Effects of Fuels, Topography, and Weather on Burn Severity

    NASA Astrophysics Data System (ADS)

    Wimberly, M. C.; Cochrane, M. A.; Baer, A. D.; Zhu, Z.

    2007-12-01

    Fire severity datasets derived from satellite remote sensing data are now being used extensively in wildfire research and land management. Maps of burn severity based on the differenced normalized burn ratio (dNBR) are being produced and disseminated by the Monitoring Trends in Burn Severity (MTBS) project for all major wildfires in the United States from 1984 to present. This abundance of data presents unprecedented new opportunities for understanding how weather, terrain, and fuels interact to determine fire severity patterns, and for testing the effectiveness of fuel-reduction strategies for mitigating wildfire impacts. However, these datasets present challenges for statistical analysis because of their large sizes and the non-independence of spatially autocorrelated pixels. To explore the importance of spatial autocorrelation, we analyzed the spatial patterns of burn severity in two recent wildfires - the 2004 School Fire in the Blue Mountains of southeastern Washington and the 2005 Warm Fire on the Kaibab Plateau in northern Arizona. Conditional autoregressive (CAR) models were fitted with dNBR as the dependent variable and topography, fuels, and locations of recent fuel treatments as the independent variables. In both fires, elevation, slope, and aspect had strong effects on burn severity. Fuels had stronger effects on burn severity for the School fire than for the Warm Fire. In both fires, fuel treatments that combined thinning and prescribed burning resulted in statistically significant reductions in fire severity. The CAR models were then decomposed to isolate the spatial signal, which reflected spatially structured variability in dNBR that was not related to the independent variables. The spatial signals were correlated with the burn progression maps, reflecting spatial and temporal variability in weather and fire behavior (e.g. wind versus plume driven) over the course of the fire. These results suggest that spatial autocorrelation in the analysis of

  14. Fuel treatments and landform modify landscape patterns of burn severity in an extreme fire event.

    PubMed

    Prichard, Susan J; Kennedy, Maureen C

    2014-04-01

    Under a rapidly warming climate, a critical management issue in semiarid forests of western North America is how to increase forest resilience to wildfire. We evaluated relationships between fuel reduction treatments and burn severity in the 2006 Tripod Complex fires, which burned over 70,000 ha of mixed-conifer forests in the North Cascades range of Washington State and involved 387 past harvest and fuel treatment units. A secondary objective was to investigate other drivers of burn severity including landform, weather, vegetation characteristics, and a recent mountain pine beetle outbreak. We used sequential autoregression (SAR) to evaluate drivers of burn severity, represented by the relative differenced Normalized Burn Ratio index, in two study areas that are centered on early progressions of the wildfire complex. Significant predictor variables include treatment type, landform (elevation), fire weather (minimum relative humidity and maximum temperature), and vegetation characteristics, including canopy closure, cover type, and mountain pine beetle attack. Recent mountain pine beetle damage was a statistically significant predictor variable with red and mixed classes of beetle attack associated with higher burn severity. Treatment age and size were only weakly correlated with burn severity and may be partly explained by the lack of treatments older than 30 years and the low rates of fuel succession in these semiarid forests. Even during extreme weather, fuel conditions and landform strongly influenced patterns of burn severity. Fuel treatments that included recent prescribed burning of surface fuels were particularly effective at mitigating burn severity. Although surface and canopy fuel treatments are unlikely to substantially reduce the area burned in regional fire years, recent research, including this study, suggests that they can be an effective management strategy for increasing forest landscape resilience to wildfires. PMID:24834742

  15. Comparison of energy expenditure measurement techniques in severely burned patients.

    PubMed

    Schane, J; Goede, M; Silverstein, P

    1987-01-01

    The degree of accuracy of existing formulas for calculating energy expenditure can be determined by comparing them to the measured energy expenditure via indirect calorimetry. As a result, one can modify traditional predicted recommendations for nutrition alimentation of the burn patient with real-time data. In this study, 21 sequential adult admissions with second- and third-degree total body surface area (TBSA) burn wounds (range 21%-81% TBSA) underwent serial assessments of energy expenditure by indirect calorimetry. On admission, maximum, and discharge, measured energy expenditure (MEE) was compared with the calculations for predicted energy expenditure by the Curreri (CEE) and modified Harris-Benedict (MBEE) equations. The mean energy expenditure calculated from the Curreri equation on admission (CEEA) overestimated the mean MEE on admission (MEEA) by 25% (P less than 0.001) and on discharge (MEED) by 36% (P less than 0.0005). The mean modified Harris-Benedict equation overestimated the mean MEEA by 32% (P less than 0.0005) and the mean MEED by 39% (P less than 0.0005). No significant difference was noted between the mean MEE at maximum (MEEM) and the mean CEEA or the mean MBEEA. This indicates excessive overfeeding of the burn patient from admission to discharge by both standard formulas. Actual measured data provide a better indicator of varying nutritional needs throughout the hospital course than the standard formulas, and their use would result in significant savings in the expenses of enteral/parenteral nutritional supplements. PMID:3667663

  16. Predicting gully rejuvenation after wildfire using remotely sensed burn severity data

    NASA Astrophysics Data System (ADS)

    Hyde, Kevin; Woods, Scott W.; Donahue, Jack

    2007-05-01

    The loss of surface vegetation and reduced infiltration caused by wildfires can trigger gully rejuvenation, resulting in damage to downstream aquatic resources and risk to human life and property. We developed a spatially explicit metric of burn severity — the Burn Severity Distribution Index (BSDI) — and tested its ability to predict post-fire gully rejuvenation in 1st and 2nd order basins burned in the 2000 Valley Complex fires in the Sapphire Mountains of western Montana. The BSDI was derived from burn severity data interpreted from Landsat 7 satellite imagery using the Normalized Burn Ratio (NBR) method, and ranged from 0.0 for completely unburned basins to 4.0 for basins burned entirely at high severity. In July 2001 rainstorms with peak 30-minute intensities of up to 17 mm h - 1 triggered gully rejuvenation in 66 of the 171 basins examined. The frequency of gully rejuvenation was higher in basins with higher BSDI values, increasing from zero for basins with a BSDI less than 1.3 to 67% for basins with a BSDI greater than 3.0. Binary logistic regression indicated that BSDI was a more significant predictor of gully rejuvenation than basin morphometric variables. The absence of gully rejuvenation in several basins with a high BSDI was attributed to low gradient, dense riparian vegetation, or concentration of high burn severity at lower elevations in the basin. The presence of gully rejuvenation in several basins with a low BSDI was associated with false negative NBR classification errors in northwest aspects, and concentration of severe burn impacts in the drainage headslopes. BSDI is a useful metric for predicting gully rejuvenation after wildfire. The use of the BSDI in Burned Area Emergency Response team assessments could improve the planning, implementation, and monitoring of burned area recovery treatments.

  17. Comparison of AVIRIS and Landsat ETM+ detection capabilities for burn severity

    USGS Publications Warehouse

    Van Wagtendonk, Jan W.; Root, Ralph R.; Key, Carl H.

    2004-01-01

    Our study compares data on burn severity collected from multi-temporal Airborne Visible and Infrared Imaging Spectrometer (AVIRIS) with similar data from the Enhanced Thematic Mapper Plus (ETM+) using the differenced Normalized Burn Ratio (dNBR). Two AVIRIS and ETM+ data acquisitions recorded surface conditions immediately before the Hoover Fire began to spread rapidly and again the following year. Data were validated with 63 field plots using the Composite Burn Index (CBI). The relationship between spectral channels and burn severity was examined by comparing pre- and post-fire datasets. Based on the high burn severity comparison, AVIRIS channels 47 and 60 at wavelengths of 788 and 913 nm showed the greatest negative response to fire. Post-fire reflectance values decreased the most on average at those wavelengths, while channel 210 at 2370 nm showed the greatest positive response on average. Fire increased reflectance the most at that wavelength over the entire measured spectral range. Furthermore, channel 210 at 2370 nm exhibited the greatest variation in spectral response, suggesting potentially high information content for fire severity. Based on general remote sensing principles and the logic of variable spectral responses to fire, dNBR from both sensors should produce useful results in quantifying burn severity. The results verify the band–response relationships to burn severity as seen with ETM+ data and confirm the relationships by way of a distinctly different sensor system.

  18. Severe burn injury in europe: a systematic review of the incidence, etiology, morbidity, and mortality

    PubMed Central

    2010-01-01

    Introduction Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death. Methods The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google. The reference lists and the Science Citation Index were used for hand searching (snowballing). Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included. Language restrictions were set on English, French, and Dutch. Results The search led to 76 eligible studies, including more than 186,500 patients in total. The annual incidence of severe burns was 0.2 to 2.9/10,000 inhabitants with a decreasing trend in time. Almost 50% of patients were younger than 16 years, and ~60% were male patients. Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated. Mortality was usually between 1.4% and 18% and is decreasing in time. Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases. (Multi) organ failure and sepsis were the most frequently reported causes of death. The main causes of early death (<48 hours) were burn shock and inhalation injury. Conclusions Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed. National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost

  19. The impact of severe burn injury on skeletal muscle mitochondrial function

    PubMed Central

    Porter, Craig; Herndon, David N; Sidossis, Labros S; Borsheim, Elisabet

    2013-01-01

    Severe burn injury induces a pathophysiological response that affects almost every physiological system within the body. Inflammation, hypermetabolism, muscle wasting, and insulin resistance are all hallmarks of the pathophysiological response to burn injury, with perturbations in metabolism known to persist for several years post injury. Skeletal muscle is the main depot of lean tissue within the body and as the primary site of peripheral glucose disposal, plays an important role in metabolic regulation. Following a large burn, skeletal muscle functions as and endogenous amino acid store, providing substrates for more pressing functions post burn, such as the synthesis of acute phase proteins and the deposition of new skin. Subsequently, burn patients become cachexic, which is associated with poor outcomes in terms of metabolic health and functional capacity. While a loss of skeletal muscle contractile proteins per se will no doubt negatively impact functional capacity, detriments in skeletal muscle quality, i.e. a loss in mitochondrial number and/or function may be quantitatively just as important. The goal of this review article is to summarize the current understanding of the impact of burn injury on skeletal muscle mitochondrial content and function, to offer direction for future research concerning skeletal muscle mitochondrial function in patients with severe burns, and to renew interest in the role of these organelles in metabolic dysfunction following burn injury. PMID:23664225

  20. Landsat-Based Detection and Severity Analysis of Burned Sugarcane Plots in Tarlac, Philippines Using Differenced Normalized Burn Ratio (dNBR)

    NASA Astrophysics Data System (ADS)

    Baloloy, A. B.; Blanco, A. C.; Gana, B. S.; Sta. Ana, R. C.; Olalia, L. C.

    2016-09-01

    The Philippines has a booming sugarcane industry contributing about PHP 70 billion annually to the local economy through raw sugar, molasses and bioethanol production (SRA, 2012). Sugarcane planters adapt different farm practices in cultivating sugarcane, one of which is cane burning to eliminate unwanted plant material and facilitate easier harvest. Information on burned sugarcane extent is significant in yield estimation models to calculate total sugar lost during harvest. Pre-harvest burning can lessen sucrose by 2.7% - 5% of the potential yield (Gomez, et al 2006; Hiranyavasit, 2016). This study employs a method for detecting burn sugarcane area and determining burn severity through Differenced Normalized Burn Ratio (dNBR) using Landsat 8 Images acquired during the late milling season in Tarlac, Philippines. Total burned area was computed per burn severity based on pre-fire and post-fire images. Results show that 75.38% of the total sugarcane fields in Tarlac were burned with post-fire regrowth; 16.61% were recently burned; and only 8.01% were unburned. The monthly dNBR for February to March generated the largest area with low severity burn (1,436 ha) and high severity burn (31.14 ha) due to pre-harvest burning. Post-fire regrowth is highest in April to May when previously burned areas were already replanted with sugarcane. The maximum dNBR of the entire late milling season (February to May) recorded larger extent of areas with high and low post-fire regrowth compared to areas with low, moderate and high burn severity. Normalized Difference Vegetation Index (NDVI) was used to analyse vegetation dynamics between the burn severity classes. Significant positive correlation, rho = 0.99, was observed between dNBR and dNDVI at 5% level (p = 0.004). An accuracy of 89.03% was calculated for the Landsat-derived NBR validated using actual mill data for crop year 2015-2016.

  1. Successful skin homografting from an identical twin in a severely burned patient.

    PubMed

    Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients.

  2. Temperature responses in severely burned children during exercise in a hot environment.

    PubMed

    McEntire, Serina J; Chinkes, David L; Herndon, David N; Suman, Oscar E

    2010-01-01

    The authors have previously described thermoregulatory responses of severely burned children during submaximal exercise in a thermoneutral environment. However, the thermoregulatory response of burned children to exercise in the heat is not well understood and could have important safety implications for rehabilitation. Children (n = 10) with >40% TBSA burns and nonburned children (n = 10) performed a 30-minute bout of treadmill exercise at 75% of their peak aerobic power in a heated environment. Intestinal temperature, burned and unburned skin temperature, and heart rate were recorded pre-exercise, every 2 minutes during exercise, and during recovery. Three of the 10 burned children completed the exercise bout in the heat; however, all the nonburned children completed the 30-minute bout. One burned child reached a core body temperature >39 degrees C at minute 23. Burned children had significantly higher core body temperature through the first 12 minutes of exercise compared with nonburned children. However, nine of 10 (90%) burned children did not become hyperthermic during exercise in the heat. Specific to this study, hyperthermia did not typically occur in burned children, relative to nonburned children. Whether this is due to an intolerance to exercise in the heat or to an inability to generate sufficient heat during exercise needs to be explored further.

  3. Burns

    MedlinePlus

    ... occur by direct or indirect contact with heat, electric current, radiation, or chemical agents. Burns can lead to ... is. The burn is caused by chemicals or electricity. The person shows signs of shock . The person ...

  4. Early and Sustained Changes in Bone Metabolism After Severe Burn Injury.

    PubMed

    Muschitz, Gabriela Katharina; Schwabegger, Elisabeth; Kocijan, Roland; Baierl, Andreas; Moussalli, Hervé; Fochtmann, Alexandra; Nickl, Stefanie; Tinhofer, Ines; Haschka, Judith; Resch, Heinrich; Rath, Thomas; Pietschmann, Peter; Muschitz, Christian

    2016-04-01

    This study investigated serum burnover marker in male patients after severe burn injury. Ongoing changes suggest alterations in bone metabolism with a likely adverse influence on bone quality and structure. PMID:26789778

  5. AmeriFlux US-An1 Anaktuvuk River Severe Burn

    SciTech Connect

    Hobbie, John; Rocha, Adrian; Shaver, Gaius

    2016-01-01

    This is the AmeriFlux version of the carbon flux data for the site US-An1 Anaktuvuk River Severe Burn. Site Description - The Anaktuvuk River fire on the North Slope of Alaska started on July 16, 2007 by lightning. It continued until the end of September when nearby lakes had already frozen over and burned >256,000 acres, creating a mosaic of patches that differed in burn severity. The Anaktuvuk River Severe Burn, Moderate Burn, and Unburned sites are 40 km to the west of the nearest road and were selected in late May 2008 to determine the effects of the fire on carbon, water, and energy exchanges during the growing season. Because the fire had burned through September of the previous year, initial deployment of flux towers occurred prior to any significant vegetative regrowth, and our sampling campaign captured the full growing season in 2008. The Severe Burn site consisted of a large area in which all of the green vegetation were consumed in the fire and some of the organic matter had burnt to the mineral soil in many places. A bear damaged the tower during the last week of August 2008, and it was repaired shortly after.

  6. Burn injuries from small airplane crashes.

    PubMed

    Moye, S J; Cruse, C W; Watkins, G M

    1991-11-01

    Because a large amount of general aviation activity occurs in Central Florida, we reviewed our admissions for victims of small airplane crashes. We identified 13 burn victims of small aircraft accidents over a 7-year period. Of the 13, 12 survived their burn injuries, an overall survival rate of 92%. The extent of burn injury, Abbreviated Burn Severity Index (ABSI), complications, other injuries and rehabilitation potential are reviewed. Burn injury resulting from small airplane crashes is usually survivable if the patient arrives at the Burn Center alive. These burn victims generally are highly motivated individuals, are easily rehabilitated, and continue productive lives. Small airports and local hospitals should be aware of burn center availability because of the usual major extent of the burn injury.

  7. Vegetation burn severity mapping using Landsat-8 and WorldView-2

    USGS Publications Warehouse

    Wu, Zhuoting; Middleton, Barry R.; Hetzler, Robert; Vogel, John M.; Dye, Dennis G.

    2015-01-01

    We used remotely sensed data from the Landsat-8 and WorldView-2 satellites to estimate vegetation burn severity of the Creek Fire on the San Carlos Apache Reservation, where wildfire occurrences affect the Tribe's crucial livestock and logging industries. Accurate pre- and post-fire canopy maps at high (0.5-meter) resolution were created from World- View-2 data to generate canopy loss maps, and multiple indices from pre- and post-fire Landsat-8 images were used to evaluate vegetation burn severity. Normalized difference vegetation index based vegetation burn severity map had the highest correlation coefficients with canopy loss map from WorldView-2. Two distinct approaches - canopy loss mapping from WorldView-2 and spectral index differencing from Landsat-8 - agreed well with the field-based burn severity estimates and are both effective for vegetation burn severity mapping. Canopy loss maps created with WorldView-2 imagery add to a short list of accurate vegetation burn severity mapping techniques that can help guide effective management of forest resources on the San Carlos Apache Reservation, and the broader fire-prone regions of the Southwest.

  8. Severe complications after negative pressure wound therapy in burned wounds: two case reports

    PubMed Central

    Ren, Haitao; Li, Yuan

    2014-01-01

    We present two typical cases of severe complications (sepsis and hemorrhage) after negative pressure wound therapy (NPWT) in burned patients. Necrotic tissues in some deep burn wounds are difficult to judge correctly and remove thoroughly. An electrically burned blood vessel looks “intact” but can easily break. Necrotic tissue or injured blood vessels when using NPWT are dangerous, both for causing sepsis and hemorrhage. This is the first article that reports the severe complications of NPWT in burned patients. It is imperative to heed indications and avoid contraindications. Proper preparation of wound beds, close observation, and sufficient irrigation are also crucial to avoid these severe complications, and there is an urgent need to substitute the central vacuum system with the low-pressure system. PMID:25061310

  9. Management of severe burn injuries with topical heparin: the first evidence-based study in Ghana

    PubMed Central

    Agbenorku, Pius; Fugar, Setri; Akpaloo, Joseph; Hoyte-Williams, Paa E; Alhassan, Zainab; Agyei, Fareeda

    2013-01-01

    Conventional therapy for burns has always produced a nightmarish illness for patients. The lack of the ability to prevent contractures often produces dysfunctional limbs and the ugly scars resulting from severe burns are an ongoing reminder of this lengthy painful illness. This study is to determine the effectiveness of topical heparin in burns management among some patients at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Patients for this prospective study were burns victims who were transported to the Accident and Emergency Center of KATH. Complete clerking of the patients and related information were taken. Six patients with ages ranging from 5-35 years, TBSA 5-42% and a combination of 2° and 3° burns were enrolled in the case study. Anatomical locations of the burns included: face, neck, trunk and limbs. Using topical heparin produced smooth skin in two patients: Patients 3 and 5 who reported on Post-burn Day 85 and 116 at the BICU. Five out of the six patients assessed the degree of pain; before treatment with heparin, all five patients stated they were experiencing severe pains, however, three (60.0%) of the patients stated they experienced no pain at all while two (40.0%) were experiencing mild pain after topical heparin application. Heparin was observed to be very effective in the management of burn injuries in the patients studied. It was effective in reduction of pain and prevention of scars and contractures. However, due to the small number of patients and lack of control for the wound healing, a firm recommendation for the use of heparin therapy in burns cannot be made and further studies would be required to establish its use especially in the African population. PMID:23386983

  10. Comparisons of the Outcome Prediction Performance of Injury Severity Scoring Tools Using the Abbreviated Injury Scale 90 Update 98 (AIS 98) and 2005 Update 2008 (AIS 2008)

    PubMed Central

    Tohira, Hideo; Jacobs, Ian; Mountain, David; Gibson, Nick; Yeo, Allen

    2011-01-01

    The Abbreviated Injury Scale (AIS) was revised in 2005 and updated in 2008 (AIS 2008). We aimed to compare the outcome prediction performance of AIS-based injury severity scoring tools by using AIS 2008 and AIS 98. We used all major trauma patients hospitalized to the Royal Perth Hospital between 1994 and 2008. We selected five AIS-based injury severity scoring tools, including Injury Severity Score (ISS), New Injury Severity Score (NISS), modified Anatomic Profile (mAP), Trauma and Injury Severity Score (TRISS) and A Severity Characterization of Trauma (ASCOT). We selected survival after injury as a target outcome. We used the area under the Receiver Operating Characteristic curve (AUROC) as a performance measure. First, we compared the five tools using all cases whose records included all variables for the TRISS (complete dataset) using a 10-fold cross-validation. Second, we compared the ISS and NISS for AIS 98 and AIS 2008 using all subjects (whole dataset). We identified 1,269 and 4,174 cases for a complete dataset and a whole dataset, respectively. With the 10-fold cross-validation, there were no clear differences in the AUROCs between the AIS 98- and AIS 2008-based scores. With the second comparison, the AIS 98-based ISS performed significantly worse than the AIS 2008-based ISS (p<0.0001), while there was no significant difference between the AIS 98- and AIS 2008-based NISSs. Researchers should be aware of these findings when they select an injury severity scoring tool for their studies. PMID:22105401

  11. Fire frequency, area burned, and severity: A quantitative approach to defining a normal fire year

    USGS Publications Warehouse

    Lutz, J.A.; Key, C.H.; Kolden, C.A.; Kane, J.T.; van Wagtendonk, J.W.

    2011-01-01

    Fire frequency, area burned, and fire severity are important attributes of a fire regime, but few studies have quantified the interrelationships among them in evaluating a fire year. Although area burned is often used to summarize a fire season, burned area may not be well correlated with either the number or ecological effect of fires. Using the Landsat data archive, we examined all 148 wildland fires (prescribed fires and wildfires) >40 ha from 1984 through 2009 for the portion of the Sierra Nevada centered on Yosemite National Park, California, USA. We calculated mean fire frequency and mean annual area burned from a combination of field- and satellite-derived data. We used the continuous probability distribution of the differenced Normalized Burn Ratio (dNBR) values to describe fire severity. For fires >40 ha, fire frequency, annual area burned, and cumulative severity were consistent in only 13 of 26 years (50 %), but all pair-wise comparisons among these fire regime attributes were significant. Borrowing from long-established practice in climate science, we defined "fire normals" to be the 26 year means of fire frequency, annual area burned, and the area under the cumulative probability distribution of dNBR. Fire severity normals were significantly lower when they were aggregated by year compared to aggregation by area. Cumulative severity distributions for each year were best modeled with Weibull functions (all 26 years, r2 ??? 0.99; P < 0.001). Explicit modeling of the cumulative severity distributions may allow more comprehensive modeling of climate-severity and area-severity relationships. Together, the three metrics of number of fires, size of fires, and severity of fires provide land managers with a more comprehensive summary of a given fire year than any single metric.

  12. SENTINEL-2A red-edge spectral indices suitability for discriminating burn severity

    NASA Astrophysics Data System (ADS)

    Fernández-Manso, Alfonso; Fernández-Manso, Oscar; Quintano, Carmen

    2016-08-01

    Fires are a problematic and recurrent issue in Mediterranean ecosystems. Accurate discrimination between burn severity levels is essential for the rehabilitation planning of burned areas. Sentinel-2A MultiSpectral Instrument (MSI) record data in three red-edge wavelengths, spectral domain especially useful on agriculture and vegetation applications. Our objective is to find out whether Sentinel-2A MSI red-edge wavelengths are suitable for burn severity discrimination. As study area, we used the 2015 Sierra Gata wildfire (Spain) that burned approximately 80 km2. A Copernicus Emergency Management Service (EMS)-grading map with four burn severity levels was considered as reference truth. Cox and Snell, Nagelkerke and McFadde pseudo-R2 statistics obtained by Multinomial Logistic Regression showed the superiority of red-edge spectral indices (particularly, Modified Simple Ratio Red-edge, Chlorophyll Index Red-edge, Normalized Difference Vegetation Index Red-edge) over conventional spectral indices. Fisher's Least Significant Difference test confirmed that Sentinel-2A MSI red-edge spectral indices are adequate to discriminate four burn severity levels.

  13. Integrating satellite imagery with simulation modeling to improve burn severity mapping.

    PubMed

    Karau, Eva C; Sikkink, Pamela G; Keane, Robert E; Dillon, Gregory K

    2014-07-01

    Both satellite imagery and spatial fire effects models are valuable tools for generating burn severity maps that are useful to fire scientists and resource managers. The purpose of this study was to test a new mapping approach that integrates imagery and modeling to create more accurate burn severity maps. We developed and assessed a statistical model that combines the Relative differenced Normalized Burn Ratio, a satellite image-based change detection procedure commonly used to map burn severity, with output from the Fire Hazard and Risk Model, a simulation model that estimates fire effects at a landscape scale. Using 285 Composite Burn Index (CBI) plots in Washington and Montana as ground reference, we found that an integrated model explained more variability in CBI (R (2) = 0.47) and had lower mean squared error (MSE = 0.28) than image (R (2) = 0.42 and MSE = 0.30) or simulation-based models (R (2) = 0.07 and MSE = 0.49) alone. Overall map accuracy was also highest for maps created with the Integrated Model (63 %). We suspect that Simulation Model performance would greatly improve with higher quality and more accurate spatial input data. Results of this study indicate the potential benefit of combining satellite image-based methods with a fire effects simulation model to create improved burn severity maps. PMID:24817334

  14. Integrating Satellite Imagery with Simulation Modeling to Improve Burn Severity Mapping

    NASA Astrophysics Data System (ADS)

    Karau, Eva C.; Sikkink, Pamela G.; Keane, Robert E.; Dillon, Gregory K.

    2014-07-01

    Both satellite imagery and spatial fire effects models are valuable tools for generating burn severity maps that are useful to fire scientists and resource managers. The purpose of this study was to test a new mapping approach that integrates imagery and modeling to create more accurate burn severity maps. We developed and assessed a statistical model that combines the Relative differenced Normalized Burn Ratio, a satellite image-based change detection procedure commonly used to map burn severity, with output from the Fire Hazard and Risk Model, a simulation model that estimates fire effects at a landscape scale. Using 285 Composite Burn Index (CBI) plots in Washington and Montana as ground reference, we found that an integrated model explained more variability in CBI ( R 2 = 0.47) and had lower mean squared error (MSE = 0.28) than image ( R 2 = 0.42 and MSE = 0.30) or simulation-based models ( R 2 = 0.07 and MSE = 0.49) alone. Overall map accuracy was also highest for maps created with the Integrated Model (63 %). We suspect that Simulation Model performance would greatly improve with higher quality and more accurate spatial input data. Results of this study indicate the potential benefit of combining satellite image-based methods with a fire effects simulation model to create improved burn severity maps.

  15. Burn Severities, Fire Intensities, and Impacts to Major Vegetation Types from the Cerro Grande Fire

    SciTech Connect

    Balice, Randy G.; Bennett, Kathryn D.; Wright, Marjorie A.

    2004-12-15

    The Cerro Grande Fire resulted in major impacts and changes to the ecosystems that were burned. To partially document these effects, we estimated the acreage of major vegetation types that were burned at selected burn severity levels and fire intensity levels. To accomplish this, we adopted independently developed burn severity and fire intensity maps, in combination with a land cover map developed for habitat management purposes, as a basis for the analysis. To provide a measure of confidence in the acreage estimates, the accuracies of these maps were also assessed. In addition, two other maps of comparable quality were assessed for accuracy: one that was developed for mapping fuel risk and a second map that resulted from a preliminary application of an evolutionary computation software system, called GENIE.

  16. Mapping burn severity in a disease-impacted forest landscape using Landsat and MASTER imagery

    NASA Astrophysics Data System (ADS)

    Chen, Gang; Metz, Margaret R.; Rizzo, David M.; Meentemeyer, Ross K.

    2015-08-01

    Global environmental change has increased forest vulnerability to the occurrence of interacting disturbances, including wildfires and invasive diseases. Mapping post-fire burn severity in a disease-affected forest often faces challenges because burned and infested trees may exhibit a high similarity in spectral reflectance. In this study, we combined (pre- and post-fire) Landsat imagery and (post-fire) high-spectral resolution airborne MASTER data [MODIS (moderate resolution imaging spectroradiometer)/ASTER (advanced spaceborne thermal emission and reflection radiometer)] to map burn severity in a California coastal forest environment, where a non-native forest disease sudden oak death (SOD) was causing substantial tree mortality. Results showed that the use of Landsat plus MASTER bundle performed better than using the individual sensors in most of the evaluated forest strata from ground to canopy layers (i.e., substrate, shrubs, intermediate-sized trees, dominant trees and average), with the best model performance achieved at the dominant tree layer. The mid to thermal infrared spectral bands (3.0-12.5 μm) from MASTER were found to augment Landsat's visible to shortwave infrared bands in burn severity assessment. We also found that infested and uninfested forests similarly experienced moderate to high degrees of burns where CBI (composite burn index) values were higher than 1. However, differences occurred in the regions with low burn severity (CBI values lower than 1), where uninfested stands revealed a much lower burn effect than that in infested stands, possibly due to their higher resilience to small fire disturbances as a result of higher leaf water content.

  17. Severe Burn Injury Induces Thermogenically Functional Mitochondria in Murine White Adipose Tissue.

    PubMed

    Porter, Craig; Herndon, David N; Bhattarai, Nisha; Ogunbileje, John O; Szczesny, Bartosz; Szabo, Csaba; Toliver-Kinsky, Tracy; Sidossis, Labros S

    2015-09-01

    Chronic cold exposure induces functionally thermogenic mitochondria in the inguinal white adipose tissue (iWAT) of mice. Whether this response occurs in pathophysiological states remains unclear. The purpose of this study was to determine the impact of severe burn trauma on iWAT mitochondrial function in mice. Male BALB/c mice (10-12 weeks) received full-thickness scald burns to ∼30% of the body surface area. Inguinal white adipose tissue was harvested from mice at 1, 4, 10, 20, and 40 days postinjury. Total and uncoupling protein 1 (UCP1)-dependent mitochondrial thermogenesis were determined in iWAT. Citrate synthase activity was determined as a proxy of mitochondrial abundance. Immunohistochemistry was performed to assess iWAT morphology and UCP1 expression. Uncoupling protein 1-dependent respiration was significantly greater at 4 and 10 days after burn compared with sham, peaking at 20 days after burn (P < 0.001). Citrate synthase activity was threefold greater at 4, 10, 20, and 40 days after burn versus sham (P < 0.05). Per mitochondrion, UCP1 function increased after burn trauma (P < 0.05). After burn trauma, iWAT exhibited numerous multilocular lipid droplets that stained positive for UCP1. The current findings demonstrate the induction of thermogenically competent mitochondria within rodent iWAT in a model of severe burn trauma. These data identify a specific pathology that induces the browning of white adipose tissue in vivo and may offer a mechanistic explanation for the chronic hypermetabolism observed in burn victims.

  18. Fire behavior, weather, and burn severity of the 2007 anaktuvuk river tundra fire, North Slope, Alaska

    USGS Publications Warehouse

    Jones, B.; Kolden, C.; Jandt, R.; Abatzoglou, J.; Urban, F.; Arp, C.

    2009-01-01

    In 2007, the Anaktuvuk River Fire (ARF) became the largest recorded tundra fire on the North Slope of Alaska. The ARF burned for nearly three months, consuming more than 100,000 ha. At its peak in early September, the ARF burned at a rate of 7000 ha d-1. The conditions potentially responsible for this large tundra fire include modeled record high summer temperature and record low summer precipitation, a late-season high-pressure system located over the Beaufort Sea, extremely dry soil conditions throughout the summer, and sustained southerly winds during the period of vegetation senescence. Burn severity mapping revealed that more than 80% of the ARF burned at moderate to extreme severity, while the nearby Kuparuk River Fire remained small and burned at predominantly (80%) low severity. While this study provides information that may aid in the prediction of future large tundra fires in northern Alaska, the fact that three other tundra fires that occurred in 2007 combined to burn less than 1000 ha suggests site specific complexities associated with tundra fires on the North Slope, which may hamper the development of tundra fire forecasting models.

  19. Influences of forest roads and their edge effects on the spatial pattern of burn severity

    NASA Astrophysics Data System (ADS)

    Narayanaraj, Ganapathy; Wimberly, Michael C.

    2013-08-01

    Previous research has shown that forest roads are an important feature in many landscapes and have significant effects on wildfire ignition and cessation. However, forest road effects on burn severity have not been studied at the landscape level. Therefore, the overarching goal of our study is to identify the influences of road edge effects on the spatial patterns of burn severity. We analyzed six fires within the Okanogan-Wenatchee National Forest on the eastern slope of the Cascades mountain range of central Washington. We generated two categories for assessing road variables: (1) Primary Road Effect Zone (area within 150 m of the nearest road) and (2) Secondary Road Effect Zone (area from 150 m to 300 m to the nearest road). A regular sampling grid including one out of every 9 cells was created for each fire. These grids were intersected with burn severity data in the form of the Relative Differenced Normalized Burn Ratio (RdNBR), road distance category, stream distance, elevation, slope, terrain shape index, heat load index, canopy cover, and fuel type. We fit spatial regression models with RdNBR as the dependent variable. We found that high burn severity is less likely to occur in the Primary Road Effect Zone for most fires, although one fire exhibited the opposite relationship. Forest road edge effects were hypothesized to be an important determinant of burn severity because fragmentation created by roads alters the roadside fuel profile and environment and because road corridors create barriers to fire spread. Recognizing roadside effects on burn severity patterns highlights the need for further study of the range of effects that roads have on fuels and the fire environment and the potential for incorporating road effects into landscape-level assessments of fire risk.

  20. Burns

    MedlinePlus

    ... are burns treated? In many cases, topical antibiotics (skin creams or ointments) are used to prevent infection. For third-degree burns and some second-degree ones, immediate blood transfusion and/or extra fluids ... is skin grafting? There are two types of skin grafts. ...

  1. Melatonin prevents acute kidney injury in severely burned rats via the activation of SIRT1

    PubMed Central

    Bai, Xiao-Zhi; He, Ting; Gao, Jian-Xin; Liu, Yang; Liu, Jia-Qi; Han, Shi-Chao; Li, Yan; Shi, Ji-Hong; Han, Jun-Tao; Tao, Ke; Xie, Song-Tao; Wang, Hong-Tao; Hu, Da-Hai

    2016-01-01

    Acute kidney injury (AKI) is a common complication after severe burns. Melatonin has been reported to protect against multiple organ injuries by increasing the expression of SIRT1, a silent information regulator that regulates stress responses, inflammation, cellular senescence and apoptosis. This study aimed to investigate the protective effects of melatonin on renal tissues of burned rats and the role of SIRT1 involving the effects. Rat severely burned model was established, with or without the administration of melatonin and SIRT1 inhibitor. The renal function and histological manifestations were determined to evaluate the severity of kidney injury. The levels of acetylated-p53 (Ac-p53), acetylated-p65 (Ac-p65), NF-κB, acetylated-forkhead box O1 (Ac-FoxO1), Bcl-2 and Bax were analyzed to study the underlying mechanisms. Our results suggested that severe burns could induce acute kidney injury, which could be partially reversed by melatonin. Melatonin attenuated oxidative stress, inflammation and apoptosis accompanied by the increased expression of SIRT1. The protective effects of melatonin were abrogated by the inhibition of SIRT1. In conclusion, we demonstrate that melatonin improves severe burn-induced AKI via the activation of SIRT1 signaling. PMID:27599451

  2. Melatonin prevents acute kidney injury in severely burned rats via the activation of SIRT1.

    PubMed

    Bai, Xiao-Zhi; He, Ting; Gao, Jian-Xin; Liu, Yang; Liu, Jia-Qi; Han, Shi-Chao; Li, Yan; Shi, Ji-Hong; Han, Jun-Tao; Tao, Ke; Xie, Song-Tao; Wang, Hong-Tao; Hu, Da-Hai

    2016-01-01

    Acute kidney injury (AKI) is a common complication after severe burns. Melatonin has been reported to protect against multiple organ injuries by increasing the expression of SIRT1, a silent information regulator that regulates stress responses, inflammation, cellular senescence and apoptosis. This study aimed to investigate the protective effects of melatonin on renal tissues of burned rats and the role of SIRT1 involving the effects. Rat severely burned model was established, with or without the administration of melatonin and SIRT1 inhibitor. The renal function and histological manifestations were determined to evaluate the severity of kidney injury. The levels of acetylated-p53 (Ac-p53), acetylated-p65 (Ac-p65), NF-κB, acetylated-forkhead box O1 (Ac-FoxO1), Bcl-2 and Bax were analyzed to study the underlying mechanisms. Our results suggested that severe burns could induce acute kidney injury, which could be partially reversed by melatonin. Melatonin attenuated oxidative stress, inflammation and apoptosis accompanied by the increased expression of SIRT1. The protective effects of melatonin were abrogated by the inhibition of SIRT1. In conclusion, we demonstrate that melatonin improves severe burn-induced AKI via the activation of SIRT1 signaling. PMID:27599451

  3. Severe burn injuries caused by bioethanol-design fireplaces-an overview on recreational fire threats.

    PubMed

    Kraemer, Robert; Knobloch, Karsten; Lorenzen, Johan; Breuing, Karl H; Koennecker, Soeren; Rennekampff, Hans-Oliver; Vogt, Peter M

    2011-01-01

    Commercially available bioethanol-fueled fireplaces have become increasingly popular additions for interior home decoration in Europe and more recently in the United States. These fireplaces are advertised as smokeless, ecologically friendly, and do not require professional installation, formal gas lines, or venting. Although manufacturers and businesses promote their safety, recent presentations of injuries have alerted the authors to the relevant danger bioethanol fireplaces can pose for the incautious user. Are bioethanol fireplaces going to become the future threat in domestic burn accidents beside common barbeque burns? A Medline literature search on barbeque and domestic fireplace accidents was performed to compare and stratify the injury patterns reported and to identify a risk profile for contemporary bioethanol-fueled fireplaces. To exemplify, two representative clinical cases of severe burn accidents caused by bioethanol-fueled fireplaces, both treated in the burn unit of the authors, are being presented. Design fireplaces are being recognized as an increasing source of fuel and fire-related danger in the home. This risk may be underestimated by the uninformed customer, resulting in severe burn injuries. Because bioethanol-fueled fireplaces have become more commonplace, they may overtake barbecue-related injury as the most common domestic burn injury.

  4. Skin tissue engineering advances in severe burns: review and therapeutic applications.

    PubMed

    Chua, Alvin Wen Choong; Khoo, Yik Cheong; Tan, Bien Keem; Tan, Kok Chai; Foo, Chee Liam; Chong, Si Jack

    2016-01-01

    Current advances in basic stem cell research and tissue engineering augur well for the development of improved cultured skin tissue substitutes: a class of products that is still fraught with limitations for clinical use. Although the ability to grow autologous keratinocytes in-vitro from a small skin biopsy into sheets of stratified epithelium (within 3 to 4 weeks) helped alleviate the problem of insufficient donor site for extensive burn, many burn units still have to grapple with insufficient skin allografts which are used as intermediate wound coverage after burn excision. Alternatives offered by tissue-engineered skin dermal replacements to meet emergency demand have been used fairly successfully. Despite the availability of these commercial products, they all suffer from the same problems of extremely high cost, sub-normal skin microstructure and inconsistent engraftment, especially in full thickness burns. Clinical practice for severe burn treatment has since evolved to incorporate these tissue-engineered skin substitutes, usually as an adjunct to speed up epithelization for wound closure and/or to improve quality of life by improving the functional and cosmetic results long-term. This review seeks to bring the reader through the beginnings of skin tissue engineering, the utilization of some of the key products developed for the treatment of severe burns and the hope of harnessing stem cells to improve on current practice. PMID:27574673

  5. Long-term effects of burn severity on non-native plant cover

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Effects of burn severity on non-native plant invasion post-fire is of great concern to managers and researchers, especially given predicted increases in large, high severity fires. However, little else is known about long-term (>10 year) vegetation recovery and non-native plant persistence. We anal...

  6. Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires

    NASA Astrophysics Data System (ADS)

    Davies, G. M.; Domènech, R.; Gray, A.; Johnson, P. C. D.

    2015-09-01

    Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the Composite Burn Index (pCBI) to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids) and ground (litter, moss, duff) fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a Generalised Linear Mixed Model (GLMM). Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System), and pre-fire fuel structure. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m-2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.

  7. Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires

    NASA Astrophysics Data System (ADS)

    Davies, G. M.; Domènech, R.; Gray, A.; Johnson, P. C. D.

    2016-01-01

    Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the composite burn index (pCBI) to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids) and ground (litter, moss, duff) fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a generalised linear mixed model (GLMM). Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System), and pre-fire vegetation type. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m-2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.

  8. Optimizing burn severity assessments in Alaskan tussock tundra from optical imagery

    NASA Astrophysics Data System (ADS)

    Loboda, T. V.; Jenkins, L. K.; French, N. H.; Bourgeau-Chavez, L. L.

    2013-12-01

    Over the past decade Alaskan tundra has experienced an increase in fire occurrence prompting rising concerns in the scientific community. Fire occurrence in tundra ecosystems has the potential to release a large amount of organic carbon stored in the deep organic layer, modify soil moisture and respiration, and make more organic matter available for decomposition and future burning through impacts on the active depth layer. Monitoring and characterization of fire occurrence and impacts in extensive, remote, and largely inaccessible tundra regions rely on satellite observations of land surface and require robust approaches to burn severity measurements. The relatively low fire activity in tundra regions between 1950 and 2000 has resulted in overall lack of understanding of fire impacts on tundra landscapes outside the Seward Peninsula where tundra fire record is better known. Thus satellite-based mapping of burn severity is limited by the lack of quantified knowledge of fire-induced physical changes on the landscape on the one hand and the capabilities of optical remote sensing systems to capture those characteristics on the other. Here we present an analysis of satellite mapping of burn severity using multi-date Landsat imagery and two field-based measurements of burn severity - the operationally applied Composite Burn Index (CBI) and the more simplistic Burn Severity Index (BSI), also known as the Burn Severity Code Matrix. The BSI used here is a four-point scale (unburned, low, moderate, severe) assessed for the surface substrate and vegetation layers. The BSI and CBI used to compare to the remote sensing data were determined from the field data by converting the qualitative fractional assessment of burn severity within 10 x 10 m plots to a single value. Since both indices represent mostly ocular assessment of the fire-impacted surface, they can relate well to Landsat's optical sensors measurements. The analysis shows that overall satellite indices have closer

  9. Thrombocytopenia induces multiple intracranial hemorrhages in patients with severe burns: A review of 16 cases

    PubMed Central

    ZHOU, JIANDA; LIU, JINYAN; LUO, CHENGQUN; HU, FENG; LIU, RUI; CHEN, ZIZI; CHEN, YAO; XIONG, WU; XIE, JIANFEI; HE, QUANYONG; YIN, CHAOQI; WANG, SHAOHUA; ZHANG, YANWEN; ZENG, SAINAN

    2013-01-01

    The aim of this study was to explore the etiology and diagnosis of multiple intracranial hemorrhages (ICHs) following severe burns, with a retrospective review of 16 cases of severe burns further complicated by multiple ICHs. Using cranial CT scans of the brains, we identified that all patients presented with low platelet counts and coagulation abnormalities prior to intracranial hemorrhaging. Following conventional treatment and various supporting treatments, five cases succumbed following a progressive reduction in blood platelet levels and the ICHs were cured in 11 cases following the restoration of normal platelet levels. We conclude that low platelet counts and coagulation abnormalities may cause multiple ICHs following severe burns and early diagnosis and treatment is the key to successful treatment. PMID:23935750

  10. Avifaunal responses to fire in southwestern montane forests along a burn severity gradient.

    PubMed

    Kotliar, Natasha B; Kennedy, Patricia L; Ferree, Kimberly

    2007-03-01

    The effects of burn severity on avian communities are poorly understood, yet this information is crucial to fire management programs. To quantify avian response patterns along a burn severity gradient, we sampled 49 random plots (2001-2002) at the 17351-ha Cerro Grande Fire (2000) in New Mexico, USA. Additionally, pre-fire avian surveys (1986-1988, 1990) created a unique opportunity to quantify avifaunal changes in 13 pre-fire transects (resampled in 2002) and to compare two designs for analyzing the effects of unplanned disturbances: after-only analysis and before-after comparisons. Distance analysis was used to calculate densities. We analyzed after-only densities for 21 species using gradient analysis, which detected a broad range of responses to increasing burn severity: (I) large significant declines, (II) weak, but significant declines, (III) no significant density changes, (IV) peak densities in low- or moderate-severity patches, (V) weak, but significant increases, and (VI) large significant increases. Overall, 71% of the species included in the after-only gradient analysis exhibited either positive or neutral density responses to fire effects across all or portions of the severity gradient (responses III-VI). We used pre/post pairs analysis to quantify density changes for 15 species using before-after comparisons; spatiotemporal variation in densities was large and confounded fire effects for most species. Only four species demonstrated significant effects of burn severity, and their densities were all higher in burned compared to unburned forests. Pre- and post-fire community similarity was high except in high-severity areas. Species richness was similar pre- and post-fire across all burn severities. Thus, ecosystem restoration programs based on the assumption that recent severe fires in Southwestern ponderosa pine forests have overriding negative ecological effects are not supported by our study of post-fire avian communities. This study illustrates the

  11. Avifaunal responses to fire in southwestern montane forests along a burn severity gradient

    USGS Publications Warehouse

    Kotliar, N.B.; Kennedy, P.L.; Ferree, K.

    2007-01-01

    The effects of burn severity on avian communities are poorly understood, yet this information is crucial to fire management programs. To quantify avian response patterns along a burn severity gradient, we sampled 49 random plots (2001-2002) at the 17 351-ha Cerro Grande Fire (2000) in New Mexico, USA. Additionally, pre-fire avian surveys (1986-1988, 1990) created a unique opportunity to quantify avifaunal changes in 13 pre-fire transects (resampled in 2002) and to compare two designs for analyzing the effects of unplanned disturbances: after-only analysis and before-after comparisons. Distance analysis was used to calculate densities. We analyzed after-only densities for 21 species using gradient analysis, which detected a broad range of responses to increasing burn severity: (I) large significant declines, (II) weak, but significant declines, (III) no significant density changes, (IV) peak densities in low- or moderate-severity patches, (V) weak, but significant increases, and (VI) large significant increases. Overall, 71% of the species included in the after-only gradient analysis exhibited either positive or neutral density responses to fire effects across all or portions of the severity gradient (responses III-VI). We used pre/post pairs analysis to quantify density changes for 15 species using before-after comparisons; spatiotemporal variation in densities was large and confounded fire effects for most species. Only four species demonstrated significant effects of burn severity, and their densities were all higher in burned compared to unburned forests. Pre- and post-fire community similarity was high except in high-severity areas. Species richness was similar pre- and post-fire across all burn severities. Thus, ecosystem restoration programs based on the assumption that recent severe fires in Southwestern ponderosa pine forests have overriding negative ecological effects are not supported by our study of post-fire avian communities. This study illustrates the

  12. Serum Levels of Neurofilament-H are Elevated in Patients Suffering From Severe Burns.

    PubMed

    Gatson, Joshua W; Liu, Ming-Mei; Rivera-Chavez, Fernando A; Minei, Joseph P; Wolf, Steven E

    2015-01-01

    In previous studies, after injury, burn patients experienced an increase in neuro-inflammation, edema, and neuronal cell death. As demonstrated in other brain injury models, fluid-based biomarkers such as phosphorylated neurofilament-H (pNFL-H) have been shown to correlate with injury severity. In this study the authors hypothesized that burn-injured patients have an increase in pNFL-H in the blood during the acute and chronic time-points after injury. In this prospective clinical study, blood (8 cc) was collected from burn patients (n = 36; TBSA 10-60%) at Parkland hospital, Dallas, Texas, on days 1, 7, and 14 after injury. The serum levels of pNFL-H were measured using the enzyme-linked immunoassay. Compared to noninjured controls, the burn patients exhibited a significant increase in the serum levels of pNFL-H on days 7 (P < .0001) and 14 (P < .0001) after burn injury. No significant increase was observed on day 1 (P < .07) after injury. A positive correlation between TBSA and pNFL-H levels was observed for day 14 (r = .55; P < .03). Additionally, using the receiver operating characteristic analysis, the authors determined the area under the curve was 98% for both day 7 and 14. In conclusion, this study describes the serum profile of pNFL-H in patients suffering from severe burns during the acute (day 1) and chronic (days 7 and 14) time-points. These results suggest that detection of pNFL-H may be useful in determining which individuals suffer from nerve cell degeneration after burn.

  13. Human Umbilical Cord Mesenchymal Stem Cells Transplantation Promotes Cutaneous Wound Healing of Severe Burned Rats

    PubMed Central

    Chai, Jiake; Duan, Hongjie; Chu, Wanli; Zhang, Haijun; Hu, Quan; Du, Jundong

    2014-01-01

    Background Severe burns are a common and highly lethal trauma. The key step for severe burn therapy is to promote the wound healing as early as possible, and reports indicate that mesenchymal stem cell (MSC) therapy contributes to facilitate wound healing. In this study, we investigated effect of human umbilical cord MSCs (hUC-MSCs) could on wound healing in a rat model of severe burn and its potential mechanism. Methods Adult male Wistar rats were randomly divided into sham, burn, and burn transplanted hUC-MSCs. GFP labeled hUC-MSCs or PBS was intravenous injected into respective groups. The rate of wound closure was evaluated by Image Pro Plus. GFP-labeled hUC-MSCs were tracked by in vivo bioluminescence imaging (BLI), and human-specific DNA expression in wounds was detected by PCR. Inflammatory cells, neutrophils, macrophages, capillaries and collagen types I/III in wounds were evaluated by histochemical staining. Wound blood flow was evaluated by laser Doppler blood flow meter. The levels of proinflammatory and anti-inflammatory factors, VEGF, collagen types I/III in wounds were analyzed using an ELISA. Results We found that wound healing was significantly accelerated in the hUC-MSC therapy group. The hUC-MSCs migrated into wound and remarkably decreased the quantity of infiltrated inflammatory cells and levels of IL-1, IL-6, TNF-α and increased levels of IL-10 and TSG-6 in wounds. Additionally, the neovascularization and levels of VEGF in wounds in the hUC-MSC therapy group were markedly higher than those in other control groups. The ratio of collagen types I and III in the hUC-MSC therapy group were markedly higher than that in the burn group at indicated time after transplantation. Conclusion The study suggests that hUC-MSCs transplantation can effectively improve wound healing in severe burned rat model. Moreover, these data might provide the theoretical foundation for the further clinical application of hUC-MSC in burn areas. PMID:24586314

  14. Association between PAI-1 polymorphisms and plasma PAI-1 level with sepsis in severely burned patients.

    PubMed

    Chi, Y F; Chai, J K; Yu, Y M; Luo, H M; Zhang, Q X; Feng, R

    2015-01-01

    We investigated the association between plasminogen activator inhibitor-1 (PAI-1) polymorphisms and plasma PAI-1 level with sepsis in severely burned patients. A total of 182 patients with burn areas lager than 30% of the body surface area were enrolled in this study. Peripheral blood samples were obtained from 103 patients with sepsis (sepsis group) and 79 patients without sepsis (control group). An allele-specific polymerase chain reaction assay was used to determine PAI-1 polymorphism 4G/5G distribution. Plasma PAI-1 levels were detected using an enzyme-linked immunosorbent assay. The frequency of the 4G/4G genotype and the 4G allele frequency in the sepsis group were 42.7 and 62.1% respectively, which were significantly higher than those in the control group (P < 0.05). Sepsis patients had a significantly higher plasma PAI-1 level than the control group (P < 0.05). Compared with the 5G/5G genotype, PAI-1 concentrations were significantly higher in the 4G/4G genotype (P < 0.05). The study indicates that the 4G/5G promoter polymorphism of PAI-1 gene may be related to the susceptibility to burn sepsis and that the 4G/4G genotype may be an important genetic risk factor of burn sepsis. Additionally, PAI-1 concentrations in the serum are increased in patients with burn sepsis.

  15. The management of pain associated with wound care in severe burn patients in Spain

    PubMed Central

    Mendoza, Antonio; Santoyo, Fernando L; Agulló, Alberto; Fenández-Cañamaque, José L; Vivó, Carmen

    2016-01-01

    Objective: To describe the management of pain prevention associated with burn care. Methods: Multi-centre, observational, cross-sectional, descriptive study performed in 4 burn units in Spain. Results: A total of 55 patients undergoing 64 procedures were analysed. Burns were classified as severe (90.4%), third-degree (78.2%) and caused by thermal agents (81.8%). Background analgesia consisted of non-opioid drugs (87.5%) and opioids (54.7%) [morphine (20.3%), morphine and fentanyl (14.1%) or fentanyl monotherapy (15.6%)]. Burn care was performed by experienced nurses (96.9%); 36.5% followed guidelines. The mean duration of procedures was 44 minutes (Statistical Deviation, SD: 20.2) and the mean duration of pain was 27 minutes (SD: 44.6). Procedural pain was primarily managed with opioid analgesics: fentanyl monotherapy and in combination (84%) and fentanyl monotherapy (48%) administered sublingually (89.1%). Patients described pain as different to usual baseline pain (97%), with a mean maximum intensity score of 4.2 points (SD: 3.3) on the VAS scale and a 34% increase in the intensity of pain. The mean patient and healthcare professional satisfaction score per procedure was 6/10 (SD: 1.9) and 5.5/10 (SD: 1.7), respectively. Conclusion: The results of the study describe the management of pain associated with burn care in clinical practice, helping optimise pain control. PMID:27069760

  16. Plasma and skeletal muscle amino acids following severe burn injury in patients and experimental animals.

    PubMed Central

    Stinnett, J D; Alexander, J W; Watanabe, C; MacMillan, B G; Fischer, J E; Morris, M J; Trocki, O; Miskell, P; Edwards, L; James, H

    1982-01-01

    This study describes and analyzes sequential changes in plasma and skeletal muscle free amino acids following severe burn injury. Plasma free amino acids were determined in children (n = 9) with burns averaging 60% total body surface area and were compared with laboratory beagles (n = 44) which received a flame burn totaling 30% of their body surface area. In addition, needle biopsy specimens were obtained from the semitendonosus muscle in the animals to determine free intracellular amino acids. In both patients and animals the amount of total free amino acids in plasma fell following burn, suggesting relative protein deficiency. This drop was primarily due to a 47% drop in nonessential amino acids. However, plasma phenylalanine was consistently higher than normal following burn, and was strongly associated with death and weight loss in both animals and patients, especially when analyzed as a ratio with tyrosine. This finding suggested excessive catabolism, hepatic dysfunction, or both. Plasma levels of several amino acids correlated significantly with weight loss. Alterations in muscle free amino acids generally were similar to plasma amino acids. Exceptions were muscle alanine and glycine which strongly correlated with weight loss. However, the determination of muscle free amino acid profiles did not yield clinically useful information not available from plasma profiles. Plasma levels of liver enzymes suggested progressive hepatic dysfunction. These studies show that the laboratory beagle is a good model for studying the metabolic alterations of amino acids that accompany burn injury, since they mimic humans in many parameters which appear to be most useful with respect to clinical evaluation. PMID:7055386

  17. Mapping wildfire burn severity in the Arctic Tundra from downsampled MODIS data

    USGS Publications Warehouse

    Kolden, Crystal A.; Rogan, John

    2013-01-01

    Wildfires are historically infrequent in the arctic tundra, but are projected to increase with climate warming. Fire effects on tundra ecosystems are poorly understood and difficult to quantify in a remote region where a short growing season severely limits ground data collection. Remote sensing has been widely utilized to characterize wildfire regimes, but primarily from the Landsat sensor, which has limited data acquisition in the Arctic. Here, coarse-resolution remotely sensed data are assessed as a means to quantify wildfire burn severity of the 2007 Anaktuvuk River Fire in Alaska, the largest tundra wildfire ever recorded on Alaska's North Slope. Data from Landsat Thematic Mapper (TM) and downsampled Moderate-resolution Imaging Spectroradiometer (MODIS) were processed to spectral indices and correlated to observed metrics of surface, subsurface, and comprehensive burn severity. Spectral indices were strongly correlated to surface severity (maximum R2 = 0.88) and slightly less strongly correlated to substrate severity. Downsampled MODIS data showed a decrease in severity one year post-fire, corroborating rapid vegetation regeneration observed on the burned site. These results indicate that widely-used spectral indices and downsampled coarse-resolution data provide a reasonable supplement to often-limited ground data collection for analysis and long-term monitoring of wildfire effects in arctic ecosystems.

  18. A time-integrated MODIS burn severity assessment using the multi-temporal differenced normalized burn ratio (dNBR MT)

    NASA Astrophysics Data System (ADS)

    Veraverbeke, S.; Lhermitte, S.; Verstraeten, W. W.; Goossens, R.

    2011-02-01

    Burn severity is an important parameter in post-fire management. It incorporates both the direct fire impact (vegetation depletion) and ecosystem responses (vegetation regeneration). From a remote sensing perspective, burn severity is traditionally estimated using Landsat's differenced normalized burn ratio (dNBR). In this case study of the large 2007 Peloponnese (Greece) wildfires, Landsat dNBR estimates correlated reasonably well with Geo composite burn index (GeoCBI) field data of severity ( R2 = 0.56). The usage of Landsat imagery is, however, restricted by cloud cover and image-to-image normalization constraints. Therefore a multi-temporal burn severity approach based on coarse spatial, high temporal resolution moderate resolution imaging spectroradiometer (MODIS) imagery is presented in this study. The multi-temporal dNBR (dNBR MT) is defined as the 1-year integrated difference between burned pixels and their unique control pixels. These control pixels were selected based on time series similarity and spatial context and reflect how burned pixels would have behaved in the case no fire had occurred. Linear regression between downsampled Landsat dNBR and dNBR MT estimates resulted in a moderate-high coefficient of determination R2 = 0.54. dNBR MT estimates are indicative for the change in vegetation productivity due to the fire. This change is considerably higher for forests than for more sparsely vegetated areas like shrub lands. Although Landsat dNBR is superior for spatial detail, MODIS-derived dNBR MT estimates present a valuable alternative for burn severity mapping at continental to global scale without image availability constraints. This is beneficial to compare trends in burn severity across regions and time. Moreover, thanks to MODIS's repeated temporal sampling, the dNBR MT accounts for both first- and second-order fire effects.

  19. Detecting post-fire burn severity and vegetation recovery using multitemporal remote sensing spectral indices and field-collected composite burn index data in a ponderosa pine forest

    USGS Publications Warehouse

    Chen, X.; Vogelmann, J.E.; Rollins, M.; Ohlen, D.; Key, C.H.; Yang, L.; Huang, C.; Shi, H.

    2011-01-01

    It is challenging to detect burn severity and vegetation recovery because of the relatively long time period required to capture the ecosystem characteristics. Multitemporal remote sensing data can providemultitemporal observations before, during and after a wildfire, and can improve the change detection accuracy. The goal of this study is to examine the correlations between multitemporal spectral indices and field-observed burn severity, and to provide a practical method to estimate burn severity and vegetation recovery. The study site is the Jasper Fire area in the Black Hills National Forest, South Dakota, that burned during August and September 2000. Six multitemporal Landsat images acquired from 2000 (pre-fire), 2001 (post-fire), 2002, 2003, 2005 and 2007 were used to assess burn severity. The normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), normalized burn ratio (NBR), integrated forest index (IFI) and the differences of these indices between the pre-fire and post-fire years were computed and analysed with 66 field-based composite burn index (CBI) plots collected in 2002. Results showed that differences of NDVI and differences of EVI between the pre-fire year and the first two years post-fire were highly correlated with the CBI scores. The correlations were low beyond the second year post-fire. Differences of NBR had good correlation with CBI scores in all study years. Differences of IFI had low correlation with CBI in the first year post-fire and had good correlation in later years. A CBI map of the burnt area was produced using regression tree models and the multitemporal images. The dynamics of four spectral indices from 2000 to 2007 indicated that both NBR and IFI are valuable for monitoring long-term vegetation recovery. The high burn severity areas had a much slower recovery than the moderate and low burn areas. ?? 2011 Taylor & Francis.

  20. The influence of burn severity on postfire vegetation recovery and albedo change during early succession in North American boreal forests

    NASA Astrophysics Data System (ADS)

    Jin, Yufang; Randerson, James T.; Goetz, Scott J.; Beck, Pieter S. A.; Loranty, Michael M.; Goulden, Michael L.

    2012-03-01

    Severity of burning can influence multiple aspects of forest composition, carbon cycling, and climate forcing. We quantified how burn severity affected vegetation recovery and albedo change during early succession in Canadian boreal regions by combining satellite observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Canadian Large Fire Database. We used the MODIS-derived difference Normalized Burn Ratio (dNBR) and initial changes in spring albedo as measures of burn severity. We found that the most severe burns had the greatest reduction in summer MODIS Enhanced Vegetation Index (EVI) in the first year after fire, indicating greater loss of vegetation cover. By 5-8 years after fire, summer EVI for all severity classes had recovered to within 90%-108% of prefire levels. Spring and summer albedo progressively increased during the first 7 years after fire, with more severely burned areas showing considerably larger postfire albedo increases during spring and more rapid increases during summer as compared with moderate- and low-severity burns. After 5-7 years, increases in spring albedo above prefire levels were considerably larger in high-severity burns (0.20 ± 0.06; defined by dNBR percentiles greater than 75%) as compared to changes observed in moderate- (0.16 ± 0.06; for dNBR percentiles between 45% and 75%) or low-severity burns (0.13 ± 0.06; for dNBR percentiles between 20% and 45%). The sensitivity of spring albedo to dNBR was similar in all ecozones and for all vegetation types along gradients of burn severity. These results suggest carbon losses associated with increases in burn severity observed in some areas of boreal forests may be at least partly offset, in terms of climate impacts, by increases in negative forcing associated with changes in surface albedo.

  1. Effects of Exercise on Soleus in Severe Burn and Muscle Disuse Atrophy

    PubMed Central

    Saeman, Melody R.; DeSpain, Kevin; Liu, Ming-Mei; Carlson, Brett A.; Song, Juquan; Baer, Lisa A.; Wade, Charles E.; Wolf, Steven E.

    2015-01-01

    Background Muscle loss is a sequela of severe burn and critical illness with bed rest contributing significantly to atrophy. We hypothesize that exercise will mitigate muscle loss after burn with bed rest. Materials and Methods Male rats were assigned to sham ambulatory (S/A), burn ambulatory (B/A), sham hindlimb unloading (S/H), or burn hindlimb unloading (B/H). Rats received a 40% scald burn or sham and were ambulatory or placed in hindlimb unloading, a model of bed rest. Half performed twice-daily resistance climbing. Hindlimb isometric forces were measured on day 14. Results Soleus mass and muscle function were not affected by burn alone. Mass was significantly lower in hindlimb unloading (79 vs.139 mg, p<0.001) and no exercise (103 vs.115 mg, p<0.01). Exercise significantly increased soleus mass in B/H (86 vs. 77mg, p<0.01). Hindlimb unloading significantly decreased muscle force in the twitch (31 vs. 12g, p<0.001), tetanic (55 vs. 148 g, p<0.001), and specific tetanic measurements (12 vs. 22 N/cm2, p<0.001). Effects of exercise on force depended on other factors. In B/H, exercise significantly increased twitch (14 vs. 8 g, p<0.05) and specific tetanic force (14 vs. 7 N/cm2, p<0.01). Fatigue index was lower in ambulatory (55%) and exercise (52%) versus hindlimb (69%, p=0.03) and no exercise (73%, p=0.002). Conclusions Hindlimb unloading is a significant factor in muscle atrophy. Exercise increased the soleus muscle mass, twitch, and specific force in this model. However, the fatigue index decreased with exercise in all groups. This suggests exercise contributes to functional muscle change in this model of disuse and critical illness. PMID:26104324

  2. Impact of Stress-Induced Diabetes on Outcomes in Severely Burned Children

    PubMed Central

    Finnerty, Celeste C.; Ali, Arham; McClean, Josef; Benjamin, Nicole; Clayton, Robert P.; Andersen, Clark R.; Mlcak, Ronald P.; Suman, Oscar E.; Meyer, Walter; Herndon, David N.

    2014-01-01

    Background Post-burn hyperglycemia leads to graft failure, multiple organ failure, and death. A hyperinsulinemic-euglycemic clamp is used to keep serum glucose between 60-110mg/dL. Because of frequent hypoglycemic episodes, a less stringent sliding scale insulin protocol is used to maintain serum glucose levels between 80-160mg/dL following elevations above 180mg/dL. Study Design We randomized pediatric patients with massive burns into two groups – patients receiving sliding scale insulin to lower blood glucose levels (n=145) and those receiving no insulin (n = 98) to determine the differences in morbidity and mortality. Patients 0-18 years old with burns covering ≥30% of the total body surface area and not randomized to receive anabolic agents were included in this study. Endpoints included glucose levels, infections, resting energy expenditure (REE), lean body mass, bone mineral content (BMC), fat mass, muscle strength, and serum inflammatory cytokines, hormones, and liver enzymes. Results Maximal glucose levels occurred within 6 days of burn injury. Blood glucose levels were age dependent with older children requiring more insulin, p<0.05. Daily maximum and daily minimum, but not 6am,glucose levels were significantly different based on treatment group, p<0.05. Insulin significantly increased REE and improved BMC, p<0.05. Each additional wound infection increased incidence of hyperglycemia, p=0.004. There was no mortality in patients not receiving insulin, only in patients who received insulin (p<0.004). Muscle strength was increased in patients receiving insulin (p<0.05). Conclusions A subset of severely burned children develops burn-induced hyperglycemia. Length of stay was reduced in the no insulin group, and there were no deaths in this group. Administration of insulin positively impacted BMC and muscle strength, but increased REE, hypoglycemic episodes, and mortality. New glucose-lowering strategies may be needed. PMID:24655871

  3. 77 FR 70389 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    .... SUMMARY: In a document published in the Federal Register on November 5, 2012 (77 FR 66419), the Department... Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile or Other Conveyance and... adding ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as...

  4. Severe burns as a consequence of seizures in patients with epilepsy.

    PubMed

    Spitz, M C

    1992-01-01

    We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of striving for optimal seizure control. Two burns each occurred from an electric iron, a hand-held hair dryer, and stove-top cooking. Minimizing these activities, especially in patients with frequent consciousness-altering seizures, may be useful. Three burns occurred while showering; these resulted in the most severe injuries, with hospital stays of 29, 30, and 41 days. Simple plumbing devices may have prevented these injuries.

  5. A soil burn severity index for understanding soil-fire relations in tropical forests

    USGS Publications Warehouse

    Jain, T.B.; Gould, W.A.; Graham, R.T.; Pilliod, D.S.; Lentile, L.B.; Gonzalez, G.

    2008-01-01

    Methods for evaluating the impact of fires within tropical forests are needed as fires become more frequent and human populations and demands on forests increase. Short- and long-term fire effects on soils are determined by the prefire, fire, and postfire environments. We placed these components within a fire-disturbance continuum to guide our literature synthesis and develop an integrated soil burn severity index. The soil burn severity index provides a set of indicators that reflect the range of conditions present after a fire. The index consists of seven levels, an unburned level and six other levels that describe a range of postfire soil conditions. We view this index as a tool for understanding the effects of fires on the forest floor, with the realization that as new information is gained, the index may be modified as warranted. ?? Royal Swedish Academy of Sciences 2008.

  6. Alterations of acute phase reaction and cytokine production in patients following severe burn injury.

    PubMed

    Dehne, Marius G; Sablotzki, Armin; Hoffmann, Andreas; Mühling, Jörg; Dietrich, Friedrich E; Hempelmann, Gunter

    2002-09-01

    To determine the acute immunologic reaction, mediated by cytokines, interleukines (ILs) and growth factors and the susceptibility to infections and sepsis after severe burn injury a prospective, single unit, longitudinal study of acute phase reactants and mediators who performed. After approval by the ethics committee of our hospital, we investigated the plasma concentrations of IL-2, -6, -8, -10, and -13, the soluble IL-2 receptor (sIL-2R), and the acute phase proteins procalcitonin (PCT) and C-reactive protein (CRP) at admission and every 3 days in 24 patients over a time course of 28 days after thermal injury and categorized by percent burn: < or =30% (group 1; n=12) and >30% (group 2; n=12). Shortly after burn injury we found higher concentrations of IL-2, -6, -10 and PCT in those patients >30% TBSA. During the study period, we found significant higher levels of acute phase proteins, IL-6 and -8 in patients >30% TBSA. The incidence of SIRS and MODS was three times increased in patients >30% TBSA. Our results show different patterns of cytokines and acute phase proteins in patients with different burned surface areas over a long time and continuous monitoring of a more distinct inflammatory response in these patients.

  7. Non-severe burn injury leads to depletion of bone volume that can be ameliorated by inhibiting TNF-α.

    PubMed

    O'Halloran, Emily; Kular, Jasreen; Xu, Jiake; Wood, Fiona; Fear, Mark

    2015-05-01

    Bone loss after severe burn injury is well established, and is thought to be a consequence of the severe hyper-metabolic response as well as changes in cytokine and glucocorticoid levels that decrease bone synthesis and increase rate of loss. However, 90% of presentations are for non-severe burns which do not elicit this response. Little is known about whether these non-severe injuries may also affect bone tissue, and whether other mechanisms may be involved. To investigate whether bone loss occurs after a non-severe burn injury we used a mouse model of an approximately 8% total body surface area (TBSA) full-thickness burn and micro-CT. We also assessed whether blocking TNF-α after a burn injury by administration of an antibody could modulate the impacts of the burn on bone tissue. There was a significant loss of trabecular bone volume of (3.27% compared to 5.27%, p=0.0051) after non-severe burn injury. Trabecular number was significantly decreased (0.57/mm after injury compared to 1.02/mm controls, p=0.0051) and spacing increased after burn injury (0.40 compared to 0.28, p=0.0083). Anti-TNF-α antibodies significantly improved trabecular bone volume (8.53%, p=0.0034) and number after burn injury (1.28/mm, p=0.0034). There was no significant change observed in cortical bone after burn injury or administration of anti-TNF-α antibodies. These findings show that non-severe burn injury can lead to changes in bone metabolism. Monitoring bone density in patients with non-severe injuries and interventions to limit the impacts of the inflammatory storm may benefit patient recovery and outcomes.

  8. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

    PubMed Central

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  9. Application of a Four-dimensional Mathematical Model in the Establishment of an Early Post-burn Cerebral Oedema Model in Severely Burned Dogs.

    PubMed

    Haitao, L; Dajun, Y; Kaifa, W; Xiuwu, B; Jiansen, S; Zongchen, Y

    2005-06-30

    The aim of this study was to explore the spatiotemporal development of cerebral oedema in the early stage of severe burn (50% TBSA, third degree), using a four-dimensional (4D) mathematical model. Twenty-six male mongrel dogs were randomly divided into control and 6, 12, 18, and 24 post-burn hour (PBH) groups. The manifestation of magnetic resonance imaging (MRI) and histopathology, changes of brain water content, and intracranial pressure were observed in each group respectively. A 4D mathematical model was established on the basis of the results of MRI scanning. Two turning points (6 and 18 PBH) and three phases of pathological change were displayed by the 4D mathematical model of cerebral oedema in the early stage of severe burn. The first phase was in the subclinical period, and effective treatment should therefore be performed as quickly as possible in order to prevent deterioration of post-burn cerebral oedema. The second phase (6-18 PBH), with pathological characteristics of cytotoxic cerebral oedema, was in the apoptosis period. The third stage (18-24 PBH) was the danger period of cerebral oedema. Intracranial pressure increased rapidly owing to the limitation of the cranial cavity. As a result, cerebral hernia could easily occur. An S-shape curve in the pathological process of cerebral oedema occurred in the early post-burn stage following severe burn. PMID:21990986

  10. Macrophage migration inhibitory factor-A potential diagnostic tool in severe burn injuries?

    PubMed

    Grieb, Gerrit; Simons, David; Piatkowski, Andrzej; Bernhagen, Jürgen; Steffens, Guy; Pallua, Norbert

    2010-05-01

    Serum macrophage migration inhibitory factor (MIF) and procalcitonin (PCT) concentrations as well as leucocyte numbers were evaluated in a retrospective study with 23 patients with severe burn injuries. The MIF and PCT concentrations as well as the number of leucocytes (LEU) were monitored over a period of 5 days. The total body surface area (TBSA) and sepsis-related organ failure assessment (SOFA) scores were also evaluated. The MIF, PCT concentrations and leucocyte counts were profoundly increased in all patients with severe burn wounds. At the time of admission into the intensive care unit, no significant differences were observed for the MIF and PCT levels between patients with a TBSA<60% (Group 1) and patients with a TBSA>60% (Group 2). After 48 h, however, the MIF and PCT levels reached very high levels in a subgroup of the patients, whereas these levels became normal again in other subgroups. The group of patients with a TBSA>60% was, therefore, subdivided in three groups (subgroups 2a-c). The MIF and PCT data pairs in these subgroups appeared to correlate in an inhomogeneous manner. These levels in the subgroup 2a (i.e., lethal within 5 days) were strongly elevated over those observed in Group 1 (TBSA<60%) and highly increased concentrations of both MIF and PCT correlated with lethal outcome. The combined determination of MIF and PCT might, therefore, be useful to discriminate between post-burn inflammation and systemic inflammatory response syndrome (SIRS) or sepsis with lethal outcome.

  11. The impact of non-severe burn injury on cardiac function and long-term cardiovascular pathology

    PubMed Central

    O’Halloran, Emily; Shah, Amit; Dembo, Lawrence; Hool, Livia; Viola, Helena; Grey, Christine; Boyd, James; O’Neill, Tomas; Wood, Fiona; Duke, Janine; Fear, Mark

    2016-01-01

    Severe burn injury significantly affects cardiovascular function for up to 3 years. However, whether this leads to long-term pathology is unknown. The impact of non-severe burn injury, which accounts for over 80% of admissions in developed countries, has not been investigated. Using a rodent model of non-severe burn injury with subsequent echocardiography we showed significantly increased left ventricular end systolic diameter (LVESD) and ventricular wall thickness at up to 3 months post-injury. Use of propranolol abrogated the changes in cardiac measures observed. Subsequently we investigated changes in a patient cohort with non-severe injury. Echocardiography measured at baseline and at 3 months post-injury showed increased LVESD at 3 months and significantly decreased posterior wall diameter. Finally, 32 years of Western Australian hospital records were used to investigate the incidence of cardiovascular disease admissions after burn injury. People who had experienced a burn had increased hospital admissions and length of stay for cardiovascular diseases when compared to a matched uninjured cohort. This study presents animal, patient and population data that strongly suggest non-severe burn injury has significant effects on cardiovascular function and long-term morbidity in some burn patients. Identification of patients at risk will promote better intervention and outcomes for burn patients. PMID:27694999

  12. Mapping burn severity, pine beetle infestation, and their interaction at the High Park Fire

    NASA Astrophysics Data System (ADS)

    Stone, Brandon

    North America's western forests are experiencing wildfire and mountain pine beetle (MPB) disturbances that are unprecedented in the historic record, but it remains unclear whether and how MPB infestation influences post-infestation fire behavior. The 2012 High Park Fire burned in an area that's estimated to have begun a MPB outbreak cycle within five years before the wildfire, resulting in a landscape in which disturbance interactions can be studied. A first step in studying these interactions is mapping regions of beetle infestation and post-fire disturbance. We implemented an approach for mapping beetle infestation and burn severity using as source data three 5 m resolution RapidEye satellite images (two pre-fire, one post-fire). A two-tiered methodology was developed to overcome the spatial limitations of many classification approaches through explicit analyses at both pixel and plot level. Major land cover classes were photo-interpreted at the plot-level and their spectral signature used to classify 5 m images. A new image was generated at 25 m resolution by tabulating the fraction of coincident 5 m pixels in each cover class. The original photo interpretation was then used to train a second classification using as its source image the new 25 m image. Maps were validated using k-fold analysis of the original photo interpretation, field data collected immediately post-fire, and publicly available classifications. To investigate the influence of pre-fire beetle infestation on burn severity within the High Park Fire, we fit a log-linear model of conditional independence to our thematic maps after controlling for forest cover class and slope aspect. Our analysis revealed a high co-occurrence of severe burning and beetle infestation within high elevation lodgepole pine stands, but did not find statistically significant evidence that infected stands were more likely to burn severely than similar uninfected stands. Through an inspection of the year-to-year changes in

  13. Normalized burn ratios link fire severity with patterns of avian occurrence

    USGS Publications Warehouse

    Rose, Eli T.; Simons, Theodore R.; Klein, Rob; McKerrow, Alexa

    2016-01-01

    ContextRemotely sensed differenced normalized burn ratios (DNBR) provide an index of fire severity across the footprint of a fire. We asked whether this index was useful for explaining patterns of bird occurrence within fire adapted xeric pine-oak forests of the southern Appalachian Mountains.ObjectivesWe evaluated the use of DNBR indices for linking ecosystem process with patterns of bird occurrence. We compared field-based and remotely sensed fire severity indices and used each to develop occupancy models for six bird species to identify patterns of bird occurrence following fire.MethodsWe identified and sampled 228 points within fires that recently burned within Great Smoky Mountains National Park. We performed avian point counts and field-assessed fire severity at each bird census point. We also used Landsat™ imagery acquired before and after each fire to quantify fire severity using DNBR. We used non-parametric methods to quantify agreement between fire severity indices, and evaluated single season occupancy models incorporating fire severity summarized at different spatial scales.ResultsAgreement between field-derived and remotely sensed measures of fire severity was influenced by vegetation type. Although occurrence models using field-derived indices of fire severity outperformed those using DNBR, summarizing DNBR at multiple spatial scales provided additional insights into patterns of occurrence associated with different sized patches of high severity fire.ConclusionsDNBR is useful for linking the effects of fire severity to patterns of bird occurrence, and informing how high severity fire shapes patterns of bird species occurrence on the landscape.

  14. Modeling Fluid Resuscitation by Formulating Infusion Rate and Urine Output in Severe Thermal Burn Adult Patients: A Retrospective Cohort Study

    PubMed Central

    Luo, Qizhi; Li, Wei; Zou, Xin; Dang, Yongming; Wu, Jun

    2015-01-01

    Acute burn injuries are among the most devastating forms of trauma and lead to significant morbidity and mortality. Appropriate fluid resuscitation after severe burn, specifically during the first 48 hours following injury, is considered as the single most important therapeutic intervention in burn treatment. Although many formulas have been developed to estimate the required fluid amount in severe burn patients, many lines of evidence showed that patients still receive far more fluid than formulas recommend. Overresuscitation, which is known as “fluid creep,” has emerged as one of the most important problems during the initial period of burn care. If fluid titration can be personalized and automated during the resuscitation phase, more efficient burn care and outcome will be anticipated. In the present study, a dynamic urine output based infusion rate prediction model was developed and validated during the initial 48 hours in severe thermal burn adult patients. The experimental results demonstrated that the developed dynamic fluid resuscitation model might significantly reduce the total fluid volume by accurately predicting hourly urine output and has the potential to aid fluid administration in severe burn patients. PMID:26090415

  15. Development of Metabolic Indicators of Burn Injury: Very Low Density Lipoprotein (VLDL) and Acetoacetate Are Highly Correlated to Severity of Burn Injury in Rats

    PubMed Central

    Izamis, Maria-Louisa; Uygun, Korkut; Sharma, Nripen S.; Uygun, Basak; Yarmush, Martin L.; Berthiaume, Francois

    2012-01-01

    Hypermetabolism is a significant sequela to severe trauma such as burns, as well as critical illnesses such as cancer. It persists in parallel to, or beyond, the original pathology for many months as an often-fatal comorbidity. Currently, diagnosis is based solely on clinical observations of increased energy expenditure, severe muscle wasting and progressive organ dysfunction. In order to identify the minimum number of necessary variables, and to develop a rat model of burn injury-induced hypermetabolism, we utilized data mining approaches to identify the metabolic variables that strongly correlate to the severity of injury. A clustering-based algorithm was introduced into a regression model of the extent of burn injury. As a result, a neural network model which employs VLDL and acetoacetate levels was demonstrated to predict the extent of burn injury with 88% accuracy in the rat model. The physiological importance of the identified variables in the context of hypermetabolism, and necessary steps in extension of this preliminary model to a clinically utilizable index of severity of burn injury are outlined. PMID:24957642

  16. Maggot therapy for repairing serious infective wound in a severely burned patient.

    PubMed

    Wu, Jun-Cheng; Lu, Ren-Rong; Huo, Ran; Fu, Hong-Bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

  17. Epidemiology and outcome analysis of severe extensive burns: a 12-year summary of 103 cases in a burn center in China.

    PubMed

    Xie, Bing; Xiao, Shi-Chu; Peng, Xu-Dong; Zhu, Shi-Hui; Lv, Kai-Yang; Li, Heng-Yu; Xia, Zhao-Fan

    2012-01-01

    The purpose of this article is to improve the treatment of severe extensive burns (SEB) patients by summarizing treatment experience in recent 12 years in China and analyzing the follow-up quality of life (QOL) in these patients. Clinical data and rescue measures of 103 SEB patients (≥70% TBSA) admitted in a burn center in Shanghai between 1997 and 2009 were reviewed, and QOL and hand function of those who survived more than 2 years were assessed by Brief Version of Burn Specific Health scale-B and Michigan Hand Outcome Questionnaire. Of these, 76.7% were caused by flames and 15.5% caused by scald. The median burn area was 87.5% (interquartile range, 77.0-95.0%) TBSA, of which third-degree burns accounted for 56.5% (interquartile range, 25.8-80.0%) TBSA; 71.8% were complicated by inhalation injury. The occurrence of in-hospital complications was 75.7%, with the respiratory system complications predominating (49.5%). The fatality rate was 28.2%, mainly due to sepsis and multiple organ dysfunction syndrome. Work, body image, and heat sensitivity got the lowest Brief Version of Burn Specific Health scale-B scores in all nine domains, and Michigan Hand Outcome Questionnaire scores were also relatively poor. Flame burns remain to be the main cause of SEB in China in recent 12 years. Treatment is still challenged because of the depth and extensive burn area and high occurrence of multiple system complications. How to ameliorate QOL of SEB patients, intensify the functional rehabilitation, and improve their physical appearance in particular remain to be a crux.

  18. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    PubMed Central

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  19. Rates of post-fire vegetation recovery and fuel accumulation as a function of burn severity and time-since-burn in four western U.S. ecosystems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vegetation recovery and fuel accumulation rates following wildfire are useful measures of ecosystem resilience, yet few studies have quantified these variables over 10 years post-fire. Conventional wisdom is that recovery time to pre-fire condition will be slower as a function of burn severity, as i...

  20. Assessing the temporal sensitivity of the differenced Normalized Burn Ratio (dNBR) to estimate burn severity using MODIS time series

    NASA Astrophysics Data System (ADS)

    Veraverbeke, Sander; Lhermitte, Stefaan; Verstraeten, Willem; Goossens, Rudi

    2010-05-01

    The temporal sensitivity of the differenced Normalized Burn Ratio (dNBR) to assess burn severity was evaluated for the case of the 2007 Peloponnese (Greece) wildfires. Prior to the analysis, a pixel-based control plot selection procedure was initiated for each burned pixel based on time series similarity of the pre-fire year 2006. Post-fire near infrared (NIR) dramatically dropped immediately post-fire, while the highest MIR reflectance values were reached three weeks after the fire. Both NIR and MIR reflectance showed an increased variability during the wet Mediterranean winter. Due to the process of early vegetation recovery, the burned pixels' NIR reflectance approached the control pixels' values during the productive spring-time. Because of the three weeks post-fire delay in MIR reflectance increase, the NBR drop and dNBR peak were obtained synchronously. Both the standard deviation of the NBR and dNBR were high during winter, as a consequence of the simultaneous increase in NIR and MIR reflectance variability. In spite of the high variation in dNBR during winter, this moment is suboptimal to estimate burn severity due to low rates of image availability and low optimality values. Index performance was clearly lower during winter and spring because vegetation regeneration clearly diminishes the distance in the bi-spectral feature space to which the dNBR is sensitive at the favor of displacements to which the index is insensitive. In contrast, NIR reflectance, MIR reflectance, NBR, dNBR and dNBR optimality changes achieved a maximum three weeks post. Consequently this was the optimal time to estimate burn severity in our case study retaining a maximal degree of information with a high reliability. Conclusions should be verified for other fires and in other ecoregions.

  1. PROPRANOLOL DECREASES CARDIAC WORK IN A DOSE-DEPENDENT MANNER IN SEVERELY BURNED CHILDREN

    PubMed Central

    Williams, Felicia N; Herndon, David N; Kulp, Gabriela A; Jeschke, Marc G

    2010-01-01

    Background Severe burn is followed by profound cardiac stress. Propranolol, a non selective β1, β2-receptor antagonist, decreases cardiac stress, but little is known about the dose necessary to cause optimal effect. Thus, the aim of this study was to determine in a large prospective randomized controlled trial the dose of propranolol that would decrease heart rate at least 15% of admission heart rate and improve cardiac function. Four-hundred six patients with burns >30% total body surface area (TBSA) were enrolled and randomized to receive standard care (controls, n=235) or standard care plus propranolol (n=171). Methods Dose-response and drug kinetics of propranolol were performed. Heart rate and mean arterial pressure were measured continuously. Cardiac output (CO), cardiac index (CI), stroke volume (SV), rate pressure product, and cardiac work (CW) were determined at regular intervals. Statistical analysis was performed using ANOVA with Tukey and Bonferroni corrections and Student’s t-test when applicable. Significance was accepted at p<0.05. Results Propranolol given initially at 1 mg/kg/day decreased heart rate by 15% compared to control patients but was increased to 4 mg/kg/day within the first 10 days to sustain treatment benefits (p<0.05). Propranolol decreased CO, rate pressure product, and CW without deleterious effects on mean arterial pressure. The effective plasma drug concentrations were achieved in 30 minutes, and the half-life was 4 hours. Conclusions The data suggest that propranolol is an efficacious modulator of the post-burn cardiac response when given at a dose of 4 mg/kg/day, which decreases and sustains heart rate 15% below admission heart rate. PMID:20598332

  2. Simulating Local and Intercontinental Pollutant Effects of Biomass Burning: Integration of Several Remotely Sensed Datasets

    NASA Technical Reports Server (NTRS)

    Chatfield, Robert B.; Vastano, John A.; Guild, Liane; Hlavka, Christine; Brass, James A.; Russell, Philip B. (Technical Monitor)

    1994-01-01

    Burning to clear land for crops and to destroy pests is an integral and largely unavoidable part of tropical agriculture. It is easy to note but difficult to quantify using remote sensing. This report describes our efforts to integrate remotely sensed data into our computer model of tropical chemical trace-gas emissions, weather, and reaction chemistry (using the MM5 mesoscale model and our own Global-Regional Atmospheric Chemistry Simulator). The effects of burning over the continents of Africa and South America have been noticed in observations from several satellites. Smoke plumes hundreds of kilometers long may be seen individually, or may merge into a large smoke pall over thousands of kilometers of these continents. These features are related to intense pollution in the much more confined regions with heavy burning. These emissions also translocate nitrogen thousands of kilometers in the tropical ecosystems, with large fixed-nitrogen losses balanced partially by locally intense fertilization downwind, where nitric acid is rained out. At a much larger scale, various satellite measurements have indicated the escape of carbon monoxide and ozone into large filaments which extend across the Tropical and Southern Atlantic Ocean. Our work relates the source emissions, estimated in part from remote sensing, in part from conventional surface reports, to the concentrations of these gases over these intercontinental regions. We will mention work in progress to use meteorological satellite data (AVHRR, GOES, and Meteosat) to estimate the surface temperature and extent and height of clouds, and explain why these uses are so important in our computer simulations of global biogeochemistry. We will compare our simulations and interpretation of remote observations to the international cooperation involving Brazil, South Africa, and the USA in the TRACE-A (Transport and Atmospheric Chemistry near the Equator - Atlantic) and SAFARI (Southern Africa Fire Atmosphere Research

  3. TSG-6 secreted by human umbilical cord-MSCs attenuates severe burn-induced excessive inflammation via inhibiting activations of P38 and JNK signaling

    PubMed Central

    Liu, Lingying; Song, Huifeng; Duan, Hongjie; Chai, Jiake; Yang, Jing; Li, Xiao; Yu, Yonghui; Zhang, Xulong; Hu, Xiaohong; Xiao, Mengjing; Feng, Rui; Yin, Huinan; Hu, Quan; Yang, Longlong; Du, Jundong; Li, Tianran

    2016-01-01

    The hMSCs have become a promising approach for inflammation treatment in acute phase. Our previous study has demonstrated that human umbilical cord-MSCs could alleviate the inflammatory reaction of severely burned wound. In this study, we further investigated the potential role and mechanism of the MSCs on severe burn-induced excessive inflammation. Wistar rats were randomly divided into following groups: Sham, Burn, Burn+MSCs, Burn+MAPKs inhibitors, and Burn, Burn+MSCs, Burn+Vehicle, Burn+siTSG-6, Burn+rhTSG-6 in the both experiments. It was found that MSCs could only down-regulate P38 and JNK signaling, but had no effect on ERK in peritoneal macrophages of severe burn rats. Furthermore, suppression of P38 and JNK activations significantly reduced the excessive inflammation induced by severe burn. TSG-6 was secreted by MSCs using different inflammatory mediators. TSG-6 from MSCs and recombinant human (rh)TSG-6 all significantly reduced activations of P38 and JNK signaling induced by severe burn and then attenuated excessive inflammations. On the contrary, knockdown TSG-6 in the cells significantly increased phosphorylation of P38 and JNK signaling and reduced therapeutic effect of the MSCs on excessive inflammation. Taken together, this study suggested TSG-6 from MSCs attenuated severe burn-induced excessive inflammation via inhibiting activation of P38 and JNK signaling. PMID:27444207

  4. Impact of a modern firefighting protective uniform on the incidence and severity of burn injuries in New York City firefighters.

    PubMed

    Prezant, D J; Kelly, K J; Malley, K S; Karwa, M L; McLaughlin, M T; Hirschorn, R; Brown, A

    1999-06-01

    The New York City Fire Department (FDNY) is the largest fire department in the United States, with over 11,000 firefighters. In 1994, FDNY changed to a modern firefighting protective uniform. The major difference between traditional and modern uniforms is that modern uniforms include both protective over-coat and over-pant, whereas traditional uniforms include only the over-coat. Furthermore, modern uniforms are manufactured using improved thermal protective textiles that meet or exceed current National Fire Protection Association standards for structural firefighting. The purpose of this study was to determine the impact of the modern uniform on the incidence and severity of FDNY burn injuries. We also evaluated the incidence and severity of other non-burn injuries to determine whether there was serious adverse impact. The number of lower-extremity burns decreased by 85% when 2 years' experience while wearing the modern uniform was compared with 2 years while wearing the traditional uniform. Upper-extremity burns and head burns decreased by 65% and 40%, respectively. Severity indicators (days lost to medical leave, hospital admissions, and skin grafts) for lower- and upper-extremity burn injuries were all substantially reduced. This occurred without significant change in the incidence or severity of trunk burns, heat exhaustion, inhalation injuries (actually decreased), or cardiac events. The reduction in the incidence and severity of burn injuries, the major occupational injury affecting this workforce, has been so dramatic and without untoward effects that the introduction of the modern uniform must be characterized as a sentinel event in the history of firefighter health and safety.

  5. Distribution and relative abundance of forest birds in relation to burn severity in southeastern Arizona

    USGS Publications Warehouse

    Kirkpatrick, C.; Conway, C.J.; Jones, P.B.

    2006-01-01

    The frequency of wild and prescribed fires in montane forests of the southwestern United States has increased after a century of fire suppression and subsequent fuels accumulation. To assess the effects of recent fires (median time since fire = 6 yr) on the montane forest bird community, we surveyed birds in 8 Sky Island mountain ranges in southeastern Arizona, USA, and examined how the distribution (i.e., presence-absence) of 65 species and relative abundance of 16 species correlated with evidence of severe and less severe fire at >1,500 survey points. We detected associations between fire and bird presence-absence for 17% of the 65 species analyzed and between fire and bird relative abundance for 25% of the 16 species analyzed. Most species (73%) were positively associated with burned areas and displayed stronger associations (i.e., more extreme odds ratios) with survey points that had evidence of severe as opposed to less severe fire. Positive associations with severe fire were strong (>3 to 1 odds) for western wood-pewee (Contopus sordidulus) and house wren (Troglodytes aedon), and negative associations with severe fire were strong for warbling vireo (Vireo gilvus) and red-breasted nuthatch (Sitta canadensis). Although recent fires appear to have had a positive effect on the distribution and relative abundance of several montane forest bird species in the region, these species are not the open-woodland birds that we would have expected to have benefited from fire based on previous research. Nevertheless, our results confirm associations between fire and bird presence-absence and relative abundance reported previously for 7 species of birds. Our results also provide new information for Grace's warbler (Dendroica graciae) and greater pewee (C. pertinax), 2 species for which fire data were formerly lacking. Managers can use these data to make and test predictions about the effects of future fires, both severe and less severe, on montane forest birds in the

  6. TLR4 and TNF-α polymorphisms are associated with an increased risk for severe sepsis following burn injury

    PubMed Central

    Barber, R; Aragaki, C; Rivera-Chavez, F; Purdue, G; Hunt, J; Horton, J

    2004-01-01

    Context: Sepsis, organ failure, and shock remain common among patients with moderate to severe burn injuries. The inability of clinical factors to identify at-risk patients suggests that genetic variation may influence the risk for serious infection and the outcome from severe injury. Objective: Resolution of genetic variants associated with severe sepsis following burn injury. Patients: A total of 159 patients with burns ⩾20% of their total body surface area or any smoke inhalation injury without significant non-burn related trauma (injury severity score (ISS)⩾16), traumatic or anoxic brain injury, or spinal cord injury and who survived more than 48 h post-admission. Methods: Candidate single nucleotide polymorphisms (SNPs) within bacterial recognition (TLR4 +896, CD14 –159) and inflammatory response (TNF-α –308, IL-1ß –31, IL-6 –174) loci were evaluated for association with increased risk for severe sepsis (sepsis plus organ dysfunction or septic shock) and mortality. Results: After adjustment for age, full-thickness burn size, ethnicity, and gender, carriage of the TLR4 +896 G-allele imparted at least a 1.8-fold increased risk of developing severe sepsis following a burn injury, relative to AA homozygotes (adjusted odds ratio (aOR) 6.4; 95% confidence interval (CI) 1.8 to 23.2). Carriage of the TNF-α –308 A-allele imparted a similarly increased risk, relative to GG homozygotes (aOR = 4.5; 95% CI 1.7 to 12.0). None of the SNPs examined were significantly associated with mortality. Conclusions: The TLR4 +896 and TNF-α –308 polymorphisms were significantly associated with an increased risk for severe sepsis following burn trauma. PMID:15520404

  7. Severe Burns and Amputation of Both Arms in the First Psychotic Episode of a Schizophrenic Patient

    PubMed Central

    Cruzado, Lizardo; Villafane-Alva, Ronald; Caballero-Atencio, Katia; Cortez-Vergara, Carla; Núñez-Moscoso, Patricia

    2015-01-01

    An alleged reduction of sensitivity to pain in people with schizophrenia has been reported, but the nature of this complex phenomenon has not been elucidated yet. Reports of insensitivity to burns from people with schizophrenia are extremely rare. We report the case of a 24-year-old man who set both of his arms on fire during the first break of paranoid schizophrenia. As a result of severe tissue damage, both of his limbs had to be amputated. Today, at the age of 59, the patient is physically and mentally rehabilitated and is adherent to treatment. Additionally, given the uncertainty about the true nature of the alleged hypoalgesia in schizophrenia, we postulate the need for a comprehensive phenomenological approach in the study of embodiment in people with this condition. PMID:26417469

  8. Abbreviations used in publications of the United States Geological Survey

    USGS Publications Warehouse

    ,

    1953-01-01

    The use of abbreviations in publications of the Geological Survey is determined by several forces working in different directions. Pulling in the direction of greater condensation and the freer use of abbreviations and symbols is the desire to achieve greater economy in publications. Working in the opposite direction is the desire to have the publications used more conveniently by an increasingly heterogeneous public.

  9. Plasma proteome response to severe burn injury revealed by 18O-labeled "universal" reference-based quantitative proteomics.

    PubMed

    Qian, Wei-Jun; Petritis, Brianne O; Kaushal, Amit; Finnerty, Celeste C; Jeschke, Marc G; Monroe, Matthew E; Moore, Ronald J; Schepmoes, Athena A; Xiao, Wenzhong; Moldawer, Lyle L; Davis, Ronald W; Tompkins, Ronald G; Herndon, David N; Camp, David G; Smith, Richard D

    2010-09-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the 12 most abundant plasma proteins with cysteinyl-peptide enrichment-based fractionation prior to LC-MS analyses of individual patient samples. Incorporation of an 18O-labeled "universal" reference among the sample sets enabled precise relative quantification across samples. In total, 313 plasma proteins confidently identified with two or more unique peptides were quantified. Following statistical analysis, 110 proteins exhibited significant abundance changes in response to the burn injury. The observed changes in protein concentrations suggest significant inflammatory and hypermetabolic response to the injury, which is supported by the fact that many of the identified proteins are associated with acute phase response signaling, the complement system, and coagulation system pathways. The regulation of approximately 35 proteins observed in this study is in agreement with previous results reported for inflammatory or burn response, but approximately 50 potentially novel proteins previously not known to be associated with burn response or inflammation are also found. Elucidating proteins involved in the response to severe burn injury may reveal novel targets for therapeutic interventions as well as potential predictive biomarkers for patient outcomes such as multiple organ failure.

  10. The effects and mechanisms of insulin on systemic inflammatory response and immune cells in severe trauma, burn injury, and sepsis.

    PubMed

    Deng, Hu-Ping; Chai, Jia-Ke

    2009-10-01

    Insulin resistance, hyperglycemia, inflammatory disorders and immune dysfunction cause high morbidity and mortality in patients with severe trauma, burn injuries, or sepsis. Many studies have shown that intensive insulin therapy can combat insulin resistance, decrease blood glucose levels, and induce anabolic processes, thus, decreasing morbidity and mortality. Moreover, in recent years, it has been proven that insulin can attenuate systemic inflammatory responses and modulate the proliferation, apoptosis, differentiation and immune functions of certain immune cells, especially monocytes/macrophages, neutrophils, and T cells associated with severe trauma, burn injury, or sepsis. This effect of insulin may expand our understanding of intensive insulin therapy in critically ill patients. This review attempts to summarize studies on the modulatory effects and mechanisms of insulin therapy on systemic inflammation and immune cells in severe trauma, burn injury and sepsis, and further propose some questions for future studies.

  11. Multispectral imaging burn wound tissue classification system: a comparison of test accuracies between several common machine learning algorithms

    NASA Astrophysics Data System (ADS)

    Squiers, John J.; Li, Weizhi; King, Darlene R.; Mo, Weirong; Zhang, Xu; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.

    2016-03-01

    The clinical judgment of expert burn surgeons is currently the standard on which diagnostic and therapeutic decisionmaking regarding burn injuries is based. Multispectral imaging (MSI) has the potential to increase the accuracy of burn depth assessment and the intraoperative identification of viable wound bed during surgical debridement of burn injuries. A highly accurate classification model must be developed using machine-learning techniques in order to translate MSI data into clinically-relevant information. An animal burn model was developed to build an MSI training database and to study the burn tissue classification ability of several models trained via common machine-learning algorithms. The algorithms tested, from least to most complex, were: K-nearest neighbors (KNN), decision tree (DT), linear discriminant analysis (LDA), weighted linear discriminant analysis (W-LDA), quadratic discriminant analysis (QDA), ensemble linear discriminant analysis (EN-LDA), ensemble K-nearest neighbors (EN-KNN), and ensemble decision tree (EN-DT). After the ground-truth database of six tissue types (healthy skin, wound bed, blood, hyperemia, partial injury, full injury) was generated by histopathological analysis, we used 10-fold cross validation to compare the algorithms' performances based on their accuracies in classifying data against the ground truth, and each algorithm was tested 100 times. The mean test accuracy of the algorithms were KNN 68.3%, DT 61.5%, LDA 70.5%, W-LDA 68.1%, QDA 68.9%, EN-LDA 56.8%, EN-KNN 49.7%, and EN-DT 36.5%. LDA had the highest test accuracy, reflecting the bias-variance tradeoff over the range of complexities inherent to the algorithms tested. Several algorithms were able to match the current standard in burn tissue classification, the clinical judgment of expert burn surgeons. These results will guide further development of an MSI burn tissue classification system. Given that there are few surgeons and facilities specializing in burn care

  12. Long-term skeletal muscle mitochondrial dysfunction is associated with hypermetabolism in severely burned children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The long-term impact of burn trauma on skeletal muscle bioenergetics remains unknown. Here, we determined respiratory capacity and function of skeletal muscle mitochondria in healthy individuals and in burn victims for up to two years post-injury. Biopsies were collected from the m. vastus lateralis...

  13. Astaxanthin Attenuates Early Acute Kidney Injury Following Severe Burns in Rats by Ameliorating Oxidative Stress and Mitochondrial-Related Apoptosis

    PubMed Central

    Guo, Song-Xue; Zhou, Han-Lei; Huang, Chun-Lan; You, Chuan-Gang; Fang, Quan; Wu, Pan; Wang, Xin-Gang; Han, Chun-Mao

    2015-01-01

    Early acute kidney injury (AKI) is a devastating complication in critical burn patients, and it is associated with severe morbidity and mortality. The mechanism of AKI is multifactorial. Astaxanthin (ATX) is a natural compound that is widely distributed in marine organisms; it is a strong antioxidant and exhibits other biological effects that have been well studied in various traumatic injuries and diseases. Hence, we attempted to explore the potential protection of ATX against early post burn AKI and its possible mechanisms of action. The classic severe burn rat model was utilized for the histological and biochemical assessments of the therapeutic value and mechanisms of action of ATX. Upon ATX treatment, renal tubular injury and the levels of serum creatinine and neutrophil gelatinase-associated lipocalin were improved. Furthermore, relief of oxidative stress and tubular apoptosis in rat kidneys post burn was also observed. Additionally, ATX administration increased Akt and Bad phosphorylation and further down-regulated the expression of other downstream pro-apoptotic proteins (cytochrome c and caspase-3/9); these effects were reversed by the PI3K inhibitor LY294002. Moreover, the protective effect of ATX presents a dose-dependent enhancement. The data above suggested that ATX protects against early AKI following severe burns in rats, which was attributed to its ability to ameliorate oxidative stress and inhibit apoptosis by modulating the mitochondrial-apoptotic pathway, regarded as the Akt/Bad/Caspases signalling cascade. PMID:25871290

  14. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring

    PubMed Central

    Sood, Ravi F.; Arbabi, Saman; Honari, Shari; Gibran, Nicole S.

    2016-01-01

    Background Hypertrophic scarring (HTS) is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK) pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs) in MAPK-pathway genes would be associated with severity of post-burn HTS. Methods We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS) assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing. Results Our study population consisted of 538 adults (median age 40 years) who were predominantly White (76%) males (71%) admitted to our center from 2007–2014 with small-to-moderate-sized burns (median burn size 6% total body surface area). Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5%) was significantly associated with decreased severity of post-burn HTS (P = 1.3×10−6). In gene-based analysis, PTPN5 (P = 1.2×10−5) showed a significant association and BDNF (P = 9.5×10−4) a borderline-significant association with HTS severity. Conclusions We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology. PMID:26872063

  15. Long-Term Skeletal Muscle Mitochondrial Dysfunction is Associated with Hypermetabolism in Severely Burned Children.

    PubMed

    Porter, Craig; Herndon, David N; Børsheim, Elisabet; Bhattarai, Nisha; Chao, Tony; Reidy, Paul T; Rasmussen, Blake B; Andersen, Clark R; Suman, Oscar E; Sidossis, Labros S

    2016-01-01

    The long-term impact of burn trauma on skeletal muscle bioenergetics remains unknown. Here, the authors determined respiratory capacity and function of skeletal muscle mitochondria in healthy individuals and in burn victims for up to 2 years postinjury. Biopsies were collected from the m. vastus lateralis of 16 healthy men (26 ± 4 years) and 69 children (8 ± 5 years) with burns encompassing ≥30% of their total BSA. Seventy-nine biopsies were collected from cohorts of burn victims at 2 weeks (n = 18), 6 months (n = 18), 12 months (n = 25), and 24 months (n = 18) postburn. Hypermetabolism was determined by the difference in predicted and measured metabolic rate. Mitochondrial respiration was determined in saponin-permeabilized myofiber bundles. Outcomes were modeled by analysis of variance, with differences in groups assessed by Tukey-adjusted contrasts. Burn patients were hypermetabolic for up to 2 years postinjury. Coupled mitochondrial respiration was lower at 2 weeks (17 [8] pmol/sec/mg; P < .001), 6 months (41 [30] pmol/sec/mg; P = .03), and 12 months (35 [14] pmol/sec/mg; P < .001) postburn compared with healthy controls (58 [13] pmol/sec/mg). Coupled respiration was greater at 6, 12, and 24 months postburn vs 2 weeks postburn (P < .001). Mitochondrial adenosine diphosphate and oligomycin sensitivity (measures of coupling control) were lower at all time-points postburn vs control (P < .05), but greater at 6, 12, and 24 months postburn vs 2 weeks postburn (P < .05). Muscle mitochondrial respiratory capacity remains significantly lower in burn victims for 1-year postinjury. Mitochondrial coupling control is diminished for up to 2 years postinjury in burn victims, resulting in greater mitochondrial thermogenesis. These quantitative and qualitative derangements in skeletal muscle bioenergetics likely contribute to the long-term pathophysiological stress response to burn trauma.

  16. Primary triage of mass burn casualties with associated severe traumatic injuries.

    PubMed

    Atiyeh, B; Gunn, S William A; Dibo, S

    2013-03-31

    A key aim in any mass disaster event is to avoid diverting resources by overwhelming specialized tertiary centers with minor casualties. The most crucial aspect of an effective disaster response is pre-hospital triage at the scene. Unfortunately, many triage systems have serious shortcomings in their methodologies and no existing triage system has enough scientific evidence to justify its universal adoption. Moreover, it is observed that the optimal approach to planning is by no means clear-cut and that each new incident involving burns appears to produce its own unique problems not all of which were predictable. In most major burns disasters, victims mostly have combined trauma burn injuries and form a heterogeneous group with a broad range of devastating injuries. Are these victims primarily burn patients or trauma patients? Should they be taken care of in a burn center or in a trauma center or only in a combined burns-trauma center? Who makes the decision? The present review is aimed at answering some of these questions.

  17. Primary triage of mass burn casualties with associated severe traumatic injuries

    PubMed Central

    Atiyeh, B.; Gunn, S. William A.; Dibo, S.

    2013-01-01

    Summary A key aim in any mass disaster event is to avoid diverting resources by overwhelming specialized tertiary centers with minor casualties. The most crucial aspect of an effective disaster response is pre-hospital triage at the scene. Unfortunately, many triage systems have serious shortcomings in their methodologies and no existing triage system has enough scientific evidence to justify its universal adoption. Moreover, it is observed that the optimal approach to planning is by no means clear-cut and that each new incident involving burns appears to produce its own unique problems not all of which were predictable. In most major burns disasters, victims mostly have combined trauma burn injuries and form a heterogeneous group with a broad range of devastating injuries. Are these victims primarily burn patients or trauma patients? Should they be taken care of in a burn center or in a trauma center or only in a combined burns-trauma center? Who makes the decision? The present review is aimed at answering some of these questions. PMID:23966900

  18. Abbreviations and acronyms

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This booklet provides a partial list of acronyms, abbreviations, and other short word forms, including their definitions, used in documents at the Goddard Space Flight Center (GSFC). This list does not preclude the use of other short forms of less general usage, as long as these short forms are identified the first time they appear in a document and are defined in a glossary in the document in which they are used. This document supplements information in the GSFC Scientific and Technical Information Handbook (GHB 2200.2/April 1989). It is not intended to contain all short word forms used in GSFC documents; however, it was compiled of actual short forms used in recent GSFC documents. The entries are listed first, alphabetically by the short form, and then again alphabetically by definition.

  19. 40 CFR 88.303-93 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) CLEAN-FUEL VEHICLES Clean-Fuel Fleet Program § 88.303-93 Abbreviations. The abbreviations in subpart A of this part and in 40 CFR part 86 apply to this subpart. The abbreviations in this section apply...

  20. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part III)*

    PubMed Central

    Atiyeh, B.S.; Gunn, S.W.A.; Dibo, S.A.

    2008-01-01

    Summary Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society.Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field. PMID:21991133

  1. Five-Year Outcomes after Oxandrolone Administration in Severely Burned Children: A Randomized Clinical Trial of Safety and Efficacy

    PubMed Central

    Porro, Laura J; Herndon, David N; Rodriguez, Noe A; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Meyer, Walter; Lee, Jong; Suman, Oscar E; Finnerty, Celeste C

    2012-01-01

    Background Oxandrolone, an anabolic agent, has been administered for 1 year post burn with beneficial effects in pediatric patients. However, the long-lasting effects of this treatment have not been studied. This single-center prospective trial determined the long-term effects of 1 year of oxandrolone administration in severely burned children; assessments were continued for up to 4 years post-therapy. Study Design Patients 0–18 years old with burns covering >30% of the total body surface area were randomized to receive placebo (n=152) or oxandrolone, 0.1 mg/kg twice daily for 12 months (n=70). At hospital discharge, patients were randomized to a 12 week exercise program or to standard of care. Resting energy expenditure (REE), standing height, weight, lean body mass, muscle strength, bone mineral content (BMC), cardiac work, rate pressure product (RPP), sexual maturation, and concentrations of serum inflammatory cytokines, hormones, and liver enzymes were monitored. Results Oxandrolone significantly decreased REE, RPP, and increased IGF-1 secretion during the first year after burn injury, and in combination with exercise significantly increased lean body mass and muscle strength. Oxandrolone-treated children exhibited improved height percentile and BMC content compared to controls. The maximal effect of oxandrolone was found in children aged 7–18 years. No deleterious side effects were attributed to long-term administration. Conclusions Administration of oxandrolone improves the long-term recovery of severely burned children in height, BMC, cardiac work and muscle strength; the increase in BMC is likely to occur by means of IGF 1. These benefits persist for up to 5 years post burn. PMID:22463890

  2. Evaluating spectral indices and spectral mixture analysis for assessing fire severity and adjusting burning efficiency using Landsat data

    NASA Astrophysics Data System (ADS)

    Veraverbeke, S.; Hook, S.

    2012-04-01

    Fire severity data are of paramount importance to (i) organize post-fire rehabilitation plans and (ii) reduce uncertainties in wildfire emission estimates by allowing spatio-temporal variability in burning efficiency values. We have used a Landsat Thematic Mapper (TM) image to assess fire severity of the large 2011 Wallow fire in Arizona, USA. The Normalized Burn Ratio (NBR), differenced NBR (dNBR), Relative dNBR (RdNBR) and the char fraction estimated by Spectral Mixture Analysis (SMA) were evaluated. Geo Composite Burn Index (GeoCBI) and vegetation mortality data were used as ground truth. Of all remotely sensed measures tested the dNBR had the highest performance (GeoCBI-dNBR R2 = 0.84 and % black trees-dNBR R2 = 0.91), which supports the operational use of the dNBR for post-fire management. Without initial calibration with field data, however, dNBR values lack biophysical meaning. The SMA-derived char fraction also had moderate-high correlations with the field data (GeoCBI-char fraction R2 = 0.66 and % black trees-char fraction R2 = 0.82). The char fractions provide a direct mechanistic link with the fire processes that occurred on the ground. Such data have big potential to adjust burning efficiency values. This is of great importance to reduce uncertainties in wildfire emission estimates.

  3. Ischemic bowel as a late sequela of abdominal compartment syndrome secondary to severe burn injury.

    PubMed

    Sun, Ken; Hancock, Betty Jean; Logsetty, Sarvesh

    2015-01-01

    Abdominal compartment syndrome (ACS) is a known complication of the large-volume resuscitation that burn patients receive. Bowel ischemia has been theorized to occur in ACS but has yet to be described in the literature. The authors report an occurrence of late bowel obstruction related to ACS-associated bowel ischemia in a burn patient. A four-year-old previously well girl sustained 70% total body surface area burns with inhalation injury. The areas injured were the anterior neck, circumferential torso from neck to waist, left arm, left thigh and two-thirds of her right thigh. Fluid resuscitation was initially administered using the modified Parkland formula. Her transfer to the regional burn unit from a local hospital was complicated by early septic shock from a line infection, which increased her resuscitation fluid requirements. Infection ultimately led to multiple instances of ACS. Intervention with percutaneous drainage led to immediate improvement; however, the episodes of ACS resulted in a late small bowel obstruction secondary to stricture, requiring a laparotomy and bowel resection. PMID:26665133

  4. A cause of severe chemical burn: topical application of herbal medicines.

    PubMed

    Karacor-Altuntas, Z; Ince, B; Dadaci, M; Altuntas, M

    2014-09-30

    We report a 73-year-old male patient with progressive chemical burn on his lower extremities following topical application of a mixture of the oils derived from Rosmarinus officinalis, Brassica nigra alba and Laurus nobilis. It should be kept in mind that herbal medicines which seem harmless can sometimes be dangerous and life-threatening, especially in elderly and diabetic patients. PMID:26170795

  5. Self-perceptions of young adults who survived severe childhood burn injury.

    PubMed

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the

  6. Self-perceptions of young adults who survived severe childhood burn injury.

    PubMed

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the

  7. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.

    PubMed

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P < 0.05. Receiver operating characteristic analysis identified a cutoff level of 234 pg/mL for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P < 0.001). In the H group, IL-8 levels were able to predict sepsis (P < 0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute-phase responses compared with the L group (P < 0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients.

  8. Do fentanyl and morphine influence body temperature after severe burn injury?

    PubMed

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Fentanyl lacks the antiinflammatory properties of morphine. Morphine attenuates the inflammatory response through differential stimulation of μ-receptor subtypes. Patients who receive morphine during coronary artery bypass graft have been shown to experience less postoperative fever than those who receive fentanyl. Patients who receive continuous fentanyl infusions in increased room temperatures after thermal injury may be at increased risk to experience higher body temperature than those who receive morphine. The records of 28 patients with >20%TBSA burn in 30 intensive care unit rooms (13 received fentanyl and 15 received morphine or hydromorphone) and 12 trauma patients who received fentanyl in 22°C intensive care unit rooms were reviewed. Mean maximum core temperature and percentage of temperature recordings > 39°C in the first 48 hours of admission were compared between burn patients who received fentanyl, those who did not, and with trauma patients. Burn patients exposed to fentanyl experienced significantly higher temperatures (40.1 ± 0.9°C) compared with those given morphine (38.7 ± 0.8°C) and compared with trauma patients (37.5 ± 2.4°C), P < .01 and P < .001, respectively. Burn patients on fentanyl had temperatures > 39°C for a higher percentage of time (33 ± 27%) than those without fentanyl (7.2 ± 13%) and trauma patients (1 ± 2.8%), P < .01 and P < .001, respectively. No differences in other medications administered, acute physiology and chronic health evaluation II scores, or the number of infections that could account for temperature disparities between groups existed. Burn patients who receive fentanyl in 30°C rooms experience higher body temperatures and are febrile for a higher percentage of time than those receiving morphine only. Morphine has well-established antiinflammatory properties and likely attenuates the postburn inflammatory response more than fentanyl, resulting in lower body temperatures. This phenomenon needs to be

  9. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    PubMed

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems.

  10. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    PubMed

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems. PMID:16843945

  11. The largest forest fires in Portugal: the constraints of burned area size on the comprehension of fire severity.

    PubMed

    Tedim, Fantina; Remelgado, Ruben; Martins, João; Carvalho, Salete

    2015-01-01

    Portugal is a European country with highest forest fires density and burned area. Since beginning of official forest fires database in 1980, an increase in number of fires and burned area as well as appearance of large and catastrophic fires have characterized fire activity in Portugal. In 1980s, the largest fires were just a little bit over 10,000 ha. However, in the beginning of 21st century several fires occurred with a burned area over 20,000 ha. Some of these events can be classified as mega-fires due to their ecological and socioeconomic severity. The present study aimed to discuss the characterization of large forest fires trend, in order to understand if the largest fires that occurred in Portugal were exceptional events or evidences of a new trend, and the constraints of fire size to characterize fire effects because, usually, it is assumed that larger the fire higher the damages. Using Portuguese forest fire database and satellite imagery, the present study showed that the largest fires could be seen at the same time as exceptional events and as evidence of a new fire regime. It highlighted the importance of size and patterns of unburned patches within fire perimeter as well as heterogeneity of fire ecological severity, usually not included in fire regime description, which are critical to fire management and research. The findings of this research can be used in forest risk reduction and suppression planning.

  12. Self Perceptions of Young Adults who Survived Severe Childhood Burn Injury

    PubMed Central

    Russell, W; Robert, RS; Thomas, CR; Holzer, CE; Blakeney, P; Meyer, WJ

    2012-01-01

    Objective The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self concept. In order to anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Method 82 young adult burn survivors (45 males, 37 females) were assessed using the Tennessee Self-Concept, 2nd Edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report, YASR) and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders, SCID I). Results This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 sub-scale scores of Physical function, appearance, and sexuality, Moral conduct, Personal values, Academics and work, and Identity than did the reference population. Pearson correlation coefficients showed that as Moral, Personal, Family and Social aspects of self concept decreased, clinical problems endorsed on the YASR sub-scales increased, including Anxiety Somatic, Attention, Intrusive and Aggressive. Persons with lower self-concept scores on the TSCS2 Personal, Family, and Social Scales, were more withdrawn on the YASR. Similarly those with lower TSCS2 scores on the Personal and Family Scales endorsed significantly more Thought Problems on the YASR. Affective distress on the SCID I was associated with significantly lower self concept. TSCS2 Total Self Concept, Personal, and all of the Supplementary Scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 Total Self

  13. Metabolism of platelet activating factor (PAF) and lyso-PAF in polymorphonuclear granulocytes from severely burned patients.

    PubMed

    Schönfeld, W; Kasimir, S; Köller, M; Erbs, G; Müller, F E; König, W

    1990-12-01

    We studied the metabolism of 3H-platelet activating factor (PAF) and lyso-PAF in human polymorphonuclear granulocytes (PMN) from severely burned patients (n = 6) on days 1, 5, 9, 15, and 25 post-trauma. All patients suffered from a severe burn trauma of more than 30% total body surface area. Stimulation of PMN in healthy donors (n = 10) with the Ca-ionophore resulted in the conversion of 3H-lyso-PAF into PAF (18 +/- 2% of total radioactivity) and alkyl-acyl-glycero-phosphorylcholine (alkyl-acyl-GPC, 50 +/- 6%). In burned patients a significantly reduced formation of 3H-PAF was observed between days 1 and 15 post-trauma (day 9: 1 +/- 1%, p less than 0.0001). This pattern was normalized again in patients (n = 5) who survived the trauma after septic periods and was observed during the second week post-trauma. In one patient who succumbed to his injuries a sustained inhibition of PAF formation was observed up to his death. The decreased formation of PAF correlated weakly with the appearance of immature granulocytes within the analyzed cell fraction (ratio of immature cells versus PAF-formation, r = -0.55, p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2258972

  14. Using NASA EOS to Assess Burn Severity and Perform Fire Risk Mapping of the 2011 North Carolina Wildfire Season

    NASA Astrophysics Data System (ADS)

    Gleason, J. L.; Ehlen, A.

    2012-12-01

    Since the beginning of 2011 North Carolina has experienced dry conditions and high winds, which has increased the fuel load on the ground. This extreme weather led to several periods of severe wildfires which burned nearly 100,000 acres, caused significant damage to the Coastal Plains region's ecosystem, and greatly affected the livelihoods of many North Carolinians. Utilizing NASA's Earth Observing Systems (EOS), burn severity, real-time drought severity, and fire- risk mapping were conducted on the two largest fires in North Carolina during the 2011 wildfire season, the Pains Bay Fire in Dare County and the Juniper Road Fire in Pender County. In order to show the impact of fires on the ecosystem and the extent of ecological change the fires caused, burn severity maps were created using Landsat 5 TM and the Relative difference Normalized Burn Ratio (RdNBR). To assess drought conditions, the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Moisture Index (NDMI) were derived from Landsat 5TM data to show changes in vegetation cover and moisture. In addition, MODIS Daily Surface Reflectance product (MOD09GA/MYD09GA) with the Normalized Multi-band Drought Index (NMDI) was utilized to estimate real-time drought severity of vegetation and soil moisture. Finally, Landsat 5 TM and various ancillary sources were used to create a fire risk map utilizing a Multi-criteria Evaluation (MCE) method with the new Fuzzification method in ArcGIS. Multiple variables were inserted into the MCE including soil survey data, Normalized Difference Moisture Index (NDMI), slope data obtained from ASTER Global DEM, land cover/fuel data, and proximity to roads. Methodologies using NASA EOS to acquire all end products were provided to project partners, the Alligator River National Wildlife Refuge (ARNWR) and the North Carolina Forest Service (NCFS), in the form of a user tutorial to allow for a better understanding of how remote sensing can be applied to analyze wildfires

  15. [A Case of a Severely Burned Patient with Suspected Takotsubo Cardiomyopathy Who Underwent Immediate Excision and Skin Grafting under General Anesthesia].

    PubMed

    Nakanishi, Mika; Oota, Takako; Kato, Takeshi; Imanishi, Toshihiro

    2015-04-01

    An 88-year-old woman was severely burned on her thigh, leg, arm, buttocks, chest and abdomen in the bathroom and was emergently admitted to our hospital. The burn index was 10.8 and the prognostic burn index (PBI) was 99. The reports of echocardiography, cardiac biomarkers and electrocardiogram showed left ventricular dysfunction with apical akinesis, which was suspected as Takotsubo cardiomyopathy. To avoid poor prognosis because of severe PBI, immediate excision and skin grafting were performed under general anesthesia 23 hours after the burn onset. More infusion and transfusion than the expected amounts were needed during anesthesia and the postoperative 4 days because of cardiac failure and septic shock, which were overcome 14 days after the surgery. The complete early excision was impossible due to cardiac failure, and that the unexcised burn scar exacerbated infection and prevented her from survival. PMID:26419106

  16. Global change: Acronyms and abbreviations

    SciTech Connect

    Woodard, C.T.; Stoss, F.W.

    1995-05-01

    This list of acronyms and abbreviations is compiled to provide the user with a ready reference to dicipher the linguistic initialisms and abridgements for the study of global change. The terms included in this first edition were selected from a wide variety of sources: technical reports, policy documents, global change program announcements, newsletters, and other periodicals. The disciplinary interests covered by this document include agriculture, atmospheric science, ecology, environmental science, oceanography, policy science, and other fields. In addition to its availability in hard copy, the list of acronyms and abbreviations is available in DOS-formatted diskettes and through CDIAC`s anonymous File Transfer Protocol (FTP) area on the Internet.

  17. Sustained Oxidative Stress Causes Late Acute Renal Failure via Duplex Regulation on p38 MAPK and Akt Phosphorylation in Severely Burned Rats

    PubMed Central

    Cai, Xiaoqing; Wang, Dexin; Wu, Kaimin; Chen, Hongli; Li, Jia; Lei, Wei

    2013-01-01

    Background Clinical evidence indicates that late acute renal failure (ARF) predicts high mortality in severely burned patients but the pathophysiology of late ARF remains undefined. This study was designed to test the hypothesis that sustained reactive oxygen species (ROS) induced late ARF in a severely burned rat model and to investigate the signaling mechanisms involved. Materials and Methods Rats were exposed to 100°C bath for 15 s to induce severe burn injury (40% of total body surface area). Renal function, ROS generation, tubular necrosis and apoptosis, and phosphorylation of MAPK and Akt were measured during 72 hours after burn. Results Renal function as assessed by serum creatinine and blood urea nitrogen deteriorated significantly at 3 h after burn, alleviated at 6 h but worsened at 48 h and 72 h, indicating a late ARF was induced. Apoptotic cells and cleavage caspase-3 in the kidney went up slowly and turned into significant at 48 h and 72 h. Tubular cell ROS production shot up at 6 h and continuously rose during the 72-h experiment. Scavenging ROS with tempol markedly attenuated tubular apoptosis and renal dysfunction at 72 h after burn. Interestingly, renal p38 MAPK phosphorylation elevated in a time dependent manner whereas Akt phosphorylation increased during the first 24 h but decreased at 48 h after burn. The p38 MAPK specific inhibitor SB203580 alleviated whereas Akt inhibitor exacerbated burn-induced tubular apoptosis and renal dysfunction. Furthermore, tempol treatment exerted a duplex regulation through inhibiting p38 MAPK phosphorylation but further increasing Akt phosphorylation at 72 h postburn. Conclusions These results demonstrate that sustained renal ROS overproduction induces continuous tubular cell apoptosis and thus a late ARF at 72 h after burn in severely burned rats, which may result from ROS-mediated activation of p38 MAPK but a late inhibition of Akt phosphorylation. PMID:23349934

  18. Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn.

    PubMed

    Csontos, C; Rezman, B; Foldi, V; Bogar, L; Drenkovics, L; Röth, E; Weber, G; Lantos, J

    2012-05-01

    Oxidative stress and inflammation generate edema in burns. The aim of our study was to assess effect of N-acetylcysteine (NAC) on oxidative stress, inflammation, fluid requirement, multiple organ dysfunction (MOD) score and vasoactive drug requirement. In this study 15 patients were on standard therapy, whereas for other 15 patients NAC was supplemented. Blood samples were taken on admission and on the next five consecutive mornings. Levels of malondialdehyde, protein sulfhydril (PSH) groups, reduced gluthation (GSH), activity of myeloperoxidase, catalase and superoxide dismutase enzymes and induced free radical generating capacity were measured as well as concentrations of TNF-α, IL-6, IL-8, and IL-10. MOD score, use of vasopressor agents and fluid utilisation were recorded daily. NAC treatment increased GSH level on days 4-5 (p<0.05) and PSH level on days 2-6 (p<0.05) compared to controls. Plasma IL-6 was lower on days 4-5 (p<0.05), IL-8 on days 4-6 (p<0.05) and IL-10 on days 4-6 (p<0.05) in NAC group. NAC group received less catecholamines than controls (p<0.01) from day 4 without significant differences in MOD score. NAC treatment is associated with a diminished oxidative stress reflected in preserved antioxidant levels, lower inflammation mirrored in lower interleukin levels and less vasopressor requirement.

  19. A revised risk analysis of stress ulcers in burn patients receiving ulcer prophylaxis

    PubMed Central

    Choi, Young Hwan; Lee, Jong Ho; Shin, Jae Jun; Cho, Young Soon

    2015-01-01

    Objective Most of the literature about Curling’s ulcer was published from 1960 through 1980. Therefore, an updated study of Curling’s ulcer is needed. We analyzed the risk factors affecting ulcer incidence in burn patients. Methods We retrospectively analyzed the medical records of burn patients who were admitted to two burn centers. We collected information about the general characteristics of patients, burn area size, abbreviated burn severity index, whether surgery was performed, endoscopy results, and the total body surface area (TBSA). We performed a multivariate regression analysis predicting development of Curling’s ulcer. Results In total, 135 patients (mean age, 49.5±13.5 years) underwent endoscopy. Endoscopy revealed ulcer in 51 patients: 36 (70.6%) with gastric ulcers, 9 (17.6%) with duodenal ulcers, and 6 (11.8%) with both ulcer types. Burn area, burn depth, epigastric pain, melena, intensive care unit admission, burn area >20% of TBSA, and undergoing surgery for the burn were significantly different between the ulcer and non-ulcer groups. Multivariate analysis showed two independent factors significantly associated with ulcer: epigastric pain (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 1.74 to 11.90), major burn (TBSA > 20%)(OR: 4.31 ,95% CI: 1.34 to 13.85). Conclusion For burn patients, presence of epigastric pain and major burn with TBSA > 20% showed significant association with ulcer development. PMID:27752605

  20. 40 CFR 86.1203-85 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Test Procedures for New Gasoline-Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.1203-85 Abbreviations. The abbreviations in § 86.079-3 apply...

  1. 40 CFR 86.1203-85 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Test Procedures for New Gasoline-Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.1203-85 Abbreviations. The abbreviations in § 86.079-3 apply...

  2. 40 CFR 86.098-3 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.098-3 Abbreviations. (a) The abbreviations in §...

  3. 40 CFR 86.096-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.096-3 Abbreviations. (a) The abbreviations in §...

  4. 40 CFR 86.096-3 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.096-3 Abbreviations. (a) The abbreviations in §...

  5. 40 CFR 86.098-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.098-3 Abbreviations. (a) The abbreviations in §...

  6. Does soil burn severity affect the post-fire runoff and interrill erosion response? A review based on meta-analysis of field rainfall simulation data

    NASA Astrophysics Data System (ADS)

    Vieira, D. C. S.; Fernández, C.; Vega, J. A.; Keizer, J. J.

    2015-04-01

    Soil burn severity has been widely used to describe the impacts of fire on soils and is increasingly being recognised as a decisive factor controlling post-fire erosion rates. However, there is no unique definition of the term and the relationship between soil burn severity and post-fire hydrological and erosion response has not yet been fully established. The objective of this work was to review the existing literature on the role of soil burn severity on post-fire runoff and erosion ratios. To this end, a meta-analysis was carried out of the runoff and inter-rill erosion data from field rainfall simulation experiments (RSE's) that compared burnt and unburnt conditions. In this study, 109 individual observations were analysed that covered a wide geographical range, various types of land cover (forest, shrubland, and grassland) and two types of fire types (wildfire and prescribed fire). The effect size of the post-fire runoff and erosion response was determined for four key factors: (i) soil burn severity; (ii) time-since-fire; (iii) rainfall intensity; and (iv) bare soil cover. Statistical meta-analysis showed that fire occurrence had a significant effect on the hydrological and erosive response. However, this effect was only significantly higher with increasing soil burn severity for inter-rill erosion, and not for runoff. This study furthermore highlighted the incoherencies between existing burn severity classifications, and proposed an unambiguous classification.

  7. The influence of burn severity on post-fire vegetation recovery and albedo change during early succession in North American boreal forests

    NASA Astrophysics Data System (ADS)

    Jin, Y.; Randerson, J. T.; Goetz, S. J.; Beck, P. S.; Loranty, M. M.; Goulden, M.

    2011-12-01

    Severity of burning can influence multiple aspects of forest composition, carbon cycling, and climate forcing. We quantified how burn severity affected vegetation recovery and albedo change during early succession in Canadian boreal regions by combining satellite observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Canadian Large Fire Data Base (LFDB). We used the difference Normalized Burn Ratio (dNBR) and changes in spring albedo derived from MODIS 500m albedo product as measures of burn severity. We found that the most severe burns had the greatest reduction in summer EVI in first year after fire, indicating greater loss of vegetation cover immediately following fire. By 5-7 years after fire, summer EVI for all severity classes had recovered to within 90-110% of pre-fire levels. Burn severity had a positive effect on the increase of post-fire spring albedo during the first 7 years after fire, and a shift from low to moderate or moderate to severe fires led to amplification of the post-fire albedo increase by approximately 30%. Fire-induced increases in both spring and summer albedo became progressively larger with stand age from years 1-7, with the trend in spring albedo likely driven by continued losses of needles and branches from trees killed by the fire (and concurrent losses of black carbon coatings on remaining debris), and the summer trend associated with increases in leaf area of short-stature herbs and shrubs. Our results suggest that increases in burn severity and carbon losses observed in some areas of boreal forests (e.g., Turetsky et al., 2011) may be at least partly offset by increases in negative forcing associated with changes in surface albedo.

  8. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment.

    PubMed

    Oláh, Gábor; Finnerty, Celeste C; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David N; Szabó, Csaba

    2011-07-01

    Activation of the nuclear enzyme poly(ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibition. The aims of the current study were to measure the activation of PARP in human skeletal muscle biopsies at various stages of severe pediatric burn injury and to identify the cell types where this activation may occur. Another aim of the study was to test the effect of propranolol (an effective treatment of patients with burns) on the activation of PARP in skeletal muscle biopsies. Poly(ADP-ribose) polymerase activation was measured by Western blotting for its product, poly(ADP-ribose) (PAR). The localization of PARP activation was determined by PAR immunohistochemistry. The results showed that PARP becomes activated in the skeletal muscle tissue after burns, with the peak of the activation occurring in the middle stage of the disease (13-18 days after burns). Even at the late stage of the disease (69-369 days after burn), an elevated degree of PARP activation persisted in some of the patients. Immunohistochemical studies localized the staining of PAR primarily to vascular endothelial cells and occasionally to resident mononuclear cells. There was a marked suppression of PARP activation in the skeletal muscle biopsies of patients who received propranolol treatment. We conclude that human burn injury is associated with the activation of PARP. We hypothesize that this response may contribute to the inflammatory responses and cell dysfunction in burns. Some of the clinical benefit of propranolol in burns may be related to its inhibitory effect on PARP activation.

  9. Topical application of docosanol- or stearic acid-containing creams reduces severity of phenol burn wounds in mice.

    PubMed

    Khalil, M H; Marcelletti, J F; Katz, L R; Katz, D H; Pope, L E

    2000-08-01

    Because of their reported antiviral and anti-inflammatory activities, cream formulations containing n-docosanol (docosanol) or stearic acid were tested for effects on chemically-induced burns in mice. In this model, injury was induced by painting the abdomens of mice with a chloroform solution of phenol. This was followed by the topical application of test substances 0.5, 3, and 6 h later. Progression of the wounds was assessed by a single evaluator after 8 h, using a numerical score of gross morphology. Docosanol- and stearic acid-containing creams substantially and reproducibly lessened the severity and progression of skin lesions compared to untreated sites with a 76% and 57% reduction in mean lesion scores, respectively. Untreated wounds appeared red and ulcerated; docosanol cream-treated wounds showed only slight erythema.

  10. SIRT1 protects rat lung tissue against severe burn-induced remote ALI by attenuating the apoptosis of PMVECs via p38 MAPK signaling

    PubMed Central

    Bai, Xiaozhi; Fan, Lei; He, Ting; Jia, Wenbin; Yang, Longlong; Zhang, Jun; Liu, Yang; Shi, Jihong; Su, Linlin; Hu, Dahai

    2015-01-01

    Silent information regulator type-1 (SIRT1) has been reported to be involved in the cardiopulmonary protection. However, its role in the pathogenesis of burn-induced remote acute lung injury (ALI) is currently unknown. The present study aims to investigate the role of SIRT1 in burn-induced remote ALI and the involved signaling pathway. We observed that SIRT1 expression in rat lung tissue after burn injury appeared an increasing trend after a short period of suppression. The upregulation of SIRT1 stimulated by resveratrol exhibited remission of histopathologic changes, reduction of cell apoptosis, and downregulation of pro-inflammatory cytokines in rat pulmonary tissues suffering from severe burn. We next used primary pulmonary microvascular endothelial cells (PMVECs) challenged by burn serum (BS) to simulate in vivo rat lung tissue after burn injury, and found that BS significantly suppressed SIRT1 expression, increased cell apoptosis, and activated p38 MAPK signaling. The use of resveratrol reversed these effects, while knockdown of SIRT1 by shRNA further augmented BS-induced increase of cell apoptosis and activation of p38 MAPK. Taken together, these results indicate that SIRT1 might protect lung tissue against burn-induced remote ALI by attenuating PMVEC apoptosis via p38 MAPK signaling, suggesting its potential therapeutic effects on the treatment of ALI. PMID:25992481

  11. Grading of severity of the condition in burn patients by serum protein and albumin/globulin studies.

    PubMed

    Kumar, Pramod

    2010-07-01

    Capillary permeability increases after inflammation with consequent leak of fluid, electrolytes, and proteins. The albumin molecule size being smaller (69 kDa) than the globulin molecule (90-156 kDa) will leak relatively at an early stage of the disease (with moderate increase in capillary pore size) than globulin leading to albumin/globulin reversal. In cases with severe permeability changes with rapid progression to larger pore size with simultaneous leak of both albumin and globulin, albumin/globulin reversal will not occur. In this study estimation the serum protein and albumin/globulin (A/G) ratio at frequent intervals was done to grade the severity of the condition of burn patients by assessing the severity of capillary leak.A total of 61 admitted patients (from March 2002 to December 2004) based on the protein values were divided into 3 groups (group 1: 6-8 g/dL, group 2: 5.1-5.9 g/dL, group 3: < or =5.0 g/dL), and all the patients who showed change in their protein levels during the study were shifted to appropriate group and were classified as group shifters. The mean survival time and mortality of various groups were compared, and A/G ratio of all the expired cases was analyzed.Group 3 patients showed higher mortality (95%) as compared to that in other groups (group 1 and 2: 0% each and group shifters: 30.2%). Median survival time of group 3 was significantly low as compared to that of group 1 (P < 0.0026), group 2 (P < 0.0006), and group shifters (P < 0.0000). In group shifters the mean time (days) required for shifting from one group to other just before death or discharge in survivors was significantly higher than that in expired cases. Of 26 cases expired during the study, initial A/G ratio at the time of first assigning the group was not reversed in 22 cases (84.6%).The study concluded that the severity (indicated by lower serum protein values) and speed (judged by A/G ratio changes and median survival time analysis) of capillary permeability changes

  12. Use of the Beck Depression Inventory for assessing depression in patients hospitalized with severe burn. Disentangling symptoms of depression from injury and treatment factors.

    PubMed

    Thombs, Brett D

    2007-08-01

    The objective of this study was to assess whether scores on the Beck Depression Inventory (BDI) are biased by injury severity among hospitalized survivors of burn (N=262). A confirmatory factor analysis (CFA) model was developed with a general depression factor that loaded on all items and somatic and cognitive factors that were orthogonal to the general factor and to each other. The model fit the data well and substantially better than an alternative three-factor model with correlated factors. Percent total body surface area burned (TBSA) was significantly associated with the general depression factor (p=.04), but also with the orthogonal somatic factor (p<.001), suggesting biased measurement due to overlap between somatic symptoms of depression and the severity of the burn injury. Analysis of item communalities, however, suggested that only approximately 2% of total predicted item variance was associated with bias related to injury severity. It was concluded that, despite a small amount of bias, the BDI is a reasonably accurate clinical tool even in the context of severe burn. Appropriate adjustments for bias, however, should be made in research with the BDI among patients with acute burn.

  13. A randomized controlled trial to compare the effects of liquid versus powdered recombinant human growth hormone in treating patients with severe burns

    PubMed Central

    CHEN, GUOXIAN; SHAO, HUAWEI; PAN, XUANLIANG

    2016-01-01

    Recombinant human growth hormone (rhGH) promotes protein utilization and synthesis, and is widely used as a therapy to treat severe burns. The present randomized controlled trial evaluated the effects of different forms of rhGH on patients with severe burns. A total of 29 adult severe burns patients were enrolled between February 2009 and November 2011, and randomly assigned to either treatment group (T, liquid rhGH) or control group (C, powder rhGH). From days 5 to 7 following the infliction of burns, both patient groups received rhGH at 0.067 mg/kg/d, once for 10 days. Median serum pre-albumin levels increased in both groups following treatment, the elevation from baseline was significantly higher in the T group on day 10 compared to the C group (88 mg/l vs. 65 mg/l, P=0.046). C-reactive protein, fasting plasma glucose and body weight decreased in both groups. Body weight was significantly lower in the T compared to the C group at baseline, Day 5 and Day 10 (P=0.046, P=0.018 and P=0.006, respectively), however the decrease from baseline levels were not significantly different. Wound healing time was similar between groups (P=0.270). In conclusion the early use of liquid rather than powder rhGH may be more beneficial for treating adult patients with severe burns. PMID:27123246

  14. Atmospheric effects on the performance and threshold extrapolation of multi-temporal Landsat derived dNBR for burn severity assessment

    NASA Astrophysics Data System (ADS)

    Fang, Lei; Yang, Jian

    2014-12-01

    The Landsat derived differenced Normalized Burn Ratio (dNBR) is widely used for burn severity assessments. Studies of regional wildfire trends in response to climate change require consistency in dNBR mapping across multiple image dates, which may vary in atmospheric condition. Conversion of continuous dNBR images into categorical burn severity maps often requires extrapolation of dNBR thresholds from present fires for which field severity measurements such as Composite Burn Index (CBI) data are available, to historical fires for which CBI data are typically unavailable. Although differential atmospheric effects between image collection dates could lead to biased estimates of historical burn severity patterns, little is known concerning the influence of atmospheric effects on dNBR performance and threshold extrapolation. In this study, we compared the performance of dNBR calculated from six atmospheric correction methods using an optimality approach. The six correction methods included one partial (Top of atmosphere reflectance, TOA), two absolute, and three relative methods. We assessed how the correction methods affected the CBI-dNBR correlation and burn severity mapping in a Chinese boreal forest fire which occurred in 2010. The dNBR thresholds of the 2010 fire for each of the correction methods were then extrapolated to classify a historical fire from 2000. Classification accuracies of threshold extrapolations were assessed based on Cohen's Kappa analysis with 73 field-based validation plots. Our study found most correction methods improved mean dNBR optimality of the two fires. The relative correction methods generated 32% higher optimality than both TOA and absolute correction methods. All the correction methods yielded high CBI-dNBR correlations (mean R2 = 0.847) but distinctly different dNBR thresholds for severity classification of 2010 fire. Absolute correction methods could substantially increase optimality score, but were insufficient to provide a

  15. Investigation of Biomass Combustion Rate of Fire Radiative Energy Using Multiple-Satellite-observed Active Fires and Landsat TM Burn Severities across the Continental United States

    NASA Astrophysics Data System (ADS)

    Li, F.; Zhang, X.; Kondragunta, S.

    2015-12-01

    Biomass burning is a major source of atmospheric aerosol and greenhouse gases that substantially influence climate and regional air quality. However, the accuracy of biomass burning emissions estimated using traditional method is limited by large uncertainties in burned area and fuel loading. Alternatively, fire radiative energy (FRE) has recently been demonstrated to be linearly related to biomass combustion, which potentially improves the estimation of biomass burning emissions. The FRE-based combustion rate is 0.368-0.453 kg/MJ according to field controlled experiments while it varies from 1.37-4.5 kg/MJ derived from satellite-based bottom-up and top-down aerosol optical thickness estimates. Here we investigate the FRE combustion rate in over 1000 burn scars from 2011 to 2012 across the Continental United States (CONUS). Specifically, FRE was calculated by combining the high spatial observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the high temporal observations from the Geostationary Operational Environmental Satellite (GOES). Biomass consumption in burn scars was modeled using Landsat TM 30m burn severities, 30m fuel loading from Fuel Characteristic Classification System, and combustion completeness compiled from recent literatures. The combustion rate was then investigated by correlating FRE to biomass consumption across CONUS and Bailey's ecoregions. Our results show that the combustion rate can be extracted from the linear relationship between biomass consumption and FRE. The combustion rate is 0.415±10% kg/MJ across CONUS, which is similar to the rate derived from field experiments. However, it varies from 0.18-1.9 kg/MJ among ecoregions. This implies that a single combustion rate could produce large uncertainty in the estimation of biomass consumption at large scales. We suggest that ecoregion specified combustion rates should help to improve the accuracy of quantifying biomass burning emissions regionally and globally.

  16. 15 CFR 995.5 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA...

  17. 15 CFR 995.5 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA...

  18. 15 CFR 995.5 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA...

  19. 15 CFR 995.5 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA...

  20. 15 CFR 995.5 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA...

  1. 40 CFR 600.503-78 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for Model Year... Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions § 600.503-78 Abbreviations. The abbreviations in § 600.003 apply to this subpart....

  2. 40 CFR 600.003-77 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy and Carbon-Related Exhaust Emission Regulations for 1977 and Later Model Year Automobiles-General Provisions § 600.003-77 Abbreviations. (a) The abbreviations used in this subpart have the same meaning as those in 40 CFR part 86,...

  3. Frequency of uncommon abbreviations in medical journals.

    PubMed

    Shocket, E

    1995-03-01

    Although the use of abbreviations not understood by the average reader is discouraged by journal editors, I nevertheless found that 43% of 147 articles published during June 1993 in eight general and surgical journals contained uncommon abbreviations. In 26 (18%) of the 147 articles, all the abbreviations and their explanatory decoding words appeared at the front of the article, either in the abstract or in the first paragraph. This up front position makes easier the reader's back-search. In 37 other articles (25%), at least one uncommon abbreviation was decoded somewhere in the body of the article. In 21 articles (14%) the uncommon abbreviations appeared in the concluding or summating paragraph(s) and the explanatory decoding words were buried in the body of the article, thus making difficult the reader's back-search. Corrective action might include (1) editorial and peer review enforcement of the "no nonstandard abbreviation" policy, which is easily done with computerized word processing; (2) tabulation of all abbreviations with their decoding words either just below the abstract at the front of the article or just above the bibliography at the rear; or (3) expansion of each abbreviation in a footnote at the bottom of the appropriate page.

  4. 40 CFR 116.2 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Abbreviations. 116.2 Section 116.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS DESIGNATION OF HAZARDOUS SUBSTANCES § 116.2 Abbreviations. ppm=parts per million mg=milligram(s) kg=kilogram(s) mg/l=milligrams(s)...

  5. 40 CFR 600.003 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Abbreviations. 600.003 Section 600.003 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES General Provisions § 600.003 Abbreviations....

  6. 40 CFR 600.003 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Abbreviations. 600.003 Section 600.003 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES General Provisions § 600.003 Abbreviations....

  7. Acronyms, initialisms, and abbreviations: Fourth Revision

    SciTech Connect

    Tolman, B.J.

    1994-04-01

    This document lists acronyms used in technical writing. The immense list is supplemented by an appendix containing chemical elements, classified information access, common abbreviations used for functions, conversion factors for selected SI units, a flowcharting template, greek alphabet, metrix terminology, proofreader`s marks, signs and symbols, and state abbreviations.

  8. 40 CFR 86.094-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.094-3 Abbreviations. (a) The abbreviations in § 86... Petroleum Gas NMHC—Nonmethane Hydrocarbons NMHCE—Non-Methane Hydrocarbon Equivalent PM—Particulate...

  9. 40 CFR 86.094-3 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.094-3 Abbreviations. (a) The abbreviations in § 86... Petroleum Gas NMHC—Nonmethane Hydrocarbons NMHCE—Non-Methane Hydrocarbon Equivalent PM—Particulate...

  10. Comparative Population Plasma and Tissue Pharmacokinetics of Micafungin in Critically Ill Patients with Severe Burn Injuries and Patients with Complicated Intra-Abdominal Infection.

    PubMed

    García-de-Lorenzo, A; Luque, S; Grau, S; Agrifoglio, A; Cachafeiro, L; Herrero, E; Asensio, M J; Sánchez, S M; Roberts, J A

    2016-10-01

    Severely burned patients have altered drug pharmacokinetics (PKs), but it is unclear how different they are from those in other critically ill patient groups. The aim of the present study was to compare the population pharmacokinetics of micafungin in the plasma and burn eschar of severely burned patients with those of micafungin in the plasma and peritoneal fluid of postsurgical critically ill patients with intra-abdominal infection. Fifteen burn patients were compared with 10 patients with intra-abdominal infection; all patients were treated with 100 to 150 mg/day of micafungin. Micafungin concentrations in serial blood, peritoneal fluid, and burn tissue samples were determined and were subjected to a population pharmacokinetic analysis. The probability of target attainment was calculated using area under the concentration-time curve from 0 to 24 h/MIC cutoffs of 285 for Candida parapsilosis and 3,000 for non-parapsilosis Candida spp. by Monte Carlo simulations. Twenty-five patients (18 males; median age, 50 years; age range, 38 to 67 years; median total body surface area burned, 50%; range of total body surface area burned, 35 to 65%) were included. A three-compartment model described the data, and only the rate constant for the drug distribution from the tissue fluid to the central compartment was statistically significantly different between the burn and intra-abdominal infection patients (0.47 ± 0.47 versus 0.15 ± 0.06 h(-1), respectively; P < 0.05). Most patients would achieve plasma PK/pharmacodynamic (PD) targets of 90% for non-parapsilosis Candida spp. and C. parapsilosis with MICs of 0.008 and 0.064 mg/liter, respectively, for doses of 100 mg daily and 150 mg daily. The PKs of micafungin were not significantly different between burn patients and intra-abdominal infection patients. After the first dose, micafungin at 100 mg/day achieved the PK/PD targets in plasma for MIC values of ≤0.008 mg/liter and ≤0.064 mg/liter for non-parapsilosis Candida spp

  11. Characterization of post-fire surface cover, soils, and burn severity at the Cerro Grande Fire, New Mexico, using hyperspectral and multispectral remote sensing

    USGS Publications Warehouse

    Kokaly, R.F.; Rockwell, B.W.; Haire, S.L.; King, T.V.V.

    2007-01-01

    Forest fires leave behind a changed ecosystem with a patchwork of surface cover that includes ash, charred organic matter, soils and soil minerals, and dead, damaged, and living vegetation. The distributions of these materials affect post-fire processes of erosion, nutrient cycling, and vegetation regrowth. We analyzed high spatial resolution (2.4??m pixel size) Airborne Visible and Infrared Imaging Spectrometer (AVIRIS) data collected over the Cerro Grande fire, to map post-fire surface cover into 10 classes, including ash, soil minerals, scorched conifer trees, and green vegetation. The Cerro Grande fire occurred near Los Alamos, New Mexico, in May 2000. The AVIRIS data were collected September 3, 2000. The surface cover map revealed complex patterns of ash, iron oxide minerals, and clay minerals in areas of complete combustion. Scorched conifer trees, which retained dry needles heated by the fire but not fully combusted by the flames, were found to cover much of the post-fire landscape. These scorched trees were found in narrow zones at the edges of completely burned areas. A surface cover map was also made using Landsat Enhanced Thematic Mapper plus (ETM+) data, collected September 5, 2000, and a maximum likelihood, supervised classification. When compared to AVIRIS, the Landsat classification grossly overestimated cover by dry conifer and ash classes and severely underestimated soil and green vegetation cover. In a comparison of AVIRIS surface cover to the Burned Area Emergency Rehabilitation (BAER) map of burn severity, the BAER high burn severity areas did not capture the variable patterns of post-fire surface cover by ash, soil, and scorched conifer trees seen in the AVIRIS map. The BAER map, derived from air photos, also did not capture the distribution of scorched trees that were observed in the AVIRIS map. Similarly, the moderate severity class of Landsat-derived burn severity maps generated from the differenced Normalized Burn Ratio (dNBR) calculation

  12. [Ocular burns].

    PubMed

    Merle, H; Gérard, M; Schrage, N

    2008-09-01

    Ocular or thermal burns account for 7.7%-18% of ocular trauma. The majority of victims are young. The burns occur in the setting of accidents at work or in the home, or during a physical attack. Chemical burns by strong acids or bases are responsible for the most serious injuries. Associated with the destruction of limbal stem cells, they present as recurrent epithelial ulcerations, chronic stromal ulcers, deep stromal revascularization, conjunctival overlap, or even corneal perforation. The initial clinical exam is sometimes difficult to perform in the presence of burning symptoms. Nevertheless, it enables the physician to classify the injury, establish a prognosis, and most importantly, guide the therapeutic management. The Roper-Hall modification of the Hughes classification system is the most widely utilized, broken down into stages based on the size of the stromal opacity and the extent of possible limbal ischemia. This classification is now favorably supplemented by those proposed by Dua and Wagoner, which are based on the extent of the limbal stem cell deficiency. The prognosis of the more serious forms of ocular burns has markedly improved over the last decade because of a better understanding of the physiology of the corneal epithelium. Surgical techniques aimed at restoring the destroyed limbal stem cells have altered the prognosis of severe corneal burns. In order to decrease the incidence of burns, prevention, particularly in industry, is essential. PMID:18971859

  13. A comparative analysis of advanced techniques for skin reconstruction with autologous keratinocyte culture in severely burned children: own experience

    PubMed Central

    Nessler, Michał B.; Drukala, Justyna; Bartoszewicz, Marzenna; Mądry, Ryszard

    2014-01-01

    Introduction The local treatment in burns larger than 50% of total body surface area is still the great challenge for surgeons. Aim This paper presents a review of different solutions for deep burn wound healing in children and the early outcomes of treatment with combined autologous cell culture technique. Material and methods For this study, 20 children aged between 4 and 12 years with 55–65% of TBSA III grade burn injury were analyzed. A skin sample, 1 cm × 1 cm in size, for keratinocyte cultivation, was taken on the day of the burn. After necrotic tissue excision, the covering of the burned area with an isolated meshed skin graft was carried out between day 4 and 7. After 7 days of keratinocyte cultivation, the mentioned areas were covered with cells from the culture. We divided the burned regions, according to the way of wound closure, into 3 groups each consisting of 15 treated regions of the body. We used meshed split thickness skin grafts (SSG group), cultured autologous keratinocytes (CAC group), and both techniques applied in one stage (SSG + CAC group). Results In the SSG group, the mean time for complete closure of wounds was 12.7 days. Wounds treated with CAC only needed a non-significantly longer time to heal – 14.2 days (p = 0.056) when compared to SSG. The shortest time to heal was observed in the group treated with SSG + CAC – 8.5 days, and it was significantly shorter when compared to the SSG and CAC groups (p < 0.001). Conclusions This study suggests that cultured keratinocytes obtained after short-time multiplication, combined with meshed autologous split thickness skin grafts, constitute the optimal wound closure in burned children. PMID:25097488

  14. Targeting α-7 nicotinic acetylcholine receptor in the enteric nervous system: a cholinergic agonist prevents gut barrier failure after severe burn injury.

    PubMed

    Costantini, Todd W; Krzyzaniak, Michael; Cheadle, Gerald A; Putnam, James G; Hageny, Ann-Marie; Lopez, Nicole; Eliceiri, Brian P; Bansal, Vishal; Coimbra, Raul

    2012-08-01

    We have previously shown that vagal nerve stimulation prevents intestinal barrier loss in a model of severe burn injury in which injury was associated with decreased expression and altered localization of intestinal tight junction proteins. α-7 Nicotinic acetylcholine receptor (α-7 nAchR) has been shown to be necessary for the vagus nerve to modulate the systemic inflammatory response, but the role of α-7 nAchR in mediating gut protection remained unknown. We hypothesized that α-7 nAchR would be present in the gastrointestinal tract and that treatment with a pharmacological agonist of α-7 nAchR would protect against burn-induced gut barrier injury. The effects of a pharmacological cholinergic agonist on gut barrier integrity were studied using an intraperitoneal injection of nicotine 30 minutes after injury. Intestinal barrier integrity was examined by measuring permeability to 4-kDa fluorescein isothiocyanate-dextran and by examining changes in expression and localization of the intestinal tight junction proteins occludin and ZO-1. Nicotine injection after injury prevented burn-induced intestinal permeability and limited histological gut injury. Treatment with nicotine prevented decreased expression and altered localization of occludin and ZO-1, as seen in animals undergoing burn alone. Defining the interactions among the vagus nerve, the enteric nervous system, and the intestinal epithelium may lead to development of targeted therapeutics aimed at reducing gut barrier failure and intestinal inflammation after severe injury.

  15. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    PubMed

    Baker, William L

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984-2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984-2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046-2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire in

  16. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    PubMed Central

    Baker, William L.

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984–2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984–2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046–2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire

  17. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    PubMed

    Baker, William L

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984-2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984-2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046-2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire in

  18. Use of a pediatric oxygenator integrated in a veno-venous hemofiltration circuit to remove CO2: a case report in a severe burn patient with refractory hypercapnia.

    PubMed

    Rousseau, Anne-Françoise; Damas, Pierre; Renwart, Ludovic; Amand, Théo; Erpicum, Marie; Morimont, Philippe; Dubois, Bernard; Massion, Paul B

    2014-11-01

    Acute respiratory distress syndrome management is currently based on lung protective ventilation. Such strategy may lead to hypercapnic acidosis. We report a case of refractory hypercapnia in a severe burn adult, treated with simplified veno-venous extracorporeal carbon dioxide removal technique. We integrated a pediatric oxygenator in a continuous veno-venous hemofiltration circuit. This technique, used during at least 96h, was feasible, sure and efficient with carbon dioxide removal rate up to 32%.

  19. 40 CFR 600.403-77 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-Dealer Availability of Fuel Economy Information § 600.403-77 Abbreviations....

  20. 40 CFR 600.403-77 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-Dealer Availability of Fuel Economy Information § 600.403-77 Abbreviations....

  1. 40 CFR 600.203-77 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-Procedures for Calculating Fuel Economy Values § 600.203-77 Abbreviations....

  2. 40 CFR 600.503-78 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 1978 Passenger Automobiles and for 1979 and Later Model Year Automobiles (Light Trucks and Passenger Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.503-78 Abbreviations....

  3. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) The abbreviations in this section apply to this subpart, and also to subparts B, E, F, M, N, and P of.... GC—Gas chromatograph. HPLC—High-pressure liquid chromatography. MeOH—Methanol (CH3OH)....

  4. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) The abbreviations in this section apply to this subpart, and also to subparts B, E, F, M, N, and P of.... GC—Gas chromatograph. HPLC—High-pressure liquid chromatography. MeOH—Methanol (CH3OH)....

  5. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) The abbreviations in this section apply to this subpart, and also to subparts B, E, F, M, N, and P of.... GC—Gas chromatograph. HPLC—High-pressure liquid chromatography. MeOH—Methanol (CH3OH)....

  6. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) The abbreviations in this section apply to this subpart, and also to subparts B, E, F, M, N, and P of.... GC—Gas chromatograph. HPLC—High-pressure liquid chromatography. MeOH—Methanol (CH3OH)....

  7. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) The abbreviations in this section apply to this subpart, and also to subparts B, E, F, M, N, and P of.... GC—Gas chromatograph. HPLC—High-pressure liquid chromatography. MeOH—Methanol (CH3OH)....

  8. Release of severe post-burn contracture of the first web space using the reverse posterior interosseous flap: Our experience with 12 cases.

    PubMed

    Kai, Shi; Zhao, Jingchun; Jin, Zhenghua; Wu, Weiwei; Yang, Ming; Wang, Yan; Xie, Chunhui; Yu, Jiaao

    2013-09-01

    We retrospectively assessed outcomes after treating severe contractures of the first web space from burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18-58 years) with burns from 10% to 70% (mean, 30.1%) total body surface area and severe contractures of the first web space of the hand (initial thumb to index angles from 10° to 35° [mean, 23°]) underwent contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9cm×6cm to 14cm×10cm (mean area, 83.6cm(2)). The patients were followed for 5-26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78°, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe contractures of the first web space of the hand after burn, with distinct advantages over currently used alternative methods. PMID:23523223

  9. The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study.

    PubMed

    Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer

    2013-09-01

    Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg. PMID:23313241

  10. Release of severe post-burn contracture of the first web space using the reverse posterior interosseous flap: Our experience with 12 cases.

    PubMed

    Kai, Shi; Zhao, Jingchun; Jin, Zhenghua; Wu, Weiwei; Yang, Ming; Wang, Yan; Xie, Chunhui; Yu, Jiaao

    2013-09-01

    We retrospectively assessed outcomes after treating severe contractures of the first web space from burns with the reverse posterior interosseous flaps (RPIF). Twelve consecutive patients (ages 18-58 years) with burns from 10% to 70% (mean, 30.1%) total body surface area and severe contractures of the first web space of the hand (initial thumb to index angles from 10° to 35° [mean, 23°]) underwent contracture release using the RPIF. Seventeen RPIFs were used, with sizes from 9cm×6cm to 14cm×10cm (mean area, 83.6cm(2)). The patients were followed for 5-26 months. All flaps survived completely, rapidly adapted to the recipient beds, and achieved good color and texture harmony. No early complications occurred. Fifteen donor sites were closed with skin grafts. Two donor sites were closed by direct suture. No paralysis of the posterior interosseous nerve was observed in these cases. At last follow-up the mean thumb to index angle was 78°, increasing the web length 260%. All patients regained fundamental hand functions. The RPIF is reliable and safe for releasing severe contractures of the first web space of the hand after burn, with distinct advantages over currently used alternative methods.

  11. Effects of a 12-week Rehabilitation Program with Music & Exercise Groups on Range of Motion in Young Children with Severe Burns

    PubMed Central

    Neugebauer, Christine Tuden; Serghiou, Michael; Herndon, David N.; Suman, Oscar E.

    2013-01-01

    Previous studies indicate that rehabilitation programs supplemented with a strength and endurance-based exercise program improve lean body mass, pulmonary function, endurance, strength, and functional outcomes in severely burned children over the age of 7-years when compared to standard of care. To date, supplemental exercise programming for severely burned children under the age of 7-years has not yet been explored. The purpose of this study was to determine if a 12-week rehabilitation program supplemented with music & exercise, was more effective in improving functional outcomes than the standard of care alone. METHODS This is a descriptive study that measured elbow and knee range of motion (ROM) in 24 severely burned children between ages two and six years. Groups were compared for demographics as well as active and passive ROM to bilateral elbows and knees. A total of 15 patients completed the rehabilitation with supplemental music and exercise, and data was compared to 9 patients who received standard of care. RESULTS Patients receiving the 12-week program significantly improved ROM in all joints assessed except for one. Patients receiving standard of care showed a significant improvement in only one of the joints assessed. CONCLUSION Providing a structured supplemental music and exercise program in conjunction with occupational and physical therapy seems to improve both passive and active ROM to a greater extent than the standard of care alone. PMID:18849852

  12. 40 CFR 92.102 - Definitions and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Definitions and abbreviations. 92.102... Definitions and abbreviations. The definitions and abbreviations of subpart A of this part apply to this subpart. The following definitions and abbreviations, as well as those found in § 92.132...

  13. Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates.

    PubMed

    Friedman, Bruce C; Mian, Mohammad A H; Mullins, Robert F; Hassan, Zaheed; Shaver, Joseph R; Johnston, Krystal K

    2015-01-01

    The objective of this study is to determine the catheter-related bloodstream infection (CRBSI) rate in a severely burned patient population, many of whom required prolonged use of central venous catheters (CVCs). Between January 2008 and June 2012, 151 patients underwent placement of 455 five-lumen minocycline/rifampin-impregnated CVCs. CRBSI was defined as at least one blood culture (>100,000 colonies) and one simultaneous roll-plate CVC tip culture (>15 colony forming units) positive for the same organism. Most patients had accidental burns (81.5%) with a mean TBSA of 50%. A mean of three catheters were inserted per patient (range, 1-25). CVCs were inserted in the femoral vein (91.2%), subclavian vein (5.3%), and internal jugular vein (3.3%). Mean overall catheter indwell time was 8 days (range, 0-39 days). The overall rate of CRBSI per 1000 catheter days was 11.2; patients with a TBSA >60% experienced significantly higher rates of CRBSI than patients with a TBSA ≤60% (16.2 vs 7.3, P = .01). CVCs placed through burned skin were four times more likely to be associated with CRBSI than CVCs placed through intact skin. The most common infectious organism was Acinetobacter baumannii. Deep venous thrombosis developed in eleven patients (7%). The overall rate of CRBSI was 11.2, consistent with published rates of CRBSI in burn patients. Thus, femoral placement of 5-lumen CVCs did not result in increased CRBSI rates. These data support the safety of femoral CVC placement in burn patients, contrary to the Centers for Disease Control recommendation to avoid femoral CVC insertion.

  14. Molecular composition and size distribution of sugars, sugar-alcohols and carboxylic acids in airborne particles during a severe urban haze event caused by wheat straw burning

    NASA Astrophysics Data System (ADS)

    Wang, Gehui; Chen, Chunlei; Li, Jianjun; Zhou, Bianhong; Xie, Mingjie; Hu, Shuyuan; Kawamura, Kimitaka; Chen, Yan

    2011-05-01

    Molecular compositions and size distributions of water-soluble organic compounds (WSOC, i.e., sugars, sugar-alcohols and carboxylic acids) in particles from urban air of Nanjing, China during a severe haze event caused by field burning of wheat straw were characterized and compared with those in the summer and autumn non-haze periods. During the haze event levoglucosan (4030 ng m -3) was the most abundant compound among the measured WSOC, followed by succinic acid, malic acid, glycerol, arabitol and glucose, being different from those in the non-haze samples, in which sucrose or azelaic acid showed a second highest concentration, although levoglucosan was the highest. The measured WSOC in the haze event were 2-20 times more than those in the non-hazy days. Size distribution results showed that there was no significant change in the compound peaks in coarse mode (>2.1 μm) with respect to the haze and non-haze samples, but a large difference in the fine fraction (<2.1 μm) was found with a sharp increase during the hazy days mostly due to the increased emissions of wheat straw burning. Molecular compositions of organic compounds in the fresh smoke particles from wheat straw burning demonstrate that sharply increased concentrations of glycerol and succinic and malic acids in the fine particles during the haze event were mainly derived from the field burning of wheat straw, although the sources of glucose and related sugar-alcohols whose concentrations significantly increased in the fine haze samples are unclear. Compared to that in the fresh smoke particles of wheat straw burning an increase in relative abundance of succinic acid to levoglucosan during the haze event suggests a significant production of secondary organic aerosols during transport of the smoke plumes.

  15. Calibration and validation of the relative differenced Normalized Burn Ratio (RdNBR) to three measures of fire severity in the Sierra Nevada and Klamath Mountains, California, USA

    USGS Publications Warehouse

    Miller, J.D.; Knapp, E.E.; Key, C.H.; Skinner, C.N.; Isbell, C.J.; Creasy, R.M.; Sherlock, J.W.

    2009-01-01

    Multispectral satellite data have become a common tool used in the mapping of wildland fire effects. Fire severity, defined as the degree to which a site has been altered, is often the variable mapped. The Normalized Burn Ratio (NBR) used in an absolute difference change detection protocol (dNBR), has become the remote sensing method of choice for US Federal land management agencies to map fire severity due to wildland fire. However, absolute differenced vegetation indices are correlated to the pre-fire chlorophyll content of the vegetation occurring within the fire perimeter. Normalizing dNBR to produce a relativized dNBR (RdNBR) removes the biasing effect of the pre-fire condition. Employing RdNBR hypothetically allows creating categorical classifications using the same thresholds for fires occurring in similar vegetation types without acquiring additional calibration field data on each fire. In this paper we tested this hypothesis by developing thresholds on random training datasets, and then comparing accuracies for (1) fires that occurred within the same geographic region as the training dataset and in similar vegetation, and (2) fires from a different geographic region that is climatically and floristically similar to the training dataset region but supports more complex vegetation structure. We additionally compared map accuracies for three measures of fire severity: the composite burn index (CBI), percent change in tree canopy cover, and percent change in tree basal area. User's and producer's accuracies were highest for the most severe categories, ranging from 70.7% to 89.1%. Accuracies of the moderate fire severity category for measures describing effects only to trees (percent change in canopy cover and basal area) indicated that the classifications were generally not much better than random. Accuracies of the moderate category for the CBI classifications were somewhat better, averaging in the 50%-60% range. These results underscore the difficulty in

  16. Object-based assessment of burn severity in diseased forests using high-spatial and high-spectral resolution MASTER airborne imagery

    NASA Astrophysics Data System (ADS)

    Chen, Gang; Metz, Margaret R.; Rizzo, David M.; Dillon, Whalen W.; Meentemeyer, Ross K.

    2015-04-01

    Forest ecosystems are subject to a variety of disturbances with increasing intensities and frequencies, which may permanently change the trajectories of forest recovery and disrupt the ecosystem services provided by trees. Fire and invasive species, especially exotic disease-causing pathogens and insects, are examples of disturbances that together could pose major threats to forest health. This study examines the impacts of fire and exotic disease (sudden oak death) on forests, with an emphasis on the assessment of post-fire burn severity in a forest where trees have experienced three stages of disease progression pre-fire: early-stage (trees retaining dried foliage and fine twigs), middle-stage (trees losing fine crown fuels), and late-stage (trees falling down). The research was conducted by applying Geographic Object-Based Image Analysis (GEOBIA) to MASTER airborne images that were acquired immediately following the fire for rapid assessment and contained both high-spatial (4 m) and high-spectral (50 bands) resolutions. Although GEOBIA has gradually become a standard tool for analyzing high-spatial resolution imagery, high-spectral resolution data (dozens to hundreds of bands) can dramatically reduce computation efficiency in the process of segmentation and object-based variable extraction, leading to complicated variable selection for succeeding modeling. Hence, we also assessed two widely used band reduction algorithms, PCA (principal component analysis) and MNF (minimum noise fraction), for the delineation of image objects and the subsequent performance of burn severity models using either PCA or MNF derived variables. To increase computation efficiency, only the top 5 PCA and MNF and top 10 PCA and MNF components were evaluated, which accounted for 10% and 20% of the total number of the original 50 spectral bands, respectively. Results show that if no band reduction was applied the models developed for the three stages of disease progression had relatively

  17. Relative Influence of Top-Down ond Bottom-Up Controls on Mixed Severity Burn Patterns in Yosemite National Park, California, USA

    NASA Astrophysics Data System (ADS)

    Kane, V. R.; Povak, N.; Brooks, M.; Collins, B.; Smith, D.; Churchill, D.

    2015-12-01

    In western North America, recent and projected increases in the frequency and severity of large wildfires have elevated the need to understand the key drivers of fire regimes across landscapes so that managers can predict where fires will have the greatest ecological impact, and anticipate changes under future climate change. Yosemite National Park offers a unique opportunity to study potential biophysical controls on fire severity patterns - fire management in this area has allowed many fires to burn since the 1970s, re-establishing a mixed severity fire regime. Previous studies within the park showed a high level of control from a variety of bottom-up (e.g., fire history, topography) and top-down (e.g., climate) variables on fire severity within a portion of the current study area, and found some evidence controls may break down for the largest fires. In the current study, we sought to identify (1) controls on fire severity across all fires that burned within Yosemite (1984-2013), (2) differences in controls across fire sizes, (3) the contributions of topographic, climatic, and fire history variables to total variance explained, and (4) the influence of spatial autocorrelation on model results. Our study includes 147 fires that burned over 78,500 ha within Yosemite. Modeling results suggested that fire size and shape, topography, and localized climate variables explained fire severity patterns. Fires responded to inter-annual climate variability (top-down) plus local variation in water balance, past fire history, and local topographic variability (bottom-up). Climate-only models lead to the highest level of pure variance explained followed by fire history, and topography models. Climate variables had distinctly non-linear relationships with fire severity, and key drivers were related to winter conditions. Fire severity was positively correlated with fire size, and severity increased towards fire interiors. Steeper and more complex topographies were associated

  18. Burning Issue: Handling Household Burns

    MedlinePlus

    ... hot objects or liquid, fire, friction, the sun, electricity, or certain chemicals. Each year, about a half- ... infant or elderly. the burn was caused by electricity, which can lead to “invisible” burns. Burns Burns ...

  19. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland

    PubMed Central

    Rohrer-Mirtschink, S.; Forster, N.; Giovanoli, P.; Guggenheim, M.

    2015-01-01

    Summary In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed. PMID:26668566

  20. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland.

    PubMed

    Rohrer-Mirtschink, S; Forster, N; Giovanoli, P; Guggenheim, M

    2015-03-31

    In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed.

  1. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland.

    PubMed

    Rohrer-Mirtschink, S; Forster, N; Giovanoli, P; Guggenheim, M

    2015-03-31

    In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed. PMID:26668566

  2. 40 CFR 600.103-78 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.103-78 Section 600.103-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1978 and...

  3. 40 CFR 600.303-77 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.303-77 Section 600.303-77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and...

  4. 40 CFR 86.000-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... with the 2000 model year: A/C—Air conditioning FTP—Federal Test Procedure SFTP—Supplemental Federal... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.000-3 Section 86.000-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...

  5. 40 CFR 86.203-94 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.203-94 Section 86.203-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later Model Year Gasoline-Fueled New Light-Duty Vehicles, New Light-Duty Trucks and New...

  6. 14 CFR 34.2 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Abbreviations. 34.2 Section 34.2 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT FUEL VENTING AND EXHAUST EMISSION REQUIREMENTS FOR TURBINE ENGINE POWERED AIRPLANES General Provisions § 34.2...

  7. 77 FR 7517 - Definitions and Abbreviations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ...-Cooperative Service Rural Utilities Service 7 CFR Part 4279 RIN 0570-AA87 Definitions and Abbreviations AGENCY... the Agency's policy not to pay out additional cost for default interest, penalty interest, and late...'' in the definition section of the regulation and clarifying the Agency's policy as it relates...

  8. 77 FR 7546 - Definitions and Abbreviations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ...-AA87 Definitions and Abbreviations AGENCY: Rural Business-Cooperative Service, Rural Utilities Service... cost for default interest, penalty interest, and late charges calculated and submitted on a final... interest with prior Agency approval. By defining ``interest'' in the definition section of the...

  9. 14 CFR 34.2 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Abbreviations. 34.2 Section 34.2 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT FUEL VENTING AND EXHAUST EMISSION REQUIREMENTS FOR TURBINE ENGINE POWERED AIRPLANES General Provisions § 34.2...

  10. 32 CFR 552.162 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort Lewis, Yakima Training...

  11. 32 CFR 552.162 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort Lewis, Yakima Training...

  12. 32 CFR 552.162 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort Lewis, Yakima Training...

  13. 32 CFR 552.162 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort Lewis, Yakima Training Center, and Camp Bonneville §...

  14. 32 CFR 552.162 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort Lewis, Yakima Training...

  15. 40 CFR 300.4 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 28 2014-07-01 2014-07-01 false Abbreviations. 300.4 Section 300.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND... Agriculture Note: Reference is made in the NCP to both the Nuclear Regulatory Commission and the...

  16. 14 CFR 34.2 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Abbreviations. 34.2 Section 34.2 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT FUEL VENTING AND EXHAUST EMISSION REQUIREMENTS FOR TURBINE ENGINE POWERED AIRPLANES General Provisions § 34.2...

  17. 49 CFR 172.308 - Authorized abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS HAZARDOUS MATERIALS TABLE, SPECIAL... shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place... column 2 of the § 172.101 table (e.g., “TNT” and “PCB”) are authorized....

  18. 49 CFR 172.308 - Authorized abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS HAZARDOUS MATERIALS TABLE, SPECIAL... shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place... column 2 of the § 172.101 table (e.g., “TNT” and “PCB”) are authorized....

  19. 49 CFR 172.308 - Authorized abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS HAZARDOUS MATERIALS TABLE, SPECIAL... shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place... column 2 of the § 172.101 table (e.g., “TNT” and “PCB”) are authorized....

  20. 49 CFR 172.308 - Authorized abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS HAZARDOUS MATERIALS TABLE, SPECIAL... shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place... column 2 of the § 172.101 table (e.g., “TNT” and “PCB”) are authorized....

  1. 49 CFR 172.308 - Authorized abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS HAZARDOUS MATERIALS TABLE, SPECIAL... shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place... column 2 of the § 172.101 table (e.g., “TNT” and “PCB”) are authorized....

  2. [Fire severity of burnt area in Huzhong forest region of Great Xing' an Mountains, Northeast China based on normalized burn ratio analysis].

    PubMed

    Wang, Xiao-li; Wang, Wen-juan; Chang, Yu; Feng, Yu-ting; Chen, Hong-wei; Hu, Yuan-man; Chi, Jian-guo

    2013-04-01

    Based on the TM images and 3S technology, and by using normalized burn ratio (NBR) , this paper quantitatively evaluated the fire severity of burnt area in Huzhong forest region of the Great Xing' an Mountains from 1986 to 2010, and analyzed the relationships of the fire severity with environmental factors such as vegetation type, elevation, slope, and aspect. In Huzhong forest region, the fire occurrence frequency and total burnt area had an obvious inter-annual change. High incidence of forest fire was from June to August, and heavily burnt area occupied 84. 2% of the total burnt area. In the burnt area, larch forest accounted for 89. 9%. 68. 8% of burnt area located at the elevations from 1000 m to 1500 m, and 62. 5% located in eastern, southern, western, and northern slopes. There was no obvious difference in the burnt area between sunny and shady slopes. The burnt area at the slope degrees 15 degree-25 degrees occupied 38.4% of the total. High severity burnt area was the largest (70% of the total), followed by moderate severity burnt area (about 10%), and low severity burnt area and un-burnt area (<5% ). The majority of the forest fires in Huzhong forest region were of high severity fire, which caused great damages to the forest resources. It was suggested that in the forest fire management in Great Xing' an Mountains forest region, it would be urgent to implement forest fuel treatments to reduce fire severity to guarantee the forest ecosystem security.

  3. [The Abbreviated Injury Scale (AIS). Options and problems in application].

    PubMed

    Haasper, C; Junge, M; Ernstberger, A; Brehme, H; Hannawald, L; Langer, C; Nehmzow, J; Otte, D; Sander, U; Krettek, C; Zwipp, H

    2010-05-01

    The new AIS (Abbreviated Injury Scale) was released with an update by the AAAM (Association for the Advancement of Automotive Medicine) in 2008. It is a universal scoring system in the field of trauma applicable in clinic and research. In engineering it is used as a classification system for vehicle safety. The AIS can therefore be considered as an international, interdisciplinary and universal code of injury severity. This review focuses on a historical overview, potential applications and new coding options in the current version and also outlines the associated problems. PMID:20376615

  4. 40 CFR 96.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Measurements, abbreviations, and... IMPLEMENTATION PLANS NOX Budget Trading Program General Provisions § 96.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows:...

  5. 40 CFR 96.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Measurements, abbreviations, and... IMPLEMENTATION PLANS NOX Budget Trading Program General Provisions § 96.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows:...

  6. 7 CFR 762.102 - Abbreviations and definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Abbreviations and definitions. 762.102 Section 762.102 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.102 Abbreviations and definitions. Abbreviations...

  7. 7 CFR 762.102 - Abbreviations and definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Abbreviations and definitions. 762.102 Section 762.102 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.102 Abbreviations and definitions. Abbreviations...

  8. Object-based assessment of burn severity in diseased forests using high-spatial and high-spectral resolution MASTER airborne imagery

    NASA Astrophysics Data System (ADS)

    Chen, Gang; Metz, Margaret R.; Rizzo, David M.; Dillon, Whalen W.; Meentemeyer, Ross K.

    2015-04-01

    Forest ecosystems are subject to a variety of disturbances with increasing intensities and frequencies, which may permanently change the trajectories of forest recovery and disrupt the ecosystem services provided by trees. Fire and invasive species, especially exotic disease-causing pathogens and insects, are examples of disturbances that together could pose major threats to forest health. This study examines the impacts of fire and exotic disease (sudden oak death) on forests, with an emphasis on the assessment of post-fire burn severity in a forest where trees have experienced three stages of disease progression pre-fire: early-stage (trees retaining dried foliage and fine twigs), middle-stage (trees losing fine crown fuels), and late-stage (trees falling down). The research was conducted by applying Geographic Object-Based Image Analysis (GEOBIA) to MASTER airborne images that were acquired immediately following the fire for rapid assessment and contained both high-spatial (4 m) and high-spectral (50 bands) resolutions. Although GEOBIA has gradually become a standard tool for analyzing high-spatial resolution imagery, high-spectral resolution data (dozens to hundreds of bands) can dramatically reduce computation efficiency in the process of segmentation and object-based variable extraction, leading to complicated variable selection for succeeding modeling. Hence, we also assessed two widely used band reduction algorithms, PCA (principal component analysis) and MNF (minimum noise fraction), for the delineation of image objects and the subsequent performance of burn severity models using either PCA or MNF derived variables. To increase computation efficiency, only the top 5 PCA and MNF and top 10 PCA and MNF components were evaluated, which accounted for 10% and 20% of the total number of the original 50 spectral bands, respectively. Results show that if no band reduction was applied the models developed for the three stages of disease progression had relatively

  9. Serum albumin level as a risk factor for mortality in burn patients

    PubMed Central

    Alejandra Aguayo-Becerra, Olivia; Torres-Garibay, Carlos; Dassaejv Macías-Amezcua, Michel; Fuentes-Orozco, Clotilde; de Guadalupe Chávez-Tostado, Mariana; Andalón-Dueñas, Elizabeth; Espinosa Partida, Arturo; Álvarez-Villaseñor, Andrea Del Socorro; Cortés-Flores, Ana Olivia; Alejandro González-Ojeda

    2013-01-01

    OBJECTIVE: Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients. METHODS: We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality. RESULTS: In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p = 0.000), full-thickness burns (p = 0.004), inhalation injuries (p = 0.000), burns affecting >30% of the body surface area (p = 0.001), and burns associated with infection (p = 0.008). Protein and lipid levels were lower in the patients who died (p<0.05). Albumin levels showed the highest sensitivity and specificity (84% and 83%, respectively), and the area under the receiver-operating characteristic curve (0.869) had a cut-off of 1.95 g/dL for mortality. CONCLUSION: Patients with albumin levels <2 g/dL had a mortality risk of >80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality. PMID:23917657

  10. [Determination of silver and cerium in the liver and the kidney from a severely burned infant treated with silver sulfadiazine and cerium nitrate].

    PubMed

    Hirakawa, K

    1983-02-01

    Silver and cerium in the liver and the kidney from severely burned infant were analyzed by neutron activation method. The patient was treated topically with cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for 3 months. Then, the treatment with these drugs was stopped because of abdominal distention. The patient died 1 month after the cessation of the treatment with these drugs. The tissue specimens, blank liver sample and reference standards were irradiated with TRIGA MARK II Reactor of Rikkyo University. About 1 month after the irradiation, the activities were measured with a Ge(Li) detector coupled to a 4096 channel pulse height analyzer. A large amount of silver was detected both in the liver and in the kidney and a trace of cerium only in the liver. A considerable amount of silver was detected in the liver and its quantity was about 1600 times more than that of normal livers reported by Hamilton, Minski and Cleary (1972-73). Neither silver nor cerium were detected in the blank liver. These results suggest that prolonged topical chemotherapy of cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for the extensive burn injuries causes considerable absorption of silver and cerium into the liver and the kidney. PMID:6867381

  11. The media glorifying burns: a hindrance to burn prevention.

    PubMed

    Greenhalgh, David G; Palmieri, Tina L

    2003-01-01

    The media have a profound influence on the actions of children and adults. Burns and burn prevention tend to be ignored or even mocked. The purpose of this presentation is to reveal the callousness of the media in its dealings with burns and burn prevention. Printed materials with a relationship to burns, risk of burning, or disrespect for the consequences of burns were collected. The materials were tabulated into four categories: comics, advertisements (ads), articles that made light of burns, and television shows that portrayed behavior that would risk burn injury. Most burn-related materials were found in comics or advertisements. Several comics made light of high-risk behavior with flames, scald injury, contact injury, or burns. In addition, several advertisements showed people on fire or actions that could easily lead to burns. Several articles and televisions shows portrayed high-risk behavior that, in some instances, led to copycat injuries. Flames are frequently used to sell items that target adolescent boys or young men. The high incidence injuries that frequent this population parallel the high-risk behaviors portrayed by the media. The media portrays flames and high-risk behavior for burn injury as being cool, funny, and without consequence. The use of flames on clothing and recreational equipment (skateboards, hot rods) particularly targets the high-risk adolescent male. The burn community should make the media aware of the harm it causes with its callous depiction and glorification of burns.

  12. Pediatric cutaneous bleach burns.

    PubMed

    Lang, Cathleen; Cox, Matthew

    2013-07-01

    Bleach is a common household product which can cause caustic injuries. Its effects on mucosal tissues and the eye have been well-described in the literature. However, there is little information published regarding the appearance and effect of bleach on a child's skin. We report three children who sustained chemical burns after contact with bleach. All three children sustained accidental bleach burns while at home, and each child had a distinct brown discoloration to the skin from the injury. All three children had treatment and follow-up for their burns. Two of the children sustained more severe burns, which were extensive and required more time to heal. There was also long-term scarring associated with the severe burns. Like most burns, pain control is required until the injury heals.

  13. Pediatric cutaneous bleach burns.

    PubMed

    Lang, Cathleen; Cox, Matthew

    2013-07-01

    Bleach is a common household product which can cause caustic injuries. Its effects on mucosal tissues and the eye have been well-described in the literature. However, there is little information published regarding the appearance and effect of bleach on a child's skin. We report three children who sustained chemical burns after contact with bleach. All three children sustained accidental bleach burns while at home, and each child had a distinct brown discoloration to the skin from the injury. All three children had treatment and follow-up for their burns. Two of the children sustained more severe burns, which were extensive and required more time to heal. There was also long-term scarring associated with the severe burns. Like most burns, pain control is required until the injury heals. PMID:23545350

  14. [Fire severity of burnt area in Huzhong forest region of Great Xing' an Mountains, Northeast China based on normalized burn ratio analysis].

    PubMed

    Wang, Xiao-li; Wang, Wen-juan; Chang, Yu; Feng, Yu-ting; Chen, Hong-wei; Hu, Yuan-man; Chi, Jian-guo

    2013-04-01

    Based on the TM images and 3S technology, and by using normalized burn ratio (NBR) , this paper quantitatively evaluated the fire severity of burnt area in Huzhong forest region of the Great Xing' an Mountains from 1986 to 2010, and analyzed the relationships of the fire severity with environmental factors such as vegetation type, elevation, slope, and aspect. In Huzhong forest region, the fire occurrence frequency and total burnt area had an obvious inter-annual change. High incidence of forest fire was from June to August, and heavily burnt area occupied 84. 2% of the total burnt area. In the burnt area, larch forest accounted for 89. 9%. 68. 8% of burnt area located at the elevations from 1000 m to 1500 m, and 62. 5% located in eastern, southern, western, and northern slopes. There was no obvious difference in the burnt area between sunny and shady slopes. The burnt area at the slope degrees 15 degree-25 degrees occupied 38.4% of the total. High severity burnt area was the largest (70% of the total), followed by moderate severity burnt area (about 10%), and low severity burnt area and un-burnt area (<5% ). The majority of the forest fires in Huzhong forest region were of high severity fire, which caused great damages to the forest resources. It was suggested that in the forest fire management in Great Xing' an Mountains forest region, it would be urgent to implement forest fuel treatments to reduce fire severity to guarantee the forest ecosystem security. PMID:23898653

  15. Burn Wound Infections

    PubMed Central

    Church, Deirdre; Elsayed, Sameer; Reid, Owen; Winston, Brent; Lindsay, Robert

    2006-01-01

    Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices. PMID:16614255

  16. Pediatric facial burns.

    PubMed

    Kung, Theodore A; Gosain, Arun K

    2008-07-01

    Despite major advances in the area of burn management, burn injury continues to be a leading cause of pediatric mortality and morbidity. Facial burns in particular are devastating to the affected child and result in numerous physical and psychosocial sequelae. Although many of the principles of adult burn management can be applied to a pediatric patient with facial burns, the surgeon must be cognizant of several important differences. Facial burns and subsequent scar formation can drastically affect the growth potential of a child's face. Structures such as the nose and teeth may become deformed due to abnormal external forces caused by contractures. Serious complications such as occlusion amblyopia and microstomia must be anticipated and urgently addressed to avert permanent consequences, whereas other reconstructive procedures can be delayed until scar maturation occurs. Furthermore, because young children are actively developing the concept of self, severe facial burns can alter a child's sense of identity and place the child at high risk for future emotional and psychologic disturbances. Surgical reconstruction of burn wounds should proceed only after thorough planning and may involve a variety of skin graft, flap, and tissue expansion techniques. The most favorable outcome is achieved when facial resurfacing is performed with respect to the aesthetic units of the face. Children with facial burns remain a considerable challenge to their caregivers, and these patients require long-term care by a multidisciplinary team of physicians and therapists to optimize functional, cosmetic, and psychosocial outcomes. PMID:18650717

  17. Post-fire Vegetation Regeneration Dynamics to Topography and Burn Severity in two contrasting ecosystems: the Case of the Montane Cordillera Ecozones of Western Canada & that of a Typical Mediterranean site in Greece

    NASA Astrophysics Data System (ADS)

    Ireland, Gareth; Petropoulos, George P.; Kalivas, Dionissios; Griffirths, Hywel M.; Louka, Panagiota

    2015-04-01

    Altering land cover dynamics is currently regarded as the single most important variable of global change affecting ecological systems. Wildfires are an integral part of many terrestrial ecosystems and are considered to dramatically affect land cover dynamics at a variety of spatial and temporal scales. In this context, knowledge of the spatio-temporal distribution of post-fire vegetation recovery dynamics is of key importance. In this study, we explore the relationships between vegetation recovery dynamics to topography and burn severity for two different ecosystems using a chronosequence of Landsat TM data images analysis. One of our experimental sites is the Okanagan Mountain Park, located in the Montane Cordillera Ecozones of western Canada at which a fire occurred in 2003. The other is Mt. Parnitha, located in Greece, representing a typical Mediterranean setting. The spatio-temporal patterns of regrowth for 8 years following the fire events were quantified based on the analysis of 2 widely used indices, the Normalized Difference Vegetation Index (NDVI) and the Regeneration Index (RI). Burn severity was derived from the differenced Normalized Burn Ratio (dNBR) index computed from the Landsat TM images. Topographical information for the studied area was obtained from the ASTER global operational product. Relationships of vegetation regrowth to both topography and burn severity was quantified using a series of additional statistical metrics. In overall, results indicated noticeable differences in the recovery rates of both ecosystems to the pre-fire patterns. Re-growth rates appeared to be somewhat higher in north-facing slopes in comparison to south facing ones for both experimental sites, in common with other similar studies in different ecosystems. Lastly, areas of lower burn severity exhibited a higher recovery rate compared to areas of high severity burns. Results are presented in detail and an explanation of the main observation trends is also attempted to

  18. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  19. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  20. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  1. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  2. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  3. Burns (image)

    MedlinePlus

    ... degree burns damage the outer layer of skin (epidermis) and cause pain, redness and swelling (erythema). Second degree burns damage the epidermis and the inner layer, the dermis, causing erythema ...

  4. Lightning burns.

    PubMed

    Russell, Katie W; Cochran, Amalia L; Mehta, Sagar T; Morris, Stephen E; McDevitt, Marion C

    2014-01-01

    We present the case of a lightning-strike victim. This case illustrates the importance of in-field care, appropriate referral to a burn center, and the tendency of lightning burns to progress to full-thickness injury.

  5. Cognitive severity-specific neuronal degenerative network in charcoal burning suicide-related carbon monoxide intoxication: a multimodality neuroimaging study in Taiwan.

    PubMed

    Chen, Nai-Ching; Huang, Chi-Wei; Huang, Shu-Hua; Chang, Wen-Neng; Chang, Ya-Ting; Lui, Chun-Chung; Lin, Pin-Hsuan; Lee, Chen-Chang; Chang, Yen-Hsiang; Chang, Chiung-Chih

    2015-05-01

    While carbon monoxide (CO) intoxication often triggers multiple intraneuronal immune- or inflammatory-related cascades, it is not known whether the pathological processes within the affected regions evolve equally in the long term. To understand the neurodegenerative networks, we examined 49 patients with a clinical diagnosis of CO intoxication related to charcoal burning suicide at the chronic stage and compared them with 15 age- and sex-matched controls. Reconstructions of degenerative networks were performed using T1 magnetic resonance imaging, diffusion-tensor imaging, and fluorodeoxyglucose positron emission tomography (PET). Tract-specific fractional anisotropy (FA) quantification of 11 association fibers was performed while the clinical significance of the reconstructed structural or functional networks was determined by correlating them with the cognitive parameters. Compared with the controls, the patients had frontotemporal gray matter (GM) atrophy, diffuse white matter (WM) FA decrement, and axial diffusivity (AD) increment. The patients were further stratified into 3 groups based on the cognitive severities. The spatial extents within the frontal-insular-caudate GM as well as the prefrontal WM AD increment regions determined the cognitive severities among 3 groups. Meanwhile, the prefrontal WM FA values and PET signals also correlated significantly with the patient's Mini-Mental State Examination score. Frontal hypometabolic patterns in PET analysis, even after adjusted for GM volume, were highly coherent to the GM atrophic regions, suggesting structural basis of functional alterations. Among the calculated major association bundles, only the anterior thalamic radiation FA values correlated significantly with all chosen cognitive scores. Our findings suggest that fronto-insular-caudate areas represent target degenerative network in CO intoxication. The topography that occurred at a cognitive severity-specific level at the chronic phase suggested the

  6. Hand chemical burns.

    PubMed

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  7. 16 CFR 301.4 - Abbreviations or ditto marks prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or...

  8. 16 CFR 301.4 - Abbreviations or ditto marks prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or...

  9. 16 CFR 301.4 - Abbreviations or ditto marks prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or...

  10. 16 CFR 301.4 - Abbreviations or ditto marks prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or...

  11. 16 CFR 301.4 - Abbreviations or ditto marks prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or...

  12. 40 CFR 89.3 - Acronyms and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... kW Kilowatt NIST National Institute for Standards and Testing NMHC Nonmethane hydrocarbon NTIS...) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES General § 89.3 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 89. AECD Auxiliary emission control...

  13. 40 CFR 90.5 - Acronyms and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS General § 90.5 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 90. AECD—Auxiliary emission... Materials CAA—Clean Air Act CAAA—Clean Air Act Amendments of 1990 CLD—chemiluminescent detector...

  14. 40 CFR 89.3 - Acronyms and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... kW Kilowatt NIST National Institute for Standards and Testing NMHC Nonmethane hydrocarbon NTIS...) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES General § 89.3 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 89. AECD Auxiliary emission control...

  15. 40 CFR 89.3 - Acronyms and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... kW Kilowatt NIST National Institute for Standards and Testing NMHC Nonmethane hydrocarbon NTIS...) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES General § 89.3 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 89. AECD Auxiliary emission control...

  16. 7 CFR 1951.852 - Definitions and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 false Definitions and abbreviations. 1951.852 Section 1951....852 Definitions and abbreviations. (a) General definitions. The following definitions are applicable...) Low-income. The level of income of a person or family which is at or below the Poverty Guidelines...

  17. 40 CFR 97.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Measurements, abbreviations, and acronyms. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms....

  18. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Measurements, abbreviations, and acronyms. 96.203 Section 96.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... IMPLEMENTATION PLANS CAIR SO 2 Trading Program General Provisions § 96.203 Measurements, abbreviations,...

  19. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Measurements, abbreviations, and acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms....

  20. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Measurements, abbreviations, and acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms....

  1. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms....

  2. Features of Word Omission and Abbreviation in Telexes.

    ERIC Educational Resources Information Center

    Zak, Helena; Dudley-Evans, Tony

    1986-01-01

    Features of telexes used for business correspondence are discussed, including omission of parts of verbs, definite and indefinite articles, pronouns, and prepositions, and also word abbreviations. The telex is different from other abbreviated texts (such as telegrams), and Business English courses should include instruction in telex writing.…

  3. Test Review: Wechsler Abbreviated Scale of Intelligence, Second Edition

    ERIC Educational Resources Information Center

    Irby, Sarah M.; Floyd, Randy G.

    2013-01-01

    The Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II; Wechsler, 2011) is a brief intelligence test designed for individuals aged 6 through 90 years. It is a revision of the Wechsler Abbreviated Scale of Intelligence (WASI; Wechsler, 1999). During revision, there were three goals: enhancing the link between the Wechsler…

  4. [Burn injuries and mental health].

    PubMed

    Palmu, Raimo; Vuola, Jyrki

    2016-01-01

    Currently a large proportion of patients with severe burn injuries survive. This gives increasing challenges also for psychological recovery after the trauma. More than half of burn patients have mental disorders already before the burn injury but also patients who previously had no mental disorders may suffer from them. Some of the hospitalize burn patients have injuries due to suicidal attempts. Only a small proportion of burn patients receive appropriate psychiatric care although psychosocial interventions specifically planned for burn victims exist. More frequent screening of symtoms of mental disorders and psychiatric consultation, also after acute care in hospital, could lead to better management of post-burn psychiatric care as well as better management of the burn treatment and rehabilitation itself. PMID:27089616

  5. Clothing burns in Canadian children

    PubMed Central

    Stanwick, Richard S.

    1985-01-01

    A Canadian survey of 11 tertiary care pediatric centres with specialized burn facilities revealed that an estimated 37 children up to 9 years of age are admitted annually to such hospitals because of clothing burns. Sleepwear accounts for an estimated 21 such burns per year. Girls were found to suffer the most severe burns and represented eight of the nine children in the series who died. Loose and flowing garments dominated the girls' styles. The results of multiple-regression analysis confirmed that style of clothing (loose and flowing as opposed to snug) was the most significant predictor of burn severity, length of hospital stay, the need for skin grafting and survival. The ignition situation (avoidance of parental supervision at the time of injury) was the only other important predictor. The success of regulatory actions in other countries in reducing the incidence of severe clothing burns is reviewed, and preventive strategies for Canada are explored. ImagesFig. 2 PMID:3995433

  6. 40 CFR 87.2 - Acronyms and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Definitions. § 87.2 Acronyms and abbreviations. Link to an amendment published at 77 FR 36381, June 18, 2012... pressure ratio sec.Seconds SPShaft power SNSmoke number TTemperature, degrees Kelvin TIMTime in mode...

  7. 7 CFR 1980.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... abbreviations are applicable to this subpart: Fannie Mae— Federal National Mortgage Association. FCS— Farm.... Ginnie Mae— Government National Mortgage Association. HUD— Department of Housing and Urban...

  8. 40 CFR 96.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS NOX Budget Trading Program General Provisions § 96.3 Measurements, abbreviations,...

  9. Management of burn wounds.

    PubMed

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  10. Parafoveal and Foveal Processing of Abbreviations during Eye Fixations in Reading: Making a Case for Case

    ERIC Educational Resources Information Center

    Slattery, Timothy J.; Schotter, Elizabeth R.; Berry, Raymond W.; Rayner, Keith

    2011-01-01

    The processing of abbreviations in reading was examined with an eye movement experiment. Abbreviations were of 2 distinct types: acronyms (abbreviations that can be read with the normal grapheme-phoneme correspondence [GPC] rules, such as NASA) and initialisms (abbreviations in which the GPCs are letter names, such as NCAA). Parafoveal and foveal…

  11. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study

    PubMed Central

    2013-01-01

    Introduction The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload to allow for sufficient vital organ perfusion. Methods We conducted a three-year prospective cohort study of 132 consecutive critically burned patients. These patients underwent resuscitation guided by MAP (>65 mmHg), urinary output (0.5 to 1 ml/kg), TPTD and lactate levels. Fluid therapy was adjusted to achieve a cardiac index (CI) >2.5 L/minute/m2 and an intrathoracic blood volume index (ITBVI) >600 ml/m2, and to optimize lactate levels. Statistical analysis was performed using mixed models. We also used Pearson or Spearman methods and the Mann-Whitney U-test. Results A total of 98 men and 34 women (mean age, 48 ± 18 years) was studied. The mean total body surface area (TBSA) burned was 35% ± 22%. During the early resuscitation phase, lactate levels were elevated (2.58 ± 2.05 mmol/L) and TPTD showed initial hypovolemia by the CI (2.68 ± 1.06 L/minute/m2) and the ITBVI (709 ± 254 mL/m2). At 24 to 32 hours, the CI and lactic levels were normalized, although the ITBVI remained below the normal range (744 ± 276 ml/m2). The mean fluid rate required to achieve protocol targets in the first 8 hours was 4.05 ml/kg/TBSA burned, which slightly increased in the next 16 hours. Patients with a urine output greater than or less than 0.5 ml/kg/hour did not show differences in heart rate, mean arterial pressure, CI, ITBVI or lactate levels. Conclusions Initial hypovolemia may be detected by TPTD monitoring during the early resuscitation phase. This hypovolemia might not be reflected by blood

  12. Biomass Burning

    NASA Technical Reports Server (NTRS)

    Levine, Joel S.; Cofer, Wesley R., III; Pinto, Joseph P.

    1993-01-01

    Biomass burning may be the overwhelming regional or continental-scale source of methane (CH4) as in tropical Africa and a significant global source of CH4. Our best estimate of present methane emissions from biomass burning is about 51.9 Tg/yr, or 10% of the annual methane emissions to the atmosphere. Increased frequency of fires that may result as the Earth warms up may result in increases in this source of atmospheric methane.

  13. Ball lightning burn.

    PubMed

    Selvaggi, Gennaro; Monstrey, Stan; von Heimburg, Dennis; Hamdi, Mustapha; Van Landuyt, Koen; Blondeel, Phillip

    2003-05-01

    Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications.

  14. Ball lightning burn.

    PubMed

    Selvaggi, Gennaro; Monstrey, Stan; von Heimburg, Dennis; Hamdi, Mustapha; Van Landuyt, Koen; Blondeel, Phillip

    2003-05-01

    Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications. PMID:12792547

  15. A review of hydrofluoric acid burn management.

    PubMed

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns.

  16. A review of hydrofluoric acid burn management.

    PubMed

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns. PMID:25114621

  17. Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia

    PubMed Central

    Chim, Harvey; Yew, Woon Si; Song, Colin

    2007-01-01

    Introduction Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. Methods The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Results Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. Conclusion The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources. PMID:17274813

  18. Vitamin C in Burn Resuscitation.

    PubMed

    Rizzo, Julie A; Rowan, Matthew P; Driscoll, Ian R; Chung, Kevin K; Friedman, Bruce C

    2016-10-01

    The inflammatory state after burn injury is characterized by an increase in capillary permeability that results in protein and fluid leakage into the interstitial space, increasing resuscitative requirements. Although the mechanisms underlying increased capillary permeability are complex, damage from reactive oxygen species plays a major role and has been successfully attenuated with antioxidant therapy in several disease processes. However, the utility of antioxidants in burn treatment remains unclear. Vitamin C is a promising antioxidant candidate that has been examined in burn resuscitation studies and shows efficacy in reducing the fluid requirements in the acute phase after burn injury. PMID:27600125

  19. Development of the Abbreviated Masculine Gender Role Stress Scale

    PubMed Central

    Swartout, Kevin M.; Parrott, Dominic J.; Cohn, Amy M.; Hagman, Brett T.; Gallagher, Kathryn E.

    2014-01-01

    Data gathered from six independent samples (n = 1,729) that assessed men’s masculine gender role stress in college and community males were aggregated used to determine the reliability and validity of an abbreviated version of the Masculine Gender Role Stress Scale (MGRS scale). The 15 items with the highest item-to-total scale correlations were used to create an abbreviated MGRS scale. Psychometric properties of each of the 15-items were examined with Item Response Theory (IRT) analysis, using the discrimination and threshold parameters. IRT results showed that the abbreviated scale may hold promise at capturing the same amount of information as the full 40-item scale. Relative to the 40-item scale, the total score of the abbreviated MGRS scale demonstrated comparable convergent validity using the measurement domains of masculine identity, hyper-masculinity, trait anger, anger expression, and alcohol involvement. An abbreviated MGRS scale may be recommended for use in clinical practice and research settings to reduce cost, time, and patient/participant burden. Additionally, IRT analyses identified items with higher discrimination and threshold parameters that may be used to screen for problematic gender role stress in men who may be seen in routine clinical or medical practice. PMID:25528163

  20. Burn Teams and Burn Centers: The Importance of a Comprehensive Team Approach to Burn Care

    PubMed Central

    Al-Mousawi, Ahmed M.; Mecott-Rivera, Gabriel A.; Jeschke, Marc G.; Herndon, David N.

    2009-01-01

    Synopsis Advances in burn care have been colossal, but while extra work is needed, it is clear that the organized effort of burn teams can continue making improvements in survival rates and quality of life possible for patients. Burn patients are unique, representing the most severe model of trauma,33 and hence this necessitates treatment in the best facilities available for that endeavor. Burn centers have developed to meet these intricate needs but can only function productively and most efficiently through well organized, multifaceted, patient-centered teams in areas of clinical care and research. PMID:19793550

  1. Medical management of paediatric burn injuries: best practice.

    PubMed

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  2. The Earth Could Burn.

    ERIC Educational Resources Information Center

    Yarrow, Ruth

    1982-01-01

    Environmental educators are worried about the ultimate ecological threat--nuclear war, which could burn thousands of square miles, sterilize the soil, destroy 70 percent of the ozone layer letting in lethal ultraviolet rays, and cause severe radiation sickness. Educators must inform themselves, teach others, contact government representatives, and…

  3. Detection of sentence boundaries and abbreviations in clinical narratives

    PubMed Central

    2015-01-01

    Background In Western languages the period character is highly ambiguous, due to its double role as sentence delimiter and abbreviation marker. This is particularly relevant in clinical free-texts characterized by numerous anomalies in spelling, punctuation, vocabulary and with a high frequency of short forms. Methods The problem is addressed by two binary classifiers for abbreviation and sentence detection. A support vector machine exploiting a linear kernel is trained on different combinations of feature sets for each classification task. Feature relevance ranking is applied to investigate which features are important for the particular task. The methods are applied to German language texts from a medical record system, authored by specialized physicians. Results Two collections of 3,024 text snippets were annotated regarding the role of period characters for training and testing. Cohen's kappa resulted in 0.98. For abbreviation and sentence boundary detection we can report an unweighted micro-averaged F-measure using a 10-fold cross validation of 0.97 for the training set. For test set based evaluation we obtained an unweighted micro-averaged F-measure of 0.95 for abbreviation detection and 0.94 for sentence delineation. Language-dependent resources and rules were found to have less impact on abbreviation detection than on sentence delineation. Conclusions Sentence detection is an important task, which should be performed at the beginning of a text processing pipeline. For the text genre under scrutiny we showed that support vector machines exploiting a linear kernel produce state of the art results for sentence boundary detection. The results are comparable with other sentence boundary detection methods applied to English clinical texts. We identified abbreviation detection as a supportive task for sentence delineation. PMID:26099994

  4. Burning Man

    ERIC Educational Resources Information Center

    Cech, Scott J.

    2006-01-01

    Former Baltimore cop and teacher Ed Burns isn't a masochist. The writer-producer for "The Wire," a critically applauded HBO series about life and death on the streets of Baltimore, is just feverishly trying to save public schools. He thinks American education is hopelessly screwed up, but that it's also the country's only hope. So it makes sense…

  5. A new classification of ophthalmic disorders with standardized ophthalmic abbreviations.

    PubMed

    Spencer, L M; Spencer, G R

    1990-03-01

    A classification of ocular disorders has been developed that is both comprehensive and easy to use. Each disorder was assigned a unique abbreviation and cross referenced to the International Classification of Diseases, 9th edition (ICD-9). Ophthalmic procedures, medications, and other terms were similarly standardized and abbreviated. The result is a system of ophthalmic terminology that improves the quality of the medical record, facilitates ICD-9 coding, and makes computer data entry faster and more accurate. The system is published as a standard text with companion handbook. A computer program that uses the system also has been developed. PMID:2336279

  6. Effects of signal salience and noise on performance and stress in an abbreviated vigil

    NASA Astrophysics Data System (ADS)

    Helton, William Stokely

    Vigilance or sustained attention tasks traditionally require observers to detect predetermined signals that occur unpredictably over periods of 30 min to several hours (Warm, 1984). These tasks are taxing and have been useful in revealing the effects of stress agents, such as infectious disease and drugs, on human performance (Alluisi, 1969; Damos & Parker, 1994; Warm, 1993). However, their long duration has been an inconvenience. Recently, Temple and his associates (Temple et al., 2000) developed an abbreviated 12-min vigilance task that duplicates many of the findings with longer duration vigils. The present study was designed to explore further the similarity of the abbreviated task to long-duration vigils by investigating the effects of signal salience and jet-aircraft engine noise on performance, operator stress, and coping strategies. Forty-eight observers (24 males and 24 females) were assigned at random to each of four conditions resulting from the factorial combination of signal salience (high and low contrast signals) and background noise (quiet and jet-aircraft noise). As is the case with long-duration vigils (Warm, 1993), signal detection in the abbreviated task was poorer for low salience than for high salience signals. In addition, stress scores, as indexed by the Dundee Stress State Questionnaire (Matthews, Joiner, Gilliland, Campbell, & Falconer, 1999), were elevated in the low as compared to the high salience condition. Unlike longer vigils, however, (Becker, Warm, Dember, & Hancock, 1996), signal detection in the abbreviated task was superior in the presence of aircraft noise than in quiet. Noise also attenuated the stress of the vigil, a result that is counter to previous findings regarding the effects of noise in a variety of other scenarios (Clark, 1984). Examination of observers' coping responses, as assessed by the Coping Inventory for Task Situations (Matthews & Campbell, 1998), indicated that problem-focused coping was the overwhelming

  7. 40 CFR 87.2 - Acronyms and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 87.2 Section 87.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES General Provisions § 87.2 Acronyms...

  8. Children's Text Messaging: Abbreviations, Input Methods and Links with Literacy

    ERIC Educational Resources Information Center

    Kemp, N.; Bushnell, C.

    2011-01-01

    This study investigated the effects of mobile phone text-messaging method (predictive and multi-press) and experience (in texters and non-texters) on children's textism use and understanding. It also examined popular claims that the use of text-message abbreviations, or "textese" spelling, is associated with poor literacy skills. A sample of 86…

  9. 40 CFR 1037.805 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Symbols, acronyms, and abbreviations. 1037.805 Section 1037.805 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW HEAVY-DUTY MOTOR VEHICLES Definitions and Other Reference Information § 1037.805 Symbols,...

  10. Is It Necessary To Create Abbreviations of Signed Languages?

    ERIC Educational Resources Information Center

    Andersson, Yerker

    2001-01-01

    Suggests considering the following before creating abbreviations of sign languages: the recognition of signed languages as official languages; the standardization of signed languages; the existence of different signed languages using the same spoken language as a substitute language; whether attention should be given to countries whose names share…

  11. 40 CFR 86.1804-01 - Acronyms and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following... per hour. mV—Millivolt N2—Nitrogen. NDIR—Nondispersive infrared. NLEV—Refers to the National Low... oxide. No.—Number. O2—Oxygen. OEM—Original equipment manufacturer. NO2—Nitrogen dioxide. NOX—Oxides...

  12. Abbreviated Pandemic Influenza Planning Template for Primary Care Offices

    SciTech Connect

    HCTT CHE

    2010-01-01

    The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

  13. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycles §...

  14. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycles §...

  15. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycles §...

  16. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycles §...

  17. Interactive Hangman Teaches Amino Acid Structures and Abbreviations

    ERIC Educational Resources Information Center

    Pennington, Britney O.; Sears, Duane; Clegg, Dennis O.

    2014-01-01

    We developed an interactive exercise to teach students how to draw the structures of the 20 standard amino acids and to identify the one-letter abbreviations by modifying the familiar game of "Hangman." Amino acid structures were used to represent single letters throughout the game. To provide additional practice in identifying…

  18. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS CAIR SO2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and...—nitrogen oxides O2—oxygen ppm—parts per million scfh—standard cubic feet per hour SO2—sulfur dioxide...

  19. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS CAIR SO2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and...—nitrogen oxides O2—oxygen ppm—parts per million scfh—standard cubic feet per hour SO2—sulfur dioxide...

  20. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS CAIR SO2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and...—nitrogen oxides O2—oxygen ppm—parts per million scfh—standard cubic feet per hour SO2—sulfur dioxide...

  1. 40 CFR 86.1804-01 - Acronyms and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., and Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following...—Gross vehicle weight rating. H2O—Water. HC—Hydrocarbon(s). HCHO—Formaldehyde. HDV—Heavy-duty vehicle...). SAE—Society of Automotive Engineers. SBC—Standard Bench Cycle SFTP—Supplemental Federal Test...

  2. 7 CFR 772.2 - Abbreviations and Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Abbreviations. AMPAssociation-Type Minor Program loan; CFRCode of Federal Regulations; FOFarm Ownership Loan; FSAFarm Service Agency; IMPIndividual-Type Minor Program loan; OLOperating Loan; USDAUnited States Department of Agriculture. (b) Definitions. Association-Type Minor Program loans (AMP): Loans to...

  3. 24 CFR 91.235 - Special case; abbreviated consolidated plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... that submit an abbreviated consolidated plan pursuant to 24 CFR 570.440. For the CDBG program, an... 24 CFR part 570, subpart D, and is not expected to be a participating jurisdiction in the HOME program under 24 CFR part 92, as well as an Insular Area that is a HOME or CDBG grantee, may submit...

  4. 24 CFR 91.235 - Special case; abbreviated consolidated plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... that submit an abbreviated consolidated plan pursuant to 24 CFR 570.440. For the CDBG program, an... 24 CFR part 570, subpart D, and is not expected to be a participating jurisdiction in the HOME program under 24 CFR part 92, as well as an Insular Area that is a HOME or CDBG grantee, may submit...

  5. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Program General Provisions § 72.3...

  6. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Program General Provisions § 72.3...

  7. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Program General Provisions § 72.3...

  8. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Program General Provisions § 72.3...

  9. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Acid Rain Program General Provisions § 72.3...

  10. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth... abbreviations. For the purposes of this subpart: Covered birth defect means the same as defined at § 3.815(c)(3... title who has a covered birth defect other than a birth defect described in § 3.815(a)(2)....

  11. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth... abbreviations. For the purposes of this subpart: Covered birth defect means the same as defined at § 3.815(c)(3... title who has a covered birth defect other than a birth defect described in § 3.815(a)(2)....

  12. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth... abbreviations. For the purposes of this subpart: Covered birth defect means the same as defined at § 3.815(c)(3... title who has a covered birth defect other than a birth defect described in § 3.815(a)(2)....

  13. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida and Covered Birth... abbreviations. For the purposes of this subpart: Covered birth defect means the same as defined at § 3.815(c)(3... title who has a covered birth defect other than a birth defect described in § 3.815(a)(2)....

  14. 7 CFR 1755.900 - Abbreviations and Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... to §§ 1755.901 and 1755.902: (a) Abbreviations. (1) ADSSAll dielectric self-supporting; (2...) Dielectric cable means a cable which has neither metallic members nor other electrically conductive materials... dielectric material that guides light. (24) Optical point discontinuities means the localized deviations...

  15. 7 CFR 1755.900 - Abbreviations and Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... to §§ 1755.901 and 1755.902: (a) Abbreviations. (1) ADSSAll dielectric self-supporting; (2...) Dielectric cable means a cable which has neither metallic members nor other electrically conductive materials... dielectric material that guides light. (24) Optical point discontinuities means the localized deviations...

  16. 7 CFR 1755.900 - Abbreviations and Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to §§ 1755.901 and 1755.902: (a) Abbreviations. (1) ADSSAll dielectric self-supporting; (2...) Dielectric cable means a cable which has neither metallic members nor other electrically conductive materials... dielectric material that guides light. (24) Optical point discontinuities means the localized deviations...

  17. 7 CFR 1755.900 - Abbreviations and Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... to §§ 1755.901 and 1755.902: (a) Abbreviations. (1) ADSSAll dielectric self-supporting; (2...) Dielectric cable means a cable which has neither metallic members nor other electrically conductive materials... dielectric material that guides light. (24) Optical point discontinuities means the localized deviations...

  18. 7 CFR 4280.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Definitions and abbreviations. 4280.302 Section 4280.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural...

  19. 7 CFR 4280.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Definitions and abbreviations. 4280.302 Section 4280.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural...

  20. 7 CFR 4280.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Definitions and abbreviations. 4280.302 Section 4280.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural...

  1. 7 CFR 4280.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Definitions and abbreviations. 4280.302 Section 4280.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural...

  2. 40 CFR 96.103 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.103 Section 96.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR...

  3. 40 CFR 97.603 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Measurements, abbreviations, and acronyms. 97.603 Section 97.603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS TR SO2...

  4. 40 CFR 97.503 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Measurements, abbreviations, and acronyms. 97.503 Section 97.503 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS TR NOX...

  5. 40 CFR 97.403 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Measurements, abbreviations, and acronyms. 97.403 Section 97.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS TR NOX...

  6. 32 CFR Appendix B to Part 806 - Abbreviations and Acronyms

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 806 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION AIR FORCE FREEDOM OF INFORMATION ACT PROGRAM Pt. 806, App. B Appendix B to Part 806—Abbreviations and Acronyms AFCA—Air Force Communications Agency AFCIC—Air Force Communications and Information Center...

  7. 32 CFR Appendix B to Part 806 - Abbreviations and Acronyms

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 806 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION AIR FORCE FREEDOM OF INFORMATION ACT PROGRAM Pt. 806, App. B Appendix B to Part 806—Abbreviations and Acronyms AFCA—Air Force Communications Agency AFCIC—Air Force Communications and Information Center...

  8. 32 CFR 507.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Explanation of abbreviations and terms. 507.3 Section 507.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL... times actual size, showing placement of stitches, color and size of yarn and number of stitches....

  9. 32 CFR Appendix F to Subpart M of... - Abbreviations

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS..., Yakima Training Center, and Camp Bonneville Pt. 552, Subpt. M, App. F Appendix F to Subpart M of Part...

  10. 32 CFR Appendix F to Subpart M of... - Abbreviations

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS..., Yakima Training Center, and Camp Bonneville Pt. 552, Subpt. M, App. F Appendix F to Subpart M of Part...

  11. 32 CFR Appendix F to Subpart M of... - Abbreviations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS..., Yakima Training Center, and Camp Bonneville Pt. 552, Subpt. M, App. F Appendix F to Subpart M of Part...

  12. 32 CFR Appendix F to Subpart M of... - Abbreviations

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort...

  13. 32 CFR 634.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Explanation of abbreviations and terms. 634.3 Section 634.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Introduction § 634.3 Explanation...

  14. 27 CFR 19.726 - Authorized abbreviations to identify spirits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... records: Kinds of spirits Abbreviations Alcohol A Brandy BR Bourbon Whisky BW Canadian Whisky CNW Completely Denatured Alcohol CDA Corn Whisky CW Grain Spirits GS Irish Whisky IW Light Whisky LW Malt Whisky MW Neutral Spirits NS Neutral Spirits Grain NSG Rye Whisky RW Scotch Whisky SW Specially...

  15. 32 CFR Appendix F to Subpart M of... - Abbreviations

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS..., Yakima Training Center, and Camp Bonneville Pt. 552, Subpt. M, App. F Appendix F to Subpart M of Part...

  16. 32 CFR 651.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Explanation of abbreviations and terms. 651.3 Section 651.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Introduction § 651.3 Explanation...

  17. 32 CFR 651.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Explanation of abbreviations and terms. 651.3 Section 651.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Introduction § 651.3 Explanation...

  18. 32 CFR 651.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Explanation of abbreviations and terms. 651.3 Section 651.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Introduction § 651.3 Explanation...

  19. 32 CFR 651.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Explanation of abbreviations and terms. 651.3 Section 651.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Introduction § 651.3 Explanation...

  20. 32 CFR 651.3 - Explanation of abbreviations and terms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Explanation of abbreviations and terms. 651.3 Section 651.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Introduction § 651.3 Explanation...

  1. 76 FR 26307 - Guidance for Industry on the Submission of Summary Bioequivalence Data for Abbreviated New Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... Bioequivalence Data for Abbreviated New Drug Applications; Availability AGENCY: Food and Drug Administration, HHS... guidance for industry entitled ``Submission of Summary Bioequivalence Data for Abbreviated New Drug Applications.'' The guidance is intended to assist abbreviated new drug application (ANDA) applicants...

  2. 78 FR 12048 - Gulf Shore Energy Partners, LP; Notice of Abbreviated Application for Limited Amendment to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... Energy Regulatory Commission Gulf Shore Energy Partners, LP; Notice of Abbreviated Application for Limited Amendment to Certificate of Public Convenience and Necessity On February 11, 2013, Gulf Shore Energy Partners, LP (``Gulf Shore''), filed an abbreviated application for limited amendment...

  3. 76 FR 13880 - Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Parts 312 and 314 Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment AGENCY: Food and Drug Administration... amending its investigational new drug application (IND) regulations and abbreviated new drug...

  4. Global Burned Area and Biomass Burning Emissions from Small Fires

    NASA Technical Reports Server (NTRS)

    Randerson, J. T.; Chen, Y.; vanderWerf, G. R.; Rogers, B. M.; Morton, D. C.

    2012-01-01

    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity

  5. Global burned area and biomass burning emissions from small fires

    NASA Astrophysics Data System (ADS)

    Randerson, J. T.; Chen, Y.; van der Werf, G. R.; Rogers, B. M.; Morton, D. C.

    2012-12-01

    In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity

  6. The biology of burn injury.

    PubMed

    Evers, Lars H; Bhavsar, Dhaval; Mailänder, Peter

    2010-09-01

    Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

  7. 49 CFR 1500.3 - Terms and abbreviations used in this chapter.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Terms and abbreviations used in this chapter. 1500... APPLICABILITY, TERMS, AND ABBREVIATIONS § 1500.3 Terms and abbreviations used in this chapter. As used in this chapter: Administrator means the Under Secretary of Transportation for Security identified in 49...

  8. Animal Models in Burn Research

    PubMed Central

    Abdullahi, A.; Amini-Nik, S.; Jeschke, M.G

    2014-01-01

    Burn injury is a severe form of trauma affecting more than two million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury; to elucidate the pathophysiology and explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review paper aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research. PMID:24714880

  9. Epidemiology of U.K. military burns.

    PubMed

    Foster, Mark Anthony; Moledina, Jamil; Jeffery, Steve L A

    2011-01-01

    The authors review the etiology of U.K. military burns in light of increasing hybrid warfare. Analysis of the nature of these injured personnel will provide commanders with the evidence to plan for on-going and future operations. Case notes of all U.K. Armed Forces burn injured patients who were evacuated to the Royal Centre for Defence Medicine were reviewed. Demographics, burn severity, pattern, and mortality details were included. There were 134 U.K. military personnel with burns requiring return to the United Kingdom during 2001-2007. The median age was 27 (20-62) years. Overall, 60% of burns seen were "accidental." Burning waste, misuse or disrespect of fuel, and scalds were the most prevalent noncombat burns. Areas commonly burned were the face, legs, and hands. During 2006-2007 in the two major conflicts, more than 59% (n = 36) of the burned patients evacuated to the United Kingdom were injured during combat. Burns sustained in combat represent 5.8% of all combat casualties and were commonly associated with other injuries. Improvised explosive device, minestrike, and rocket-propelled grenade were common causes. The mean TBSA affected for both groups was 5% (1-70). The majority of combat burn injuries have been small in size. Greater provision of flame retardant equipment and clothing may reduce the extent and number of combat burns in the future. The numbers of noncombat burns are being reduced by good military discipline. PMID:21422938

  10. Adult burn patients with more than 60% TBSA involved-Meek and other techniques to overcome restricted skin harvest availability--the Viennese Concept.

    PubMed

    Lumenta, David B; Kamolz, Lars-Peter; Frey, Manfred

    2009-01-01

    Despite the fact that early excision and grafting has significantly improved outcome over the last decades, the management of severely burned adult patients with >/=60% total body surface area (% TBSA) burned still represents a challenging task for burn care specialists all over the world. In this article, we present our current treatment concept for this entity of severely burned patients and analyze its effect in a comparative cohort study. Surgical strategy comprised the use of split-thickness skin grafts (Meek, mesh) for permanent coverage, fluidized microsphere bead-beds for wound conditioning, temporary coverage (polyurethane sheets, Epigard; nanocrystalline silver dressings, Acticoat; synthetic copolymer sheets based on lactic acid, Suprathel; acellular bovine derived collagen matrices, Matriderm; allogeneic cultured keratinocyte sheets; and allogeneic split-thickness skin grafts), and negative-pressure wound therapy (vacuum-assisted closure). The autologous split-thickness skin graft expansion using the Meek technique for full-thickness burns and the delayed approach for treating dorsal burn wounds is discussed in detail. To demonstrate differences before and after the introduction of the Meek technique, we have compared patients of 2007 with >/=60% TBSA (n = 10) to those in a matched observation period (n = 7). In the first part of the comparative analysis, all patients of the two samples were analyzed with regard to age, abbreviated burn severity index, Baux, different entities of % TBSA, and survival. In the second step, only the survivors of both years were separated in two groups as follows: patients receiving skin grafts, using the Meek technique (n = 6), were compared with those without Meek grafting (n = 4). When comparing the severely burned patients of 2007 with a cohort of 2006, there were no differences for age (2007: 46.4 +/- 13.4 vs. 2006: 39.1 +/- 14.8 years), abbreviated burn severity index score (2007: 12.2 +/- 1.0 vs. 2006: 12.1 +/- 1

  11. Vesicant burns.

    PubMed

    Mellor, S G; Rice, P; Cooper, G J

    1991-01-01

    (1) Of the 120,000 victims of sulphur mustard gas in World War I there were only 2-3% fatalities, and few long term effects. (2) The interactions of sulphur mustard with the skin are complete within a few minutes of exposure. Once the victim has been decontaminated there is no risk to the attendant and there is no active agent in the blister fluid. (3) The rate of wound healing is slow for sulphur mustard burns, but in general the wounds heal satisfactorily. (4) There is no specific therapy for poisoning by sulphur mustard.

  12. [Hydrofluoric acid burns].

    PubMed

    Holla, Robin; Gorter, Ramon R; Tenhagen, Mark; Vloemans, A F P M Jos; Breederveld, Roelf S

    2016-01-01

    Hydrofluoric acid is increasingly used as a rust remover and detergent. Dermal contact with hydrofluoric acid results in a chemical burn characterized by severe pain and deep tissue necrosis. It may cause electrolyte imbalances with lethal consequences. It is important to identify high-risk patients. 'High risk' is defined as a total affected body area > 3% or exposure to hydrofluoric acid in a concentration > 50%. We present the cases of three male patients (26, 31, and 39 years old) with hydrofluoric acid burns of varying severity and describe the subsequent treatments. The application of calcium gluconate 2.5% gel to the skin is the cornerstone of the treatment, reducing pain as well as improving wound healing. Nails should be thoroughly inspected and possibly removed if the nail is involved, to ensure proper healing. In high-risk patients, plasma calcium levels should be evaluated and cardiac monitoring is indicated.

  13. [Hydrofluoric acid burns].

    PubMed

    Holla, Robin; Gorter, Ramon R; Tenhagen, Mark; Vloemans, A F P M Jos; Breederveld, Roelf S

    2016-01-01

    Hydrofluoric acid is increasingly used as a rust remover and detergent. Dermal contact with hydrofluoric acid results in a chemical burn characterized by severe pain and deep tissue necrosis. It may cause electrolyte imbalances with lethal consequences. It is important to identify high-risk patients. 'High risk' is defined as a total affected body area > 3% or exposure to hydrofluoric acid in a concentration > 50%. We present the cases of three male patients (26, 31, and 39 years old) with hydrofluoric acid burns of varying severity and describe the subsequent treatments. The application of calcium gluconate 2.5% gel to the skin is the cornerstone of the treatment, reducing pain as well as improving wound healing. Nails should be thoroughly inspected and possibly removed if the nail is involved, to ensure proper healing. In high-risk patients, plasma calcium levels should be evaluated and cardiac monitoring is indicated. PMID:27189091

  14. The Burn Wound Microenvironment

    PubMed Central

    Rose, Lloyd F.; Chan, Rodney K.

    2016-01-01

    Significance: While the survival rate of the severely burned patient has improved significantly, relatively little progress has been made in treatment or prevention of burn-induced long-term sequelae, such as contraction and fibrosis. Recent Advances: Our knowledge of the molecular pathways involved in burn wounds has increased dramatically, and technological advances now allow large-scale genomic studies, providing a global view of wound healing processes. Critical Issues: Translating findings from a large number of in vitro and preclinical animal studies into clinical practice represents a gap in our understanding, and the failures of a number of clinical trials suggest that targeting single pathways or cytokines may not be the best approach. Significant opportunities for improvement exist. Future Directions: Study of the underlying molecular influences of burn wound healing progression will undoubtedly continue as an active research focus. Increasing our knowledge of these processes will identify additional therapeutic targets, supporting informed clinical studies that translate into clinical relevance and practice. PMID:26989577

  15. Synonym extraction and abbreviation expansion with ensembles of semantic spaces

    PubMed Central

    2014-01-01

    Background Terminologies that account for variation in language use by linking synonyms and abbreviations to their corresponding concept are important enablers of high-quality information extraction from medical texts. Due to the use of specialized sub-languages in the medical domain, manual construction of semantic resources that accurately reflect language use is both costly and challenging, often resulting in low coverage. Although models of distributional semantics applied to large corpora provide a potential means of supporting development of such resources, their ability to isolate synonymy from other semantic relations is limited. Their application in the clinical domain has also only recently begun to be explored. Combining distributional models and applying them to different types of corpora may lead to enhanced performance on the tasks of automatically extracting synonyms and abbreviation-expansion pairs. Results A combination of two distributional models – Random Indexing and Random Permutation – employed in conjunction with a single corpus outperforms using either of the models in isolation. Furthermore, combining semantic spaces induced from different types of corpora – a corpus of clinical text and a corpus of medical journal articles – further improves results, outperforming a combination of semantic spaces induced from a single source, as well as a single semantic space induced from the conjoint corpus. A combination strategy that simply sums the cosine similarity scores of candidate terms is generally the most profitable out of the ones explored. Finally, applying simple post-processing filtering rules yields substantial performance gains on the tasks of extracting abbreviation-expansion pairs, but not synonyms. The best results, measured as recall in a list of ten candidate terms, for the three tasks are: 0.39 for abbreviations to long forms, 0.33 for long forms to abbreviations, and 0.47 for synonyms. Conclusions This study demonstrates

  16. [Current treatment strategies for paediatric burns].

    PubMed

    Küntscher, M V; Hartmann, B

    2006-06-01

    Paediatric burns occupy the third place in the severe accident statistics in Germany after traffic injuries and drowning. The paper reviews current treatment concepts of pre-hospital management, fluid resuscitation and surgical therapy in paediatric burned patients. Specific features in the approximation of the total body surface area burn and indications for transfer of paediatric burn victims to specialized units are discussed. The therapy of severe paediatric burns requires an interdisciplinary team consisting of especially skilled plastic or paediatric surgeons,anaesthetists, psychiatrists or psychologists, specifically trained nurses, physiotherapists and social workers. The rehabilitation process starts basically with admission to the burn unit. A tight cooperation between therapists and the relatives of the paediatric burn victim is needed for psychological recovery and reintegration into society.'The adaptation to the suffered trauma resulting in life-long disability and disfigurement is the main task of psychotherapy.

  17. [Reconstruction of facial burn sequelae].

    PubMed

    Foyatier, J L; Comparin, J P; Boulos, J P; Bichet, J C; Jacquin, F

    2001-06-01

    The deep burns of the face can lead to horrible scars functionally and aesthetically. Treatment of these scars need several surgical interventions frequently and during many years. In our region we deal with this type of wounds as team work, multidisciplinary approach carrying out many process starting by emergency treatment of acute burns till the social rehabilitation. The expansion technique was great help in improving the shape of scars, by using the expanding skin as full thickness grafts. Reconstruction of the anatomical units and application of aesthetic techniques (like rhinoplasty, lifting, tattooing and autologous fat injections) participate equally in improving the quality of results. Many examples of treatments of burns scars are shown.

  18. Physical and psychiatric recovery from burns.

    PubMed

    Stoddard, Frederick J; Ryan, Colleen M; Schneider, Jeffrey C

    2014-08-01

    Burn injuries pose complex biopsychosocial challenges to recovery and improved comprehensive care. The physical and emotional sequelae of burns differ, depending on burn severity, individual resilience, and stage of development when they occur. Most burn survivors are resilient and recover, whereas some are more vulnerable and have complicated outcomes. Physical rehabilitation is affected by orthopedic, neurologic, and metabolic complications and disabilities. Psychiatric recovery is affected by pain, mental disorders, substance abuse, and burn stigmatization. Individual resilience, social supports, and educational or occupational achievements affect outcomes.

  19. Ultrasonic technique for characterizing skin burns

    DOEpatents

    Goans, Ronald E.; Cantrell, Jr., John H.; Meyers, F. Bradford; Stambaugh, Harry D.

    1978-01-01

    This invention, a method for ultrasonically determining the depth of a skin burn, is based on the finding that the acoustical impedance of burned tissue differs sufficiently from that of live tissue to permit ultrasonic detection of the interface between the burn and the underlying unburned tissue. The method is simple, rapid, and accurate. As compared with conventional practice, it provides the important advantage of permitting much earlier determination of whether a burn is of the first, second, or third degree. In the case of severe burns, the usual two - to three-week delay before surgery may be reduced to about 3 days or less.

  20. Interactive Hangman teaches amino acid structures and abbreviations.

    PubMed

    Pennington, Britney O; Sears, Duane; Clegg, Dennis O

    2014-01-01

    We developed an interactive exercise to teach students how to draw the structures of the 20 standard amino acids and to identify the one-letter abbreviations by modifying the familiar game of "Hangman." Amino acid structures were used to represent single letters throughout the game. To provide additional practice in identifying structures, hints to the answers were written in "amino acid sentences" for the students to translate. Students were required to draw the structure of the corresponding letter they wished to guess on a whiteboard. Each student received a reference sheet of the structures and abbreviations, but was required to draw from memory when guessing a letter. Preassessments and postassessments revealed a drastic improvement in the students' ability to recognize and draw structures from memory. This activity provides a fun, educational game to play in biochemistry discussion sections or during long incubations in biochemistry laboratories.

  1. Abbreviated laparotomy or damage control laparotomy: Why, when and how to do it?

    PubMed

    Voiglio, E J; Dubuisson, V; Massalou, D; Baudoin, Y; Caillot, J L; Létoublon, C; Arvieux, C

    2016-08-01

    The goal of abbreviated laparotomy is to treat severely injured patients whose condition requires an immediate surgical operation but for whom a prolonged procedure would worsen physiological impairment and metabolic failure. Indeed, in severely injured patients, blood loss and tissue injuries enhance the onset of the "bloody vicious circle", triggered by the triad of acidosis-hypothermia-coagulopathy. Abbreviated laparotomy is a surgical strategy that forgoes the completeness of operation in favor of a physiological approach, the overriding preference going to rapidity and limiting the procedure to control the injuries. Management is based on sequential association of the shortest possible preoperative resuscitation with surgery limited to essential steps to control injury (stop the bleeding and contamination), without definitive repair. The latter will be ensured during a scheduled re-operation after a period of resuscitation aiming to correct physiological abnormalities induced by the trauma and its treatment. This strategy necessitates a pre-defined plan and involvement of the entire medical and nursing staff to reduce time loss to a strict minimum. PMID:27542655

  2. 40 CFR 86.1804-01 - Acronyms and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., and Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following... per hour. mV—Millivolt N2—Nitrogen. NDIR—Nondispersive infrared. NLEV—Refers to the National Low... oxide. No.—Number. O2—Oxygen. OEM—Original equipment manufacturer. NO2—Nitrogen dioxide. NOX—Oxides...

  3. 40 CFR 86.1804-01 - Acronyms and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., and Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following... per hour. mV—Millivolt N2—Nitrogen. NDIR—Nondispersive infrared. NLEV—Refers to the National Low... oxide. No.—Number. O2—Oxygen. OEM—Original equipment manufacturer. NO2—Nitrogen dioxide. NOX—Oxides...

  4. 40 CFR 86.1804-01 - Acronyms and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., and Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following... per hour. mV—Millivolt N2—Nitrogen. NDIR—Nondispersive infrared. NLEV—Refers to the National Low... oxide. No.—Number. O2—Oxygen. OEM—Original equipment manufacturer. NO2—Nitrogen dioxide. NOX—Oxides...

  5. Space transportation system and associated payloads: Glossary, acronyms, and abbreviations

    NASA Technical Reports Server (NTRS)

    1992-01-01

    A collection of some of the acronyms and abbreviations now in everyday use in the shuttle world is presented. It is a combination of lists that were prepared at Marshall Space Flight Center and Kennedy and Johnson Space Centers, places where intensive shuttle activities are being carried out. This list is intended as a guide or reference and should not be considered to have the status and sanction of a dictionary.

  6. 40 CFR 60.3 - Units and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES General Provisions § 60.3 Units and abbreviations. Used... feet at standard conditions dscm—dry cubic meter at standard conditions eq—equivalent °F—degree Fahrenheit ft—feet gal—gallon gr—grain g-eq—gram equivalent hr—hour in—inch k—1,000 l—liter lpm—liter...

  7. 40 CFR 60.3 - Units and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES General Provisions § 60.3 Units and abbreviations. Used... feet at standard conditions dscm—dry cubic meter at standard conditions eq—equivalent °F—degree Fahrenheit ft—feet gal—gallon gr—grain g-eq—gram equivalent hr—hour in—inch k—1,000 l—liter lpm—liter...

  8. Word Sense Disambiguation of clinical abbreviations with hyperdimensional computing.

    PubMed

    Moon, Sungrim; Berster, Bjoern-Toby; Xu, Hua; Cohen, Trevor

    2013-01-01

    Automated Word Sense Disambiguation in clinical documents is a prerequisite to accurate extraction of medical information. Emerging methods utilizing hyperdimensional computing present new approaches to this problem. In this paper, we evaluate one such approach, the Binary Spatter Code Word Sense Disambiguation algorithm, on 50 ambiguous abbreviation sets derived from clinical notes. This algorithm uses reversible vector transformations to encode ambiguous terms and their context-specific senses into vectors representing surrounding terms. The sense for a new context is then inferred from vectors representing the terms it contains. One-to-one BSC-WSD achieves average accuracy of 94.55% when considering the orientation and distance of neighboring terms relative to the target abbreviation, outperforming Support Vector Machine and Naïve Bayes classifiers. Furthermore, it is practical to deal with all 50 abbreviations in an identical manner using a single one-to-many BSC-WSD model with average accuracy of 93.91%, which is not possible with common machine learning algorithms.

  9. Rehabilitation of the burn patient

    PubMed Central

    Procter, Fiona

    2010-01-01

    Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ‘Burns Rehabilitation’ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration PMID:21321643

  10. A half-century of burn epidemiology and burn care in a rural state.

    PubMed

    Blaisdell, Laura L; Chace, Reeve; Hallagan, Lee D; Clark, David E

    2012-01-01

    The aim of this study is to quantify the changes in incidence, severity, and mortality in burn injuries in the state of Maine over the past 50 years from both prevention and treatment perspectives. The authors analyzed the data from multiple sources, including the U.S. Census, death certificates, hospital discharge abstracts, and institutional burn registries in Maine and Boston. The average annual number of burn-related deaths decreased from 53 in 1960-1964 to 14 in 2004-2008. The Maine age-adjusted rate of burn deaths was 8.6% above the national rate in 1960 and 1.4% below it in 2006. The annual number of burn patients admitted to Maine hospitals declined by 65% from 1978 to 2009. Since 1999, 12% of hospitalized patients in Maine were treated in an American Burn Association-certified burn center in Boston. Mortality for Maine burn patients, including those treated at Boston hospitals, is directly related to age and burn severity and similar to stratified mortality in the National Burn Repository. Incidence, severity, and mortality of burn injuries in Maine have decreased dramatically over the past 5 decades. Prevention programs, legislation, and a regionalized system of burn care have all likely contributed to bringing Maine's morbidity and mortality rate below the national average. PMID:22002206

  11. Ram Burn Observations (RAMBO)

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Ram Burn Observations (RAMBO) is a Department of Defense experiment that observes shuttle Orbital Maneuvering System engine burns for the purpose of improving plume models. On STS-107 the appropriate sensors will observe selected rendezvous and orbit adjust burns.

  12. [Immunology and sepsis syndrome in burn trauma].

    PubMed

    Ipaktchi, K; Vogt, P M

    2009-05-01

    Despite significant advances in burn surgery and critical care, severe burn trauma defined as injuries covering more than 25% of the total body surface area, is still associated with high mortality and morbidity. Burn trauma is a whole body injury where peripheral dermal injury rapidly results in systemic inflammation and inflammatory core organ damage. The severe disturbance of internal homeostasis involves all vital organ systems and obligates early referral to specialized burn centers. Treatment of severely burned patients is a multifaceted challenge directed by pathophysiologic events which progress from local skin destruction, disruption of physicochemical and microvascular barriers to breakdown of peripheral and central circulation, organ failure and ultimately death. While early intensive care focuses on maintenance of tissue oxygenation and perfusion, surgical treatment deals with management of the burn wounds as a source of inflammation and infection. Here wound debridement and coverage is essential to abrogate systemic effects of inflammation and limit pathogen invasion. While control of early burn stages minimizes mortality due to burn shock, subsequent burn sepsis continues to be a formidable challenge for physicians and the main cause of burn mortality.

  13. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    PubMed

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome. PMID:27209717

  14. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    PubMed

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.

  15. Efficacy of topical phenol decontamination strategies on severity of acute phenol chemical burns and dermal absorption: in vitro and in vivo studies in pig skin.

    PubMed

    Monteiro-Riviere, N A; Inman, A O; Jackson, H; Dunn, B; Dimond, S

    2001-05-01

    Pure phenol is colorless and used in the manufacture of phenolic resins, plastics, explosives, fertilizers, paints, rubber, textiles, adhesives, pharmaceuticals, paper, soap, and wood preservatives. The purpose of this study was to compare the efficacy of several phenol decontamination strategies following dermal exposure using the pig as a model for human exposure, and then assess the effect of the two best treatments on phenol absorption in the isolated perfused porcine skin flap (IPPSF). Six anesthetized Yorkshire pigs were exposed to 89% aqueous phenol for 1 min using Hilltop chambers (10 skin sites/pig; 400 microl/site). Exposure to phenol was followed by one of 10 different decontamination procedures: 1-, 5-, 15-, and 30-min water wash; Ivory soap solution; polyethylene glycol (PEG 400); PEG 400/industrial methylated spirits (IMS); PEG 400/ethanol (EtOH); polyvinyl pyrrolidone (PVP)/70% isopropanol (IPA); and 70% IPA. For each of the last five strategies, 1-min treatment washes were repeatedly alternated with 1-min water washes for a total of 15 min. Evaluation was based on scoring of erythema, edema, and histological parameters such as intracellular and intercellular epidermal edema, papillary dermal edema, perivascular infiltrates, pyknotic stratum basale cells, and epidermal-dermal separation. It was concluded that PEG 400 and 70% IPA were superior to the other treatments investigated and equally efficacious in the reduction of phenol-induced skin damage. In addition, phenol absorption was assessed utilizing the two most effective in vivo treatments in the IPPSF. The assessment of percutaneous absorption of phenol found the PEG 400, 70% IPA, and 15-min water treatments significantly (P < 0.05) reduced phenol absorption relative to no treatment.

  16. Intervention to reduce the use of unsafe abbreviations in a teaching hospital

    PubMed Central

    Alshaikh, Mashael; Mayet, Ahmed; Adam, Mansour; Ahmed, Yusuf; Aljadhey, Hisham

    2012-01-01

    Objectives To determine the effectiveness of a two-phase intervention designed to reduce the use of unsafe abbreviations. Methods An observational prospective study was conducted at the King Khalid University Hospital in Riyadh, Saudi Arabia during May–September 2009. A list of unsafe abbreviations was formulated based on the recommendations of the Institute for Safe Medication Practices. The first 7000 medication orders written at the beginning of each period were collected. Phase one of the intervention involved educating health care professionals about the dangers of using unsafe abbreviations. In the second phase of the intervention, a policy was approved that prohibited the use of unsafe abbreviations hospital-wide. Then, another educational campaign targeted toward prescribers was organized. Descriptive statistics are used in this paper to present the results. Results At baseline, we identified 1980 medication abbreviations used in 7000 medication orders (28.3%). Three months after phase one of the intervention, the number of abbreviations found in 7000 medication orders had decreased to 1489 (21.3%). Six months later, after phase two of the intervention, the number of abbreviations used had decreased to 710 (10%). During this phase, the use of all abbreviations had declined relative to the baseline and phase one use levels. The decrease in the use of abbreviations was statistically significant in all three periods (P < 0.001). Conclusion The implementation of a complex intervention program reduced the use of unsafe abbreviations by 65%. PMID:23960844

  17. Chemical Debridement of Burns

    PubMed Central

    Levenson, Stanley M.; Kan, Dorinne; Gruber, Charles; Crowley, Leo V.; Lent, Richard; Watford, Alvin; Seifter, Eli

    1974-01-01

    The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. The removal of the devitalized tissue, without damage to unburned skin or skin only partially injured by burning, and in ways which would permit immediate (or very prompt) skin grafting, would lessen substantially the problems of sepsis, speed convalescence and the return of these individuals to society as effective human beings, and would decrease deaths. The usefulness and limitations of surgical excision for patients with extensive third degree burns are discussed. Chemical debridement lends itself to complementary use with surgical excision and has the potential advantage over surgical excision in not requiring anesthesia or a formal surgical operation. The authors' work with the chemical debridement of burns, in particular the use of Bromelain, indicates that this approach will likely achieve clinical usefulness. The experimental studies indicate that rapid controlled debridement, with minimal local and systemic toxicity, is possible, and that effective chemotherapeutic agents may be combined with the Bromelain without either interfering with the actions of the other. The authors believe that rapid (hours) debridement accomplished by the combined use of chemical debriding and chemotherapeutic agents will obviate the possibility of any increase in infection, caused by the use of chemical agents for debridement, as reported for Paraenzyme21 and Travase.39,48 It is possible that the short term use of systemic antibiotics begun just before and continued during, and for a short time after, the rapid chemical debridement may prove useful for the prevention of infection, as appears to be the case for abdominal operations of the clean-contaminated and

  18. Occupational Burns Treated in Emergency Departments

    PubMed Central

    Reichard, Audrey A.; Konda, Srinivas; Jackson, Larry L.

    2015-01-01

    Background Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences. Methods We used the National Electronic Injury Surveillance System—Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data. Results From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15–24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns. Conclusions Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns. PMID:25678457

  19. A comparison of muscle activations during traditional and abbreviated tennis serves.

    PubMed

    Seeley, Matthew K; Uhl, Tim L; McCrory, Jean; McGinn, Patricia; Kibler, W Ben; Shapiro, Robert

    2008-05-01

    The abbreviated tennis serve is a relatively novel modification of the traditional serve that has been reported to provide performance advantages over the traditional technique. However, there are limited objective data regarding the benefits and biomechanics of the abbreviated serve; no data exist that describe shoulder muscle activations during the abbreviated serve. The purpose of this study was to compare muscle activations between the traditional and abbreviated serves. Electromyographic data were collected for the anterior and posterior deltoid, infraspinatus, middle trapezius, latissimus dorsi, serratus anterior, and pectoralis major. When muscle activations were compared during each serve phase, no significant differences were observed between the traditional and abbreviated tennis serve techniques, indicating that the traditional and abbreviated serves are similar regarding shoulder muscle activations. These results could have implications for performance of and injury related to the abbreviated versus traditional serve technique. Although the abbreviated serve has anecdotally been described as advantageous, the present data do not indicate any significant advantages or disadvantages in performing the abbreviated serve technique versus the traditional serve. PMID:18610776

  20. Parafoveal and foveal processing of abbreviations during eye fixations in reading: Making a case for case

    PubMed Central

    Slattery, Timothy J.; Schotter, Elizabeth R.; Berry, Raymond W.; Rayner, Keith

    2011-01-01

    The processing of abbreviations in reading was examined with an eye movement experiment. Abbreviations were of two distinct types: Acronyms (abbreviations that can be read with the normal grapheme-phoneme correspondence rules, such as NASA) and initialisms (abbreviations in which the grapheme-phoneme correspondences are letter names, such as NCAA). Parafoveal and foveal processing of these abbreviations was assessed with the use of the boundary change paradigm (Rayner, 1975). Using this paradigm, previews of the abbreviations were either identical to the abbreviation (NASA or NCAA), orthographically legal (NUSO or NOBA), or illegal (NRSB or NRBA). The abbreviations were presented as capital letter strings within normal, predominantly lowercase sentences and also sentences in all capital letters such that the abbreviations would not be visually distinct. The results indicate that acronyms and initialisms undergo different processing during reading, and that readers can modulate their processing based on low-level visual cues (distinct capitalization) in parafoveal vision. In particular, readers may be biased to process capitalized letter strings as initialisms in parafoveal vision when the rest of the sentence is normal, lower case letters. PMID:21480754

  1. Patient safety measures in burn care: do National reporting systems accurately reflect quality of burn care?

    PubMed

    Mandell, Samuel P; Robinson, Ellen F; Cooper, Claudette L; Klein, Matthew B; Gibran, Nicole S

    2010-01-01

    Recently, much attention has been placed on quality of care metrics and patient safety. Groups such as the University Health-System Consortium (UHC) collect and review patient safety data, monitor healthcare facilities, and often report data using mortality and complication rates as outcomes. The purpose of this study was to analyze the UHC database to determine if it differentiates quality of care across burn centers. We reviewed UHC clinical database (CDB) fields and available data from 2006 to 2008 for the burn product line. Based on the September 2008 American Burn Association (ABA) list of verified burn centers, we categorized centers as American Burn Association-verified burn centers, self-identified burn centers, and other centers that are not burn units but admit some burn patients. We compared total burn admissions, risk pool, complication rates, and mortality rates. Overall mortality was compared between the UHC and National Burn Repository. The UHC CDB provides fields for number of admissions, % intensive care unit admission, risk pool, length of stay, complication profiles, and mortality index. The overall numbers of burn patients in the database for the study period included 17,740 patients admitted to verified burn centers (mean 631 admissions/burn center/yr or per 2 years), 10,834 for self-identified burn centers (mean 437 admissions/burn center/yr or per 2 years), and 1,487 for other centers (mean 11.5 admissions/burn center/yr or per 2 years). Reported complication rates for verified burn centers (21.6%), self-identified burn centers (21.3%), and others (20%) were similar. Mortality rates were highest for self-identified burn centers (3.06%), less for verified centers (2.88%), and lowest for other centers (0.74%). However, these outcomes data may be misleading, because the risk pool criteria do not include burn-specific risk factors, and the inability to adjust for injury severity prevents rigorous comparison across centers. Databases such as the

  2. Management of burns in major disasters.

    PubMed

    Sharpe, D T; Foo, I T

    1990-01-01

    This paper discusses the problems of handling major burns in disasters with particular reference to the disaster that occurred in Bradford. Several major features of the Bradford fire, in which 56 people died, made its management much simpler than might be expected in subsequent burns disasters; these are discussed. Lessons that have been learned from handling this disaster are indicated. PMID:2347631

  3. Clinical forensic evidence in burns: rescuer burns.

    PubMed

    Kumar, Pramod; Gopal, Kirun; Ramnani, Sunil

    2006-12-01

    In the literature no systematic study is available on rescuer burn for victims of burn injury. This is a retrospective study of nine patients (five admitted and four outpatients) were treated in this hospital as rescuer burns in 3.5 years. All nine patients were males. Average age of the patient treated on outpatient basis was 47 years (ranging between 44 and 52) and total burn area ranged for 1-4%. Average age of the five patients treated on inpatient basis was 32.6 years (ranging between 30 and 34). The total burn area ranged from 14.5 to 38%. During the period of study, in addition to nine rescuer burns, one patient sustained burn before the rescue attempt due to the victim hugging the rescuer. Based on the study of patterns of burn, these patients were found to have three grades of burn injury: Grade 1--upper extremity involvement only. (A) only one upper extremity involvement, (B) both upper extremities involvement, Grade 2--upper extremity/extremities and face involvement, Grade 3--upper extremity/extremities, face-neck, adjacent chest and lower extremity involvement. PMID:17011132

  4. [Quantification of crop residue burned areas based on burning indices using Landsat 8 image].

    PubMed

    Ma, Jian-hang; Song, Kai-shar; Wen, Zhi-dan; Shao, Tian-tian; Li, Bo-nan; Qi, Cai

    2015-11-01

    Crop residue burning leads to atmospheric pollution and is an enormous waste of crop residue resource. Crop residue burning can be monitored timely in large regions as the fire points can be recognized through remotely sensed image via thermal infrared bands. However, the area, the detailed distribution pattern and especially the severity of the burning areas cannot be derived only by the thermal remote sensing approach. The burning index, which was calculated with two or more spectral bands at where the burned and unburned areas have distinct spectral characteristics, is widely used in the forest fire investigation. However its potential application for crop residue burning evaluation has not been explored. With two Landsat 8 images that cover a part of the Songnen Plain, three burning indices, i.e., the normalized burned ratio (NBR), the normalized burned ratio incorporating the thermal band (NBRT), and the burned area index (BAI), were used to classify the crop residue burned and unburned areas. The overall classification accuracies were 91.9%, 92.3%, and 87.8%, respectively. The correlation analysis between the indices and the crop residue coverage indicated that the NBR and NBRT were positively correlated with the crop residue coverage (R2 = 0.73 and 0.64, respectively) with linear regression models, while the BAI was exponentially correlated with the crop residue coverage (R2 = 0.68). The results indicated that the use of burning indices in crop residue burning monitoring could quantify crop residue burning severity and provide valuable data for evaluating atmospheric pollution.

  5. [Quantification of crop residue burned areas based on burning indices using Landsat 8 image].

    PubMed

    Ma, Jian-hang; Song, Kai-shar; Wen, Zhi-dan; Shao, Tian-tian; Li, Bo-nan; Qi, Cai

    2015-11-01

    Crop residue burning leads to atmospheric pollution and is an enormous waste of crop residue resource. Crop residue burning can be monitored timely in large regions as the fire points can be recognized through remotely sensed image via thermal infrared bands. However, the area, the detailed distribution pattern and especially the severity of the burning areas cannot be derived only by the thermal remote sensing approach. The burning index, which was calculated with two or more spectral bands at where the burned and unburned areas have distinct spectral characteristics, is widely used in the forest fire investigation. However its potential application for crop residue burning evaluation has not been explored. With two Landsat 8 images that cover a part of the Songnen Plain, three burning indices, i.e., the normalized burned ratio (NBR), the normalized burned ratio incorporating the thermal band (NBRT), and the burned area index (BAI), were used to classify the crop residue burned and unburned areas. The overall classification accuracies were 91.9%, 92.3%, and 87.8%, respectively. The correlation analysis between the indices and the crop residue coverage indicated that the NBR and NBRT were positively correlated with the crop residue coverage (R2 = 0.73 and 0.64, respectively) with linear regression models, while the BAI was exponentially correlated with the crop residue coverage (R2 = 0.68). The results indicated that the use of burning indices in crop residue burning monitoring could quantify crop residue burning severity and provide valuable data for evaluating atmospheric pollution. PMID:26915202

  6. Future Therapies in Burn Resuscitation.

    PubMed

    Hodgman, Erica I; Subramanian, Madhu; Arnoldo, Brett D; Phelan, Herb A; Wolf, Steven E

    2016-10-01

    Since the 1940s, the resuscitation of burn patients has evolved with dramatic improvements in mortality. The most significant achievement remains the creation and adoption of formulae to calculate estimated fluid requirements to guide resuscitation. Modalities to attenuate the hypermetabolic phase of injury include pharmacologic agents, early enteral nutrition, and the aggressive approach of early excision of large injuries. Recent investigations into the genomic response to severe burns and the application of computer-based decision support tools will likely guide future resuscitation, with the goal of further reducing mortality and morbidity, and improving functional and quality of life outcomes. PMID:27600132

  7. Burn injury and prevention in the Lebanon War, 1982.

    PubMed

    Shafir, R; Nili, E; Kedem, R

    1984-04-01

    Measures taken during the Lebanon War, 1982, to prevent and minimize the extent and severity of tank-crew combat burns proved to be of value. Since 98% of tank crewmen who were burned were wearing fireproof suits at the time, only 12% sustained abdominal burns; 77% had facial burns, as none of them were wearing fireproof masks. Only 9% of the burned soldiers who wore fireproof gloves sustained hand burns, compared with 75% who did not wear the gloves. A comparison of the extent of tank-crew burns in the Lebanon War and the October 1973 War revealed that 51% of the burns in 1982 were minor, compared with 21% in 1973. Of the burns sustained in 1973, 29% covered greater than 40% of the body surface area, compared with 18% in 1982.

  8. Work-related burns in Washington State, 1994 to 1998.

    PubMed

    Baggs, James; Curwick, Christy; Silverstein, Barbara

    2002-07-01

    This article describes an investigation of work-related burns in Washington State during 1994-1998. Workers' compensation data were used to describe the general characteristics of burn injuries, estimate industrial claims rates, and compare nonhospitalized and hospitalized burn cases. The completeness of workers' compensation data as a source for surveillance was evaluated. During 1994-1998, a total of 20,213 burn claims were accepted by the workers' compensation system. Hospitalized burn cases represented only 1.5% of burn claims but incurred 55% of the costs. In addition, workers' compensation data underestimated the frequency and rate of burns. Although workers' compensation claims rates decreased during 1994-1998, work-related burns remain a problem in Washington State. Several industries (e.g., roofing, foundries, and aluminum smelting) were identified as priorities for prevention of burn hospitalizations, which incur the greater cost and time loss.

  9. 78 FR 25279 - Agency Information Collection Activities; Proposed Collection; Comment Request; Abbreviated New...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-30

    ... Collection; Comment Request; Abbreviated New Animal Drug Applications AGENCY: Food and Drug Administration... solicits comments on the paperwork associated with abbreviated new animal drug applications submitted to the Center for Veterinary Medicine, FDA. DATES: Submit either electronic or written comments on...

  10. 21 CFR 314.105 - Approval of an application and an abbreviated application.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Approval of an application and an abbreviated application. 314.105 Section 314.105 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... abbreviated application. (a) The Food and Drug Administration will approve an application and send...

  11. 21 CFR 314.105 - Approval of an application and an abbreviated application.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Approval of an application and an abbreviated application. 314.105 Section 314.105 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... abbreviated application. (a) The Food and Drug Administration will approve an application and send...

  12. 21 CFR 314.105 - Approval of an application and an abbreviated application.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Approval of an application and an abbreviated application. 314.105 Section 314.105 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... abbreviated application. (a) The Food and Drug Administration will approve an application and send...

  13. 21 CFR 314.105 - Approval of an application and an abbreviated application.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Approval of an application and an abbreviated application. 314.105 Section 314.105 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... abbreviated application. (a) The Food and Drug Administration will approve an application and send...

  14. 21 CFR 314.105 - Approval of an application and an abbreviated application.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Approval of an application and an abbreviated application. 314.105 Section 314.105 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... abbreviated application. (a) The Food and Drug Administration will approve an application and send...

  15. 78 FR 26785 - Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-08

    ...DHQ documents under 21 CFR 601.12. In the Federal Register of October 24, 2011 (76 FR 65735), FDA... Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of... ``Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire...

  16. 21 CFR 314.101 - Filing an application and receiving an abbreviated new drug application.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.101 Filing an application and receiving an abbreviated new drug application. (a)(1) Within 60 days after FDA receives...

  17. 21 CFR 314.153 - Suspension of approval of an abbreviated new drug application.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Suspension of approval of an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA... new drug application. (a) Suspension of approval. The approval of an abbreviated new drug...

  18. 21 CFR 314.101 - Filing an application and receiving an abbreviated new drug application.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... new drug application. 314.101 Section 314.101 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.101 Filing an application and receiving an abbreviated new drug application. (a)(1) Within 60 days after FDA receives...

  19. 77 FR 50702 - Ranbaxy Laboratories Limited; Withdrawal of Approval of 27 Abbreviated New Drug Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... Abbreviated New Drug Applications AGENCY: Food and Drug Administration, HHS. ACTION: Notice. ] SUMMARY: The Food and Drug Administration (FDA) is withdrawing approval of 27 abbreviated new drug applications... introduction into interstate commerce of products without approved new drug applications violates section...

  20. 75 FR 37295 - Change of Address; Abbreviated New Drug Applications; Technical Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-29

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Parts 312 and 314 Change of Address; Abbreviated New... the address for applicants to submit abbreviated new drug applications (ANDAs) and ANDA amendments... new drug applications (INDs) for in vivo bioavailability and bioequivalence studies in humans that...

  1. Automatic Word Sense Disambiguation of Acronyms and Abbreviations in Clinical Texts

    ERIC Educational Resources Information Center

    Moon, Sungrim

    2012-01-01

    The use of acronyms and abbreviations is increasing profoundly in the clinical domain in large part due to the greater adoption of electronic health record (EHR) systems and increased electronic documentation within healthcare. A single acronym or abbreviation may have multiple different meanings or senses. Comprehending the proper meaning of an…

  2. Test Review: Review of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II)

    ERIC Educational Resources Information Center

    McCrimmon, Adam W.; Smith, Amanda D.

    2013-01-01

    The Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II; Wechsler, 2011), published by Pearson, is a newly updated abbreviated measure of cognitive intelligence designed for individuals 6 to 90 years of age. Primarily used in clinical, psychoeducational, and research settings, the WASI-II was developed to quickly and accurately…

  3. Burning Rate Emulator

    NASA Video Gallery

    The Burning Rate Emulator is a gas fuel investigation attempting to emulate the burning of solids to improve our understanding of materials''flammability over a wide range of conditions. The approa...

  4. First Aid: Burns

    MedlinePlus

    ... You can get burned by heat, fire, radiation, sunlight, electricity, chemicals or hot or boiling water. There ... skin. The burned area will be sensitive to sunlight for up to one year, so you should ...

  5. Burns and Fire Safety

    MedlinePlus

    ... common among older children. 5 6 7 8 • Tap water burns most often occur in the bathroom and ... Feldman KW, Schaller RT, Feldman JA, McMillon M. Tap water scald burns in children. Pediatrics. 1978; 62(1): ...

  6. American Burn Association

    MedlinePlus

    ... and Activities Educational Resources Prevention Posters Awards FAQs Burn Awareness Week About IAC Accomplishments IAC Members IAC ... About Verification Verification Step by Step ACS Resources Burn Chapter Verification Criteria - Effective 1/1/2017 New! ...

  7. Prevention-oriented epidemiology of burns in Ardabil provincial burn centre, Iran.

    PubMed

    Sadeghi Bazargani, H; Arshi, S; Ekman, R; Mohammadi, R

    2011-05-01

    In preventing burns, it is essential to know how they occur and which population groups, environments and heating appliances can be targeted for prevention work. The aim of this study was to determine the epidemiological characteristics of burns leading to hospitalisation in the northwest of Iran with a focus on the pre-event phase of injury. Between 2007 and 2008, 237 burn victims hospitalised in Ardabil provincial burn centre were enrolled into a descriptive study. A questionnaire was filled in during hospital stay for all patients, with a focus on obtaining information necessary for prevention purposes. Males constituted 56% of victims. Mean age was 22 years. The most severe burns occurred between the ages of 18 and 32 years, and were mainly flame related. Both in case of flame and non-flame burns, women suffered more severe burns and mortality than men. However, with respect to non-flame burns of which most were scalds, the majority of the severe cases involved children under the age of 5 years. More than 80% of burns occurred at home. The kitchen was the main place of injury in 47% of cases, followed by living rooms in 28%. Nearly 45% of burns were scalds and 47% were flame burns. The main container was the samovar in 37%, followed by kettles in 32% and pots in 22%. The overturning of a container was the major mechanism of contact with hot liquids in 86%. Bumping into a container was the main scenario of a scald injury, constituting nearly 70% of the cases. The difference between flame and non-flame burns in the distribution of burns in extremities was not statistically significant, but head and neck burns were 3.7 times more likely to be caused by flame. The two most important injury patterns, more common among women, were getting burned while using a camping gas stove or while refilling the chamber of kerosene-burning appliances without first extinguishing them. Domestic burns among children and young women are a priority in injury-prevention programmes

  8. Pediatric Burn Resuscitation.

    PubMed

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  9. Allie: a database and a search service of abbreviations and long forms.

    PubMed

    Yamamoto, Yasunori; Yamaguchi, Atsuko; Bono, Hidemasa; Takagi, Toshihisa

    2011-01-01

    Many abbreviations are used in the literature especially in the life sciences, and polysemous abbreviations appear frequently, making it difficult to read and understand scientific papers that are outside of a reader's expertise. Thus, we have developed Allie, a database and a search service of abbreviations and their long forms (a.k.a. full forms or definitions). Allie searches for abbreviations and their corresponding long forms in a database that we have generated based on all titles and abstracts in MEDLINE. When a user query matches an abbreviation, Allie returns all potential long forms of the query along with their bibliographic data (i.e. title and publication year). In addition, for each candidate, co-occurring abbreviations and a research field in which it frequently appears in the MEDLINE data are displayed. This function helps users learn about the context in which an abbreviation appears. To deal with synonymous long forms, we use a dictionary called GENA that contains domain-specific terms such as gene, protein or disease names along with their synonymic information. Conceptually identical domain-specific terms are regarded as one term, and then conceptually identical abbreviation-long form pairs are grouped taking into account their appearance in MEDLINE. To keep up with new abbreviations that are continuously introduced, Allie has an automatic update system. In addition, the database of abbreviations and their long forms with their corresponding PubMed IDs is constructed and updated weekly. Database URL: The Allie service is available at http://allie.dbcls.jp/. PMID:21498548

  10. Allie: a database and a search service of abbreviations and long forms.

    PubMed

    Yamamoto, Yasunori; Yamaguchi, Atsuko; Bono, Hidemasa; Takagi, Toshihisa

    2011-01-01

    Many abbreviations are used in the literature especially in the life sciences, and polysemous abbreviations appear frequently, making it difficult to read and understand scientific papers that are outside of a reader's expertise. Thus, we have developed Allie, a database and a search service of abbreviations and their long forms (a.k.a. full forms or definitions). Allie searches for abbreviations and their corresponding long forms in a database that we have generated based on all titles and abstracts in MEDLINE. When a user query matches an abbreviation, Allie returns all potential long forms of the query along with their bibliographic data (i.e. title and publication year). In addition, for each candidate, co-occurring abbreviations and a research field in which it frequently appears in the MEDLINE data are displayed. This function helps users learn about the context in which an abbreviation appears. To deal with synonymous long forms, we use a dictionary called GENA that contains domain-specific terms such as gene, protein or disease names along with their synonymic information. Conceptually identical domain-specific terms are regarded as one term, and then conceptually identical abbreviation-long form pairs are grouped taking into account their appearance in MEDLINE. To keep up with new abbreviations that are continuously introduced, Allie has an automatic update system. In addition, the database of abbreviations and their long forms with their corresponding PubMed IDs is constructed and updated weekly. Database URL: The Allie service is available at http://allie.dbcls.jp/.

  11. Allie: a database and a search service of abbreviations and long forms

    PubMed Central

    Yamamoto, Yasunori; Yamaguchi, Atsuko; Bono, Hidemasa; Takagi, Toshihisa

    2011-01-01

    Many abbreviations are used in the literature especially in the life sciences, and polysemous abbreviations appear frequently, making it difficult to read and understand scientific papers that are outside of a reader’s expertise. Thus, we have developed Allie, a database and a search service of abbreviations and their long forms (a.k.a. full forms or definitions). Allie searches for abbreviations and their corresponding long forms in a database that we have generated based on all titles and abstracts in MEDLINE. When a user query matches an abbreviation, Allie returns all potential long forms of the query along with their bibliographic data (i.e. title and publication year). In addition, for each candidate, co-occurring abbreviations and a research field in which it frequently appears in the MEDLINE data are displayed. This function helps users learn about the context in which an abbreviation appears. To deal with synonymous long forms, we use a dictionary called GENA that contains domain-specific terms such as gene, protein or disease names along with their synonymic information. Conceptually identical domain-specific terms are regarded as one term, and then conceptually identical abbreviation-long form pairs are grouped taking into account their appearance in MEDLINE. To keep up with new abbreviations that are continuously introduced, Allie has an automatic update system. In addition, the database of abbreviations and their long forms with their corresponding PubMed IDs is constructed and updated weekly. Database URL: The Allie service is available at http://allie.dbcls.jp/. PMID:21498548

  12. Learn Not To Burn.

    ERIC Educational Resources Information Center

    English, Nancy; Hendricks, Charlotte M.

    1997-01-01

    Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

  13. First Aid: Burns

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  14. Workplace-related burns.

    PubMed

    Mian, M A H; Mullins, R F; Alam, B; Brandigi, C; Friedman, B C; Shaver, J R; Hassan, Z

    2011-06-30

    Introduction. The key element of a safe workplace for employees is the maintenance of fire safety. Thermal, chemical, and electrical burns are common types of burns at the workplace. This study assessed the epidemiology of work-related burn injuries on the basis of the workers treated in a regional burn centre. Methods. Two years' retrospective data (2005-2006) from the Trauma Registry of the American College of Surgeons of the Joseph M. Still Burn Center at Doctors Hospital in Augusta, Georgia, were collected and analysed. Results. During the time period studied, 2510 adult patients with acute burns were admitted; 384 cases (15%) were work-related. The average age of the patients was 37 yr (range, 15-72 yr). Males constituted the majority (90%) of workrelated burn injury admissions. The racial distribution was in accordance with the Centre's admission census. Industrial plant explosions accounted for the highest number of work-related burns and, relatively, a significant number of patients had chemical burns. The average length of hospital stay was 5.54 days. Only three patients did not have health insurance and four patients (1%) died. Conclusion. Burn injuries at the workplace predominantly occur among young male workers, and the study has shown that chemical burns are relatively frequent. This study functions as the basis for the evaluation of work-related burns and identification of the causes of these injuries to formulate adequate safety measures, especially for young, male employees working with chemicals.

  15. Chemical burn or reaction

    MedlinePlus

    Burn from chemicals ... in contact with the toxic substance Rash , blisters , burns on the skin Unconsciousness or other states of ... Make sure the cause of the burn has been removed. Try not to come ... yourself. If the chemical is dry, brush off any excess. Avoid ...

  16. Pathophysiologic Response to Burns in the Elderly.

    PubMed

    Jeschke, Marc G; Patsouris, David; Stanojcic, Mile; Abdullahi, Abdikarim; Rehou, Sarah; Pinto, Ruxandra; Chen, Peter; Burnett, Marjorie; Amini-Nik, Saeid

    2015-10-01

    Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50) burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p < 0.05. Interestingly, we could not find a higher incidence of infection or sepsis in elderly, p > 0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly.

  17. 21 CFR 314.152 - Notice of withdrawal of approval of an application or abbreviated application for a new drug.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or abbreviated application for a new drug. 314.152 Section 314.152 Food and Drugs FOOD AND DRUG... APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.152 Notice of withdrawal of approval of an application or abbreviated application for a new drug. If the Food and...

  18. Infections in critically ill burn patients.

    PubMed

    Hidalgo, F; Mas, D; Rubio, M; Garcia-Hierro, P

    2016-04-01

    Severe burn patients are one subset of critically patients in which the burn injury increases the risk of infection, systemic inflammatory response and sepsis. The infections are usually related to devices and to the burn wound. Most infections, as in other critically ill patients, are preceded by colonization of the digestive tract and the preventative measures include selective digestive decontamination and hygienic measures. Early excision of deep burn wound and appropriate use of topical antimicrobials and dressings are considered of paramount importance in the treatment of burns. Severe burn patients usually have some level of systemic inflammation. The difficulty to differentiate inflammation from sepsis is relevant since therapy differs between patients with and those without sepsis. The delay in prescribing antimicrobials increases morbidity and mortality. Moreover, the widespread use of antibiotics for all such patients is likely to increase antibiotic resistance, and costs. Unfortunately the clinical usefulness of biomarkers for differential diagnosis between inflammation and sepsis has not been yet properly evaluated. Severe burn injury induces physiological response that significantly alters drug pharmacokinetics and pharmacodynamics. These alterations impact antimicrobials distribution and excretion. Nevertheless the current available literature shows that there is a paucity of information to support routine dose recommendations. PMID:27013315

  19. Infections in critically ill burn patients.

    PubMed

    Hidalgo, F; Mas, D; Rubio, M; Garcia-Hierro, P

    2016-04-01

    Severe burn patients are one subset of critically patients in which the burn injury increases the risk of infection, systemic inflammatory response and sepsis. The infections are usually related to devices and to the burn wound. Most infections, as in other critically ill patients, are preceded by colonization of the digestive tract and the preventative measures include selective digestive decontamination and hygienic measures. Early excision of deep burn wound and appropriate use of topical antimicrobials and dressings are considered of paramount importance in the treatment of burns. Severe burn patients usually have some level of systemic inflammation. The difficulty to differentiate inflammation from sepsis is relevant since therapy differs between patients with and those without sepsis. The delay in prescribing antimicrobials increases morbidity and mortality. Moreover, the widespread use of antibiotics for all such patients is likely to increase antibiotic resistance, and costs. Unfortunately the clinical usefulness of biomarkers for differential diagnosis between inflammation and sepsis has not been yet properly evaluated. Severe burn injury induces physiological response that significantly alters drug pharmacokinetics and pharmacodynamics. These alterations impact antimicrobials distribution and excretion. Nevertheless the current available literature shows that there is a paucity of information to support routine dose recommendations.

  20. Acute and Perioperative Care of the Burn-Injured Patient

    PubMed Central

    Bittner, Edward A.; Shank, Erik; Woodson, Lee; Martyn, J.A. Jeevendra

    2016-01-01

    Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive airway and/or lung edema can occur rapidly and unpredictably after burn and/or inhalation injury. Hemodynamics in the early phase of severe burn injury are characterized by a reduction in cardiac output, increased systemic and pulmonary vascular resistance. Approximately 2–5 days after major burn injury, a hyperdynamic and hypermetabolic state develops. Electrical burns result in morbidity much higher than expected based on burn size alone. Formulae for fluid resuscitation should serve only as guideline; fluids should be titrated to physiologic end points. Burn injury is associated basal and procedural pain requiring higher than normal opioid and sedative doses. Operating room concerns for the burn-injured patient include airway abnormalities, impaired lung function, vascular access, deceptively large and rapid blood loss, hypothermia and altered pharmacology. PMID:25485468

  1. Cooling of burns: Mechanisms and models.

    PubMed

    Wright, E H; Harris, A L; Furniss, D

    2015-08-01

    The role of cooling in the acute management of burns is widely accepted in clinical practice, and is a cornerstone of basic first aid in burns. This has been underlined in a number of animal models. The mechanism by which it delivers its benefit is poorly understood, but there is a reduction in burns progression over the first 48 h, reduced healing time, and some subjective improvements in scarring when cooling is administered after burning. Intradermal temperature normalises within a matter of seconds to a few minutes, yet the benefits of even delayed cooling persist, implying it is not simply the removal of thermal energy from the damaged tissues. Animal models have used oedema formation, preservation of dermal perfusion, healing time and hair retention as indicators of burns severity, and have shown cooling to improve these indices, but pharmacological or immunological blockade of humoural and cellular mediators of inflammation did not reproduce the benefit of cooling. More recently, some studies of tissue from human and animal burns have shown consistent, reproducible, temporal changes in gene expression in burned tissues. Here, we review the experimental evidence of the role and mechanism of cooling in burns management, and suggest future research directions that may eventually lead to improved treatment outcomes.

  2. Burn Injury and Explosions: An Australian Perspective

    PubMed Central

    Greenwood, John E.

    2009-01-01

    Objectives: Increasingly (but not exclusively), terrorist activity and the use of explosive devices have enjoyed the focus of the global media. This paper aims to bring a range of issues to attention, to highlight how burn injuries are sustained in such incidents and why burn injuries (and thus burn disasters) are so complicated to manage. Materials and Methods: The author's experience with burn injury caused during explosions and his involvement in burn disaster situations has been summarized to form the basis of the article. This has been expanded upon with discussion points which provide a strategy for planning for such events and by a broad sample of the literature. Results: Several strategies are suggested to facilitate planning for burn disasters and to illustrate to those not directly involved why forward planning is pivotal to success when these incidents occur. Conclusions: Disasters generating large numbers of burn-injured are relatively frequent. Explosive devices are widespread in their use both in military and increasingly in civilian fields. Encompassing a large range of aetiologies, geographical sites, populations, and resources; burn disaster management is difficult and planning essential. PMID:19834533

  3. Adaptation of abbreviated mathematics anxiety rating scale for engineering students

    NASA Astrophysics Data System (ADS)

    Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah

    2015-05-01

    Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.

  4. Burns and epilepsy.

    PubMed

    Berrocal, M

    1997-01-01

    This is a report of the first descriptive analytic study of a group of 183 burn patients, treated in the Burn Unit at the University Hospital of Cartagena, Colombia during the period since January 1985 until December 1990. There is presented experience with the selected group of 24 patients in whom the diagnosis of burn was associated with epilepsy. There is also analysed and described the gravity of the scars sequels, neurological disorders, the complication of the burn and an impact of this problem on the patient, his (her) family and the community. It is very important to report that there was found Neurocisticercosis in 66.6% of the group of burn patients with epilepsy, and it is probably the first risk factor of burn in this group.

  5. 'Therapeutic' burns (Maqua).

    PubMed

    Baruchin, A M

    1984-12-01

    Cauterization of the skin by a red-hot iron, a pinch of hot cinder or a burning coal, is a form of 'treatment' used by lay healers in some parts of Africa and the Middle East. The burns are limited to small circular areas, and are usually full-thickness skin loss. Most frequently, the patients do not seek medical treatment and the burns heal by secondary intention. Sometimes, however, disastrous complications such as infectious osteomyelitis, septicaemia and death may occur.

  6. Disseminated intravascular coagulation in burn injury.

    PubMed

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a complex and multifaceted disorder characterized by the activation of coagulation and fibrinolytic pathways, consumption of coagulation factors, and depletion of coagulation regulatory proteins. The introduction into the circulation of cellular debris characterized by strong thromboplastic activity due to tissue factor exposition or release (in or from burned tissues), which can thereby activate extrinsic pathway of coagulation system and trigger massive thrombin generation when present in sufficient concentration, represents the most plausible biological explanation to support the development of intravascular coagulation in patients with burn injury. Severe burns left untreated might also lead to an immunological and inflammatory response (activation of the complement cascade), which can amplify fibrinolysis and blood clotting. Overall, the real prevalence of DIC in patients with burns is as yet unclear. Postmortem, retrospective, and even longitudinal investigations are in fact biased by several factors, such as the objective difficulty to establish whether DIC might have occurred as a primary complication of burns or rather as a consequence of other superimposed pathologies (e.g., sepsis, multiple organ failure), the different diagnostic criteria for assessing DIC, and the heterogeneity of the patient samples studied. Nevertheless, the current scientific evidence is consistent with the hypothesis that biochemical changes suggestive for DIC (hypercoagulability, hypo- and hyperfibrinolysis) are commonplace in patients with burn trauma, and their severity increases exponentially with the severity of injury. Overt DIC seems to occur especially in critically ill burn patients or in those with severe burns (up to third degree) and large involvement of body surface area, in whom an appropriate therapy might be effective to prevent the otherwise fulminant course. Although early prophylaxis with antithrombin concentrates

  7. 76 FR 44013 - Draft Guidance for Industry: Implementation of Acceptable Full-Length and Abbreviated Donor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry: Implementation of Acceptable Full- Length and Abbreviated Donor History Questionnaires and Accompanying Materials for Use in Screening Donors of Source Plasma; Availability AGENCY: Food and Drug Administration, HHS. ACTION:...

  8. Using Abbreviated Injury Scale (AIS) codes to classify Computed Tomography (CT) features in the Marshall System

    PubMed Central

    2010-01-01

    Background The purpose of Abbreviated Injury Scale (AIS) is to code various types of Traumatic Brain Injuries (TBI) based on their anatomical location and severity. The Marshall CT Classification is used to identify those subgroups of brain injured patients at higher risk of deterioration or mortality. The purpose of this study is to determine whether and how AIS coding can be translated to the Marshall Classification Methods Initially, a Marshall Class was allocated to each AIS code through cross-tabulation. This was agreed upon through several discussion meetings with experts from both fields (clinicians and AIS coders). Furthermore, in order to make this translation possible, some necessary assumptions with regards to coding and classification of mass lesions and brain swelling were essential which were all approved and made explicit. Results The proposed method involves two stages: firstly to determine all possible Marshall Classes which a given patient can attract based on allocated AIS codes; via cross-tabulation and secondly to assign one Marshall Class to each patient through an algorithm. Conclusion This method can be easily programmed in computer softwares and it would enable future important TBI research programs using trauma registry data. PMID:20691038

  9. WHAT, HOW, AND HOW MUCH SHOULD BURN PATIENTS BE FED?

    PubMed Central

    Williams, Felicia N.; Branski, Ludwik K.; Jeschke, Marc G.; Herndon, David N.

    2011-01-01

    SYNOPSIS The hypermetabolic response to severe burn injury is characterized by hyperdynamic circulation, profound metabolic, physiologic, catabolic and immune system derangements. Failure to satisfy overwhelming energy and protein requirements after, and during severe burn injury, results in multi-organ dysfunction, increased susceptibility to infection, and death. Attenuation of the hypermetabolic response by various pharmacologic modalities is emerging as an essential component of the management of severe burn patients. This review focuses on the more recent advances in therapeutic strategies to attenuate the hypermetabolic response and its post-burn associated insulin resistance. Modulation of the response by early excision and grafting of burn wounds, environmental thermoregulation, early and continuous enteral feeding with high protein-high carbohydrate feedings and pharmacologic treatments that stimulate anabolism and oppose catabolism have markedly decreased morbidity in the acute phase post severe burn injury. PMID:21621699

  10. Advantages of using an abbreviated dossier for drug master file applications in Taiwan.

    PubMed

    Sun, I-Chen

    2016-10-01

    In Taiwan, the quality of active pharmaceutical ingredients is recorded in a drug master file (DMF), the applications for which can be submitted in two dossier types, either full (complete technical information) or abbreviated (partially complete technical information with an approved document issued by developed countries). However, the advantages of the abbreviated approach remain unknown. This study compared full and abbreviated dossier profiles and reviewed their outcomes in acceptance rates and deficiencies leading to rejection. Data were collected from new submissions of both dossier types that were completed in 2014 by the Center for Drug Evaluation, Taiwan. The results revealed that the abbreviated applications took shorter review time and had a higher acceptance rate. Among the eligible types of document for abbreviated applications, Certification of Suitability to the Monographs of the European Pharmacopeia (CEP) was the most frequently used. For categorical deficiencies, both dossier types presented the deficiencies in similar sections leading to rejection, namely Manufacture (3.2.S.2), Control of drug substance (3.2.S.4), and Stability (3.2.S.7). In summary, CEP serves a favorable document for the abbreviated DMF application in which it shortens the review time, increases the acceptance rate, and its deficiencies are similar to those of the full DMF application.

  11. Advantages of using an abbreviated dossier for drug master file applications in Taiwan.

    PubMed

    Sun, I-Chen

    2016-10-01

    In Taiwan, the quality of active pharmaceutical ingredients is recorded in a drug master file (DMF), the applications for which can be submitted in two dossier types, either full (complete technical information) or abbreviated (partially complete technical information with an approved document issued by developed countries). However, the advantages of the abbreviated approach remain unknown. This study compared full and abbreviated dossier profiles and reviewed their outcomes in acceptance rates and deficiencies leading to rejection. Data were collected from new submissions of both dossier types that were completed in 2014 by the Center for Drug Evaluation, Taiwan. The results revealed that the abbreviated applications took shorter review time and had a higher acceptance rate. Among the eligible types of document for abbreviated applications, Certification of Suitability to the Monographs of the European Pharmacopeia (CEP) was the most frequently used. For categorical deficiencies, both dossier types presented the deficiencies in similar sections leading to rejection, namely Manufacture (3.2.S.2), Control of drug substance (3.2.S.4), and Stability (3.2.S.7). In summary, CEP serves a favorable document for the abbreviated DMF application in which it shortens the review time, increases the acceptance rate, and its deficiencies are similar to those of the full DMF application. PMID:27237380

  12. Burns and military clothing.

    PubMed

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

  13. Initial evaluation and management of the critical burn patient.

    PubMed

    Vivó, C; Galeiras, R; del Caz, Ma D P

    2016-01-01

    The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. PMID:26724246

  14. Initial evaluation and management of the critical burn patient.

    PubMed

    Vivó, C; Galeiras, R; del Caz, Ma D P

    2016-01-01

    The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound.

  15. Solid fuel burning stove

    SciTech Connect

    Good, L.D.

    1982-07-13

    A solid fuel burning stove includes a firebox having an insulated bottom chamber in which fuel is burned. The bottom chamber includes an insulated bottom surface and walls which provides for heat retention when fuel is burn therein thereby creating high temperatures. The bottom chamber of the firebox is divided from a top chamber by a horizontally extending baffle which directs flow of exhaust gases from the bottom to the top of the firebox. The exhaust gases are burned in the top portion of the firebox by means of the heat generated within the lower chamber and the introduction of fresh combustion air. This fresh combustion air is drawn in through an orificed pipe extending along the length of the firebox. After the gases are burned in the top portion of the stove, they are communicated to a heat saver including an inverted v-shaped flow diverter which reduces the velocity of the exiting gases and provides for greater recovery of heat therefrom. The stove in accordance with the invention provides for a two-stage burning process wherein solid fuel is burned in the first stage and the volatile gases released by the fuel are burned in the second stage. In this way, the fuel is consumed in a most efficient manner.

  16. Critical issues in burn care.

    PubMed

    Holmes, James H

    2008-01-01

    Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation.

  17. Critical issues in burn care.

    PubMed

    Holmes, James H

    2008-01-01

    Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation. PMID:18997561

  18. Burning Mouth Syndrome.

    PubMed

    Kamala, K A; Sankethguddad, S; Sujith, S G; Tantradi, Praveena

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

  19. Gunpowder-related burns.

    PubMed

    Navarro-Monzonis, A; Benito-Ruiz, J; Baena-Montilla, P; Mena-Yago, A; de la Cruz-Ferrer, L I

    1992-04-01

    Gunpowder misuse is a frequent cause of burn injury in our area. The injuries are mostly minor lesions which may be treated on an outpatient basis, the more serious injuries need surgical treatment. Experience of the management of these burns is reported by reviewing 123 clinical charts of patients admitted between 1983 and 1990. The most frequent victims are teenage males who are involved mainly in accidents in the street. The most serious burns followed work-related accidents, with a fatal outcome in 47 per cent of the patients. The serious burns are usually deep dermal or full skin thickness. A common pattern affects groins, genitalia, hypogastrium and hands, and are produced when fireworks ignite in the pockets of the patient's trousers. The management of these lesions does not differ from burns caused by other agents, although attention should be paid to the presence of associated lesions, chiefly to eyes, ears and hands, due to the shockwave and shrapnel. PMID:1590935

  20. Gunpowder-related burns.

    PubMed

    Navarro-Monzonis, A; Benito-Ruiz, J; Baena-Montilla, P; Mena-Yago, A; de la Cruz-Ferrer, L I

    1992-04-01

    Gunpowder misuse is a frequent cause of burn injury in our area. The injuries are mostly minor lesions which may be treated on an outpatient basis, the more serious injuries need surgical treatment. Experience of the management of these burns is reported by reviewing 123 clinical charts of patients admitted between 1983 and 1990. The most frequent victims are teenage males who are involved mainly in accidents in the street. The most serious burns followed work-related accidents, with a fatal outcome in 47 per cent of the patients. The serious burns are usually deep dermal or full skin thickness. A common pattern affects groins, genitalia, hypogastrium and hands, and are produced when fireworks ignite in the pockets of the patient's trousers. The management of these lesions does not differ from burns caused by other agents, although attention should be paid to the presence of associated lesions, chiefly to eyes, ears and hands, due to the shockwave and shrapnel.

  1. Burning Mouth Syndrome

    PubMed Central

    Kamala, KA; Sankethguddad, S; Sujith, SG; Tantradi, Praveena

    2016-01-01

    Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

  2. Southeast U.S. burns

    NASA Astrophysics Data System (ADS)

    Maggs, William Ward

    Human beings were responsible for most of 12,000 forest fires in the southeastern United States that burned for 10 days in late October and early November 1987. 910 km2, mostly hardwood forest, were destroyed in the fires, with arson and carelessness as the primary causes, according to the U.S. Department of Agriculture Forest Service.Measured in monetary terms, the toll was more than $40 million in resource and property damage. While the amount of forest burned did not rival the 3390 km2 lost to fires in the western United States last summer, the human impact was severe in the southeast and all along the East Coast. Favorable winds blew smoke from the southern and central Appalachians as far north as New England and as far east as Delaware, and cool fall air close to the ground prevented the smoke from rising, thickening the air in many northeastern cities on November 8 and 9.

  3. Fluconazole Pharmacokinetics in Burn Patients

    PubMed Central

    Boucher, Bradley A.; King, Stephen R.; Wandschneider, Heidi L.; Hickerson, William L.; Hanes, Scott D.; Herring, Vanessa L.; Canada, Todd W.; Hess, Mary M.

    1998-01-01

    The pharmacokinetics of fluconazole in nine adult patients with severe (30 to 95% total body surface area) burns were studied. There was no significant difference in half-life (t1/2), clearance (CL), or volume of distribution (V) over time in five patients on days 3 and 8 of the study (P > 0.05). Combined parameter estimates (means ± standard deviations) for all nine patients for the two study periods were as follows: t1/2, 24.4 ± 5.8 h; CL, 0.36 ± 0.09 ml/min/kg; and V, 0.72 ± 0.12 liters/kg. These estimates of t1/2 and CL in burn patients were approximately 13% shorter and 30% more rapid, respectively, than the most extreme estimates reported for other populations. PMID:9559811

  4. Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations

    PubMed Central

    Kuhn, Jens H.; Becker, Stephan; Ebihara, Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka, Yoshihiro; Lipkin, W. Ian; Negredo, Ana I.; Netesov, Sergey V.; Nichol, Stuart T.; Palacios, Gustavo; Peters, Clarence J.; Tenorio, Antonio; Volchkov, Viktor E.; Jahrling, Peter B.

    2011-01-01

    The taxonomy of the family Filoviridae (marburgviruses and ebolaviruses) has changed several times since the discovery of its members, resulting in a plethora of species and virus names and abbreviations. The current taxonomy has only been partially accepted by most laboratory virologists. Confusion likely arose for several reasons: species names that consist of several words or which (should) contain diacritical marks, the current orthographic identity of species and virus names, and the similar pronunciation of several virus abbreviations in the absence of guidance for the correct use of vernacular names. To rectify this problem, we suggest (1) to retain the current species names Reston ebolavirus, Sudan ebolavirus, and Zaire ebolavirus, but to replace the name Cote d'Ivoire ebolavirus [sic] with Taï Forest ebolavirus and Lake Victoria marburgvirus with Marburg marburgvirus; (2) to revert the virus names of the type marburgviruses and ebolaviruses to those used for decades in the field (Marburg virus instead of Lake Victoria marburgvirus and Ebola virus instead of Zaire ebolavirus); (3) to introduce names for the remaining viruses reminiscent of jargon used by laboratory virologists but nevertheless different from species names (Reston virus, Sudan virus, Taï Forest virus), and (4) to introduce distinct abbreviations for the individual viruses (RESTV for Reston virus, SUDV for Sudan virus, and TAFV for Taï Forest virus), while retaining that for Marburg virus (MARV) and reintroducing that used over decades for Ebola virus (EBOV). Paying tribute to developments in the field, we propose (a) to create a new ebolavirus species (Bundibugyo ebolavirus) for one member virus (Bundibugyo virus, BDBV); (b) to assign a second virus to the species Marburg marburgvirus (Ravn virus, RAVV) for better reflection of now available high-resolution phylogeny; and (c) to create a new tentative genus (Cuevavirus) with one tentative species (Lloviu cuevavirus) for the recently

  5. Do Large Fire Runs Result in More Severe Fires?

    NASA Astrophysics Data System (ADS)

    Morgan, P.; Birch, D.; Kolden, C.; Smith, A. M.

    2013-12-01

    Do large fire runs consistently result in high severity fires, and how do climate, weather topography and fuels influence where they burn severely? We analyzed burn severity on 11,938 polygons representing daily area growth (0.09 - 5559 ha, median 0.75 ha) from 410 days of fire progression totaling more than 141,363 ha from 43 large forest fires from Idaho and Montana that burned 2007-2011. We used burn severity classes interpreted using differenced Normalized Burn Ratio from 30-m Landsat satellite imagery by the Monitoring Trends in Burn Severity project, along with infrared perimeter maps provided by the USDA Forest Service National Infrared Operations. Proportion burned with high severity, likely indicating tree mortality >70%, was not correlated with the daily area growth (Kendall Tau=0.288, p=<0.0001), and no burn severity class was correlated to the size of individual daily areas of growth. Burn severity proportions were variable even when extensive areas burned in a day, with proportion burned moderately commonly about 20%, proportion burned with low severity commonly about 23%, and proportion in high severity or other class more variable. On days of large fire growth, fires burn across areas of varying topography and fuels and under different weather conditions. We use the Random Forest Machine Learning algorithm to analyze burn severity relative to 31 fuel, topography, and weather factors, with weather factors such as temperature and relative humidity based on the 24-hour burn period, all at randomly located points within polygons. Results support our hypothesis that local, bottom-up fuels and topography influences where fires burn severely, while top-down climate and weather more strongly influence area burned, even when large areas burn within a single 24-hour period.

  6. "Fishing for Burn Prevention": a novel approach to burn and fire safety.

    PubMed

    Albrecht, R C; Hansen, S L; Voigt, D W; Paul, C N

    1999-01-01

    "Fishing for Burn Prevention" is an interactive educational burn and fire safety program designed to stimulate family involvement at health fairs, and it provides an alternative to handing out safety information. The program attracts preschoolers through preteens and is staffed by burn center personnel. The design consists of a small pool, a wooden fishing rod, several cutout fish, and hook-and-loop fasteners. Words that will stimulate interaction between the presenter and the participant are written on the fish; these can include "smoke detector," "cool the burn," "fire escape plan," "matches," "grease fire," and "120 degrees F." Providing an interactive, hands-on activity at health fairs can increase burn and fire safety awareness for the entire family.

  7. "Fishing for Burn Prevention": a novel approach to burn and fire safety.

    PubMed

    Albrecht, R C; Hansen, S L; Voigt, D W; Paul, C N

    1999-01-01

    "Fishing for Burn Prevention" is an interactive educational burn and fire safety program designed to stimulate family involvement at health fairs, and it provides an alternative to handing out safety information. The program attracts preschoolers through preteens and is staffed by burn center personnel. The design consists of a small pool, a wooden fishing rod, several cutout fish, and hook-and-loop fasteners. Words that will stimulate interaction between the presenter and the participant are written on the fish; these can include "smoke detector," "cool the burn," "fire escape plan," "matches," "grease fire," and "120 degrees F." Providing an interactive, hands-on activity at health fairs can increase burn and fire safety awareness for the entire family. PMID:10613693

  8. Comparison of the pharmacokinetics of linezolid in burn and non-burn rabbits.

    PubMed

    Ma, Jian-Li; Gao, Lei; Li, Xiang; Chu, Wan-Li; Feng, Yong-Qiang; Wang, Xiao-Qin; Zhang, Qing-Zhe

    2015-09-01

    Linezolid is effective on many resistant organisms for the treatment of severe infections in burns. However, its pharmacokinetics was difficult to predict after major burns. The study aimed to describe the pharmacokinetic properties of linezolid administered intravenously at a dose of 10 mg/kg in severely burned rabbits in comparison to that in non-burns. Linezolid concentrations were quantitatively analyzed by high-performance liquid chromatography. The direct consequence of the physiological changes after burn injury was lower plasma linezolid concentrations. In addition, burn injury induced significantly altered pharmacokinetic parameters with higher inter-individual variability. The distribution volume and clearance rate were increased (2.88 vs. 1.92 L/kg, P > 0.05; 0.28 vs. 0.20 L/h/kg, P < 0.05), and the AUC0-∞ was significantly lower (37.99 vs. 51.47 mg/L h, P < 0.05). However, there were almost no changes in half-life and mean residence time. These results suggested that therapeutic drug monitoring and dosage individualization of linezolid in patients with severe burns were necessary.

  9. Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

    PubMed

    Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

    2015-09-01

    Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians.

  10. Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

    PubMed

    Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

    2016-05-01

    Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. PMID:27088728

  11. Tap water scald burns in children

    PubMed Central

    Feldman, K.; Schaller, R.; Feldman, J.; McMillon, M.

    1998-01-01

    Tap water scald burns account for 7% to 17% of all childhood scald burns that require hospitalization. Often the burns are severe and disabling. Toddlers and preschool children are the most frequent victims. In 45% of the injuries, the unsupervised victim or a peer turned on the tap water; in 28% the cause was abuse. Eighty per cent of the homes tested had unsafe bathtub water temperatures of 54°C (130°F) or greater, exposing the occupants to the risk of full thickness scalds with 30 second exposure to hot water. Such burns may be prevented passively by limiting household water temperatures to less than 52°C (125°F). New water heaters could be preset at this temperature and families could be taught to turn down the temperature on existing units. PMID:9867427

  12. Adulterated Kerosene Burn Disaster: the Nigeria Experience

    PubMed Central

    Olugbenga, S.A.

    2005-01-01

    Summary A major kerosene explosion disaster occurred in oil-producing Nigeria in October 2001. One hundred and twenty-five burn patients were treated at the Lagos State University Teaching Hospital in a 25-day period of 12/10/01 to 6/11/01. All but two of the patients sustained fire/flame burns resulting from hurricane lantern and cooking stove explosions in home or enclosed environments. In a scene reminiscent of petrol bomb explosions, most burns were extensive, covering the face, chest, and abdomen. Burns were relatively deep because the clothing was usually perfused with the splashed fuel. Severity was greater in females than males, as they were more in contact with lamps and cooking stoves in the household. Almost 50% of the patients required hospitalization upwards of 3 weeks. PMID:21990977

  13. On burning a lump of coal

    NASA Astrophysics Data System (ADS)

    Alonso-Serrano, Ana; Visser, Matt

    2016-06-01

    Burning something, (e.g. the proverbial lump of coal, or an encyclopaedia for that matter), in a blackbody furnace leads to an approximately Planck emission spectrum with an average entropy/information transfer of approximately 3.9 ± 2.5 bits per emitted photon. This quantitative and qualitative result depends only on the underlying unitarity of the quantum physics of burning, combined with the statistical mechanics of blackbody radiation. The fact that the utterly standard and unitarity preserving process of burning something (in fact, burning anything) nevertheless has an associated entropy/information budget, and the quantitative size of that entropy/information budget, is a severely under-appreciated feature of standard quantum statistical physics.

  14. Epilepsy and Full-Thickness Burns

    PubMed Central

    Botan, A.

    2010-01-01

    Summary This paper presents various aspects of severe burns involving epileptic patients, who may suffer dramatic accidents during seizure attacks. Epileptics may fall onto an open fire or hot surface (e.g. a kitchen range) and they may upset containers full of boiling liquids, suffering deep burns and scalds. In our experience in this field, the most commonly affected body areas are the face and hands, the trunk, and the lower limbs. All such injuries are full-thickness burns, owing to the very long contact of the skin surface with the lesional agent. Three cases are presented of epileptics with severe burns who were admitted to the Burn Unit of Targu Mures Teaching Hospital, Romania, where they were hospitalized; conservative debridement using polyurethanefoam (PUR-foam) dressings was the standard procedure, which all the patients received. Split-thickness skin grafting was the final method for closing the granulating bed resulting from the conservative debridement. We have found that conservative debridement using PUR-foam dressings is a cheaper and more reliable alternative than sharp debridement (which may remove healthy tissue at the same time as burn eschars). PMID:21991200

  15. Hyperspectral Imaging for Burn Depth Assessment in an Animal Model

    PubMed Central

    Chin, Michael S.; Babchenko, Oksana; Lujan-Hernandez, Jorge; Nobel, Lisa; Ignotz, Ronald; Lalikos, Janice F.

    2015-01-01

    Abstract Background: Differentiating between superficial and deep-dermal (DD) burns remains challenging. Superficial-dermal burns heal with conservative treatment; DD burns often require excision and skin grafting. Decision of surgical treatment is often delayed until burn depth is definitively identified. This study’s aim is to assess the ability of hyperspectral imaging (HSI) to differentiate burn depth. Methods: Thermal injury of graded severity was generated on the dorsum of hairless mice with a heated brass rod. Perfusion and oxygenation parameters of injured skin were measured with HSI, a noninvasive method of diffuse reflectance spectroscopy, at 2 minutes, 1, 24, 48 and 72 hours after wounding. Burn depth was measured histologically in 12 mice from each burn group (n = 72) at 72 hours. Results: Three levels of burn depth were verified histologically: intermediate-dermal (ID), DD, and full-thickness. At 24 hours post injury, total hemoglobin (tHb) increased by 67% and 16% in ID and DD burns, respectively. In contrast, tHb decreased to 36% of its original levels in full-thickness burns. Differences in deoxygenated and tHb among all groups were significant (P < 0.001) at 24 hours post injury. Conclusions: HSI was able to differentiate among 3 discrete levels of burn injury. This is likely because of its correlation with skin perfusion: superficial burn injury causes an inflammatory response and increased perfusion to the burn site, whereas deeper burns destroy the dermal microvasculature and a decrease in perfusion follows. This study supports further investigation of HSI in early burn depth assessment. PMID:26894016

  16. Burn depth assessments by photoacoustic imaging and laser Doppler imaging.

    PubMed

    Ida, Taiichiro; Iwazaki, Hideaki; Kawaguchi, Yasushi; Kawauchi, Satoko; Ohkura, Tsuyako; Iwaya, Keiichi; Tsuda, Hitoshi; Saitoh, Daizoh; Sato, Shunichi; Iwai, Toshiaki

    2016-03-01

    Diagnosis of burn depths is crucial to determine the treatment plan for severe burn patients. However, an objective method for burn depth assessment has yet to be established, although a commercial laser Doppler imaging (LDI) system is used limitedly. We previously proposed burn depth assessment based on photoacoustic imaging (PAI), in which thermoelastic waves originating from blood under the burned tissue are detected, and we showed the validity of the method by experiments using rat models with three different burn depths: superficial dermal burn, deep dermal burn and deep burn. On the basis of those results, we recently developed a real-time PAI system for clinical burn diagnosis. Before starting a clinical trial, however, there is a need to reveal more detailed diagnostic characteristics, such as linearity and error, of the PAI system as well as to compare its characteristics with those of an LDI system. In this study, we prepared rat models with burns induced at six different temperatures from 70 to 98 °C, which showed a linear dependence of injury depth on the temperature. Using these models, we examined correlations of signals obtained by PAI and LDI with histologically determined injury depths and burn induction temperatures at 48 hours postburn. We found that the burn depths indicated by PAI were highly correlative with histologically determined injury depths (depths of viable vessels) as well as with burn induction temperatures. Perfusion values measured by LDI were less correlative with these parameters, especially for burns induced at higher temperatures, being attributable to the limited detectable depth for light involving a Doppler shift in tissue. In addition, the measurement errors in PAI were smaller than those in LDI. On the basis of these results, we will be able to start clinical studies using the present PAI system.

  17. Burning coal's waste

    SciTech Connect

    Daly, J.M.; Duffy, T.J.

    1988-07-01

    In an old Pennsylvania coal valley, growing fresh produce and eliminating ancient waste piles both depend on a fluidized bed boiler cogeneration plant. The builders of a complex now nearing completion at Archbald, however, will soon begin to turn two of the waste piles, called culm banks, into economic assets. Culm will burn although it has a low, variable heat content. The project combines several recently developed technologies to use culm as fuel for a fluidized bed boiler cogeneration plant that will heat a hydroponic greenhouse. What makes the venture economically viable are the products that will be sold: 23 mw of electricity to the local utility and fresh produce to meet burgeoning demands in East Coast supermarkets. For instance, if the ''salad plant'' were completely devoted to growing lettuce, 3 million heads could be harvested in 11 hydroponic seasons a year. The owners, Archbald Power Corp., chose a 271 acre stie that had been mined for anthracite by both open pit and deep shaft methods.

  18. Burn wound management.

    PubMed

    Davies, M R; Rode, H; Cywes, S; van der Riet, R L

    1981-01-01

    In this chapter the local therapy for burns is discussed. Between 400 and 500 children with burns are treated every year at the Red Cross War Memorial Children's Hospital in Cape Town, but in only 10% of them do the burns affect over 20% of the body surface. These latter patients are treated in special rooms equipped for intensive therapy. Open and closed methods of treatment for burns used in addition to early excision are compared. The first aim is early skin cover for areas with skin loss preserving as much function as possible and achieving the best possible cosmetic result. Local therapy must be atraumatic to prevent extension of the skin lesion. Bacterial contamination must be prevented as far as possible by keeping the wound clean. Emergency treatment and the course of wound healing up to the third week after the injury using the appropriate dressings are described. Early excision until the fifth day after the accident should be used mainly for burns of the hand, deep second degree burns of up to 10% of the body surface, deep second degree burns over the joints and deep second degree burns of the neck. It must be admitted that the depth of the burn can only be definitely estimated between the seventh and tenth day after the accident. If no autografts are available homografts or grafts from animals are used. The age of the patient, associated injuries, associated diseases and the extent of the burn all play a role in determining the prognosis. Furthermore endogenous bacterial infections, absorption of local therapeutic agents and the state of the surrounding skin do also influence the healing process. Finally the various local therapeutic agents like sulphamylon, silver sulphadiazine and betadine are discussed. A 0.05% solution of silver nitrate is also active against gram-negative infections. Skin transplants are disinfected with a solution containing one third 0.25% acetic acid, one third 3% cent hydrogen peroxide and one third saline. Hydrogen peroxide

  19. Burn injury in children.

    PubMed

    Zámecníková, I; Stĕtinský, J; Tymonová, J; Kadlcík, M

    2005-01-01

    The authors have analyzed the data files of 580 child patients up to 15 years of age who were hospitalized at the Burn Center of the FNsP Hospital in Ostrava in the years 1999 - 2003. The authors focused on mechanisms of burn injury in relation to the age of a child as well as extent, depth, localization, and local treatment of the injury. The data file was divided to four age groups: up to two years of age, 2 - 5 years of age, 5 - 10 years of age, and 10 - 15 years of age. As regards the mechanisms of injury, the authors have analyzed scalding by hot liquids, burns due to contact with a hot object, burns due to electric current, explosion, and injury caused by burning clothing. Injury by scalding prevails to a very significant degree in the youngest children. In the second age group the incidence of burn following contact with hot objects increases, as does the percentage of children injured by burning of clothing in children aged 5 - 10. The older children have increased prevalence of injuries caused by explosions. The greatest average extent of an injury is from burning of clothing. Most of the areas are burned deeply, localized in more areas of the body, and almost half of the cases required surgical intervention. Scalding comes second in terms of average extent of an injury. More than half of the injured areas are superficial, and areas of injury are different in the individual age groups. We addressed about a fifth of the cases surgically. The explosion of combustible materials caused a smaller extent of injury, on average, taking third place. The injuries were predominantly superficial, most commonly involving the head, trunk, and upper extremities. In none of the cases it was necessary for us to operate. Burn injuries caused by contact with hot objects are of a smaller extent. More than half of the burned areas are deep, localized most commonly in the upper extremities. Surgical intervention was necessary in more than half the cases. In terms of average

  20. Infrared imaging of burn wounds to determine burn depth

    NASA Astrophysics Data System (ADS)

    Hargroder, Andrew G.; Davidson, James E., Sr.; Luther, Donald G.; Head, Jonathan F.

    1999-07-01

    Determination of burn wound depth is at present left to the surgeons visual examination. Many burn wounds are obviously, by visual inspection, superficial 2 degree burns or true 3 degree burns. However, those burn wounds that fall between the obvious depth burns are difficult to assess visually, and therefore wound depth determination often requires waiting 5 to 7 days postburn. Initially, 10 burn patients underwent IR imaging at various times during the evaluation of their burn wounds. These patients were followed to either healing or skin grafting. The IR images were then reviewed to determine their accuracy in determining the depth of the wound. IR imaging of burn wounds with focal plane staring array midrange IR systems appears promising in determination of burn depth one to two days postburn. This will allow clinical decision regarding operative or nonoperative intervention to be made earlier, thus decreasing hospital stays and time to healing.

  1. New Fashioned Book Burning.

    ERIC Educational Resources Information Center

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  2. Burns (For Parents)

    MedlinePlus

    ... you drowsy, or in bed. Don't use fireworks or sparklers. Bathroom Set the thermostat on your ... For Kids For Parents MORE ON THIS TOPIC Fireworks Safety First Aid: Burns First Aid: Sunburn Sun ...

  3. Minor burns - aftercare

    MedlinePlus

    ... put a thin layer of ointment, such as petroleum jelly or aloe vera, on the burn. The ... is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation ...

  4. Atmospheric Effects of Biomass Burning

    NASA Technical Reports Server (NTRS)

    Thompson, Anne M.

    2000-01-01

    Biomass fires are both natural and anthropogenic in origin. The natural trigger is lightning, which leads to mid- and high-latitude fires and episodes of smoke and pollution associated with them. Lightning is also prominent in tropical regions when the dry season gives way to the wet season and lightning in convective systems ignites dry vegetation. Atmospheric consequences of biomass fires are complex. When considering the impacts of fires for a given ecosystem, inputs of fires must be compared to other process that emit trace gases and particles into the atmosphere. Other processes include industrial activity, fires for household purposes and biogenic sources which may themselves interact with fires. That is, fires may promote or restrict biogenic processes. Several books have presented various aspects of fire interactions with atmospheric chemistry and a cross-disciplinary review of a 1992 fire-oriented experiment appears in SAFARI: The Role of southern African Fires in Atmospheric and Ecological Environments. The IGAC/BIBEX core activity (see acronyms at end of Chapter) has sponsored field campaigns that integrate multiple aspects of fires ground-based measurements with an ecological perspective, atmospheric measurements with chemical and meteorological components, and remote sensing. This Chapter presents two aspects of biomass fires and the environment. Namely, the relationship between biomass burning and ozone is described, starting with a brief description of the chemical reactions involved and illustrative measurements and interpretation. Second, because of the need to observe biomass burning and its consequences globally, a summary of remote sensing approaches to the study of fires and trace gases is given. Examples in this Chapter are restricted to tropical burning for matters of brevity and because most burning activity globally is within this zone.

  5. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the companyused technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  6. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications

  7. Burn Depth Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Supra Medical Systems is successfully marketing a device that detects the depth of burn wounds in human skin. To develop the product, the company used technology developed by NASA Langley physicists looking for better ultrasonic detection of small air bubbles and cracks in metal. The device is being marketed to burn wound analysis and treatment centers. Through a Space Act agreement, NASA and the company are also working to further develop ultrasonic instruments for new medical applications.

  8. Accidental burns during surgery.

    PubMed

    Demir, Erhan; O'Dey, Dan Mon; Pallua, Norbert

    2006-01-01

    The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.

  9. Root Disease, Longleaf Pine Mortality, and Prescribed Burning

    SciTech Connect

    Otrosina, W.J; C.H. Walkinshaw; S.J. Zarnoch; S-J. Sung; B.T. Sullivan

    2001-01-01

    Study to determine factors involved in decline of longleaf pine associated with prescribed burning. Trees having symptoms were recorded by crown rating system based upon symptom severity-corresponded to tree physiological status-increased in hot burn plots. Root pathogenic fungi widespread throughout the study site. Histological studies show high fine root mortality rate in the hot burn treatment. Decline syndrome is complexed by root pathogens, soil factors, root damage and dysfunction.

  10. PBXN-110 Burn Rate Estimate

    SciTech Connect

    Glascoe, E

    2008-08-11

    It is estimated that PBXN-110 will burn laminarly with a burn function of B = (0.6-1.3)*P{sup 1.0} (B is the burn rate in mm/s and P is pressure in MPa). This paper provides a brief discussion of how this burn behavior was estimated.

  11. Multispectral Imaging Of Burn Wounds

    NASA Astrophysics Data System (ADS)

    Afromowitz, Martin A.; Callis, James B.; Heimbach, David M.; DeSoto, Larry A.; Norton, Mary K.

    1988-06-01

    This research program successfully developed a real-time video imaging system (the Imaging Burn Depth Indicator, or IBDI) which can discriminate areas of burn wounds expected to heal in three weeks or less from the day of injury from those areas not expected to heal in that time period. The analysis can be performed on or about the third day post-burn on debrided burn wounds. Early evaluation of burn healing probability is a crucial factor in the decision to tangentially excise the burn wound. The IBDI measures the reflectivity of the burn wound in the red, green, and near infrared wavelength bands, which data correlate with burn healing probability. The instrument uses an algorithm established in an earlier study to translate the optical data into burn healing probabilities. The IBDI produces two types of images: a true-color image of the burn and a false-color image of the burn. The false-color image consists of up to four colors, each of which indicates a distinct range of probability that the area of the burn so colored will heal within 21 days. Over 100 burn wound sites were studied. Burn sites were evaluated on day three post-burn by our instrument and by the attending physician. Of 55 sites considered to be of intermediate depth, the IBDI predicted the healing outcome accurately in 84% of the cases. By comparison, the predictions of burn surgeons supervising the care of these patients were accurate in 62% of the cases.

  12. Assessment of Electrosurgery Burns in Cardiac Surgery

    PubMed Central

    Jalali, Seyyed Mehdi; Moradi, Mohammad; Khalaj, Alireza; Pazouki, Alireza; Tamannaie, Zeinab; Ghanbari, Sajjad

    2015-01-01

    Background: Monopolar surgery is applied mostly in major operations, while bipolar is used in delicate ones. Attention must be paid in electrosurgery application to avoid electrical burns. Objectives: We aimed to assess factors associated with electrosurgery burns in cardiac surgery operating rooms. Patients and Methods: This was a case-control study in which two groups of 150 patients undergoing cardiac surgery in Imam Khomeini Hospital were recruited. Several factors like gender, age, operation duration, smoking, diseases, infection, atopia, , immunosuppressive drugs use, hepatic cirrhosis, and pulmonary diseases were compared between the two groups. Patients were observed for 24 hours for development of any burn related to the operation. Data was analyzed using SPSS v.11.5, by Chi square and T-test. Results: Patients in the two groups were similar except for two factors. DM and pulmonary diseases which showed significant differences (P = 0.005 and P = 0.002 respectively). Seventy-five patients from controls and 35 from the study group developed burns, which was significant (P ˂ 0.0001). Conclusions: None of the factors were significantly related to developing burns. The differences between the two groups highlights the importance of systems modifications to lessen the incidence of burns. PMID:26839854

  13. Assessment of an abbreviated odorant identification task for children: a rapid screening device for schools and clinics.

    PubMed

    Richman, R A; Wallace, K; Sheehe, P R

    1995-04-01

    To validate the level of olfactory performance of children, we tested 825 volunteers, aged 4-17 years, with an abbreviated form of our pediatric odorant identification task. The test consisted of sniffing and identifying five odorants (baby powder, bubble gum, candy cane, licorice and peach). Mean olfactory scores increased as a function of age, reaching a plateau of about 94-95% correct at 8 years of age. In general, girls out-performed boys. Physicians require a test instrument such as the one we have devised to allow them to diagnose olfactory dysfunction in children. The present task is particularly applicable in screening large numbers of children in clinics or schools because it can be administered easily and rapidly. Adult subjects with olfactory dysfunction also performed poorly on this odorant identification task designed for children. Therefore, we expect that our odorant identification task will also detect children with severe olfactory dysfunction. PMID:7795355

  14. Use of text message abbreviations and literacy skills in children with dyslexia.

    PubMed

    Veater, Helen M; Plester, Beverly; Wood, Clare

    2011-02-01

    This small-scale study compared 10 to 13-year-old dyslexic children's use of text message abbreviations with that of reading age- and chronological age-matched controls. There were no significant differences in the proportion of textisms used between the dyslexic children and the two control groups, although a preference for non-phonetic text abbreviations was observed in the dyslexic group. Unlike the controls, there was little evidence of an association between phonological awareness and textism use in children with dyslexia. These results are discussed in relation to strategy use by dyslexic children when decoding text.

  15. Ethnicity and etiology in burn trauma.

    PubMed

    Papp, Anthony; Haythornthwaite, Jordan

    2014-01-01

    The purpose of this study was to retrieve data from the British Columbia Professional Firefighters Burn Unit registry, with a focus on ethnicity and how it is involved in burn trauma. It is hypothesized that mechanism, severity, and other patient characteristics are significantly different among different ethnic groups. Furthermore, it is believed that these data can be used to augment burn prevention strategies. Data for burn patients admitted from 1979 to 2009 were reviewed from the burn registry. The main focus was with differences seen among the four main ethnicities throughout the analysis, Caucasian, Aboriginal, Asian, and Indoasian, reflecting the population distribution of the region. Age and sex were also considered when looking at burn mechanism, severity, contributing and copresenting factors. Caucasians were the largest group (79.1%) and included the largest male:female ratio (3.3:1), with high numbers of flame injury (53.9%). Caucasians presented with the highest mortality (6.6% compared with 4.1% for all other ethnicities; P < .006). Asian patients (8.1%) showed significantly higher occurrences of urban (64%) and workplace (28.9%) injuries with a larger proportion of scald injury (38.9%). Indoasian patients included larger numbers of women (36.4%) and household scald injuries (33.9%) whereas Aboriginals suffered the most flame injuries (60.1%) in rural areas with more frequent contributing factors such as alcohol. The study found multiple significant differences in the burn injury population when segmented by ethnicity. Though the exact reasons for these differences are difficult to say with certainty, it allows a unique opportunity to focus communication and prevention efforts to specific communities. PMID:24503965

  16. Ethnicity and etiology in burn trauma.

    PubMed

    Papp, Anthony; Haythornthwaite, Jordan

    2014-01-01

    The purpose of this study was to retrieve data from the British Columbia Professional Firefighters Burn Unit registry, with a focus on ethnicity and how it is involved in burn trauma. It is hypothesized that mechanism, severity, and other patient characteristics are significantly different among different ethnic groups. Furthermore, it is believed that these data can be used to augment burn prevention strategies. Data for burn patients admitted from 1979 to 2009 were reviewed from the burn registry. The main focus was with differences seen among the four main ethnicities throughout the analysis, Caucasian, Aboriginal, Asian, and Indoasian, reflecting the population distribution of the region. Age and sex were also considered when looking at burn mechanism, severity, contributing and copresenting factors. Caucasians were the largest group (79.1%) and included the largest male:female ratio (3.3:1), with high numbers of flame injury (53.9%). Caucasians presented with the highest mortality (6.6% compared with 4.1% for all other ethnicities; P < .006). Asian patients (8.1%) showed significantly higher occurrences of urban (64%) and workplace (28.9%) injuries with a larger proportion of scald injury (38.9%). Indoasian patients included larger numbers of women (36.4%) and household scald injuries (33.9%) whereas Aboriginals suffered the most flame injuries (60.1%) in rural areas with more frequent contributing factors such as alcohol. The study found multiple significant differences in the burn injury population when segmented by ethnicity. Though the exact reasons for these differences are difficult to say with certainty, it allows a unique opportunity to focus communication and prevention efforts to specific communities.

  17. The role of acute pancreatitis in pediatric burn patients.

    PubMed

    Rivero, Haidy G; Lee, Jong O; Herndon, David N; Mecott, Gabriel A; Kulp, Gabriela A; Kraft, Robert; Brooks, Natasha C; Diblidox-Gonzales, Manuel; Hawkins, Hal K; Jeschke, Marc G

    2011-02-01

    Few publications recognize acute pancreatitis as a complication after large burns, consequently the incidence and outcome acute pancreatitis after burn in children is not well defined. The aim of this study was to determine the incidence, morbidity, and mortality relating to acute pancreatitis in a pediatric burn population and to correlate clinical diagnosis with autopsy findings to determine the incidence of unrecognized pancreatitis. Records of 2699 patients with acute burns were reviewed. Acute pancreatitis was defined as abdominal pain and/or feeding intolerance in addition to a three-fold elevation of amylase and/or lipase. One-hundred twenty-seven burned children served as the control cohort. To assess the presence of autopsy confirmed AP in pediatric burn patients, we evaluated autopsy reports of 78 children who died from burns, looking for reported evidence of pancreatic inflammation, and fat/parenchymal necrosis. Our data show that acute pancreatitis in children has a low incidence after burn. The study included 2699 patients of which 13 were suffering acute pancreatitis (13/2699 = 0.05%). Mortality is significantly higher for the acute pancreatitis group vs. the control group, p < 0.05. Autopsy reports established 11 of 78 patients with evidence of pancreatitis, resulting in an incidence of 0.17% for pancreatitis at autopsy. Although it has low incidence, acute pancreatitis is associated with increased mortality in severely burned pediatric patients, which underlines the importance of increased vigilance in the evaluation and treatment of pancreatitis in burned children.

  18. Oxidative stress and anti-oxidative mobilization in burn injury.

    PubMed

    Parihar, Arti; Parihar, Mordhwaj S; Milner, Stephen; Bhat, Satyanarayan

    2008-02-01

    A severe burn is associated with release of inflammatory mediators which ultimately cause local and distant pathophysiological effects. Mediators including Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) are increased in affected tissue, which are implicated in pathophysiological events observed in burn patients. The purpose of this article is to understand the role of oxidative stress in burns, in order to develop therapeutic strategies. All peer-reviewed, original and review articles published in the English language literature relevant to the topic of oxidative stress in burns in animals and human subjects were selected for this review and the possible roles of ROS and RNS in the pathophysiology of burns are discussed. Both increased xanthine oxidase and neutrophil activation appear to be the oxidant sources in burns. Free radicals have been found to have beneficial effects on antimicrobial action and wound healing. However following a burn, there is an enormous production of ROS which is harmful and implicated in inflammation, systemic inflammatory response syndrome, immunosuppression, infection and sepsis, tissue damage and multiple organ failure. Thus clinical response to burn is dependent on the balance between production of free radicals and its detoxification. Supplementation of antioxidants in human and animal models has proven benefit in decreasing distant organ failure suggesting a cause and effect relationship. We conclude that oxidative damage is one of the mechanisms responsible for the local and distant pathophysiological events observed after burn, and therefore anti-oxidant therapy might be beneficial in minimizing injury in burned patients.

  19. Nitrated Secondary Organic Tracer Compounds in Biomass Burning Smoke

    NASA Astrophysics Data System (ADS)

    Iinuma, Y.; Böge, O.; Gräfe, R.; Herrmann, H.

    2010-12-01

    Natural and human-initiated biomass burning releases large amounts of gases and particles into the atmosphere, impacting climate, environment and affecting public health. Several hundreds of compounds are emitted from biomass burning and these compounds largely originate from the pyrolysis of biopolymers such as lignin, cellulose and hemicellulose. Some of compounds are known to be specific to biomass burning and widely recognized as tracer compounds that can be used to identify the presence of biomass burning PM. Detailed chemical analysis of biomass burning influenced PM samples often reveals the presence compounds that correlated well with levoglucosan, a known biomass burning tracer compound. In particular, nitrated aromatic compounds correlated very well with levoglucosan, indicating that biomass burning as a source for this class of compounds. In the present study, we present evidence for the presence of biomass burning originating secondary organic aerosol (BSOA) compounds in biomass burning influenced ambient PM. These BSOA compounds are typically nitrated aromatic compounds that are produced in the oxidation of precursor compounds in the presence of NOx. The precursor identification was performed from a series of aerosol chamber experiments. m-Cresol, which is emitted from biomass burning at significant levels, is found to be a major precursor compounds for nitrated BSOA compounds found in the ambient PM. We estimate that the total concentrations of these compounds in the ambient PM are comparable to biogenic SOA compounds in winter months, indicating the BSOA contributes important amounts to the regional organic aerosol loading.

  20. [Changes in mesenteric microcirculation in rats following repeated skin burns].

    PubMed

    Shtykhno, Iu M

    1976-07-01

    Acute experiments were conducted on rats; repeated extensive burn of a convalescent who formerly sustained the burn disease was better tolerated, led tono fatal outcome and was accompanied by moderate microcirculatory disturbances. The smae burn was accompanied in intact rats by a severe shock followed by death, intravascular aggregation of erythrocytes and significant microcirculatory disturbances leading to disturbance of tissue nutrition. It is supposed that the results obtained could serve as an indirect proof that toxemia played an important role in the genesis of intravascular aggregation of erythrocytes in burn shock.