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. 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.

  4. [The Nutrition Care of Severe Burn Patients].

    PubMed

    Hsieh, Yu-Hsiu

    2016-02-01

    In addition to recent advances in burn patient care techniques such as maintaining warm circumambient temperature, the early excision of wounds, and the use of closed dressing, providing nutrition support through early feeding has proven instrumental in greatly increasing the survival rate of burn patients. Severe burns complicated by many factors initiate tremendous physiological stress that leads to postburn hypermetabolism that includes enhanced tissue catabolism, the loss of muscle mass, and decreases in the body's reservoirs of protein and energy. These problems have become the focus of burn therapy. Treating severe burns aims not only to enhance survival rates but also to restore normal bodily functions as completely as possible. Recent research evaluating the application of anabolic agents and immune-enhance formula for severe burns therapy has generated significant controversy. Inadequate caloric intake is one of the main differences among the related studies, with the effect of many special nutrients such as bran acid amides not taken into consideration. Therefore, considering the sufficiency of caloric and protein intake is critical in assessing effectiveness. Only after patients receive adequate calories and protein may the effect of special nutrients such as glutamine and supplements be evaluated effectively. PMID:26813059

  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. PMID:27395025

  6. Anabolic Effects of Oxandrolone After Severe Burn

    PubMed Central

    Hart, David W.; Wolf, Steven E.; Ramzy, Peter I.; Chinkes, David L.; Beauford, Robert B.; Ferrando, Arny A.; Wolfe, Robert R.; Herndon, David N.

    2001-01-01

    Objective To explore the hypothesis that oxandrolone may reverse muscle catabolism in cachectic, critically ill pediatric burn patients. Summary Background Data Severe burn causes exaggerated muscle protein catabolism, contributing to weakness and delayed healing. Oxandrolone is an anabolic steroid that has been used in cachectic hepatitis and AIDS patients. Methods Fourteen severely burned children were enrolled during a 5-month period in a prospective cohort analytic study. There was a prolonged delay in the arrival of these patients to the burn unit for definitive care. This neglect of skin grafting and nutritional support resulted in critically ill children with significant malnutrition. On arrival, all patients underwent excision and skin grafting and received similar clinical care. Subjects were studied 5 to 7 days after admission, and again after 1 week of oxandrolone treatment at 0.1 mg/kg by mouth twice daily or no pharmacologic treatment. Muscle protein kinetics were derived from femoral arterial and venous blood samples and vastus lateralis muscle biopsies during a stable isotope infusion. Results Control and oxandrolone subjects were similar in age, weight, and percentage of body surface area burned. Muscle protein net balance decreased in controls and improved in the oxandrolone group. The improvement in the oxandrolone group was associated with increased protein synthesis efficiency. Muscle protein breakdown was unchanged. Conclusions In burn victims, oxandrolone improves muscle protein metabolism through enhanced protein synthesis efficiency. These findings suggest the efficacy of oxandrolone in impeding muscle protein catabolism in cachectic, critically injured children. PMID:11303139

  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. Severe metabolic acidosis following assault chemical burn.

    PubMed

    Roock, Sophie D; Deleuze, Jean-Paul; Rose, Thomas; Jennes, Serge; Hantson, Philippe

    2012-04-01

    Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9) obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure). Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene. PMID:22787349

  9. RECENT ADVANCES IN BIOMARKERS IN SEVERE BURNS

    PubMed Central

    Ruiz-Castilla, Mireia; Roca, Oriol; Masclans, Joan R.; Barret, Joan P.

    2016-01-01

    ABSTRACT The pathophysiology of burn injuries is tremendously complex. A thorough understanding is essential for correct treatment of the burned area and also to limit the appearance of organ dysfunction, which, in fact, is a key determinant of morbidity and mortality. In this context, research into biomarkers may play a major role. Biomarkers have traditionally been considered an important area of medical research: the measurement of certain biomarkers has led to a better understanding of pathophysiology, while others have been used either to assess the effectiveness of specific treatments or for prognostic purposes. Research into biomarkers may help to improve the prognosis of patients with severe burn injury. The aim of the present clinical review is to discuss new evidence of the value of biomarkers in this setting. PMID:26771933

  10. Hematogenous cervical spondylodiscitis after severe burn injury.

    PubMed

    Riedel, G; Becker, S; Steen, M

    2001-12-01

    A 47-year-old man sustained a 31% TBSA burn injury. In spite of early escharectomy and mesh-graft-transplantation the patient suffered a septicaemic phase in the first week, which was treated by a specific antibiotic. Five weeks after the burn injury a cervical spondylodiscitis was diagnosed. Immediate wound debridement, ventral and dorsal spondylodesis with a tricortical bone-graft from the left iliac crest and titanium plates and specific antibiotic therapy led to the stabilization and healing of the cervical spinal column. The spondylodiscitis was microbiologically proved to be hematogenous after spread of Staphylococcus aureus from the blood in the early septicaemic phase. Swab culture from the burn surface wound, infected vertebrae and blood during the septicaemic phase revealed coagulase positive S. aureus. The aetiology, predisposing factors and management of this rare, but recognized, complication of major burns are discussed. Case features of this patient are compared with the single site's reported case of hematogenous cervical spondylodiscitis after severe burn injury. PMID:11718988

  11. Pathogenic alteration in severe burn wounds.

    PubMed

    Fu, Yang; Xie, Bing; Ben, DaoFeng; Lv, KaiYang; Zhu, ShiHui; Lu, Wei; Tang, HongTai; Cheng, DaSheng; Ma, Bing; Wang, GuangYi; Xiao, ShiChu; Wang, GuangQing; Xia, ZhaoFan

    2012-02-01

    The present study aims to define the trend of time related changes with local bacterial alteration of bacterial resistance in severe burns in our burn center during a 12-year period. Retrospective analysis of microbiological results on severely burned wounds between 1998 and 2009 was carried out. A study of 3615 microbial isolates was performed. Staphylococcus aureus was the most commonly isolated pathogen (38.2%) followed by A. baumannii (16.2%), Streptococcus viridans (11.4%), Pseudomonas aeruginosa (10.4%), coagulase-negative staphylococci (CNS, 9.2%). The species ratios of S. aureus and A. baumannii increased significantly from 1st to 8th week of hospitalization, while those of Streptococcus viridans, P. aeruginosa and coagulase-negative staphylococci decreased during the same period. Bacterial resistance rates were compared between the periods 1998-2003 and 2004-2009. Vancomycin remained as the most sensitive antibiotic in S. aureus including methicillin-resistant S. aureus (MRSA). It was very likely that the majority of infections caused by Streptococcus viridans, P. aeruginosa and coagulase-negative staphylococci occurred in the early stage of burn course and the majority of infections caused by A. baumannii occurred 4 weeks after admission. The use of different antibiotics was probably the major contributor to these trends. PMID:22100426

  12. Application of abbreviated injury scale and injury severity score in fatal cases with abdominopelvic injuries.

    PubMed

    Subedi, Nuwadatta; Yadav, Bishwanath; Jha, Shivendra

    2014-12-01

    In forensic casework, investigation of injury severity is important in evaluating the mortality, occasionally in terms of the adequacy of clinical management. The study was conducted with an objective to study the relationship of severity of the injuries using Abbreviated Injury Scale and Injury Severity Score (ISS) with survival period and place of death among fatal cases with abdominopelvic trauma.The total number of cases studied was 80. The injuries in all the body parts were allotted using the Abbreviated Injury Scale 2005, Update 2008, and the ISS was calculated. The male/female ratio was 4:1, and the mean (SD) age was 30.76 (15.2) years. The cause of trauma was road traffic accidents in 82.5% of the cases. The median duration of survival was 2 hours. The mean (SD) ISS was 38.90 (14.89). Abbreviated Injury Scale scores of 5 and 4 were the most common in the region. With increase in the ISS, the survival period was decreased. There was a highly significant difference between the mean ISS of the victims who died prehospital and that of who died in the emergency department (P < 0.005). The mean ISS of the victims who died in the emergency department and of those who died in the ward, intensive care unit, or after discharge was also significantly different (P < 0.05).Although the cases with more severe injuries died sooner, there should be provision of treatment on the spot without delay. More time taken to start the treatment increases the fatalities. PMID:25354224

  13. Nutrition in the severely burned child.

    PubMed

    Solomon, J R

    1981-01-01

    Adequate nutrition in the severely burned child often determines the morbidity and mortality and its supervision demands a high priority in the management of the burn injury. A disciplined, detailed programme is required, but this is often neglected. The hypermetabolism experienced in the severe burn may require a calorie intake up to 2 1/2 times normal, and in the growing child, with extra requirements, a negative balance can easily eventuate if careful management is not instituted. A daily metabolic plan provides firstly, the basic calories and protein per kilogram depending on age as for a normal child and, secondly additional requirements depending on the surface area of the burn. With such a programme the weakness of treating all children, whatever their age, on the same formula related only to surface area burn, is overcome. Parenteral nutrition is commenced as soon as the shock phase has been controlled and is continued until enteral intake by gastric tube is sufficient to cover the requirements. Such tube feeding requires the selection of an isotonic liquid diet so as so limit the possibility of diarrhoea. Isocal (Mead Johnson) has been found generally acceptable. Gradually as the patient recovers, oral intake is introduced and the child returns home on a normal nutritional diet, expectantly without weight loss and even with some weight gain, which befits any normal child under treatment for some months. Preburn nutrition, disease and infection, hyperthermia, hypothermia, evaporative water loss, active exercise, psychological well being, social state, early skin cover and limitation of stress are important aspects affecting metabolism and require careful supervision and management. The limitation of metabolism is as important as increasing the caloric intake and this is exemplified at the time of operation, which should be as nonstressful as possible. Every two weeks an adjusted assessment is made of the burned area still to be grafted and the caloric

  14. 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.

  15. [Abbreviated laparotomy for treatment of severe abdominal trauma: use in austere settings].

    PubMed

    Balandraud, P; Biance, N; Peycru, T; Savoie, P H; Avaro, J P; Tardat, E; Pourrière, M; Cador, L

    2007-10-01

    Abbreviated laparotomy is a recent technique for management of patients with severe abdominal trauma. It is based on a unified approach taking into account the overall extent of injury and the victim's physiologic potential to respond to hemorrhage. It is the first step in a multi-modal strategy. The second step is the critical care phase. The third step consists of "second-look" laparotomy that should ideally be performed on an elective basis within 48 hours and is aimed at definitive treatment of lesions. The goal of abbreviated laparotomy is damage control using temporary quick-fix procedures limited to conspicuous lesions and rapid hemostasis and/or viscerostasis procedures so that the patient can survive the acute critical period. Tension-free closure of the abdominal wall, if necessary using laparostomy, is essential to avoid abdominal compartment syndrome. With reported survival rates of about 50% in Europe and the United States, this simple life-saving technique that requires limited resources should be introduced in Africa where severe abdominal trauma often involves young patients. PMID:18225739

  16. THE PATHOPHYSIOLOGIC RESPONSE TO SEVERE BURN INJURY

    PubMed Central

    Jeschke, Marc G; Chinkes, David L; Finnerty, Celeste C; Kulp, Gabriela; Suman, Oscar E; Norbury, William B; Branski, Ludwik K; Gauglitz, Gerd G; Mlcak, Ronald P; Herndon, David N

    2014-01-01

    Objective To improve clinical outcome and to determine new treatment options, we studied the pathophysiologic response postburn in a large prospective, single center, clinical trial. Summary Background Data A severe burn injury leads to marked hypermetabolism and catabolism, which are associated with morbidity and mortality. The underlying pathophysiology and the correlations between humoral changes and organ function have not been well delineated. Methods Two hundred forty-two severely burned pediatric patients [>30% total body surface area (TBSA)], who received no anabolic drugs, were enrolled in this study. Demographics, clinical data, serum hormones, serum cytokine expression profile, organ function, hypermetabolism, muscle protein synthesis, incidence of wound infection sepsis, and body composition were obtained throughout acute hospital course. Results Average age was 8 ± 0.2 years, and average burn size was 56 ± 1% TBSA with 43 ± 1% third-degree TBSA. All patients were markedly hypermetabolic throughout acute hospital stay and had significant muscle protein loss as demonstrated by a negative muscle protein net balance (−0.05% ± 0.007 nmol/100 mL leg/min) and loss of lean body mass (LBM) (−4.1% ± 1.9%); P < 0.05. Patients lost 3% ± 1% of their bone mineral content (BMC) and 2 ± 1% of their bone mineral density (BMD). Serum proteome analysis demonstrated profound alterations immediately postburn, which remained abnormal throughout acute hospital stay; P < 0.05. Cardiac function was compromised immediately after burn and remained abnormal up to discharge; P < 0.05. Insulin resistance appeared during the first week postburn and persisted until discharge. Patients were hyperinflammatory with marked changes in IL-8, MCP-1, and IL-6, which were associated with 2.5 ± 0.2 infections and 17% sepsis. Conclusions In this large prospective clinical trial, we delineated the complexity of the postburn pathophysiologic response and conclude that the postburn

  17. 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.

  18. 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. PMID:23884685

  19. 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

  20. Coagulopathy and its management in patients with severe burns.

    PubMed

    Glas, G J; Levi, M; Schultz, M J

    2016-05-01

    Severe burn injury is associated with systemic coagulopathy. The changes in coagulation described in patients with severe burns resemble those found patients with sepsis or major trauma. Coagulopathy in patients with severe burns is characterized by procoagulant changes, and impaired fibrinolytic and natural anticoagulation systems. Both the timing of onset and the severity of hemostatic derangements are related to the severity of the burn. The exact pathophysiology and time course of coagulopathy are uncertain, but, at least in part, result from hemodilution and hypothermia. As the occurrence of coagulopathy in patients with severe burns is associated with increased comorbidity and mortality, coagulopathy could be seen as a potential therapeutic target. Clear guidelines for the treatment of coagulopathy in patients with severe burns are lacking, but supportive measures and targeted treatments have been proposed. Supportive measures are aimed at avoiding preventable triggers such as tissue hypoperfusion caused by shock, or hemodilution and hypothermia following the usually aggressive fluid resuscitation in these patients. Suggested targeted treatments that could benefit patients with severe burns include systemic treatment with anticoagulants, but sufficient randomized controlled trial evidence is lacking. PMID:26854881

  1. Characteristics of elderly Japanese patients with severe burns.

    PubMed

    Morita, Seiji; Higami, Shigeo; Yamagiwa, Takeshi; Iizuka, Shinichi; Nakagawa, Yoshihide; Yamamoto, Isotoshi; Inokuchi, Sadaki

    2010-11-01

    In this study, we report the clinical characteristics of elderly Japanese patients with severe burns. We studied the clinical features of 76 adult patients with severe burns, 35 of whom (46.1%) were ≥65 years old. We evaluated the characteristics of patients with respect to each type of burn. In addition, we studied the rate of death and survival in the elderly and also between the elderly and non-elderly patients. The following parameters were either assessed or compared between the elderly and non-elderly: gender, average age, vital signs (Glasgow Coma Scale, systolic blood pressure, heart rate and respiratory rate) and PaO(2)/FiO(2) (P/F) ratio at admission, cause of burn and a history of physical or psychiatric disease. Further, we investigated whether the burn was caused by attempting suicide and determined the percent total body surface area (%TBSA), second- and third-degree burn area, burn index (BI), prognostic burn index (PBI), presence of tracheal burns, presence of alcohol intoxication and overdose poisoning, presence of tracheal intubation, outcome and cause of death. The male:female ratio of the elderly patients was 17:18 (average age, 78.1 (8.2) years). Burns were mostly caused by flame (26/35), followed by scalding (8/35). Ten patients had attempted suicide. The %TBSA, second-degree burn area, third-degree burn area, BI and PBI, respectively were 46.6% (26.7%), 15.3% (19.0%), 35.6% (26.0%), 41.1 (25.2) and 119.2 (25.9). Of the 35 patients, 23 died. The notable characteristics of the elderly patients who died were flame as the cause of the burns: high %TBSA, BI and PBI, and a high rate of tracheal intubation. Elderly patients constituted approximately 45% of our study population. Most burns were caused by flames. The incidence of accidental bathtub-related burns was higher and that of suicide attempts was lower in the elderly patients, as compared with the non-elderly patients. Severe burns were fatal for elderly patients. Therefore, elderly

  2. 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.

  3. Determinants of Skeletal Muscle Catabolism After Severe Burn

    PubMed Central

    Hart, David W.; Wolf, Steven E.; Chinkes, David L.; Gore, Dennis C.; Mlcak, Ronald P.; Beauford, Robert B.; Obeng, Michael K.; Lal, Sophia; Gold, Warren F.; Wolfe, Robert R.; Herndon, David N.

    2000-01-01

    Objective To determine which patient factors affect the degree of catabolism after severe burn. Summary Background Data Catabolism is associated with severe burn and leads to erosion of lean mass, impaired wound healing, and delayed rehabilitation. Methods From 1996 to 1999, 151 stable-isotope protein kinetic studies were performed in 102 pediatric and 21 adult subjects burned over 20–99.5% of their total body surface area (TBSA). Patient demographics, burn characteristics, and hospital course variables were correlated with the net balance of skeletal muscle protein synthesis and breakdown across the leg. Data were analyzed sequentially and cumulatively through univariate and cross-sectional multiple regression. Results Increasing age, weight, and delay in definitive surgical treatment predict increased catabolism (P < .05). Body surface area burned increased catabolism until 40% TBSA was reached; catabolism did not consistently increase thereafter. Resting energy expenditure and sepsis were also strong predictors of net protein catabolism. Among factors that did not significantly correlate were burn type, pneumonia, wound contamination, and time after burn. From these results, the authors also infer that gross muscle mass correlates independently with protein wasting after burn. Conclusions Heavier, more muscular subjects, and subjects whose definitive surgical treatment is delayed are at the greatest risk for excess catabolism after burn. Sepsis and excessive hypermetabolism are also associated with protein catabolism. PMID:10998644

  4. 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.

  5. Burn Severity Estimation Using MERIS Full Resolution Imagery

    NASA Astrophysics Data System (ADS)

    Oliva, Patricia; De Santis, Angela

    2010-12-01

    This paper presents the first results of Fire Effects Modelling and Mapping (FEMM) project carried out in the framemark of the Changing Earth Science Network. The objective of this study is to test the performance of the inversion of Radiative Transfer Models (RTMs) in ENVISA T-MERIS Full Resolution data to estimate burn severity levels in terms of Composite Burn Index (CBI) levels. Nevertheless, as the RTM model was calibrated in Landsat-TM images, evaluation of its performance in MERIS imagery was needed. We tested the performance of the RTM model in several study sites located in two large fires occurred in Spain during 2009 fire season. The results were validated by comparison with burn severity maps computed from Landsat-TM imagery. The results obtained showed values of the coefficient of determination of 0.92 and 0.95 thus, the estimation of burn severity was accurate and consistent, in spite of the different spatial and spectral resolutions.

  6. Changes in Fat Distribution in Children Following Severe Burn Injury

    PubMed Central

    Patel, Pavankumar; Sallam, Hanaa S.; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Abstract Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution. Methods: We studied body composition, fat distribution, and inflammatory cytokines changes in children with severe burn injury up to 6 months from discharge. Sixty-two boys and 35 girls (burn ≥30% of total body surface area) were included. Results: We found a decrease in total body fat and subcutaneous peripheral fat at 6 months (6% and 2%, respectively; P<0.05 each). An inverse correlation between the decrease in peripheral fat content at 6 months and the extent of burn injury (r=−041, P=0.02) was also observed. In addition, there was a 12% increase in serum tumor necrosis factor-α (TNF-α) (P=0.01 vs. discharge) and 9% decrease in serum interleukin-10 (IL-10) (P<0.0001 vs. discharge) over 6 months after burn. Conclusion: Severe burn injury in children is associated with changes in body fat content and distribution up to 6 months from hospital discharge. These changes, accompanied by persisting systemic inflammation, could possibly mediate the observed persistence of insulin resistance, predisposing burn patients to the development of T2DM and CVD. PMID:25211297

  7. 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.

  8. 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

  9. 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.

  10. CHANGES IN CARDIAC PHYSIOLOGY AFTER SEVERE BURN INJURY

    PubMed Central

    Williams, Felicia N; Herndon, David N; Suman, Oscar E; Lee, Jong O; Norbury, William B; Branski, Ludwik K; Mlcak, Ronald P; Jeschke, Marc G

    2012-01-01

    Objective Cardiac stress, mediated by increased catecholamines, is the hallmark of severe burn injury typified by marked tachycardia, increased myocardial oxygen consumption, and increased cardiac output. It remains one of the main determinants of survival in large burns. It is currently unknown for how long cardiac stress persists after a severe injury. Therefore, the aim of this study was to determine the extent and duration of cardiac stress after a severe burn. To determine persistence of cardiac alteration we determined cardiac parameters of all surviving patients with burns ≥ 40% total body surface area (TBSA) from 1998 to 2008. Methods One-hundred ninety-four patients were included in this study. Heart Rate (HR), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), cardiac index (CI), and ejection fractions (EF) were measured at regular intervals from admission up to two years after injury. Rate pressure product (RPP) was calculated as a correlate of myocardial oxygen consumption. All values were compared to normal non-burned children to validate our findings. Statistical analysis was performed using log transformed ANOVA with Bonferroni correction, and Student’s t-test where applicable. Results Heart rate, cardiac output, cardiac index and RPP remained significantly elevated in burned children for up to two years when compared to normal ranges (p<0.05) indicating vastly increased cardiac stress. Ejection fraction was within normal limits for two years. Conclusions Cardiac stress persists for at least 2 years post burn and we suggest that attenuation of these detrimental responses may improve long-term morbidity. PMID:21228708

  11. 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

  12. Intensive Insulin Therapy in Severely Burned Pediatric Patients

    PubMed Central

    Jeschke, Marc G.; Kulp, Gabriela A.; Kraft, Robert; Finnerty, Celeste C.; Mlcak, Ron; Lee, Jong O.; Herndon, David N.

    2010-01-01

    Rationale: Hyperglycemia and insulin resistance have been shown to increase morbidity and mortality in severely burned patients, and glycemic control appears essential to improve clinical outcomes. However, to date no prospective randomized study exists that determines whether intensive insulin therapy is associated with improved post-burn morbidity and mortality. Objectives: To determine whether intensive insulin therapy is associated with improved post-burn morbidity. Methods: A total of 239 severely burned pediatric patients with burns over greater than 30% of their total body surface area were randomized (block randomization 1:3) to intensive insulin treatment (n = 60) or control (n = 179). Measurements and Main Results: Demographics, clinical outcomes, sepsis, glucose metabolism, organ function, and inflammatory, acute-phase, and hypermetabolic responses were determined. Demographics were similar in both groups. Intensive insulin treatment significantly decreased the incidence of infections and sepsis compared with controls (P < 0.05). Furthermore, intensive insulin therapy improved organ function as indicated by improved serum markers, DENVER2 scores, and ultrasound (P < 0.05). Intensive insulin therapy alleviated post-burn insulin resistance and the vast catabolic response of the body (P < 0.05). Intensive insulin treatment dampened inflammatory and acute-phase responses by deceasing IL-6 and acute-phase proteins compared with controls (P < 0.05). Mortality was 4% in the intensive insulin therapy group and 11% in the control group (P = 0.14). Conclusions: In this prospective randomized clinical trial, we showed that intensive insulin therapy improves post-burn morbidity. Clinical trial registered with www.clinicaltrials.gov (NCT00673309). PMID:20395554

  13. [Functional reconstruction of multiple severe deformities after extensive deep burn].

    PubMed

    Chen, Bi; Jia, Chi-yu; Hu, Da-hai; Zhu, Xiong-xiang; Han, Jun-tao; Yao, Qing-jun; Xu, Ming-da

    2008-10-01

    To explore new measures for functional reconstruction of multiple severe deformities as a result of extensive deep burn (total burn surface area > or = 90% TBSA, including deep burn > or = 70%TBSA) in late stage. Twelve severe burn patients with above-mentioned deformities were hospitalized in our ward during 1960--2005, the scars resulted from burns were distributed from head to foot with 173 deformities, including 27 scar ulcers. All patients lacked of self-care ability, among them some could not stand. Due to inadequate skin source, deformities were corrected by skin from matured scars expanded with subcutaneous balloon at late postburn stage. Following our former clinical experience, anatomic investigation and experimental research, we chose the following methods to correct deformities and restore functions: application of split-thickness scar skin after expansion (88 wounds); use of scar skin flap/scar-Achilles tendon flaps (59 wounds); combination of thin split-thickness skin grafts from scar and allogeneic acellular dermal matrix (composite skin, 40 wounds). All grafts survived, the appearance and function were improved obviously without complications. Follow-up 1-40 years, all patients could take care themselves with satisfactory function and appearance, and among them 8 patients returned to work (one had worked for 40 years), 2 patients married and had children. The above-mentioned measures are safe, reliable and effective for functional reconstruction of deformities. PMID:19103016

  14. Update on Severe Burn Management for the Intensivist.

    PubMed

    Lundy, Jonathan B; Chung, Kevin K; Pamplin, Jeremy C; Ainsworth, Craig R; Jeng, James C; Friedman, Bruce C

    2016-09-01

    Thermal injury of humans causes arguably the most severe perturbations in physiology that can be experienced. These physiologic derangements start immediately and can persist in some form until months or even years after the burn wounds are healed. Burn shock, marked activation of the systemic inflammatory response, multiple-organ failure, infection, and wound failure are just a few of the insults that may require management by the intensivist. The purpose of this article is to review recent advances in the critical care management of thermally injured patients. PMID:26112758

  15. Operative utilization following severe combat-related burns.

    PubMed

    Chan, Rodney K; Aden, James; Wu, Jesse; Hale, Robert G; Renz, Evan M; Wolf, Steven E

    2015-01-01

    The goal of burn surgical therapy is to minimize mortality and to return survivors to their preinjury state. Prompt removal of the burn eschar, early durable coverage, and late corrections of functional deformities are the basic surgical principles. The operative burden, while presumed to be substantial and significant, is neither well described nor quantified. The burn registry at the U.S. Institute of Surgical Research Burn Center was queried from March 2003 to August 2011 for all active duty burn admissions; active duty subjects were chosen to eliminate subject follow-up as a significant variable. Subject demographics including age, sex, branch of service, injury type, injury severity score, transfusion, allograft use, length of stay, mechanism of injury, and survival were tabulated as were their percentage TBSA, specific body region involvement, and nature and dates of operations performed. Univariate analysis and multiple logistic regressions were performed to determine independent factors which predict early and late operative burden. In the 8-year study period, 864 active duty patients were admitted to the burn center. Among them, 569 (66%) were operative in nature. The operations that were performed during acute hospitalization were 62%, while the remaining 38% were performed following discharge. A linear relationship exists between TBSA and the number of acute operations with an average of one acute operation required per 5% TBSA. No direct relationships however were found between TBSA and the number of reconstructive operations. Based on multiple logistic regression, battle vs nonbattle (odds ratio [OR], 0.559; 95% confidence interval [CI], 0.298-1.050; P = .0706), injury severity score (OR, 1.021; 95% CI, 1.003-1.039; P = .0222), intensive care unit length of stay (OR, 1.076; 95% CI, 1.053-1.099; P ≤ .0001), allograft use (OR, 2.610; 95% CI, 1.472-4.628; P = .0010), and TBSA of the trunk (OR, 0.982; 95% CI, 0.965-1.000; P = .0439) (but not overall TBSA

  16. [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

  17. Evolving forest fire burn severity classification algorithms for multispectral imagery

    NASA Astrophysics Data System (ADS)

    Brumby, Steven P.; Harvey, Neal R.; Bloch, Jeffrey J.; Theiler, James P.; Perkins, Simon J.; Young, Aaron C.; Szymanski, John J.

    2001-08-01

    Between May 6 and May 18, 2000, the Cerro Grande/Los Alamos wildfire burned approximately 43,000 acres (17,500 ha) and 235 residences in the town of Los Alamos, NM. Initial estimates of forest damage included 17,000 acres (6,900 ha) of 70-100% tree mortality. Restoration efforts following the fire were complicated by the large scale of the fire, and by the presence of extensive natural and man-made hazards. These conditions forced a reliance on remote sensing techniques for mapping and classifying the burn region. During and after the fire, remote-sensing data was acquired from a variety of aircraft-based and satellite-based sensors, including Landsat 7. We now report on the application of a machine learning technique, implemented in a software package called GENIE, to the classification of forest fire burn severity using Landsat 7 ETM+ multispectral imagery. The details of this automatic classification are compared to the manually produced burn classification, which was derived from field observations and manual interpretation of high-resolution aerial color/infrared photography.

  18. 1984–2010 trends in fire burn severity and area for the conterminous US

    USGS Publications Warehouse

    Picotte, Joshua J.; Peterson, Birgit; 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.

  19. 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

  20. [Burns].

    PubMed

    Arai, Takao

    2016-02-01

    Burns extending deep into the skin and those affecting a wide surface area trigger various responses in the body and pose a serious threat to life. Therefore, the degree of severity needs to be determined accurately, and appropriate transfusion and local management should be provided accordingly. Systematic and meticulous management that considers not just the risk of death but also functional prognosis is essential from the early stage of burn injuries. Such management requires comprehensive care by a medical team concerning infections, nutrition and rehabilitation. This article outlines the current status of intensive care for severe burns. PMID:26915244

  1. 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

  2. Multidisciplinary care in severe pediatric electrical oral burn.

    PubMed

    Pontini, A; Reho, F; Giatsidis, G; Bacci, C; Azzena, B; Tiengo, C

    2015-05-01

    Oral burns in pediatric patient are commonly due to electrical injuries, representing an important reconstructive issue even for functional than esthetic reason. Different classification, surgical management and even oral device were described to allow the best long-term result. In most case a multidisciplinary approach is necessary to achieve a satisfactory outcome. A severe case of pediatric oral burn with germinative teeth damage is presented, describing a multispecialist team approach that guarantee a satisfactory outcome by reconstructive surgery, careful progressive evaluation of dental and soft tissue healing and speech recovery. The use of acellular dermal substitute template within traditional reconstructive surgery had provided a good functional and esthetic result joint to valid preservation of germinative dental element as shown at long-term X-ray evaluation. Intensive rehabilitation speech program has also avoided phonetic impairment in an important speech develop period. It was so evident that the necessity of a multispecialist care in such difficult injury to achieve the best long-term result. PMID:25716757

  3. [Experimental study on early multiple organ failure after severe burns].

    PubMed

    Chen, F M

    1992-03-01

    Forty-three male mongrel dogs (12.5 +/- 2.5 kg) were divided into normal control (n = 7), immediate infusion (n = 8), non-infusion (n = 13) and delayed infusion (n = 15) groups. A 50% TBSA third degree surface burn was produced by igniting 3% napalm for 30 seconds on the shaved back. Cardiac, pulmonary, hepatic, renal and gastrointestinal functions were monitored following the thermal injury. The findings of these studies showed that mean arterial pressure, cardiac index, left ventricular work, right ventricular work, ADP/O ratio and ATP were all significantly decreased (P less than 0.05). However pulmonary artery wedge pressure, pulmonary vascular resistance, systemic vascular resistance, P(A-a)O2, Beef, Cr, UN, ALT, LDH, TB, DB, and MDA were markedly increased (P less than 0.05). Severe shock occurred soon after burns. Thirteen dogs died within 12 hours in the non-infusion group. All the dogs were resuscitated when immediate infusion of lactic acid Ringers solution was given according to Parkland formula, and all of them tide over shock stage smoothly without obvious changes in visceral functions. However, dogs were not resuscitated when infusion was delayed 6 hours postburn. The changes in visceral were even more severe in this group than those in non-infusion group. These results demonstrated that delayed resuscitation was an important factor of MOF in the early postburn stage. The marked increase in MDA in the myocardiac, lung, liver, renal and gastrointestinal tissues indicated that lipoperoxidation by free oxygen radicals was closely related with visceral damages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1596785

  4. 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.

  5. Uncoupled skeletal muscle mitochondria contribute to hypermetabolism in severely burned adults

    PubMed Central

    Herndon, David N.; Børsheim, Elisabet; Chao, Tony; Reidy, Paul T.; Borack, Michael S.; Rasmussen, Blake B.; Chondronikola, Maria; Saraf, Manish K.; Sidossis, Labros S.

    2014-01-01

    Elevated metabolic rate is a hallmark of the stress response to severe burn injury. This response is mediated in part by adrenergic stress and is responsive to changes in ambient temperature. We hypothesize that uncoupling of oxidative phosphorylation in skeletal muscle mitochondria contributes to increased metabolic rate in burn survivors. Here, we determined skeletal muscle mitochondrial function in healthy and severely burned adults. Indirect calorimetry was used to estimate metabolic rate in burn patients. Quadriceps muscle biopsies were collected on two separate occasions (11 ± 5 and 21 ± 8 days postinjury) from six severely burned adults (68 ± 19% of total body surface area burned) and 12 healthy adults. Leak, coupled, and uncoupled mitochondrial respiration was determined in permeabilized myofiber bundles. Metabolic rate was significantly greater than predicted values for burn patients at both time points (P < 0.05). Skeletal muscle oxidative capacity, citrate synthase activity, a marker of mitochondrial abundance, and mitochondrial sensitivity to oligomycin were all lower in burn patients vs. controls at both time points (P < 0.05). A greater proportion of maximal mitochondrial respiration was linked to thermogenesis in burn patients compared with controls (P < 0.05). Increased metabolic rate in severely burned adults is accompanied by derangements in skeletal muscle mitochondrial function. Skeletal muscle mitochondria from burn victims are more uncoupled, indicating greater heat production within skeletal muscle. Our findings suggest that skeletal muscle mitochondrial dysfunction contributes to increased metabolic rate in burn victims. PMID:25074988

  6. The role of exercise in the rehabilitation of patients with severe burns

    PubMed Central

    Porter, Craig; Hardee, Justin; Herndon, David N; Suman, Oscar E

    2014-01-01

    Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and efficacious strategy to restores lean body mass and physical function in burn victims. Here, we review the evidence for the utility of rehabilitative exercise training in restoring physiological function in burn survivors. PMID:25390300

  7. 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

  8. [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

  9. Temperature Responses during Exercise in a Hot Environment in Severely Burned Children

    PubMed Central

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

    2014-01-01

    Objective We 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. Study design Children (n=10) with >40% total body surface area burns and non-burned 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. Results Three of the 10 burned children completed the exercise bout in the heat; however, all of the non-burned children completed the 30 minute bout. One burned child reached a core body temperature > 39°C at minute 23. Burned children had a significantly higher core body temperature thru the first 12 minutes of exercise compared to non-burned children. However, 9 of 10 (90%) burned children did not become hyperthermic during exercise in the heat. Conclusion Specific to this study, hyperthermia did not typically occur in burned children, relative to non-burned 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. PMID:20616652

  10. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction

    PubMed Central

    Yan, Hong; Mao, Qingxiang; Ma, Yongda; Wang, Li; Chen, Xian; Hu, Yi; Ge, Hengjiang

    2016-01-01

    This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group), or burn injury combined with seawater immersion (BI group), or only immersion in seawater (I group), or control animals with no injury or immersion (C group). The circulating endothelial cell (CEC) count and coagulation-fibrinolysis parameters were measured. The CEC count in B group increased at 4 h, 7 h, and 10 h after injury and then reduced, whereas it continuously increased to a greater extent in BI group (P < 0.05). The von Willebrand factor (vWF) activity, plasminogen activator inhibitor (PAI-1), and the ratio of thromboxane B2 (TXB2) to 6-keto-prostaglandin F1α (6-K-PGF1α) in BI group had a marked increase after injury, and the tissue-type plasminogen activator (tPA) in the BI group decreased. Microscope observations revealed thrombus formation in lungs of the animals in BI group, but not in C, I, or B groups. Burn injury causes endothelial dysfunction, and seawater immersion lastingly aggravates this injury, leading to a higher risk of developing thrombosis. PMID:26885523

  11. [Acute upper limb embolism in a severely burned patient].

    PubMed

    Wiebringhaus, P; Pierson, T; Menke, H

    2014-12-01

    Thrombosis and pulmonary embolisms are the most common complications in the hospital. The need for anticoagulation during hospital stay is obligatory. Arterial embolisms are rare. They often take place in patients with a pre-existing peripheral artery occlusive disease or in patients with atrial fibrillation. The most common complications in burn patients are wound infection, pneumonia, catheter-associated infections and paralytic ileus. There are almost no data available regarding arterial embolism in burn patients. Therefore we would like to present the case of a 60-year-old woman who was injured by a fire at home and was transported to our special burn unit. She sustained partial thickness burns of both legs and buttocks. The TBSA was 15%. During the first days of clinical stay the patient suffered from a pain induced movement reduction of the left hand. There were no peripheral pulses palpable or by pulsed-wave Doppler detectable. An urgent selected angiography of the left arm was performed and a arterial embolism of the proximal part of the a. brachialis was detected. The patient was operated immediately. After debridement and split-skin graft of the burn wounds the patient was taken to rehabiliation after 35 days. PMID:25564950

  12. Plasma ceruloplasmin and total copper levels in burned children receiving parenteral copper: Effect of dose and burn severity

    SciTech Connect

    Cunningham, J.; Chowanski, Z.; Leffell, M.; Stoker, T.; Lydon, M.; Harmatz, P. Univ. of Massachusetts, Amherst )

    1991-03-15

    The response to injury includes an acute-phase stimulation of plasma ceruloplasmin (CP). Patients recovering from nonburn trauma respond to copper (Cu) supplementation by increasing CP. However, plasma CP has been observed to decrease following moderate to severe burn injury, despite adequate enteral provision of Cu. The authors delivered intravenous Cu via TPN to 10 burned children daily at LOW dose or at HIGH dose during the first 3 weeks of recovery. Plasma CP and total Cu (tot Cu) were measured and nonceruloplasmin' Cu (nonCP-Cu) was calculated assuming 3 ug Cu/mg CP. All patients had low CP (range 6-25 mg/dl, normal = 27-37 mg/dl). The HIGH dose raised both CP and tot Cu without increasing non CP-Cu without increasing nonCp-Cu. CP explained 32% of the tot Cu variance while dose and CP explained 84%. Tot Cu was negatively correlated with % BSA burned. They also observed that this relationship does not hold for burns exceeding 95% BSA. These results are consistent with observations for enteral Cu in burns. They show that CP is responsive to dose in burns and suggest at least 20ug/kg as an appropriate daily Cu dose in TPN for burns.

  13. 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

  14. 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

  15. 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

  16. 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. PMID:26796241

  17. 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 ...

  18. 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

  19. Abdominal compartment syndrome (ACS) in a severely burned patient.

    PubMed

    Kollias, S; Stampolidis, N; Kourakos, P; Mantzari, E; Koupidis, S; Tsaousi, S; Dimitrouli, A; Atiyeh, B; Castana, O

    2015-03-31

    Abdominal compartment syndrome (ACS) occurs when increasing intra abdominal-pressure (IAP) reduces blood flow to abdominal organs. This results in impairment of pulmonary, cardiovascular, renal, hepatic, central nervous system and gastro-intestinal (gi) function, causing multiple organ dysfunction syndrome and death. The significant prognostic value of elevated intra-abdominal pressure has prompted many intensive care units to adopt measurement of this physiologic parameter as a routine vital sign in patients at risk. ACS generally occurs in patients who are critically ill due to any of a wide variety of medical and surgical conditions. it has been recently described as a rare complication of burn injury. it is fundamental to: 1) recognize IAP and ACS; 2) resuscitate effectively; and 3) prevent the development IAP-induced end-organ dysfunction and failure. We present our recent experience with one patient suffering from ACS secondary to burn injury and the physiologic results of abdominal wall escharotomy. PMID:26668555

  20. Abdominal compartment syndrome (ACS) in a severely burned patient

    PubMed Central

    kollias, S.; Stampolidis, N.; kourakos, P.; Mantzari, E.; Koupidis, S.; Tsaousi, S.; Dimitrouli, A.; Atiyeh, B.; Castana, O.

    2015-01-01

    Summary Abdominal compartment syndrome (ACS) occurs when increasing intra abdominal-pressure (IAP) reduces blood flow to abdominal organs. This results in impairment of pulmonary, cardiovascular, renal, hepatic, central nervous system and gastro-intestinal (gi) function, causing multiple organ dysfunction syndrome and death. The significant prognostic value of elevated intra-abdominal pressure has prompted many intensive care units to adopt measurement of this physiologic parameter as a routine vital sign in patients at risk. ACS generally occurs in patients who are critically ill due to any of a wide variety of medical and surgical conditions. it has been recently described as a rare complication of burn injury. it is fundamental to: 1) recognize IAP and ACS; 2) resuscitate effectively; and 3) prevent the development IAP-induced end-organ dysfunction and failure. We present our recent experience with one patient suffering from ACS secondary to burn injury and the physiologic results of abdominal wall escharotomy. PMID:26668555

  1. 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.

  2. [First aid for severe burns and scalds in childhood].

    PubMed

    Balzar, E; Strigl, E; Wiedermann, V; Khoss, A; Meissl, G

    1988-08-26

    A marked increase in the rate of admission of children with burns and scalding has been observed since 1977 at the Paediatric Hospital of Vienna University. The average age of 94 patients admitted between 1982 and 1986 was 2.2 +/- 2.1 years. An analysis of the age group 1 to 2 years revealed that burns with an extent of up to 10% of the body surface were seen in 18% of patients, up to a body surface of 20% in 18%, and more than 30% of the body surface in 5.3%. Among the entire group of 94 patients 32.9% had burns of up to 10% of the body surface, 41.4% of up to 20%. Written information as to primary care at the place of injury or in the nearest hospital was obtainable in only 35 out of 94 patients (38%). 21.1% of all patients had a raised temperature on the day of admission to this hospital as a consequence of a negative fluid balance. However, only 4 patients (4.2%) out of the 94 were transferred because of fever and/or septicaemia. Guidelines are proposed as to primary care at the site of trauma and during transport to hospital on the basis of a survey of the literature. PMID:3055686

  3. Determining Relative Contributions of Vegetation and Topography to Burn Severity from LANDSAT Imagery

    NASA Astrophysics Data System (ADS)

    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.

  4. 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

  5. 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

  6. 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.

  7. Contributions of Severe Burn and Disuse to Bone Structure and Strength in Rats

    PubMed Central

    Baer, L.A.; Wu, X.; Tou, J. C.; Johnson, E.; Wolf, S.E.; Wade, C.E.

    2012-01-01

    Burn and disuse results in metabolic and bone changes associated with substantial and sustained bone loss. Such loss can lead to an increased fracture incidence and osteopenia. We studied the independent effects of burn and disuse on bone morphology, composition and strength, and microstructure of the bone alterations 14 days after injury. Sprague-Dawley rats were randomized into four groups: Sham/Ambulatory (SA), Burn/Ambulatory (BA), Sham/Hindlimb Unloaded (SH) and Burn/Hindlimb Unloaded (BH). Burn groups received a 40% total body surface area full-thickness scald burn. Disuse by hindlimb unloading was initiated immediately following injury. Bone turnover was determined in plasma and urine. Femur biomechanical parameters were measured by three-point bending tests and bone microarchitecture was determined by microcomputed tomography (uCT). On day 14, a significant reduction in body mass was observed as a result of burn, disuse and a combination of both. In terms of bone health, disuse alone and in combination affected femur weight, length and bone mineral content. Bending failure energy, an index of femur strength, was significantly reduced in all groups and maximum bending stress was lower when burn and disuse were combined. Osteocalcin was reduced in BA compared to the other groups, indicating influence of burn. The reductions observed in femur weight, BMC, biomechanical parameters and indices of bone formation are primarily responses to the combination of burn and disuse. These results offer insight into bone degradation following severe injury and disuse. PMID:23142361

  8. Improved markers for burn wound perfusion in the severely burned patient: the role for tissue and gastric Pco2.

    PubMed

    Jeng, James C; Jaskille, Amin D; Lunsford, Patricia M; Jordan, Marion H

    2008-01-01

    Improved markers of resuscitation are needed in patients with severe burn injuries. In previous animal and human work, we showed 1) wound hypoperfusion plays a role in burn depth progression, 2) that there are periods of repetitive ischemia and reperfusion which correlate closely to wound hypoperfusion, and 3) that wound and splanchnic bed CO2 measurements are dependent on the adequacy of resuscitation. We and others believe that current markers for resuscitation, urine output (U/O), and mean arterial pressure (MAP), lag behind in reflecting wound perfusion. In this study, we explore whether gastric and tissue tonometry are better in reflecting minute-to-minute changes in wound perfusion in humans. During the 48-hour experimental period, burn wound, gastric, and arterial pH, Pco2, and PaO2 were measured every 6 seconds using a Paratrend 7 monitor in four patients with life threatening burns. Slopes of change were analyzed and a proportion derived relative to pooled data on 5-minute intervals. Serum lactate, U/O, and MAP were recorded. Laser Doppler Imager (LDI) scans were performed on burn areas every 4 hours, allowing real-time determination of burn perfusion. Resuscitation followed current clinical guidelines. All four patients eventually succumbed, one doing so during the observation period. In the remaining three, U/O and MAP goals were met within 2 hours of resuscitation. Our analysis shows cyclic changes in burn wound pH, CO2, and PaO2, gastric CO2, and PaO2, and arterial base deficit (all P < .005). LDI showed cyclic changes in perfusion (P < .0001) which closely mimic the changes in wound pH, gastric CO2, and arterial base deficit. These changes preceded changes in U/O, MAP, and lactate. Although U/O, MAP, and serum lactate reflect changes in burn wound perfusion, they lag behind other markers. Tissue pH and CO2 and gastric CO2 seem to be more timely related to changes in actual burn perfusion. PMID:18182897

  9. Abbreviations in Maritime English

    ERIC Educational Resources Information Center

    Yang, Zhirong

    2011-01-01

    Aiming at the phenomena that more and more abbreviations occur in maritime English correspondences, the composing laws of the abbreviations in maritime English correspondence are analyzed, and the correct methods to answer the abbreviations are pointed out, and the translation method of abbreviations are summarized in this article, and the…

  10. Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

    PubMed

    Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

    2016-07-01

    Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns. PMID:26997326

  11. Morphological Changes in Subcutaneous White Adipose Tissue After Severe Burn Injury.

    PubMed

    Saraf, Manish Kumar; Herndon, David N; Porter, Craig; Toliver-Kinsky, Tracy; Radhakrishnan, Ravi; Chao, Tony; Chondronikola, Maria; Sidossis, Labros S

    2016-01-01

    Severe burn injury produces a plethora of metabolic abnormalities which contribute to the prolonged morbidity of burn survivors. The authors have recently demonstrated trans-differentiation of white adipose tissue (WAT) after burn trauma, toward a more thermogenic phenotype. However, the impact of burn injury on subcutaneous WAT (sWAT) morphology in humans is unknown. Here, the authors studied the effect of severe burn injury on the architecture of sWAT. sWAT was collected from 11 severely burned children (11 ± 3 years; 55 ± 16% total BSA burned) and 12 nonburned healthy children (9 ± 3 years). Histology, electron microscopy, immunohistochemistry, and immunofluorescence were performed on fixed adipose tissue sections. sWAT cytokine and collagen concentrations were measured by multiplex assay and sirius/fast green staining method, respectively. sWAT histology demonstrated multiple fat droplets, significantly (P < .05) reduced mean cell size (104 ± 6 vs 68 ± 3 μm) and higher collagen content (7 ± 0.8 vs 4 ± 0.4) in burn patients. sWAT from burn victims stained positive for CD68 suggesting infiltration of macrophages. Furthermore, electron microscopic analysis showed multiple fat droplets and greater mitochondrial abundance in sWAT of burn survivors. In agreement with this, mitochondrial respiratory capacity in the leak and coupled state increased by 100% in sWAT of burned children from 1 to 3 weeks postinjury. The cytokines IL-6, IL-8, IL-13, IL-1a, IL-1b, MCP-1, and TNF-α were all significantly greater in the sWAT of burned children versus healthy children (P < .05). Furthermore, IL-6, IL-8, IL1-a, IL-1b, and TNF-α significantly increased after injury in sWAT of burned children (P < .05). This study provides detailed evidence of morphological and functional changes in sWAT of burn survivors which was associated with tissue inflammation. A better understanding of morphological and functional changes in sWAT will help discern the mechanisms underlying

  12. 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

  13. 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.

  14. [Further understanding on myocardial damage in the early stage post severe burn and its clinical significance].

    PubMed

    Huang, Y S

    2016-05-20

    A series of studies demonstrated that myocardial damage and cardiac dysfunction occurs immediately following severe burn, even before significant reduction in blood volume due to increased capillary permeability. Such myocardial damage and cardiac dysfunction leads to cardiac deficiency, and it is a precipitating factor for burn shock and ischemic/hypoxic injury. In recent years, many experimental and clinical studies elucidated the pathogenesis and confirmed the clinical importance of prevention and treatment of"shock heart"in the early stage post severe burn. PMID:27188482

  15. Predicting burn severity and patterns of biomass consumption in support of national-scale carbon assessment

    NASA Astrophysics Data System (ADS)

    Shi, H.; Hawbaker, T. J.; Rollins, M. G.; Volegmann, J. E.; Yang, L.

    2009-12-01

    The U.S. Geological Survey (USGS) is prototyping a methodology to conduct an assessment of current carbon stocks and fluxes, and potential increases for ecological carbon sequestration under a range of climate change, policy and economic scenarios, as required by Section 712 of the Energy Independence and Security Act (EISA) of 2007. Disturbances, especially fire, are recognized as having a critical role in carbon dynamics and EISA explicitly requires accounting for their potential impacts. The quantity of carbon released from fires and post-fire carbon sequestration rates are both related to burn severity. However, models explaining and predicting patterns of burn severity are lacking, but needed for long-term assessments quantifying how carbon dynamics will change in response to climate change and future disturbance regimes. To address this knowledge gap, we first quantified changes in field-measured biomass pools according to vegetation types and burn severity categories. We then, constructed statistical models predicting burn severity based on a suite of topographic, climate, and biophysical variables. We selected fires from the Monitoring Trends in Burn Severity (MTBS) database that burned between 1989 and 2007 across representative ecosystems of the U.S. The MTBS data were combined with plot data from the LANDFIRE field reference database where pre- and post-disturbance measurements were made to summarize changes in biomass pools by burn severity and vegetation type. Second, we built statistical models relating the burn severity patterns to LANDFIRE vegetation types, satellite-derived land surface phenology, topographic, and climate variables. We found that the burn severity data captured disturbance-driven changes in above-ground biomass pools well. In the predictive models, vegetation type and fuel loading (measured through land surface phenology) explained the largest amount of variability in burn severity patters; however, climate and topography also had

  16. 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.

  17. A new burn severity index based on land surface temperature and enhanced vegetation index

    NASA Astrophysics Data System (ADS)

    Zheng, Zhong; Zeng, Yongnian; Li, Songnian; Huang, Wei

    2016-03-01

    Remotely sensed data have already become one of the major resources for estimating the burn severity of forest fires. Recently, Land Surface Temperature (LST) calculated from remote sensing data has been considered as a potential indicator for estimating burn severity. However, using the LST-based index alone may not be sufficient for estimating burn severity in the areas that has unburned trees and vegetation. In this paper, a new index is proposed by considering LST and enhanced vegetation index (EVI) together. The accuracy of the proposed index was evaluated by using 264 composite burn index (CBI) field sample data of the five fires across different regional eco-type areas in the Western United States. Results show that the proposed index performed equally well for post-fire areas covered with both sparse vegetation and dense vegetation and relatively better than some commonly-used burn severity indices. This index also has high potential of estimating burn severity if more accurate surface temperatures can be obtained in the future.

  18. Detection of Burn Area and Severity with MODIS Satellite Images and Spatial Autocorrelation Techniques

    NASA Astrophysics Data System (ADS)

    Kaya, S.; Kavzoglu, T.; Tonbul, H.

    2014-12-01

    Effects of forest fires and implications are one of the most important natural disasters all over the world. Statistical data observed that forest fires had a variable structure in the last century in Turkey, but correspondingly the population growth amount of forest fires and burn area increase widely in recent years. Depending on this, erosion, landslides, desertification and mass loss come into existence. In addition; after forest fires, renewal of forests and vegetation are very important for land management. Classic methods used for detection of burn area and severity requires a long and challenging process due to time and cost factors. Thanks to advanced techniques used in the field of Remote Sensing, burn area and severity can be determined with high detail and precision. The purpose of this study based on blending MODIS (Moderate Resolution Imaging Spectradiometer) satellite images and spatial autocorrelation techniques together, thus detect burn area and severity absolutely. In this context, spatial autocorrelation statistics like Moran's I and Get is-Ord Local Gi indexes were used to measure and analyze to burned area characteristics. Prefire and postfire satellite images were used to determine fire severity depending on spectral indexes corresponding to biomass loss and carbon emissivity intensities. Satellite images have used for identification of fire damages and risks in terms of fire management for a long time. This study was performed using prefire and postfire satellite images and spatial autocorrelation techniques to determining and analyzing forest fires in Antalya, Turkey region which serious fires occurred. In this context, this approach enables the characterization of distinctive texture of burned area and helps forecasting more precisely. Finally, it is observed that mapping of burned area and severity could be performed from local scale to national scale. Key Words: Spatial autocorrelation, MODIS, Fire, Burn Severity

  19. 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.

  20. Vagal nerve stimulation blocks peritoneal macrophage inflammatory responsiveness after severe burn injury.

    PubMed

    Lopez, Nicole E; Krzyzaniak, Michael; Costantini, Todd W; De Maio, Antonio; Baird, Andrew; Eliceiri, Brian P; Coimbra, Raul

    2012-08-01

    Large surface area burn injuries lead to activation of the innate immune system, which can be blocked by parasympathetic inputs mediated by the vagus nerve. We hypothesized that vagal nerve stimulation (VNS) would alter the inflammatory response of peritoneal macrophages after severe burn injury. Male BALB/c mice underwent right cervical VNS before 30% total body surface area steam burn and were compared with animals subjected to burn alone. Peritoneal macrophages were harvested at several time points following injury and exposed to lipopolysaccharide (LPS) in culture conditions. The inflammatory response of peritoneal macrophages was measured by analyzing changes in nuclear factor κB p65 phosphorylation using flow cytometry. We found that peritoneal macrophages isolated from mice subjected to burn injury were hyperresponsive to LPS challenge, suggesting burn-induced macrophage activation. We identified a protective role for VNS in blocking peritoneal macrophage activation. Analysis of the phosphorylation state of nuclear factor κB pathway mediator, p65 Rel A, revealed a VNS-mediated reduction in p65 phosphorylation levels after exposure to LPS compared with burn alone. In combination, these studies suggest VNS mediates the inflammatory response in peritoneal macrophages by affecting the set point of LPS responsiveness. PMID:22683732

  1. 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

  2. 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.

  3. 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.

  4. Burn severity and non-native species in Yosemite National Park, California, USA

    USGS Publications Warehouse

    Kaczynski, Kristen M.; Beatty, Susan W.; van Wagtendonk, Jan W.; Marshall, Kristin N.

    2011-01-01

    We examined non-native species density three years after the Tuolumne Fire, which burned 1540 ha in upper montane forest in California, USA. We sampled 60 plots, stratified by burn severity (low, moderate, or high severity) and landscape position (lowland or upland). We detected non-native species in 8 of 11 (73 %) of high severity lowland sites and in 5 of 10 (50 %) of moderate severity lowland sites but, overall, richness and abundance was low. We detected only five non-native species, of which bull thistle (Cirsium vulgare [Savi] Ten.) was the most common. Although non-native abundance is currently low, we recommend continued low intensity monitoring, especially on high severity burned lowland sites.

  5. 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.

  6. 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. PMID:26009824

  7. 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.

  8. Land surface temperature as potential indicator of burn severity in forest Mediterranean ecosystems

    NASA Astrophysics Data System (ADS)

    Quintano, C.; Fernández-Manso, A.; Calvo, L.; Marcos, E.; Valbuena, L.

    2015-04-01

    Forest fires are one of the most important causes of environmental alteration in Mediterranean countries. Discrimination of different degrees of burn severity is critical for improving management of fire-affected areas. This paper aims to evaluate the usefulness of land surface temperature (LST) as potential indicator of burn severity. We used a large convention-dominated wildfire, which occurred on 19-21 September, 2012 in Northwestern Spain. From this area, a 1-year series of six LST images were generated from Landsat 7 Enhanced Thematic Mapper (ETM+) data using a single channel algorithm. Further, the Composite Burn Index (CBI) was measured in 111 field plots to identify the burn severity level (low, moderate, and high). Evaluation of the potential relationship between post-fire LST and ground measured CBI was performed by both correlation analysis and regression models. Correlation coefficients were higher in the immediate post-fire LST images, but decreased during the fall of 2012 and increased again with a second maximum value in summer, 2013. A linear regression model between post-fire LST and CBI allowed us to represent spatially predicted CBI (R-squaredadj > 85%). After performing an analysis of variance (ANOVA) between post-fire LST and CBI, a Fisher's least significant difference test determined that two burn severity levels (low-moderate and high) could be statistically distinguished. The identification of such burn severity levels is sufficient and useful to forest managers. We conclude that summer post-fire LST from moderate resolution satellite data may be considered as a valuable indicator of burn severity for large fires in Mediterranean forest ecosytems.

  9. 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.

  10. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    PubMed Central

    Finnerty, Celeste C; Jeschke, Marc G; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in children. We enrolled 25 adults and 24 children who survived a flame burn covering more than 20% of total body surface area (TBSA). The concentrations of 22 cytokines were measured using the Linco multiplex array system (St. Charles, MO, USA). Large perturbations in the expression of pro- and anti-inflammatory cytokines were seen following thermal injury. During the first week following burn injury, IFN-γ, IL-10, IL-17, IL-4, IL-6, and IL-8 were detected at significantly higher levels in adults compared with children, P < 0.05. Significant differences were measured during the second week post-burn for IL-1β (higher in children) and IL-5 (higher in adults), P < 0.05. IL-18 was more abundant in children compared with adults during the third week post-burn, P < 0.05. Between post-burn d 21 and d 66, IL-1α was detected at higher concentrations in pediatric compared with adult patients, P < 0.05. Only GM-CSF expression was significantly different at all time points; it was detected at lower levels in pediatric patients, P < 0.05. Eotaxin, G-CSF, IL-13, IL-15, IP-10, MCP-1, and MIP-1α were detected at significantly different concentrations in adult compared with pediatric patients at multiple time points, P < 0.05. There were no differences in IL-12, IL-2, IL-7, or TNF levels in adult compared with pediatric burn patients at any of these time points. Following severe flame burns, the cytokine profiles in pediatric patients differ compared with those in adult patients, which may

  11. 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. ...

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. Metabolic and Hormonal Changes of Severely Burned Children Receiving Long-Term Oxandrolone Treatment

    PubMed Central

    Przkora, Rene; Jeschke, Marc G.; Barrow, Robert E.; Suman, Oscar E.; Meyer, Walter J.; Finnerty, Celeste C.; Sanford, Arthur P.; Lee, Jong; Chinkes, David L.; Mlcak, Ronald P.; Herndon, David N.

    2005-01-01

    Objective: When given to children for 1 year after a severe burn, oxandrolone significantly improves lean body mass, bone mineral content, and muscle strength. The beneficial effects of oxandrolone on height and weight were observed 1 year after treatment was discontinued. To study the efficacy of oxandrolone in severely burned children for 12 months after burn and 12 months after the drug was discontinued. Summary Background Data: Oxandrolone attenuates body catabolism during the acute phase after burn. It is unclear whether oxandrolone would have any beneficial effects during long-term treatment or if there were any effects after the drug was stopped. Methods: Sixty-one children with 40% total body surface area burns were enrolled in this study. Patients were randomized into those to receive oxandrolone (n = 30) or placebo (n = 31) for the first 12 months. Treatment was discontinued after 12 months, and the patients were studied without the drug for the following 12 months. At discharge and 6, 12, 18, and 24 months after burn, height, weight, body composition, resting energy expenditure, muscle strength, and serum human growth hormone, insulin-like growth factor-I (IGF-1), IGF binding protein-3, insulin, cortisol, parathyroid hormone, tri-iodothyronine uptake (T3 uptake), and free thyroxine index (FTI) were measured. Statistical analysis used Tukey multiple comparison test. Significance was accepted at P < 0.05. Results: Oxandrolone improved lean body mass, bone mineral content and muscle strength compared with controls during treatment, P < 0.05. Serum IGF-1, T3 uptake, and FTI were significantly higher during drug treatment compared with controls, P < 0.05. Significant increases in height and weight with oxandrolone were observed after the end of treatment. Conclusions: Oxandrolone improved body composition and strength in severely burned children during the 12 months of treatment. Its effect on height and weight continued after treatment was discontinued. PMID

  20. Impact of Oxandrolone Treatment on Acute Outcomes After Severe Burn Injury

    PubMed Central

    Pham, Tam N.; Klein, Matthew B.; Gibran, Nicole S.; Arnoldo, Brett D.; Gamelli, Richard L.; Silver, Geoffrey M.; Jeschke, Marc G.; Finnerty, Celeste C.; Tompkins, Ronald G.; Herndon, David N.

    2013-01-01

    Pharmacologic modulation of hypermetabolism clearly benefits children with major burns, however, its role in adult burns remains to be defined. Oxandrolone appears to be a promising anabolic agent although few outcome data are as yet available. We examined whether early oxandrolone treatment in severely burned adults was associated with improved outcomes during acute hospitalization. We evaluated for potential associations between oxandrolone treatment and outcomes in a large cohort of severely burned adults in the context of a multicenter observational study. Patients were dichotomized with respect to oxandrolone treatment, defined as administration within 7 days after admission, with duration of at least 7 days. Acute hospitalization outcomes were compared with univariate and multivariate analyses. One hundred seventeen patients were included in this analysis. Mean patient age was 42.6 years (range, 18–86); 77% were male, with an average TBSA of 44.1%. Baseline and injury characteristics were similar among treatment and nontreatment cohorts. Oxandrolone treatment (N =59) did not impact length of stay but was associated with a lower mortality rate (P = .01) by univariate analysis. Oxandrolone treatment was independently associated with higher survival by adjusted analyses (P = .02). Examination of early oxandrolone treatment in this cohort of severely burned adults suggests that this therapy is safe and may be associated with improved survival. Further studies are necessary to define the exact mechanisms by which oxandrolone is beneficial during inpatient treatment. PMID:18849836

  1. Burns

    MedlinePlus

    ... to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot liquids and ... to infections because they damage your skin's protective barrier. Treatment for burns depends on the cause of ...

  2. Burns

    MedlinePlus

    ... of Surgery . 18th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 22. Holmes JH, Heimbach DM. Burns. In: Brunicardi FC, Andersen DK, Billiar TR, et al, eds. Schwartz's Principles of Surgery . 9th ed. New ...

  3. Long-Term Propranolol Use in Severely Burned Pediatric Patients: A Randomized Controlled Study

    PubMed Central

    Herndon, David N.; Rodriguez, Noe A.; Diaz, Eva C.; Hegde, Sachin; Jennings, Kristofer; Mlcak, Ronald P.; Suri, Jaipreet S.; Lee, Jong O.; Williams, Felicia N.; Meyer, Walter; Suman, Oscar E.; Barrow, Robert E.; Jeschke, Marc G.; Finnerty, Celeste C.

    2012-01-01

    Objective To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective randomized single-center controlled study in pediatric patients with large burns. Summary Background Data Severe burns trigger a hypermetabolic response that persists for up to 2 years after burn. Propranolol given for 1 month post burn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods One-hundred seventy nine pediatric patients with >30% total body surface area burns were randomized to receive control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months after burn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjust for non-normality, repeated measures, and regression analyses. P <0.05 was considered significant. Results Long-term propranolol treatment significantly reduced the percent of the predicted heart rate and percent of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions Propranolol treatment for 12 months, following thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients. This study is registered at clinicaltrials.gov, NCT00675714. PMID:22895351

  4. 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

  5. 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

  6. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    PubMed Central

    Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in the study. Inhalation injury was diagnosed by bronchoscopy during the first operation. Blood was collected within 24 hours of admission and again at five to seven days following admission. Cytokine expression was profiled using multi-plex antibody-coated beads. Significance was accepted at a p value of less than 0.05. Results The mean percentages of total body surface area burned were 67% ± 4% (56% ± 6%, third-degree burns) in the inhalation injury group and 60% ± 3% (45% ± 3%, third-degree burns) in the non-inhalation injury group (p value not significant [NS]). Mean age was 9 ± 1 years in the inhalation injury group and 8 ± 1 years in the non-inhalation injury group (p value NS). Time from burn to admission in the inhalation injury group was 2 ± 1 days compared to 3 ± 1 days in the non-inhalation injury group (p value NS). Mortalities were 40% in the inhalation injury group and 12% in the non-inhalation injury group (p < 0.05). At the time of admission, serum interleukin (IL)-7 was significantly increased in the non-inhalation injury group, whereas IL-12p70 was significantly increased in the inhalation injury group compared to the non-inhalation injury group (p < 0.05). There were no other significant differences between groups. Five to seven days following admission, all cytokines decreased with no differences between the inhalation injury and non-inhalation injury cohorts. Conclusion In the present study, we show that an inhalation injury causes alterations in IL-7

  7. Trace Element Supplementation Following Severe Burn Injury: A Systematic Review and Meta-Analysis.

    PubMed

    Kurmis, Rochelle; Greenwood, John; Aromataris, Edoardo

    2016-01-01

    Trace elements have an important physiological role after severe burn injury with patients routinely receiving supplementation. Although commonly prescribed after burn injury, variation exists among supplement composition, frequency, and the dosage administered. This review aims to assess the effectiveness of trace element supplementation on clinically meaningful outcomes in patients who have sustained a severe burn injury. Supplementation of selenium, copper and zinc, either alone or combined, compared with placebo or standard treatment were eligible for inclusion. Predetermined primary outcome measures were mortality, length of stay, rate of wound healing, and complications. A comprehensive search strategy was undertaken. Methodological quality of eligible studies was appraised and relevant data extracted for meta-analysis. Eight studies met eligibility criteria for the review; four randomized controlled trials and four nonrandomized experimental trials, including a total of 398 participants with an age range of 6 to 67 years. Parenteral supplementation of combined trace elements was associated with a significant decrease in infectious episodes (weighted mean difference: -1.25 episodes, 95% confidence intervals: -1.70, -0.80; P < .00001). The results of this review indicate that the use of parentally administered combined trace elements after burn injury confer positive effects in decreasing infectious complications. Combined parenteral trace element supplementation and combined oral and parenteral zinc supplementation have potentially clinically significant findings on reducing length of stay. Oral zinc supplementation shows possible beneficial effects on mortality. Definitive studies are required to accurately define optimal trace element supplementation regimens, dosages, and routes after burn injury. PMID:26056754

  8. High severity experimental burns in Siberian larch forests increase permafrost thaw and larch tree regeneration

    NASA Astrophysics Data System (ADS)

    Alexander, H. D.; Davydov, S.; Zimov, N.; Mack, M. C.

    2013-12-01

    Global change models predict increased fire activity in boreal forests as climate warms and dries. We hypothesized that fire-driven decreases in soil organic layer (SOL) depth will (1) increase permafrost thaw by reducing the insulating capacity of the SOL and (2) improve seedbed conditions for tree regeneration. Over time, these changes will lead to altered patterns of above- and belowground carbon (C) accumulation. To test these hypotheses, we conducted plot-level experimental burns in July 2012 in a low-density, mature larch stand near the Northeast Science Station in Cherskii, Siberia. Dried fuels of naturally occurring vegetation were added to plots to achieve four burn severity treatments based on residual SOL depths: control, low (> 8 cm), moderate (5-8 cm), and high severity (2-5 cm). Pre-fire and during two growing seasons post-fire, we measured thaw depth, soil moisture, and soil temperature to determine severity effects on permafrost thaw. We also sowed larch seeds in fall 2012 and quantified germination rates the following growing season. By 1 wk post-fire, thaw depth was 15-25 cm deeper in plots burned at high severity (55 cm) compared to other treatments (30-40 cm). These differences in thaw depth with burn severity were maintained during the subsequent growing season and were associated with increased soil temperature and moisture. Larch regeneration was 10x higher on severely burned plots than those unburned. Our findings highlight the potential for increased fire severity to degrade permafrost and alter successional dynamics and patterns of C accumulation.

  9. Muscle Protein Catabolism After Severe Burn: Effects of IGF-1/IGFBP-3 Treatment

    PubMed Central

    Herndon, David N.; Ramzy, Peter I.; DebRoy, Meelie A.; Zheng, Ming; Ferrando, Arny A.; Chinkes, David L.; Barret, Juan P.; Wolfe, Robert R.; Wolf, Steven E.

    1999-01-01

    Objective To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. Summary Background Data Severe burns are associated with a persistent hypermetabolic response characterized by hyperdynamic circulation and severe muscle catabolism and wasting. Previous studies showed that nutritional support and pharmacologic intervention with anabolic agents such as growth hormone and insulin abrogated muscle wasting and improved net protein synthesis in the severely burned. The use of these agents, however, has several adverse side effects. A new combination of IGF-1 and IGFBP-3 is now available for clinical study. Methods Twenty-nine severely burned children were prospectively studied before and after treatment with 0.5, 1, 2, or 4 mg/kg/day IGF-1/IGFBP-3 to determine net balance of protein across the leg, muscle protein fractional synthetic rates, and glucose metabolism. Another group was studied in a similar fashion without IGF-1/IGFBP-3 treatment as time controls. Results Seventeen of 29 children were catabolic before starting treatment. The infusion of 1.0 mg/kg/day IGF-1/IGFBP-3 increased serum IGF-1, which did not further increase with 2.0 and 4.0 mg/kg/day. IGF-1/IGFBP-3 treatment at 1 to 4 mg/kg/day improved net protein balance and increased muscle protein fractional synthetic rates. This effect was more pronounced in catabolic children. IGF-1/IGFBP-3 did not affect glucose uptake across the leg or change substrate utilization. Conclusions IGF-1/IGFBP-3 at doses of 1 to 4 mg/kg/day attenuates catabolism in catabolic burned children with negligible clinical side effects. PMID:10235530

  10. Severe burn-induced endoplasmic reticulum stress and hepatic damage in mice.

    PubMed

    Song, Juquan; Finnerty, Celeste C; Herndon, David N; Boehning, Darren; Jeschke, Marc G

    2009-01-01

    Severe burn injury results in liver dysfunction and damage, with subsequent metabolic derangements contributing to patient morbidity and mortality. On a cellular level, significant postburn hepatocyte apoptosis occurs and likely contributes to liver dysfunction. However, the underlying mechanisms of hepatocyte apoptosis are poorly understood. The endoplasmic reticulum (ER) stress response/unfolded protein response (UPR) pathway can lead to hepatocyte apoptosis under conditions of liver dysfunction. Thus, we hypothesized that ER stress/UPR may mediate hepatic dysfunction in response to burn injury. We investigated the temporal activation of hepatic ER stress in mice after a severe burn injury. Mice received a scald burn over 35% of their body surface and were killed at 1, 7, 14, and 21 d postburn. We found that severe burn induces hepatocyte apoptosis as indicated by increased caspase-3 activity (P < 0.05). Serum albumin levels decreased postburn and remained lowered for up to 21 d, indicating that constitutive secretory protein synthesis was reduced. Significantly, upregulation of the ER stress markers glucose-related protein 78 (GRP78)/BIP, protein disulfide isomerase (PDI), p-protein kinase R-like endoplasmic reticulum kinase (p-PERK), and inositol-requiring enzyme 1alpha (IRE-1alpha) were found beginning 1 d postburn (P < 0.05) and persisted up to 21 d postburn (P < 0.05). Hepatic ER stress induced by burn injury was associated with compensatory upregulation of the calcium chaperone/storage proteins calnexin and calreticulin (P < 0.05), suggesting that ER calcium store depletion was the primary trigger for induction of the ER stress response. In summary, thermal injury in mice causes long-term adaptive and deleterious hepatic function alterations characterized by significant upregulation of the ER stress response. PMID:19603103

  11. Screening of Key Genes in Severe Burn Injury at Different Stages via Analyzing Gene Expression Data.

    PubMed

    Li, Zhihong; Wang, Qihong; Yu, Haifeng; Zou, Kun; Xi, Yong; Mi, Wenxin; Ma, Yindong

    2016-01-01

    Microarray analysis was performed to investigate the changes in gene expression profiles after severe burn injury at the early and middle stages, further discovering therapeutic targets for severe burn injury. Microarray data (GSE19743) were downloaded from Gene Expression Omnibus. First, differentially expressed genes (DEGs) at different stages were screened using limma package. Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of DEGs were then performed using DAVID. Protein-protein interaction (PPI) networks were also constructed using String database. Additionally, transcription factor binding site was detected using the Whole-Genome rVISTA. Compared with the healthy controls, 160 DEGs were identified in patients with early-stage burn injury and 261 DEGs were obtained in patients with middle-stage burn injury. Only 10 genes showed differential expression between the early and middle stages. KEGG functional analysis indicated that DEGs detected at the early stage were mainly enriched in the immune response, kinase activity, and signaling pathways and DEGs detected at the middle stage were involved in the immune response, protein and fat metabolism, and programmed cell death pathways. Three PPI networks were constructed and hub proteins with high degrees of connection were screened, such as lactotransferrin, interleukin 8, and perforin-1. Additionally, many transcription factor binding sites that may be involved in the regulation of these DEGs were also detected. A number of DEGs were identified in patients with early- and middle-stage burn injury, which helps to deepen the understanding about the molecular mechanism underlying severe burn injury. PMID:25412053

  12. Effects of glutamine treatment on myocardial damage and cardiac function in rats after severe burn injury

    PubMed Central

    Yan, Hong; Zhang, Yong; Lv, Shang-jun; Wang, Lin; Liang, Guang-ping; Wan, Qian-xue; Peng, Xi

    2012-01-01

    Treatment with glutamine has been shown to reduce myocardial damage associated with ischemia/reperfusion injury. However, the cardioprotective effect of glutamine specifically after burn injury remains unclear. The present study explores the ability of glutamine to protect against myocardial damage in rats that have been severely burned. Seventy-two Wistar rats were randomly divided into three groups: normal controls (C), burned controls (B) and a glutamine-treated group (G). Groups B and G were subjected to full thickness burns comprising 30% of total body surface area. Group G was administered 1.5 g/ (kg•d) glutamine and group B was given the same dose of alanine via intragastric administration for 3 days. Levels of serum creatine kinase (CK), lactate dehydrogenase (LDH), aspartate transaminase (AST) and blood lactic acid were measured, as well as myocardial ATP and glutathione (GSH) contents. Cardiac function indices and histopathological changes were analyzed at 12, 24, 48 and 72 post-burn hours. In both burned groups, levels of serum CK, LDH, AST and blood lactic acid increased significantly, while myocardial ATP and GSH contents decreased. Compared with group B, CK, LDH, and AST levels were lower and blood lactic acid, myocardial ATP and GSH levels were higher in group G. Moreover, cardiac contractile function inhibition and myocardial histopathological damage were significantly reduced in group G compared to B. Taken together, these results show that glutamine supplementation protects myocardial structure and function after burn injury by improving energy metabolism and by promotedthe synthesis of ATP and GSH in cardiac myocytes. PMID:22977661

  13. [Advances in the application of extracorporeal membrane oxygenation in the treatment of severe burn].

    PubMed

    Lyu, Lin; Gao, Guodong; Long, Cun

    2015-12-01

    Extracorporeal membrane oxygenation (ECMO) is a kind of technique that uses extracorporeal circulation system to draw patients' blood into the circuit, and then oxygenate the blood when it passes along the membrane, followed by returning the blood into patients. At present, ECMO is mainly used in treating patients with respiratory failure and circulatory failure, for whom the conventional treatment such as mechanical ventilation and vasoactive drugs are invalid. ECMO can provide cardiopulmonary support for burn patients with respiratory failure or circulatory failure, and put the heart and lung at rest. The purpose of this paper is to review the application of ECMO in the treatment of severe burn. PMID:26837253

  14. [Fatal hyperpyrexia in an adolescent patient with severe burns after a traffic accident].

    PubMed

    Jaehn, T; Sievers, R; Junger, A; Graunke, F; Blings, A; Reichert, B

    2016-07-01

    After a motorcycle accident a 16-year-old patient suffered severe burns to 40.5 % of the total body surface area (TBSA) of which 37 % were deep subdermal burns. After tangential and partly epifascial necrosectomy, Integra® was used as a temporary dermis replacement material for the lower extremities, combined with extensive negative pressure wound therapy (NPWT). In the further course of the treatment the patient developed uncontrollable hyperpyrexia with a fatal outcome. Possible influencing factors, such as the dermis replacement material combined with NPWT over large areas as well as the differential diagnoses propofol infusion syndrome, heatstroke and malignant hyperthermia are discussed. PMID:26767381

  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. Influence of Metformin on Glucose Intolerance and Muscle Catabolism Following Severe Burn Injury

    PubMed Central

    Gore, Dennis C.; Wolf, Steven E.; Sanford, Arthur; Herndon, David N.; Wolfe, Robert R.

    2005-01-01

    Summary Background Data: Hyperglycemia and accelerated muscle catabolism have been shown to adversely affect immune response and survival. The purpose of this study was to determine the effect of metformin on glucose kinetics and muscle protein metabolism in severely burned patients and assess any potential benefit of metformin in this clinical setting. Methods: In a double-blind, randomized manner, 8 adult burn patients received metformin (850 mg every 8 hours × 7 days), while 5 burn patients received placebo. Infusions of 6,6d2 glucose, d5 phenylalanine, sequential muscle biopsies, and femoral arterial, venous blood sampling allowed determination of glucose and muscle protein kinetics. Measurements were obtained immediately prior and at the conclusion of 7 days of treatment (metformin versus placebo). All patients received enteral feeds of comparable amounts during study. Results: Patients receiving metformin had a significant decrease in their plasma glucose concentration, the rate of glucose production, and an increase in glucose clearance. Metformin administration was also associated with a significant increase in the fractional synthetic rate of muscle protein and improvement in net muscle protein balance. Glucose kinetics and muscle protein metabolism were not significantly altered in the patients receiving placebo. Conclusions: Metformin attenuates hyperglycemia and increases muscle protein synthesis in severely burned patients, thereby indicating a metabolic link between hyperglycemia and muscle loss following severe injury. Therefore, therapies that improve glucose tolerance such as metformin may be of clinical value in ameliorating muscle catabolism in critically injured patients. PMID:15650645

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 77 FR 66419 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ... Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile or Other Conveyance and... eligibility for financial assistance in the purchase of an automobile or other conveyance and adaptive... the Armed Forces with Severe Burn Injuries for Financial Assistance in the Purchase of an...

  5. Absence of Exertional Hyperthermia in a 17 Year Old with Severe Burns

    PubMed Central

    McEntire, Serina J.; Lee, Jong O.; Herndon, David N.; Suman, Oscar E.

    2014-01-01

    Objective An important safety concern when exercising burned patients is the potential for an excessive increase in core body temperature (hyperthermia = body core temperature > 39°C) during exercise. Methods We examined the thermoregulatory response to exercise in the heat (31°C, relative humidity 40%) in a 17 year old with a 99% total body surface area burn. A 30 minute exercise test was performed at an intensity of 75% of his peak aerobic capacity. Intestinal temperature was assessed via telemetry with an ingestible capsule. Intestinal temperature was measured pre-exercise, during, and post-exercise. Results The patient completed 12 minutes of the 30 minute exercise test. Starting core temperature was 36.98 °C and increased 0.69 °C during exercise. After excercise, intestinal temperature continued to increase, but no hyperthermia was noted. Conclusion It has been reported that burned children can safely exercise at room temperature, however, the response in the heat is unknown. This patient did not develop exertional hyperthermia, which we propose is due to his low fitness level and heat intolerance. However, the potential for hyperthermia would be increased if he were forced to maintain a high relative workload in the heat. We propose that severely burned individuals should be able to safely participate in physical activities. However, the decision to stop exercising should be accepted to avoid development of exertional hyperthermia. PMID:19506510

  6. A submaximal dose of insulin promotes net skeletal muscle protein synthesis in patients with severe burns.

    PubMed Central

    Ferrando, A A; Chinkes, D L; Wolf, S E; Matin, S; Herndon, D N; Wolfe, R R

    1999-01-01

    OBJECTIVE: To investigate the hypothesis that a submaximal insulin dose reverses the net muscle catabolism associated with severe burns, and to determine its effects on amino acid kinetics. SUMMARY BACKGROUND DATA: The authors previously showed that a maximal dose of insulin administered to patients with severe burns promoted skeletal muscle glucose uptake and net protein synthesis. However, this treatment was associated with caloric overload resulting from the large quantities of exogenous glucose required to maintain euglycemia, and hypoglycemia was a potential problem. METHODS: Thirteen patients were studied after severe burn injury (>60% total body surface area). Patients were randomly treated by standard care (n = 5) or with exogenous insulin (n = 8). Data were derived from an arteriovenous model with primed-continuous infusions of stable isotopes and biopsies of the vastus lateralis muscle. RESULTS: Net amino acid balance was significantly improved with insulin treatment. Skeletal muscle protein synthesis was significantly greater in the group receiving insulin, whereas muscle protein breakdown was not different between the groups. This submaximal dose of insulin did not affect glucose or amino acid uptake or require a greater caloric intake to avoid hypoglycemia. CONCLUSIONS: Submaximal insulin can promote muscle anabolism without eliciting a hypoglycemic response. PMID:9923795

  7. Treatment of severe burn with DermACELL®, an acellular dermal matrix

    PubMed Central

    Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Wang, Chih-Hsin

    2012-01-01

    For treatment of skin burn injuries, there exist several methods of treatment related to tissue regeneration, including the use of autograft skin and cryopreserved skin. However, each method has drawbacks. An alternative method for tissue regeneration is allograft acellular dermal matrix, with potential as a biocompatible scaffold for new tissue growth. One recently produced material of this type is DermACELL®, which was used in this case presentation for treating a scar resulting from second- and third-degree burns in a 33-year-old female patient. The patient presented with significant hypertrophic scarring from the elbow to the hand and with limited wrist and elbow motion. The scarring was removed, and the patient was treated with a 1:3 mesh of DermACELL. The wound was resurfaced with a split thickness skin graft, and postoperative care included application of pressure garment and silicone sheet, as well as range of motion exercise and massage. At 30 days after DermACELL application, the wound appeared well-healed with little scar formation. At 180 days post-application, the wound continued to appear healed well without significant scar formation. Additionally, the wound was supple, and the patient experienced significant improvement in range of motion. In the case presented, DermACELL appears to have been a successful method of treatment for scarring due to severe burns by preventing further scar formation and improving range of motion. PMID:23071908

  8. [Pathophysiologic changes in patients with severe burns: role of hormones and chemical mediators].

    PubMed

    Ikeda, H; Kobayashi, K

    1998-01-01

    The body's general response to serious thermal injury is characterized by increased vascular permeability immediately after injury and subsequent hypovolemic shock. Skeleto-muscular proteolysis, lipolysis, gluconeogenesis, increased metabolic rate, and a severe systemic inflammatory response induced by local infections or surgical procedures. The increased vascular permeability is mediated by histamine and numerous vasoactive substances, including serotonin, bradykinin, prostaglandins, leukotrienes, and platelet activating factor. Hyper-metabolism is mediated by hormones such as catecholamines, glucagon, and particularly cortisol. In addition, among the putative mediators of the metabolic response to injury, attention has recently been focused on cytokines and lipid mediators which are mainly produced by activated reticuloendothelial cells. Cytokines such as interleukin-1, interleukin-6 and tumor necrosis factor and cortisol responses are interrelated, since cytokines activate the hypothalamo-adrenal axis. The cytokine storm seen in burn patients may be associated with depression of the immune system and with susceptibility to infection. Thermal injury can also lead to activation of the renin-angiotensin-aldosterone system, increased ADH production, and production of atrial natriuretic polypeptide to maintain the circulatory volume. Burn wound infections or surgical procedures can produce and perpetuate a mediator-induced systemic inflammatory response that may lead to multiple organ failure. Serum levels of interleukin-6 are very sensitive to surgical stress, and may be a useful indicator of the general condition of severely burned patients. PMID:9547740

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

    PubMed Central

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

    2005-01-01

    Summary 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

  11. 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

  12. Effects of resveratrol on the treatment of inflammatory response induced by severe burn.

    PubMed

    Tao, Ke; Bai, Xiaozhi; Jia, Wenbin; Liu, Yang; Zhu, Xiongxiang; Han, Juntao; Dong, Maolong; Li, Jun; Chen, Dongdong; Hu, Dahai

    2015-01-01

    The aim of this study was to preliminarily investigate the effects of resveratrol on the treatment of systemic inflammatory response induced by severe burn wounding. Through the simulation experiment in vivo on burned mice and simulative experiment in vitro on mice macrophage respectively, differences of the related pro-inflammatory cytokines and SIRT1 expression levels between the resveratrol-treated group and the untreated control group were detected and analyzed. The results of the simulation experiment in vivo on burned mice manifested that the survival rate of the mice in the resveratrol-treated group was markedly higher than that of controls (p<0.05). Resveratrol could significantly reduce the levels of pro-inflammatory factors TNF-α, IL-1β, and IL-6 in serum (p<0.01) and greatly elevate the expression level of SIRT1 (p<0.01). The results of the simulative experiment in vitro on mice macrophage showed no significant difference in TNF-α, IL-1β, or IL-6 contents among three groups (C, mice macrophage control group; R, resveratrol-treated macrophage group; I, SIRT1-inhibitor-treated macrophage group). Whereas, after lipopolysaccharide (LPS) activation (L group), macrophage TNF-α, IL-1β, and IL-6 levels were significantly increased in L group, dramatically higher than those in L+R group (LPS and resveratrol treatment group) (p<0.01). After adding SITR1 inhibitor, three pro-inflammatory cytokines in L+R+I group all showed significant increases compared with those in L+R group (p<0.01). LPS activated macrophages were able to promote the expression of pro-inflammatory cytokines. By upregulating the expression levels of SIRT1, resveratrol could effectively inhibit the inflammation cascade reaction and increase the survival rate of severe burn with bacterial infections in a large extent. PMID:25586484

  13. Severe burn and disuse in the rat independently adversely impact body composition and adipokines

    PubMed Central

    2013-01-01

    Introduction Severe trauma is accompanied by a period of hypermetabolism and disuse. In this study, a rat model was used to determine the effects of burn and disuse independently and in combination on body composition, food intake and adipokines. Methods Male rats were assigned to four groups 1) sham ambulatory (SA), 2) sham hindlimb unloaded (SH), 3) 40% total body surface area full thickness scald burn ambulatory (BA) and 4) burn and hindlimb unloaded (BH). Animals designated to the SH and BH groups were placed in a tail traction system and their hindlimbs unloaded. Animals were followed for 14 days. Plasma, urine, fecal and tissue samples were analyzed. Results SA had a progressive increase in body mass (BM), SH and BA no change and BH a reduction. Compared to SA, BM was reduced by 10% in both SH and BA and by 17% when combined in BH. Compared to SA, all groups had reductions in lean and fat body mass with BH being greater. The decrease in lean mass was associated with the rate of urinary corticosterone excretion. The loss in fat mass was associated with decreases in plasma leptin and adiponectin and an increase in ghrelin. Following the acute response to injury, BH had a greater food intake per 100 g BM. Food intake was associated with the levels of leptin, adiponectin and ghrelin. Conclusions The effects of the combination of burn and disuse in this animal model were additive, therefore in assessing metabolic changes with severe trauma both injury and disuse should be considered. Furthermore, the observed changes in adipokines, corticosterone and ghrelin provide insights for interventions to attenuate the hypermetabolic state following injury, possibly reducing catabolism and muscle loss and subsequent adverse effects on recovery and function. PMID:24099533

  14. Gene Expression Changes With Time in Skeletal Muscle of Severely Burned Children

    PubMed Central

    Dasu, Mohan R. K.; Barrow, Robert E.; Herndon, David N.

    2005-01-01

    Objective: The purpose of this study was to identify gene-expression changes in leg muscle for up to 24 months after a severe thermal injury. Summary Background Data: Hypermetabolism associated with severe burns was thought to cease with wound healing and closure. It has been recently shown that hypermetabolism does not completely resolve after healing, and muscle catabolism continues after hospital discharge; however, just how long after discharge has not been established. Methods: Six children, admitted to our hospital within 1 week after injury, were studied. Patients ranged in age from 3 to 18 years, with flame or scald burns covering more than 40% of their body surface area. At 1.5, 6, 12, 18, and 24 months postburn, a biopsy of the vastus lateralis muscle was taken and snap frozen at −80°C. Total RNA was isolated and in vitro transcribed and hybridized to HG-U95 Av.2 Affymetrix arrays. The images were scanned and analyzed using Affymetrix GeneChip Analysis Suite 5.2 and dChip programs. Using 1 to 7 days after injury as baseline, comparisons were made of expression profiles at the various time intervals after injury. Results: When comparisons are made to nonburned children, 38 genes were significantly altered at 1.5 months, 10 genes remained altered at 6 months, 4 remained altered at 12 months, and 2 at 18 months. No differences could be shown at 24 months. Western blot analysis of β-2 microglobulin and myosin light chain was used to corroborate the microarray data. Conclusions: Gene changes can be identified for up to 18 months after burn but not at 24 months. These gene changes may provide information concerning what genes in skeletal muscle contribute to recovery from burn trauma. PMID:15798467

  15. 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.

  16. 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

  17. Role of the PPAR-α agonist fenofibrate in severe pediatric burn injury

    PubMed Central

    Elijah, Itoro E.; Børsheim, Elisabet; Maybauer, Dirk M.; Finnerty, Celeste C.; Herndon, David N.; Maybauer, Marc O.

    2013-01-01

    Fenofibrate is a peroxisome proliferator activated receptor alpha agonist that contains both pro and anti-inflammatory properties, and has been used in the treatment of dyslipidemia and diabetes for decades. Its receptors are expressed in the liver, skeletal muscle, cardiac, enteric, and renal cells, which allow it to provide systemic regulation of lipoprotein metabolism, fatty acid oxidation, and fatty acid transport. Hyperglycemia is a common complication found in the burn population because hepatic glucose production and catecholamine-mediated hepatic glycogenolysis are augmented. Insulin resistance occurs often in these patients and is associated with poor outcomes. In the pediatric burn population, fenofibrate has been found to ameliorate or decrease the number of hypoglycemic episodes when compared to management with insulin alone. Its mechanism of action is thought to involve an improvement in insulin signaling in skeletal muscle, as well as improvements in mitochondrial function, glucose oxidation, and insulin sensitivity. The long term use of fenofibrate in severely burned patients may improve hyperglycemia and insulin resistance, as well as improve wound healing, and reduce apoptosis, and oxidative stress. PMID:22226866

  18. Pyogenic cervical spondylitis with quadriplegia as a complication of severe burns: Report of a case.

    PubMed

    Asakage, Naoki; Katami, Atsuo; Takekawa, Satoru; Suzuki, Tetsuya; Goto, Michitoshi; Fukai, Ryuta

    2006-01-01

    We report a case of cervical pyogenic spondylitis complicated by epidural abscess with quadriplegia during treatment of severe burns. The patient was a 49-year-old man with 3rd-degree burns to 20% of his body, involving the lower extremities. We performed escharectomy of the 3rd-degree necrosis on days 7 and 16, followed by the first skin graft on day 23. Pseudomonas aeruginosa was detected in the postoperative graft wound culture. On day 23 after the skin graft, he became febrile and began to experience cervical pain and muscle weakness of the extremities. By day 24, quadriplegia had developed. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylitis with an epidural abscess, which was causing the quadriplegia. We treated the patient by performing curettage of the pyogenic lesion and anterior fixation of the cervical vertebral bodies. The fact that P. aeruginosa was detected in the pyogenic focus culture indicated that burn wound sepsis was responsible for the infection. This case reinforces that acting on a strong suspicion helps to establish a diagnosis and initiate appropriate treatment early. PMID:17072727

  19. Initial Release of Severe Post-Burn Contracture Scar of the Neck for Intubation Under Ketamine

    PubMed Central

    Al-Zacko, S.M.; Al-Kazzaz, D.A.

    2009-01-01

    Summary Background. Severe anterior post-burn contracture (PBC) of the neck poses the anaesthesiologist some difficult problems and results in difficult intubation when extension of the atlanto-occipital joint is impaired. Such patients must therefore have the PBC scar released before other procedures are performed, in order to ensure airway control. Objectives. To show our experience with quick surgical neck release of patients with severe anterior PBC of the neck to facilitate direct laryngoscopy and orotracheal intubation (OTI). Material and methods. A prospective study of patients with severe anterior PBC of the neck was carried out from January 2003 to December 2007 in the Burns Unit of Mosul Teaching Hospital in Mosul, Iraq. The patients were given ketamine, after which a release incision was made over the anterior PBC of the neck scar. OTI was then performed successfully. Results. Twelve patients with severe neck PBC (3 males, 9 females; age range, 7-37 yr; mean age, 20 yr) all had successful OTI after PBC release under intravenous ketamine. None showed any complications attributed to the anaesthesia. PMID:21991181

  20. Safety of recombinant human granulocyte-macrophage colony-stimulating factor in healing pediatric severe burns.

    PubMed

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

    2015-01-01

    We explored the safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for healing burns in children. Subjects were randomly assigned to two groups: the experimental group received external rhGM-CSF gel, and the control group received rhGM-CSF gel matrix components, applied to the burn surface. Neither group was given any other drugs that promote wound healing. Each day we recorded the pulse, body temperature, and respiration status in the two groups. We detected the blood routine, urine routine, and hepatic and renal function before the patients received drug treatment and after 72 h. The wound scab and healing states in the two groups were recorded every 4 days to evaluate wound healing rate and time taken for complete healing. Adverse reactions and their rate of occurrence were also recorded. The median time of healing was 15 days in the experimental group and 19 days in the control group (log-rank χ(2) = 5.139, P < 0.05). After 10 days, the experimental group healing rate was consistently higher than that of the control group (significantly different using intuitive analysis), suggesting the experimental group method was more effective. There were no obvious adverse reactions. There was no significant difference between the blood routine, urine routine, and liver and kidney function in the two groups before the treatment and after 3 days (P > 0.05). Compared with saline treatment of severe burns, rhGM-CSF can effectively shorten the healing time without significant adverse reactions, and is an effective and safe treatment for burns in children. PMID:25867422

  1. [A propose to suspend the use of hydroxyethyl starch for fluid resuscitation in shock phase of severe burns].

    PubMed

    Luo, Gao-xing; Peng, Yi-zhi; Wu, Jun

    2013-10-01

    Based on the result of randomized controlled trials and meta-analysis recently, the infusion of hydroxyethyl starch (HES) was not shown to over match routine crystalline solution in exerting resuscitation effect against hypovolemia of patients with burn shock, severe systematic infection, or other critical conditions, on the other hand, it may induce renal toxicity and other toxic and side effects. Since the pathological mechanism underlying hypovolemia during shock phase after burn is similar to that of severe systemic infection, we propose to suspend the use of HES for fluid resuscitation during the shock phase of severe burn until further elucidation. PMID:24359998

  2. 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. PMID:22480679

  3. 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

  4. Heterogeneity in fire severity within early season and late season prescribed burns in a mixed-conifer forest

    USGS Publications Warehouse

    Knapp, E.E.; Keeley, J.E.

    2006-01-01

    Structural heterogeneity in forests of the Sierra Nevada was historically produced through variation in fire regimes and local environmental factors. The amount of heterogeneity that prescription burning can achieve might now be more limited owing to high fuel loads and increased fuel continuity. Topography, woody fuel loading, and vegetative composition were quantified in plots within replicated early and late season burn units. Two indices of fire severity were evaluated in the same plots after the burns. Scorch height ranged from 2.8 to 25.4 m in early season plots and 3.1 to 38.5 m in late season plots, whereas percentage of ground surface burned ranged from 24 to 96% in early season plots and from 47 to 100% in late season plots. Scorch height was greatest in areas with steeper slopes, higher basal area of live trees, high percentage of basal area composed of pine, and more small woody fuel. Percentage of area burned was greatest in areas with less bare ground and rock cover (more fuel continuity), steeper slopes, and units burned in the fall (lower fuel moisture). Thus topographic and biotic factors still contribute to the abundant heterogeneity in fire severity with prescribed burning, even under the current high fuel loading conditions. Burning areas with high fuel loads in early season when fuels are moister may lead to patterns of heterogeneity in fire effects that more closely approximate the expected patchiness of historical fires.

  5. 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...

  6. Central American biomass burning smoke can increase tornado severity in the U.S.

    NASA Astrophysics Data System (ADS)

    Saide, P. E.; Spak, S. N.; Pierce, R. B.; Otkin, J. A.; Schaack, T. K.; Heidinger, A. K.; Silva, A. M.; Kacenelenbogen, M.; Redemann, J.; Carmichael, G. R.

    2015-02-01

    Tornadoes in the Southeast and central U.S. are episodically accompanied by smoke from biomass burning in central America. Analysis of the 27 April 2011 historical tornado outbreak shows that adding smoke to an environment already conducive to severe thunderstorm development can increase the likelihood of significant tornado occurrence. Numerical experiments indicate that the presence of smoke during this event leads to optical thickening of shallow clouds while soot within the smoke enhances the capping inversion through radiation absorption. The smoke effects are consistent with measurements of clouds and radiation before and during the outbreak. These effects result in lower cloud bases and stronger low-level wind shear in the warm sector of the extratropical cyclone generating the outbreak, two indicators of higher probability of tornadogenesis and tornado intensity and longevity. These mechanisms may contribute to tornado modulation by aerosols, highlighting the need to consider aerosol feedbacks in numerical severe weather forecasting.

  7. 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.

  8. Clinical Impact of Sample Interference on Intensive Insulin Therapy in Severely Burned Patients: A Pilot Study

    PubMed Central

    Tran, Nam K.; Godwin, Zachary R.; Bockhold, Jennifer C.; Passerini, Anthony G.; Cheng, Julian; Ingemason, Morgan

    2013-01-01

    Objective Severely burned patients benefit from intensive insulin therapy (IIT) for tight glycemic control (TGC). We evaluated the clinical impact of automatic correction of hematocrit and ascorbic acid interference for bedside glucose monitoring performance in critically ill burn patients. Methods The performance of two point-of-care glucose monitoring systems (GMS): (a) GMS1, an autocorrecting device, and (b) GMS2, a non-correcting device were compared. Sixty remnant arterial blood samples were collected in a prospective observational study to evaluate hematocrit and ascorbic acid effects on GMS1 vs. GMS2 accuracy paired against a plasma glucose reference. Next we enrolled 12 patients in a pilot randomized controlled trial (RCT). Patients were randomized 1:1 to receive IIT targeting a TGC interval of 111–151 mg/dL and guided by either GMS1 or GMS2. GMS bias, mean insulin rate, and glycemic variability were calculated. Results In the prospective study, GMS1 results were similar to plasma glucose results (mean bias: −0.75[4.0] mg/dL, n=60, P=0.214). GMS2 results significantly differed from paired plasma glucose results (mean bias: −5.66[18.7] mg/dL, n=60, P=0.048). Ascorbic acid therapy elicited significant GMS2 performance bias (29.2[27.2], P<0.001). RCT results reported lower mean bias (P<0.001), glycemic variability (P<0.05), mean insulin rate (P<0.001), and frequency of hypoglycemia (P<0.001) in the GMS1 group than the GMS2 group. Conclusions Anemia and high dose ascorbic acid therapy negatively impact GMS accuracy and TGC in burn patients. Automatic correction of confounding factors improves glycemic control. Further studies are warranted to determine outcomes associated with accurate glucose monitoring during IIT. PMID:23884048

  9. 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

  10. Late outcomes after grafting of the severely burned face: a quality improvement initiative.

    PubMed

    Philp, Lauren; Umraw, Nisha; Cartotto, Robert

    2012-01-01

    Many approaches to surgical management of the severely burned face are described, but there are few objective outcome studies. The purpose of this study was to perform a detailed evaluation of the late outcomes in adult patients who have undergone grafting using a standardized surgical and rehabilitation approach for full-thickness (FT) facial burns to identify areas for improvement in the treatment strategy of authors. This was a prospective observational study in which patients who had undergone grafting for FT facial burns by the senior investigator at a regional burn centre between 1999 and 2010 were examined by a single evaluator. The surgical approach included tangential excision based on the facial aesthetic units, temporary cover with allograft then autografting with scalp skin preferentially, split grafts for the upper eyelid, and FT grafts for the lower eyelid. Rehabilitation included compression (uvex and or soft cloth), scar massage, and silicone gel sheeting. Of 35 patients with facial grafts, 14 subjects (age 43 ± 16 years with 22 ± 21% TBSA burns) returned for late follow-up at 40 ± 33 months (range, 5-91 months). A mean of four facial aesthetic units per patient were grafted (range, 1-9 units), with six full facial grafts performed. Scalp was used as donor in 10 of 14 cases. Scalp donor sites were well tolerated with minor alopecia visible in only one case although the donor site visibly extended slightly past the hairline in two cases. Color match with native skin was rated at 8.8 ± 0.8 of 10 when scalp skin was used compared with 7.5 ± 1.6 with other donor sites (P = .06). On the lip and chin, hypertrophic scars were significantly worse compared with the rest of the facial grafts (Vancouver scar scale 8 ± 2 vs 3 ± 1, P < .01). Sensory recovery was poor with overall moving two-point discrimination at 11 ± 3 mm (range, 4-15 mm), and monofilament light touch was 3.8 ± 0.6. Graft borders were significantly more elevated than graft seams. On

  11. 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

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

    PubMed

    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

  13. Stimulation of muscle protein synthesis by long-term insulin infusion in severely burned patients.

    PubMed Central

    Sakurai, Y; Aarsland, A; Herndon, D N; Chinkes, D L; Pierre, E; Nguyen, T T; Patterson, B W; Wolfe, R R

    1995-01-01

    OBJECTIVE: To determine if long-term (7 days) infusion of insulin can ameliorate altered protein kinetics in skeletal muscle of severely burned patients and to investigate the hypothesis that changes in protein kinetics during insulin infusion are associated with an increased rate of transmembrane amino acid transport from plasma into the intracellular free amino acid pool. SUMMARY BACKGROUND DATA: In critically ill patients, vigorous nutritional support alone may often fail to entirely curtail muscle catabolism; insulin stimulates muscle protein synthesis in normal volunteers. METHODS: Nine patients with severe burns were studied once during enteral feeding alone (control period), and once after 7 days of high-dose insulin. The order of treatment with insulin was randomized. Data were derived from a model based on a primed-continuous infusion of L-[15N]phenylalanine, sampling of blood from the femoral artery and vein, and biopsies of the vastus lateralis muscle. RESULTS: Net leg muscle protein balance was significantly (p < 0.05) negative during the control period. Exogenous insulin eliminated this negative balance by stimulating protein synthesis approximately 350% (p < 0.01). This was made possible in part by a sixfold increase in the inward transport of amino acids from blood (p < 0.01). There was also a significant increase in leg muscle protein breakdown. The new rates of synthesis, breakdown, and inward transport during insulin were in balance, such that there was no difference in the intracellular phenylalanine concentration from the control period. The fractional synthetic rate of protein in the wound was also stimulated by insulin by approximately 50%, but the response was variable and did not reach significance. CONCLUSIONS: Exogenous insulin may be useful in promoting muscle protein synthesis in severely catabolic patients. PMID:7677459

  14. 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

  15. Intensive insulin therapy improves insulin sensitivity and mitochondrial function in severely burned children

    PubMed Central

    Fram, Ricki Y.; Cree, Melanie G.; Wolfe, Robert R.; Mlcak, Ronald P.; Qian, Ting; Chinkes, David L.; Herndon, David N.

    2013-01-01

    /min for state 4, p < .002), whereas conventional insulin therapy remained at the same level of activity (0.9 ± 0.1 to 0.8 ± 0.1.μm O2/CS/mg protein/min for state 3, p = .4; 0.6 ± 0.03 to 0.7 ± 0.1 μm O2/CS/mg protein/min, p = .6). Conclusion Controlling blood glucose levels ≤120 mg/dL using an intensive insulin therapy protocol improves insulin sensitivity and mitochondrial oxidative capacity while decreasing resting energy expenditure in severely burned children. PMID:20400899

  16. Multidecadal trends in burn severity and patch size in the Selway-Bitterroot Wilderness Area, 1900-2007

    NASA Astrophysics Data System (ADS)

    Wells, A.; Morgan, P.; Smith, A. M.; Hudak, A. T.; Hicke, J. A.

    2013-12-01

    How the proportion of area burned severely has changed over time is critical to understanding trends in the ecological effects of fire, but most assessments over large areas are limited to 30 years of satellite data. Little is known about multidecadal trends in burn severity, patch size, and implications for species diversity. Our objective was to analyze the change in proportion of area burned severely and patch size across 346,304 ha in the Selway-Bitterroot Wilderness Area in Idaho and Montana, USA. We used 30-meter fire perimeters and burn severity classes inferred from 1984-2007 satellite imagery from the Monitoring Trends in Burn Severity project and 1900-2000 aerial photography. We also analyzed the effect of patch size on species diversity of understory vegetation from field data collected from 20 sites burned in 2000, a year of widespread fires in the region. Fires occurred in 38 out of the 107 years in the record; 13 of these in the early period (1900-1934), 4 in the middle (1935-1974), and 21 in the late (1975-2007). Although 78% (270,918 ha) burned at least once and 48% (131,198) of the area burned severely with >70% tree mortality, there was no trend in total area burned severely through time (n=38, Spearman's Rank Correlation r = -0.14, p = 0.39), nor in proportion of area burned severely through time (n=38, Spearman's Rank Correlation r = -00.27, p = 0.09). Median patch size decreased through time (n= 38, Spearman's Rank Correlation r = -0.73 and p<0.01) and the number of high severity patches increased (n = 38, Spearman's Rank Correlation r = 0.35 and p = 0.02). Median perimeter-to-area ratio of high severity patches increased (n = 38, Spearman's Rank Sum Test r = 0.79 and p <.01); the greater perimeter-to-area ratio and shorter distance to the unburned edge through time is not an artifact of satellite data as patch size inferred from aerial photography 1900-2000 decreased (n= 31, Spearman's Rank, r = -0.42 and p <0.01), but did not for satellite

  17. TIMP-1, MMP-2, MMP-9, and PIIINP as serum markers for skin fibrosis in patients following severe burn trauma.

    PubMed

    Ulrich, Dietmar; Noah, Ernst-Magnus; von Heimburg, Dennis; Pallua, Norbert

    2003-04-01

    The wound-healing process of patients with severe burns often leads to the formation of extensive fibrotic scars. In this study, serum concentrations of tissue inhibitors of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and amino-terminal propeptide of procollagen type III (PIIINP) were measured by enzyme-linked immunosorbent assay as markers for excessive cicatrization in 22 patients with acute burn injuries. All patients were followed up for 6 months to determine a fibrotic reaction during the wound-healing process after operative treatment using the Burn Scar Index. Blood samples were drawn immediately before the operation; at postoperative days 1, 3, 7, and 14; and 1, 3, and 6 months after the operation. Twenty patients who underwent elective plastic surgical operations served as the control group. There was a significant increase (p < 0.05) of TIMP-1 in the burned patients by the third postoperative day. Later in the follow-up period, the serum concentrations remained at a significantly elevated level (p < 0.05) compared with preoperative values. In comparison with the control group, the postoperative serum concentrations of TIMP-1 of the burned patients were significantly higher (p < 0.05) at any time and correlated with the total body surface area burned at the third and seventh postoperative days (p < 0.05; r2 = 0.46 versus r2 = 0.53) and the Burn Scar Index after 6 months (p < 0.05; r2 = 0.65). Serum levels of MMP-2 and MMP-9 showed a significant elevation (p < 0.05) only between postoperative days 3 and 14 in patients with burn wounds. PIIINP increased significantly (p < 0.05) in the sera of the burned patients at postoperative day 3 and remained significantly elevated up to 6 months after injury. At any time after trauma, PIIINP serum levels were significantly higher (p < 0.05) in the burned patients than in the control group and correlated with the total body surface area burned at postoperative

  18. Role of Central American biomass burning smoke in increasing tornado severity in the US

    NASA Astrophysics Data System (ADS)

    Saide, P. E.; Spak, S.; Pierce, R.; Otkin, J.; Rabin, R.; Schaack, T.; Heidinger, A. K.; da Silva, A.; Kacenelenbogen, M. S.; Redemann, J.; Carmichael, G. R.

    2013-12-01

    Violent tornadoes in the Southeast and Central US during spring are often accompanied by smoke from biomass burning in Central America. We analyzed the effect of smoke on a historic severe weather outbreak that occurred 27 April 2011 using a coupled aerosol, chemistry and weather model (WRF-Chem) and a suite of satellite and ground-based observations. Smoke from Central American biomass burning was present in the boundary layer and lower free troposphere before and during the storm outbreak. Simulations show that adding smoke to the environment already conducive to severe thunderstorm development increases the likelihood of significant tornado occurrence, which is assessed by analyzing effects of smoke on meteorological conditions (tornado parameters) used by prediction centers to forecast tornado occurrence and severity. Smoke effects generate slightly lower rain rates and cloud top heights, indicating no evidence of storm invigoration for these storms and instead pointing towards convection inhibition. Further analysis shows that there are two mechanisms responsible for the parameter intensification: First, through indirect effects, stratiform clouds present during and before the outbreak became optically thicker, which reduced the amount of solar radiation reaching the ground and produced more stable conditions and higher low-level shear in the mixed layer. Second, through semi-direct effects, soot contained in the smoke heated the aerosol layer stabilizing the atmosphere and enhancing cloud cover below the aerosol layer, producing a more stable boundary layer and conditions leading to higher probability of violent tornadoes. The inclusion of aerosol-cloud-radiation interactions in weather forecasts may help improve the predictability of these extreme events, which can improve the timeliness and accuracy of severe weather alerts within future operational forecast systems. Left panel: Back trajectories from the beginning of violent tornado tracks, with circles

  19. Evaluation of burn severity in vivo in a mouse model using spectroscopic optical coherence tomography

    PubMed Central

    Zhao, Yang; Maher, Jason R.; Kim, Jina; Selim, Maria Angelica; Levinson, Howard; Wax, Adam

    2015-01-01

    Clinical management of burn injuries depends upon an accurate assessment of the depth of the wound. Current diagnostic methods rely primarily on subjective visual inspection, which can produce variable results. In this study, spectroscopic optical coherence tomography was used to objectively evaluate burn injuries in vivo in a mouse model. Significant spectral differences were observed and correlated with the depth of the injury as determined by histopathology. The relevance of these results to clinical burn management in human tissues is discussed. PMID:26417505

  20. 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...

  1. Skin graft fixation in severe burns: use of topical negative pressure.

    PubMed

    Kamolz, L P; Lumenta, D B; Parvizi, D; Wiedner, M; Justich, I; Keck, M; Pfurtscheller, K; Schintler, M

    2014-09-30

    Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is invariably linked to the take rate and survival of skin grafts. The application of topical negative pressure (TNP) therapy devices has demonstrated improved graft take in comparison to conventional dressing methods alone. The aim of this study was to analyze the impact of TNP therapy on skin graft fixation in large burns. In all patients, we applied TNP dressings covering a %TBSA of >25. The following parameters were recorded and documented using BurnCase 3D: age, gender, %TBSA, burn depth, hospital length-of-stay, Baux score, survival, as well as duration and incidence of TNP dressings. After a burn depth adapted wound debridement, coverage was simultaneously performed using split-thickness skin grafts, which were fixed with staples and covered with fatty gauzes and TNP foam. The TNP foam was again fixed with staples to prevent displacement and finally covered with the supplied transparent adhesive film. A continuous subatmospheric pressure between 75-120 mm Hg was applied (VAC®, KCI, Vienna, Austria). The first dressing change was performed on day 4. Thirty-six out of 37 patients, suffering from full thickness burns, were discharged with complete wound closure; only one patient succumbed to their injuries. The overall skin graft take rate was over 95%. In conclusion, we consider that split thickness skin graft fixation by TNP is an efficient method in major burns, notably in areas with irregular wound surfaces or subject to movement (e.g. joint proximity), and is worth considering for the treatment of aged patients. PMID:26170793

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

    USGS Publications Warehouse

    U.S. Geological Survey

    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.

  3. Evolution of the Emergency Management of Severe Burns (EMSB) course in the UK.

    PubMed

    Stone, C A; Pape, S A

    1999-05-01

    The principle of the 'golden hour' is now well established and forms the basis of a growing number of instructional courses teaching a systematic approach to the management of major trauma. In April 1997, the EMSB course, developed by the Australian and New Zealand Burn Association, was adopted by the British Burn Association to meet the needs of health professionals dealing with major burn injuries in this country. The experience of the first 13 courses following the introduction of EMSB is discussed and the course is recommended as a requirement for the training of UK plastic surgeons and plastic surgery nurses. PMID:10323612

  4. A small single-nozzle rainfall simulator to measure erosion response on different burn severities in southern British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Covert, Ashley; Jordan, Peter

    2010-05-01

    To study the effects of wildfire burn severity on runoff generation and soil erosion from high intensity rainfall, we constructed an effective yet simple rainfall simulator that was inexpensive, portable and easily operated by two people on steep, forested slopes in southern British Columbia, Canada. The entire apparatus, including simulator, pumps, hoses, collapsible water bladders and sample bottles, was designed to fit into a single full-sized pick-up truck. The three-legged simulator extended to approximately 3.3 metres above ground on steep slopes and used a single Spraying Systems 1/2HH-30WSQ nozzle which can easily be interchanged for other sized nozzles. Rainfall characteristics were measured using a digital camera which took images of the raindrops against a grid. Median drop size and velocity 5 cm above ground were measured and found to be 3/4 of the size of natural rain drops of that diameter class, and fell 7% faster than terminal velocity. The simulator was used for experiments on runoff and erosion on sites burned in 2007 by two wildfires in southern British Columbia. Simulations were repeated one and two years after the fires. Rainfall was simulated at an average rate of 67 mm hr-1 over a 1 m2 plot for 20 minutes. This rainfall rate is similar to the 100 year return period rainfall intensity for this duration at a nearby weather station. Simulations were conducted on five replicate 1 m2 plots in each experimental unit including high burn severity, moderate burn severity, unburned, and unburned with forest floor removed. During the simulation a sample was collected for 30 seconds every minute, with two additional samples until runoff ceased, resulting in 22 samples per simulation. Runoff, overland flow coefficient, infiltration and sediment yield were compared between treatments. Additional simulations were conducted immediately after a 2009 wildfire to test different mulch treatments. Typical results showed that runoff on plots with high burn

  5. 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

  6. Improved Net Protein Balance, Lean Mass, and Gene Expression Changes With Oxandrolone Treatment in the Severely Burned

    PubMed Central

    Wolf, Steven E.; Thomas, Steven J.; Dasu, Mohan R.; Ferrando, Arny A.; Chinkes, David L.; Wolfe, Robert R.; Herndon, David N.

    2003-01-01

    Objective To determine the effects of the anabolic agent oxandrolone on muscle protein and gene expression in severely burned children. Summary Background Data The authors previously showed that oxandrolone increased net muscle protein synthesis in emaciated burned patients receiving delayed treatment for severe burns. They hypothesized that similar effects would be seen in those treated early after burn. Methods Thirty-two severely burned children were enrolled in a prospective randomized trial. Subjects underwent studies to assess leg protein net balance 5 days after the first excision and grafting procedure. Immediately after these studies, treatment with placebo (n = 18) or 0.1 mg/kg oxandrolone (n = 14) twice a day was started. One week after this, another net balance study was performed in each subject. Body weights and total body potassium counting were used to determine body compositional changes. Muscle biopsies were taken 1 week after treatment in oxandrolone subjects to examine gene expression changes with gene array (12,600 genes). Results Protein net balance did not change in the placebo group, while oxandrolone-treated subjects had a significant improvement. Body weights and fat free mass significantly decreased in the placebo group, while no changes were found in the oxandrolone-treated subjects. Expression changes were seen in 14 genes in the oxandrolone group compared to placebo. Some of these included myosin light chain (+2.7-fold change), tubulin (+2.3), calmodulin (−2.3), and protein phosphatase I inhibitor (−2.8). Conclusions Oxandrolone improves protein net balance and lean mass in the severely burned. These changes are associated with increased gene expression for functional muscle proteins. PMID:12796576

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

    PubMed Central

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

    2014-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As 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 post-burn sepsis, infections, and mortality other outcomes post-burn. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure (MOF), and mortality were recorded. A cut-off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical significance is set at (p<0.05). ROC analysis identified a cut-off level of 234 pg/ml for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cut off 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 (TBSA) 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 to 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. PMID:25514427

  8. 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... financial assistance in the purchase of an automobile or other conveyance and adaptive equipment....

  9. Effects of glycyl-glutamine dipeptide supplementation on myocardial damage and cardiac function in rats after severe burn injury

    PubMed Central

    Zhang, Yong; Yan, Hong; Lv, Shang-Gun; Wang, Lin; Liang, Guang-Ping; Wan, Qian-Xue; Peng, Xi

    2013-01-01

    Glutamine decreases myocardial damage in ischemia/reperfusion injury. However, the cardioprotective effect of glutamine after burn injury remains unclear. Present study was to explore the protective effect of glycyl-glutamine dipeptide on myocardial damage in severe burn rats. Seventy-two Wistar rats were randomly divided into three groups: normal control (C), burned control (B) and glycyl-glutamine dipeptide-treated (GG) groups. B and GG groups were inflicted with 30% total body surface area of full thickness burn. The GG group was given 1.5 g/kg glycyl-glutamine dipeptide per day and the B group was given the same dose of alanine via intraperitoneal injection for 3 days. The serum CK, LDH, AST, and, blood lactic acid levels, as well as the myocardium ATP and GSH contents, were measured. The indices of cardiac contractile function and histopathological change were analyzed at 12, 24, 48, and 72 post-burn hours (PBH). The serum CK, LDH, AST and blood lactic acid levels increased, and the myocardium ATP and GSH content decreased in both burned groups. Compared with B group, the CK, LDH, AST and blood lactic acid levels reduced, myocardium ATP and GSH content increased in GG group. Moreover, the inhibition of cardiac contractile function and myocardial histopathological damage were reduced significantly in GG group. We conclude that myocardial histological structure and function were damaged significantly after burn injury, glycyl-glutamine dipeptide supplementation is beneficial to myocardial preservation by improving cardiocyte energy metabolism, increasing ATP and glutathione synthesis. PMID:23638213

  10. The effect of occlusive dressings on the energy metabolism of severely burned children.

    PubMed

    Caldwell, F T; Bowser, B H; Crabtree, J H

    1981-05-01

    Metabolic studies were performed on 23 burned children. They were studied sequentially until their burn wounds were healed. A metabolic study lasted 20 minutes, during which continuous measurements were made of O2 consumption and CO2 production rates, rectal temperature, average surface temperatures (dressings, skin and wound), body heat content, and rate of body weight loss using a bed scale. These measurements allowed solution of the heat balance equation for each study period. After 24 hours in a constant temperature room kept at 28 C and 40% relative humidity, metabolic studies were initiated when blood was drawn for catecholamine assay, followed by a metabolic analysis, after which dressings were removed and fresh silvadene applied to the wounds. No dressings were applied. Metabolic analyses were repeated after two and four hours of exposure, after which blood for catecholamine analysis was drawn and the study terminated. Without dressings in a thermally neutral environment, burn patients demonstrated an increased rate of heat loss of 27 watts/square meter body surface area (W/M2), compared with the predicted normal. The major portion of this increment is by evaporation, which increased 300%. The rate of heat production equals heat loss, and is increased 50% above the predicted normal. Occlusive dressings result in a 15 W/M2 decrease in the rate of heat loss, about evenly divided between evaporative and dry routes, with a corresponding 15 W/M2 decrease in the rate of heat production. Plasma catecholamine levels of bandaged burn patients are not significantly different from values for healed burn patients, and do not correlate with the rate of heat production. The increased heat production of burn patients is a response to an increased rate of heat loss, not vice versa. The use of occlusive dressings substantially reduces the energy requirements to manageable levels, even in patients with very large burns. PMID:7235763

  11. Cognitive Severity-Specific Neuronal Degenerative Network in Charcoal Burning Suicide-Related Carbon Monoxide Intoxication

    PubMed Central

    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

    2015-01-01

    Abstract 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

  12. 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

  13. 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.

  14. 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

  15. 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

  16. Quantifying the Influence of Hillslope Form, Aspect and Burn Severity on Post-Wildfire Hillslope Erosion Rates

    NASA Astrophysics Data System (ADS)

    Perreault, L. M.; Yager, E. M.; Aalto, R. E.

    2010-12-01

    Wildfires can profoundly affect hillslope erosion rates by altering the physical and chemical attributes of the soil and denuding stabilizing vegetation. Increased hillslope erosion can raise stream channel sediment loads, which can change the channel morphology and impact aquatic habitat structure and downstream dam sedimentation. Current climate change predictions for the intermountain West forecast more frequent and severe droughts, and correspondingly more severe fire events, increasing the potential for post-fire erosion. Despite the widespread impacts of such erosion events, hillslope erosion processes remain poorly understood. Thus, to better understand these processes, we measure hillslope erosion rates in the mountainous terrain of central Idaho following a large, severe 2007 forest fire. Specifically, we use radionuclide (Lead-210, Cesium-137) inventories to quantify hillslope erosion rates in several watersheds with different burn severity (severe, moderate and unburned), on different aspects (north vs. south facing slopes), and on different hillslope forms (concave vs. convex profiles). In mid-latitude areas of high relief, aspect strongly influences the amount of solar radiation received and thus impacts local moisture conditions, vegetation and soil development, all of which can affect soil erosion rates. Hillslope form may influence the dominant erosion process, with convex profiles characterized by diffusive erosion, and concave profiles potentially enabling more overland flow, rill and gully formation. These variables, in addition to burn severity, are therefore likely to affect erosion rates. Our study quantifies the effect of burn severity, hillslope form, and aspect on the rates and processes of post-fire hillslope erosion. In addition, our study offers insight into the relatively novel use of radionuclide inventories to measure post-wildfire erosion rates. An improved quantitative understanding of hillslope erosion processes would enable us to

  17. 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

  18. 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...

  19. 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.

  20. [A pathologic study of adenohypophyseal growth hormone cells in the rabbit after severe burn].

    PubMed

    Wu, J

    1989-06-01

    The growth hormone(GH), produced by the growth hormone cell in pars distalis of the adenohypophysis, acts on the sugar, protein and fat metabolism in various degrees. After trauma, the GH has relations with the energy supply, the maintenance of nitrogen balance, the tissue repair and the body resistance. However, pathological study on the GH cell after burn injury is rare in the literature so far. The purpose of the present investigation is to take a dynamic observation on the ultrastructural changes of the rabbit GH cell after napalm burn within one week. 46 male rabbits were used and divided into two groups, napalm burn group (N = 36) and control group (N = 10). The former is inflicted with 3rd degree burn covering 30% TBSA. The animals of former group were sacrificed at 3, 6, 12, 24, 48, 72, 96, 120, 168 hours postburn respectively. Using the light and electron microscopy and stereological method, the results revealed that: (1) the synthesis activity in GH cell was enhanced, the process of secretion was rapid, and the rate of granule maturation was increased; (2) the nude GH granules were found both in the sinusoids and the endothelial cells; (3) the newly formed mitochondria may be originated from the Golgi complex, and the newly formed Golgi complex from the reutilization of the plasma membrane components; (4) some endothelial cells manifested degeneration, and the others showed in active condition; (5) under the light microscopy, the distribution of the lower tint-phil GH cells had its regional-characteristics. PMID:2509038

  1. Effects of topical 10% ascorbate solution on established corneal ulcers after severe alkali burns.

    PubMed

    Pfister, R R; Paterson, C A; Hayes, S A

    1982-03-01

    When established corneal ulcers induced by alkali burning were treated with 10% ascorbate drops, no perforation occurred, in contrast to a 25% incidence in the control group. If perforations and descemetoceles were grouped together, these difference became insignificant (i.e., 14.2% ascorbate-treated vs. 25% control). Prolongation of descemetocele presence without perforation in the ascorbate-treated group indicated some therapeutic effect. We conclude that topical ascorbate does not substantially alter the outcome of established corneal ulcers. PMID:7061209

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

    PubMed Central

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

    2014-01-01

    Summary 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

  3. Association of Postburn Fatty Acids and Triglycerides with Clinical Outcome in Severely Burned Children

    PubMed Central

    Kraft, Robert; Herndon, David N.; Finnerty, Celeste C.; Hiyama, Yaeko

    2013-01-01

    Context: Free fatty acids (FFAs) and triglycerides (TGs) are altered postburn, but whether these alterations are associated with postburn outcomes is not clear. Objective: The aim of the present study was to analyze lipid metabolic profiles in pediatric burn patients and to correlate these profiles with patient outcomes and hospital courses. Design and Setting: We conducted a prospective cohort study at an academic pediatric hospital burn center. Patients: Our study included 219 pediatric burn patients. Main Outcome Measures: Patients were stratified according to their plasma TG and FFA levels. Main patient outcomes, such as postburn morbidity and mortality, and clinical metabolic markers were analyzed. Results: All groups were similar in demographics and injury characteristics. Patients with elevated TGs had significantly worse clinical outcomes associated with increased acute-phase protein synthesis indicating augmented inflammation and hypermetabolism, whereas increased FFAs did not seem to profoundly alter postburn outcomes. Conclusions: Elevated TGs, but not FFAs, postburn are associated with worsened organ function and clinical outcomes. PMID:23150682

  4. 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

  5. The Effect of Burn Severity on Short-Term Post-Fire Boreal Vegetation Recovery in Interior Alaska

    NASA Astrophysics Data System (ADS)

    Oyler, J. W.; Smithwick, E.; Mack, M. C.

    2008-12-01

    Fire is the dominant disturbance in the interior boreal region of Alaska and is predicted to increase with climate warming. This variation in the boreal fire regime could play a critical role in climate feedbacks by altering forest productivity and succession and, consequently, biogeochemical cycling, carbon sequestration, and surface energy fluxes. Due to limited fine-scale studies, however, it is not known how increased burn severity (i.e.-amount of organic material consumed) alters post-fire recovery of vegetation productivity, nor how the relationship between severity and post-fire recovery varies across heterogeneous landscapes. In examining fires from the 2004 Alaska fire season (n=72), the objective of this research was to determine how between and within fire variation in burn severity and related variables (pre-fire vegetation, elevation, insolation, etc.) mediates short-term post-fire recovery at the regional scale (i.e.-interior Alaska) and at the landscape scale (i.e.-a single fire complex).The Normalized Burn Ratio was used to measure burn severity and MODIS NDVI was used as a proxy for vegetation recovery. For the between fire analysis, remotely sensed data was overlaid on the fire perimeters in a GIS to create a multivariate dataset with variables aggregated by fire. The dependent variables for each fire were percent NDVI growing season change from 2003 to 2005 (i.e.-productivity drop) and from 2005 to 2007 (i.e.-productivity recovery), while the independent variables included mean dNBR, elevation, and insolation, and percentages of pre-fire land cover types. This dataset was explored in a geovisualization application (GeoViz Toolkit) to help interpret a more detailed adjusted R-square multivariate regression.The top 3 models (R-square ~ 0.60) for the productivity drop per fire showed that fires in higher elevations and containing higher percentages of pre-fire conifer forest were correlated with larger drops in NDVI. In contrast, the models for

  6. 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

  7. 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

  8. A pregnant patient with fetal distress with severe post burn contracture of anterior trunk and perineum: A surgeon's nightmare!

    PubMed Central

    Vathulya, Madhubari; Joshi, Meenakshi

    2014-01-01

    Introduction: A case report of a pregnant lady in the third trimester, presenting in the emergency with absent fetal movements is being described. A multi-speciality expertise was involved and a full term female baby was delivered. Presentation: The patient presented in a Government hospital, Dehradun, India. At the time of presentation the fetal heart sounds were absent and subsequently the severe post-burn deformity involving the anterior trunk, perineum and thighs were discovered. Management: Immediately a multi-speciality approach involving the plastic, obstetrics and pediatrics field were called for and an emergency caesarean with simultaneous contracture release with split skin grafts were performed after optimizing the patient for surgery. Conclusion: This is one of the first case reports reporting this rare combination of post burn contracture of trunk and perineum with fetal distress requiring emergency caesarean section along with release of abdominal and perineal post-burn contracture. This case interestingly reinforces that in such complicated cases a systematic and a combined multi-speciality approach still holds the key to patient's treatment even in district hospitals. PMID:25593442

  9. Combining Ketamine and Virtual Reality Pain Control During Severe Burn Wound Care: One Military and One Civilian Patient

    PubMed Central

    Maani, Christopher V.; Hoffman, Hunter G.; Fowler, Marcie; Maiers, Alan J.; Gaylord, Kathryn M.; DeSocio, Peter A.

    2015-01-01

    Background US soldiers injured in Iraq, and civilian burn trauma patients are treated at the US Army Institute of Surgical Research. Burn patients experience extrem pain during wound care, and they typically receive opioid analgesics and anxiolytics for debridement. Virtual Reality (VR) has been applied as an adjunct to opioid analgesics for procedural pain. We describe the first use of ketamine combined with immersive VR to reduce excessive pain during wound care. Case Report A 21-year-old male US Army soldier stationed in Iraq, and a 41-year-old civilian male sustained a 13% and 50% total body surface area (TBSA) burn, respectively. Each patient received 40 mg ketamine intraveneous (IV) for wound care. Using a within-subject design, nurses conducted half of a painful segment of wound care treatments with no VR and the other half with immersive VR. Graphic pain rating scores for each of the two treatment conditions served as the dependent variables. Results Compared to ketamine + no VR, both patients reported less pain during ketamine + VR for all three pain ratings. Both patients rated wound care during no VR as “no fun at all”, but those same patients rated wound care during virtual reality as either “pretty fun” or “extremely fun”, and rated nausea as either “mild” or “none”. Conclusions Results from these first two cases suggest that a moderate dose of ketamine combined with immersive virtual reality distraction may be an effective multimodal analgesic regimen for reducing acute procedural pain during severe burn wound cleanings. PMID:21481162

  10. [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

  11. 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

  12. The Abbreviated Injury Scale: application to autopsy data.

    PubMed

    Adams, V I; Carrubba, C

    1998-09-01

    Twenty autopsy reports, comprising 1 fall, 1 cutting, 1 burn, 1 drowning, 1 strangulation, 3 gunshot wound, and 13 traffic fatalities, were scored by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS). The codes were adequate for wounds of skin and long bones, and for most wounds of viscera. The autopsy descriptions were more detailed than the coding criteria for craniocerebral, cervicovertebral and muscular trauma, and less detailed for thoracoabdominal visceral, and long bone trauma. Lung contusions and rib fractures received scores that seemed unduly high, possibly reflecting the greater sensitivity of autopsy diagnosis over clinical diagnosis for these lesions. Complete hinge fractures of the skull base scored 4 (severe), which does not reflect the almost universally lethal nature of the accompanying cerebral concussion, which was itself not codeable. AIS scores were low and did not seem to reflect the lethal outcome when the lethal mechanism was purely physiologic and without a striking morphologic derangement, as in instances of cerebral or cardiac concussion, compression of the neck, occlusive airway hemorrhage, and visceral herniation into an adjacent body cavity. The scores were similarly low when therapy was delayed or adverse. Low AIS and ISS scores in a fatality from blunt or penetrating trauma may be useful retrospective clues to the presence of purely physiologic death mechanisms or therapeutic problems. PMID:9760090

  13. [Anesthesia and intensive care management of severely burned children of Jehovah's Witnesses].

    PubMed

    Donner, B; Tryba, M; Kurz-Müller, K; Vogt, P; Steinau, U; Zenz, M; Pern, U

    1996-02-01

    A 3.5-year-old girl suffered from a thermal injury affecting 37% of the body surface area. The parents, being Jehovah's witnesses, refused permission for their child to receive blood transfusions. As the haemoglobin level was only 7.5% and a necrectomy was planned, the patient was likely to need blood transfusions. Indications for transfusion were defined as clinical signs of hypoxia and/or cardiovascular instability. A judicial declaration was proposed. Hb decreased during the therapy. To stimulate the erythropoiesis erythropoietin and iron were administered. During the clinical course the anaemia worsened. First, a conservative treatment with polyvidoniodine ointment for tanning was started, to avoid an operation during the acute phase after the injury, as in this case it was thought a blood transfusion would definitely be necessary. On the 19th day after the injury a necrectomy of 10% of the body surface was necessary because of fever and leucocytosis not responding to antibiotics. The most likely cause of the symptoms was an infection of the burned area. Hb was 4.6 g/dl%. General anaesthesia was performed with midazolam, ketamine and vecuronium and mechanical ventilation. No blood transfusion was required during the operation. Vital signs were stable during the preoperative period, during anaesthesia and following the operation. There were no signs of tissue hypoxia. Peripheral oxygen saturation ranged between 98% and 100%, lactate and arterial blood gas samples were normal, and the child was awake and cooperative before and after anaesthesia. The lowest Hb was 3.3 g/dl on the 22th day after injury (3rd postoperative day). In this phase the patient was still playing and riding a tricycle. On the 45th day after injury the child was discharged home with Hb of 10.9 g/dl and reticulocytosis of 33%. PMID:8720890

  14. 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.

  15. Impact of anesthesia, analgesia, and euthanasia technique on the inflammatory cytokine profile in a rodent model of severe burn injury.

    PubMed

    Al-Mousawi, Ahmed M; Kulp, Gabriela A; Branski, Ludwik K; Kraft, Robert; Mecott, Gabriel A; Williams, Felicia N; Herndon, David N; Jeschke, Marc G

    2010-09-01

    Anesthetics used in burn and trauma animal models may be influencing results by modulating inflammatory and acute-phase responses. Accordingly, we determined the effects of various anesthetics, analgesia, and euthanasia techniques in a rodent burn model. Isoflurane (ISO), ketamine-xylazine (KX), or pentobarbital (PEN) with or without buprenorphine were administered before scald-burn in 72 rats that were euthanized without anesthesia by decapitation after 24 h and compared with unburned shams. In a second experiment, 120 rats underwent the same scald-burn injury using KX, and 24 h later were euthanized under anesthesia or carbon dioxide (CO2). In addition, we compared euthanasia by exsanguination with that of decapitation. Serum cytokine levels were determined by an enzyme-linked immunosorbent assay. In the first experiment, ISO was associated with elevation of cytokine-induced neutrophil chemoattractant 2 (CINC-2) and monocyte chemotactic protein 1 (MCP-1), and KX and PEN was associated with elevation of CINC-1,CINC-2, IL-6, and MCP-1. Pentobarbital also decreased IL-1". IL-6 increased significantly when ISO or PEN were combined with buprenorphine. In the second experiment, euthanasia performed by exsanguination under ISO was associated with reduced levels of IL-1", CINC-1, CINC-2, and MCP-1, whereas KX reduced CINC-2 and increased IL-6 levels. Meanwhile, PEN reduced levels of IL-1" and MCP-1, and CO2 reduced CINC-2 and MCP-1. In addition,decapitation after KX, PEN, or CO2 decreased IL-1" and MCP-1, although we found no significant difference between ISO and controls. Euthanasia by exsanguination compared with decapitation using the same agent also led to modulation of several cytokines. Differential expression of inflammatory markers with the use of anesthetics and analgesics should be considered when designing animal studies and interpreting results because these seem to have a significant modulating impact. Our findings indicate that brief anesthesia with ISO

  16. Soil water repellency within a burned pinon-juniper woodland: spatial distribution, severity, and ecohydrologic implications

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Post-fire recovery of juniper-dominated ecosystems is dependent on the extent that ecological processes have been altered. Soil water repellency is a common condition in these ecosystems that may limit site recovery. In this study we examined the extent, severity, and ecohydrologic implications of p...

  17. Interactive effects of burn severity and canopy cover on ecophysiology of tree seedlings in boreal forests

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Wildfires are an important disturbance because they improve habitat conditions for establishing plants. Fires of differing severity can have dramatically different impacts on habitat, particularly when coupled with canopy-level disturbances. In a boreal forest, we outplanted seedlings of four specie...

  18. 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.

  19. 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.

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

    PubMed Central

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

    2011-01-01

    Summary 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 aim of the current study was 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. PARP 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 post-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. PMID:21368715

  1. 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 §...

  2. 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...

  3. 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 §...

  4. 40 CFR 86.000-3 - 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 § 86.000-3 Abbreviations. The abbreviations in §...

  5. 40 CFR 86.094-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-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...

  6. 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

  7. Restoration of the shape, location and skin of the severe burn-damaged breast.

    PubMed

    Grishkevich, Viktor M

    2009-11-01

    Thermal injuries to the anterior chest in pre-pubescent girls result in breast contracture. During puberty, the breast parenchyma develops and grows underneath the scars, resulting in being flattened and disfigured. The breast mound, as well as the nipple-areolar complex, is partially or completely levelled out and displaced. The contours are unclear and the inframammary fold is effaced. This feature of the most severe breast contracture still poses a challenge for most surgeons. This type of breast contracture can be successfully eliminated with the author-suggested, improved free-skin grafting technique. The scars are excised and the shifted area of parenchyma is mobilised symmetrically to the border of the undamaged breast. Then, the shape and positioning of the breast as well as the nipple-areolar complex are reconstructed with the help of circular suturing through the fat layer on two to three breast levels. The suture ends are led beyond the wound area and are affixed with certain tension contralateral to the breast displacement. The suture ends, being in state of tension, are tied into untied knots around bolsters and are retained in place for about 3 months. During this time, the form and the positioning of the breast can be corrected using the traction of the untied sutures; the skin transplants are stabilised, under which the scar tissue is formed. Skin transplant and the scar tissue hold the shape and positioning of the breast and the sutures can be removed at this stage. In this series, 11 patients were operated upon and 13 breasts were reconstructed. Good results were achieved in all cases: the breast's shape and skin was restored and the positioning was corrected. PMID:19409709

  8. 40 CFR 600.003-77 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Abbreviations. (a) The abbreviations used in this subpart have the same meaning as those in 40 CFR part 86, with... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Abbreviations. 600.003-77 Section 600.003-77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY...

  9. Effect of gamma-hydroxybutyrate on keratinocytes proliferation: A preliminary prospective controlled study in severe burn patients

    PubMed Central

    Rousseau, Anne-Françoise; Bargues, Laurent; Bever, Hervé Le; Vest, Philippe; Cavalier, Etienne; Ledoux, Didier; Piérard, Gérald E.; Damas, Pierre

    2014-01-01

    Background: Hypermetabolism and hyposomatotropism related to severe burns lead to impaired wound healing. Growth hormone (GH) boosts wound healing notably following stimulation of the production of insulin-like growth factor-1 (IGF1), a mitogen factor for keratinocytes. Gamma-hydroxybutyrate (GHB) stimulates endogenous GH secretion. Aim: To assess effects of GHB sedation on keratinocytes proliferation (based on immunohistochemical techniques). Design: Monocentric, prospective, controlled trial. Materials and Methods: Patients (aging 18-65 years, burn surface area >30%, expected to be sedated for at least one month) were alternately allocated, at the 5th day following injury, in three groups according to the intravenous GHB dose administered for 21 days: Evening bolus of 50 mg/kg (Group B), continuous infusion at the rate of 10 mg/kg/h (Group C), or absence of GHB (Group P). They all received local standard cares. Immunohistochemistry (Ki67/MIB-1, Ulex europaeus agglutinin-1 and Mac 387 antibodies) was performed at D21 on adjacent unburned skin sample for assessing any keratinocyte activation. Serum IGF1 levels were measured at initiation and completion of the protocol. Statistical Analysis: Categorical variables were compared with Chi-square test. Comparisons of medians were made using Kruskal-Wallis test. Post hoc analyses were performed using Mann-Whitney test with Bonferroni correction for multiple comparisons. A P < 0.05 was considered to be statistically significant. Results: A total of 14 patients completed the study (Group B: n = 5, Group C: n = 5, Group P: n = 4). Continuous administration of GHB was associated with a significant higher Ki67 immunolabeling at D21 (P = 0.049) and with a significant higher increase in the IGF1 concentrations at D21 (P = 0.024). No adverse effects were disclosed. Conclusions: Our preliminary data support a positive effect of GHB on keratinocyte proliferation and are encouraging enough to warrant large prospective studies. PMID

  10. Plasma Proteome Response to Severe Burn Injury Revealed by 18O-Labeled “Universal” Reference-based Quantitative Proteomics

    PubMed Central

    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.

    2010-01-01

    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 ~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. PMID:20698492

  11. 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

  12. 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

  13. Detecting abbreviations in discharge summaries using machine learning methods.

    PubMed

    Wu, Yonghui; Rosenbloom, S Trent; Denny, Joshua C; Miller, Randolph A; Mani, Subramani; Giuse, Dario A; Xu, Hua

    2011-01-01

    Recognition and identification of abbreviations is an important, challenging task in clinical natural language processing (NLP). A comprehensive lexical resource comprised of all common, useful clinical abbreviations would have great applicability. The authors present a corpus-based method to create a lexical resource of clinical abbreviations using machine-learning (ML) methods, and tested its ability to automatically detect abbreviations from hospital discharge summaries. Domain experts manually annotated abbreviations in seventy discharge summaries, which were randomly broken into a training set (40 documents) and a test set (30 documents). We implemented and evaluated several ML algorithms using the training set and a list of pre-defined features. The subsequent evaluation using the test set showed that the Random Forest classifier had the highest F-measure of 94.8% (precision 98.8% and recall of 91.2%). When a voting scheme was used to combine output from various ML classifiers, the system achieved the highest F-measure of 95.7%. PMID:22195219

  14. Detecting Abbreviations in Discharge Summaries using Machine Learning Methods

    PubMed Central

    Wu, Yonghui; Rosenbloom, S. Trent; Denny, Joshua C.; Miller, Randolph A.; Mani, Subramani; Giuse, Dario A.; Xu, Hua

    2011-01-01

    Recognition and identification of abbreviations is an important, challenging task in clinical natural language processing (NLP). A comprehensive lexical resource comprised of all common, useful clinical abbreviations would have great applicability. The authors present a corpus-based method to create a lexical resource of clinical abbreviations using machine-learning (ML) methods, and tested its ability to automatically detect abbreviations from hospital discharge summaries. Domain experts manually annotated abbreviations in seventy discharge summaries, which were randomly broken into a training set (40 documents) and a test set (30 documents). We implemented and evaluated several ML algorithms using the training set and a list of pre-defined features. The subsequent evaluation using the test set showed that the Random Forest classifier had the highest F-measure of 94.8% (precision 98.8% and recall of 91.2%). When a voting scheme was used to combine output from various ML classifiers, the system achieved the highest F-measure of 95.7%. PMID:22195219

  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. Amino acid infusion fails to stimulate skeletal muscle protein synthesis up to one year post injury in children with severe burns

    PubMed Central

    Cotter, Matthew; Diaz, Eva C; Jennings, Kristofer; Herndon, David N; Børsheim, Elisabet

    2013-01-01

    Background Burn injury results in increased skeletal muscle protein turnover, where the magnitude of protein breakdown outweighs synthesis resulting in muscle wasting. The impact of increased amino acid (AA) provision on skeletal muscle fractional synthesis rate (FSR) in severely burned patients during their convalescence after discharge from hospital is not known. Subsequently, the purpose of this study was to determine skeletal muscle FSR in response to AA infusion in severely burned pediatric patients at discharge from hospital, and at six and twelve months post injury. Methods Stable isotope infusion studies were performed in the postprandial state and during intravenous AA infusion. Skeletal muscle biopsies were obtained and isotope enrichment determined in order to calculate skeletal muscle FSR. Patients were studied at discharge from hospital (n=11), and at six (n=15), and twelve months (n=14) post injury. Results The cohorts of patients studied at each time point post injury were not different with regards to age, body mass or burn size. AA infusion failed to stimulate FSR above basal values at discharge from hospital (0.27±0.04 vs. 0.26±0.06 %·hr−1), six months post injury (0.20±0.04 vs. 0.22±0.03 %·hr−1), and twelve months post injury (0.16±0.03 vs. 0.15±0.05 %·hr−1). Daily FSR was numerically lower at six months post burn (5.51±0.79 %·day−1) and significantly (P<0.05) lower at 12 months post burn (3.67±0.65 %·day−1) relative to discharge group (6.32±1.02 %·day−1). Discussion The findings of the current study suggest that the deleterious impact of burn injury on skeletal muscle AA metabolism persists for up to one year post injury. In light of these findings, nutritional and pharmacological strategies aimed at attenuating muscle protein breakdown post burn may be a more efficacious approach to maintaining muscle mass in severely burned patients. PMID:23694875

  17. Predicting severity of pathological scarring due to burn injuries: a clinical decision making tool using Bayesian networks.

    PubMed

    Berchialla, Paola; Gangemi, Ezio Nicola; Foltran, Francesca; Haxhiaj, Arber; Buja, Alessandra; Lazzarato, Fulvio; Stella, Maurizio; Gregori, Dario

    2014-06-01

    It is important for clinicians to understand which are the clinical signs, the patient characteristics and the procedures that are related with the occurrence of hypertrophic burn scars in order to carry out a possible prognostic assessment. Providing clinicians with an easy-to- use tool for predicting the risk of pathological scars. A total of 703 patients with 2440 anatomical burn sites who were admitted to the Department of Plastic and Reconstructive Surgery, Burn Center of the Traumatological Hospital in Torino between January 1994 and May 2006 were included in the analysis. A Bayesian network (BN) model was implemented. The probability of developing a hypertrophic scar was evaluated on a number of scenarios. The error rate of the BN model was assessed internally and it was equal to 24·83%. While classical statistical method as logistic models can infer only which variables are related to the final outcome, the BN approach displays a set of relationships between the final outcome (scar type) and the explanatory covariates (patient's age and gender, burn surface area, full-thickness burn surface area, burn anatomical area and wound-healing time; burn treatment options such as advanced dressings, type of surgical approach, number of surgical procedures, type of skin graft, excision and coverage timing). A web-based interface to handle the BN model was developed on the website www.pubchild.org (burns header). Clinicians who registered at the website could submit their data in order to get from the BN model the predicted probability of observing a pathological scar type. PMID:22958613

  18. 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

  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. Effects of Pre-Fire Fuels Treatments on Post-Fire Burn Severity on the 2007 Fires in the Northern Rocky Mountains, USA

    NASA Astrophysics Data System (ADS)

    Hudak, A. T.; Morgan, P.; Robichaud, P. R.; Lewis, S. A.; Evans, J. S.

    2007-12-01

    Climate change may be contributing to regional warming and drying trends that are increasing the size and severity of wildfires. Regardless if climate is a factor, the escalating costs of fire suppression and post-fire rehabilitation on the many large fires of recent decades have driven a national effort to reduce hazardous fuels across large areas, particularly those in the wildland-urban interface (WUI). Nationally, concern is especially focused on the numerous large wildfires currently burning in the Northern Rocky Mountains with a need for rapid science-based assessment of burn severity, even as fires and fire suppression efforts continue. Our objective is to assess if and how well various fuels reduction treatments applied pre-fire mitigated burn severity measured in the field immediately post-fire. We will obtain data from the incident command teams, including fire weather, daily fire progression maps, and where strategic and tactical fire suppression measures were applied. Location and type of fuels treatment as well as data on local vegetation type, structure, and fuels will be obtained from local management agencies and national databases. We will pair our sampled field plots in treated and burned areas with those not treated and burned in similar stand and topographic conditions across three or more large forest fires. Our analysis is both quantitative and qualitative, and linked with efforts to assess fuel treatment effects on fire behavior and ease of fire suppression. We report specifically on whether various fuels treatments are mitigating fire effects on soil (e.g., char, percent exposed, infiltration rate, water repellency) and vegetation (e.g., scorch, tree mortality, understory abundance, recovery). We discuss which fuels treatments work and which do not work, and the extent to which fire weather and other factors beyond the control of fire managers may determine whether or not fuels treatments are effectively mitigating severe fire effects.

  1. Superthin Abdominal Wall Glove-Like Flap Combined With Vacuum-Assisted Closure Therapy for Soft Tissue Reconstruction in Severely Burned Hands or With Infection.

    PubMed

    Wang, Fei; Liu, Sheng; Qiu, Le; Ma, Ben; Wang, Jian; Wang, Yong-Jie; Peszel, April; Chen, Xu-Lin

    2015-12-01

    Severe burn and infection to hands always involves the deep structures, such as tendons, joints, and bones. These wounds cannot be closed immediately and therefore creates a high risk for complication. We presented 9 cases with deep dermal burns to the dorsal of the hand (6 electrical burns and 3 thermal crush injuries) with wound infections in 2 cases. The vacuum-assisted closure system was used continuously until the flap reconstruction was performed. A random pattern and superthin abdominal wall skin flap-like glove was designed. The flap was transferred to the defected portion of the dorsum of the hand and resected from the abdominal wall about 3 weeks later. The flaps in 8 of the patients treated by this technique survived completely and partial necrosis of the distal flap occurred in 1 patient. The defect resolved after operative treatment and the function of the hands and fingers were successfully salvaged. All patients resulted in having a satisfactory aesthetic outcome with no or minor discomfort at the abdominal donor area. Integration of the vacuum-assisted closure system and the superthin abdominal wall glove-like flap reconstruction appeared to be successful and should be considered in patients with severely burned hands. PMID:26418768

  2. Donor site wound protein synthesis correlates with length of acute hospitalization in severely burned children: a pilot study

    PubMed Central

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Aarsland, Asle; Herndon, David N.

    2014-01-01

    Autografting of burn wounds results in generation of donor site wounds. Here we measured donor site wound protein Fractional Synthesis Rate (FSR) in a burn pediatric population and showed that FSR increases over time postsurgery and correlates with the length of hospital stay (LOS) normalized for total body surface area (TBSA) burn size. 3.9±1.1 days after the grafting surgery patients participated in a metabolic study consisting of continuous infusion of L-[ring-2H5]-phenylalanine and donor site wound punch biopsies. Donor site wound protein FSR was 10.4±7.5 %/day. Wound FSR demonstrated linear correlation with the time postsurgery (p < 0.05). Multiple regression analysis showed that LOS/TBSA correlated with donor site wound protein FSR and time postsurgery (p < 0.001) and the following equation describes the relationship: Estimated LOS/TBSA = (FSR - 12.95 – 1.414 × Postsurgery day)/(−17.8). This equation predicted that FSR corrected for the postsurgery day when the metabolic study was conducted accounted for 67 % of the variability (r2 = 0.673) in the LOS/TBSA. Donor site wound protein FSR correlated to LOS/TBSA of burn patients admitted to the intensive care unit. Measurement of protein deposition in regenerating donor site wound using stable isotope technique provides a quantitative measure of wound healing. PMID:20412556

  3. 21 CFR 1002.12 - Abbreviated reports.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products § 1002.12 Abbreviated reports. Manufacturers...

  4. 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....

  5. 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....

  6. 40 CFR 116.2 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 22 2011-07-01 2011-07-01 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)...

  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 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)...

  9. 48 CFR 1002.70 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Abbreviations. 1002.70 Section 1002.70 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL DEFINITIONS OF WORDS AND TERMS Definitions 1002.70 Abbreviations. BCPOBureau Chief Procurement Officer...

  10. Expansion abdominoplasty for a pregnant woman with severe abdominal wall contracture due to a major burn during childhood: a case report.

    PubMed

    Takeda, Kohsuke; Sowa, Yoshihiro; Numajiri, Toshiaki; Nishino, Kenichi

    2013-06-01

    Normal abdominal expansion that occurs as a result of hormonal actions during pregnancy may be prevented by the presence of excessive scar tissue in individuals who have received severe burns. In these instances, the lack of abdominal expansion may cause maternal pain and put the infant at risk. A 23-year-old pregnant woman presented with severe abdominal wall contracture due to a major burn sustained during childhood. At 20 weeks of pregnancy, expansion abdominoplasty, consisting of zigzag incisions in the fascia to release the contracture and a split-thickness skin graft, was performed. The patient gave birth, via a planned cesarean operation at 36 weeks of pregnancy, to a baby girl in good condition; the postpartum course was uneventful. PMID:23673563

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. Effects of a 12-week rehabilitation program with music & exercise groups on range of motion in young children with severe burns.

    PubMed

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

    2008-01-01

    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 with standard of care (SOC). 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 SOC alone. This is a descriptive study that measured elbow and knee range of motion (ROM) in 24 severely burned children between ages 2 and 6 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 with 9 patients who received SOC. Patients receiving the 12-week program significantly improved ROM in all joints assessed except for one. Patients receiving SOC showed a significant improvement in only one of the joints assessed. 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 SOC alone. PMID:18849852

  17. 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.

  18. Reducing the Indication for Ventilatory Support in the Severely Burned Patient: Results of a New Protocol Approach at a Regional Burn Center.

    PubMed

    Gille, Jochen; Bauer, Nicole; Malcharek, Michael J; Dragu, Adrian; Sablotzki, Armin; Taha, Hischam; Czeslick, Elke

    2016-01-01

    Initial management of the severely injured routinely includes sedation and mechanical ventilatory support. However, nonjudiciously applied mechanical ventilatory support can itself lead to poorer patient outcomes. In an attempt to reduce this iatrogenic risk, a standardized, in-house, five-point protocol providing clinical guidance on the use and duration of ventilation was introduced and analyzed, and the impact on patient outcomes was assessed. In 2007, a protocol for early spontaneous breathing was introduced and established in clinical practice. This protocol included: 1) early extubation (≤6 hours after admission) in the absence of absolute ventilatory indication; 2) avoidance of "routine intubation" in spontaneously breathing patients; 3) early postoperative extubation, including patients requiring multiple surgical interventions; 4) intensive chest and respiratory physiotherapy with routine application of expectorants; and 5) early active mobilization. A retrospective clinical study compared patients (group A) over a 2-year period admitted under the new protocol with a historical patient group (group B). Patients in group A (n = 38) had fewer ventilator days over the time-course of treatment (3 [1; 5.8] vs 18.5 days [0.5; 20.5]; P = .0001) with a lower rate of tracheostomies (15.8 vs 54%; P = .0003). Patients on ventilation at admission in group A had shorter ventilation periods after admission (4.75 [4; 22.25] vs 378 hours [8.5; 681.5]; P = .0003), and 66.7% of these patients were extubated within 6 hours of admission (vs 9.1% in group B). No patients fulfilling the inclusion criteria required re- or emergency intubation. In the first 5 days of treatment, significantly lower Sequential Organ Failure Assessment scores were recorded in group A. There was also a trend for lower mortality rates (0 [0%] vs 6 [14%]), sepsis rates (24 [63.2%] vs 37 [88.1%]), and cumulative fluid balance on days 3 and 7 in group A. In contrast, group A demonstrated an elevated

  19. 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

  20. Effects of a Hospital Based Wellness and Exercise Program on Quality of Life of Children with Severe Burns

    PubMed Central

    Rosenberg, Marta; Celis, Mario M; Meyer, Walter; Tropez-Arceneaux, Lisa; McEntire, Serina J.; Fuchs, Helen; Richardson, Lisa; Holzer, Charles; Herndon, David N.; Suman, Oscar E.

    2012-01-01

    Objective To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥ 40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes. Methods Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28. Results The mean age of children in the W&E group was 14.07y±3.5 and mean TBSA was 58%±11.8. The mean age of children in the SOC group was 13.9y±3.1 and mean TBSA was 49%±7.8. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children’s physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning post-exercise. Conclusions These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes. PMID:22985974

  1. 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....

  2. 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....

  3. 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....

  4. 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

  5. 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

  6. Insulinlike Growth Factor I Plus Insulinlike Growth Factor Binding Protein 3 Attenuates the Proinflammatory Acute Phase Response in Severely Burned Children

    PubMed Central

    Jeschke, Marc G.; Barrow, Robert E.; Herndon, David N.

    2000-01-01

    Objective To determine the effect of insulinlike growth factor I (IGF-I) in combination with its principal binding protein (IGFBP-3) on the hepatic acute phase response in severely burned children. Summary Background Data The hepatic acute phase response is a cascade of events initiated to restore homeostasis after trauma. A prolonged response, however, may contribute to multiple organ failure, hypermetabolism, complications, and death. Methods Twenty-two children with a mean total body surface area (TBSA) burn of 57 ± 3% were given a continuous infusion of 1 to 4 mg/kg/day IGF-I/BP-3 for 5 days after wound excision and grafting. Eight children with a TBSA burn of 54 ± 4% were given saline as controls. Before and 5 days after excision and grafting, blood samples were taken for serum hepatic constitutive protein, acute phase protein, and proinflammatory cytokine analysis. Results Serum IGF-I levels in burned children given the IGF-I/BP-3 complex increased from 113 ± 15 to 458 ± 40 ng/mL and IGFBP-3 levels increased from 1.8 ± 0.2 to 3.1 ± 0.3 ng/mL. Levels of serum constitutive hepatic proteins (prealbumin, retinol-binding protein, and transferrin) increased with IGF-I/BP-3, whereas levels of type I acute phase proteins (C-reactive protein, α1-acid glycoprotein, and complement C-3) decreased when compared with controls. The complex had no effect on type II acute phase proteins. Tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) levels decreased with IGF-I/BP-3 compared with controls, with no effect on interleukin-6. Conclusion Severely burned children receiving IGF-I/BP-3 showed a decrease in IL-1β and TNF-α followed by a decrease in type I acute phase proteins that was associated with a concomitant increase in constitutive hepatic proteins. Attenuating the proinflammatory acute phase with IGF-1/BP-3 response may prevent multiple organ failure and improve clinical outcomes after thermal injury without any detectable adverse side effects. PMID

  7. 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 ...

  8. A protocol of early aggressive acceleration of tube feeding increases ileus without perceptible benefit in severely burned patients.

    PubMed

    Kesey, Jennifer; Dissanaike, Sharmila

    2013-01-01

    Optimal nutrition is essential to the recovery of burned patients. The authors evaluated the efficacy of an aggressive nutrition delivery protocol. The following protocol was implemented: initiation of tube feeds within 4 hours, acceleration to goal rate within 8 hours, and tolerance of gastric residual volumes of 400 ml. Patients on the protocol formed the study group whereas patients admitted immediately before implementation served as controls for a study period of 7 days after admission. Outcome variables included ileus, prokinetic medication use, intensive care unit and overall length of stay, ventilator days and mortality. Variables were compared using bivariate analysis. The 42 study subjects and 34 controls were similar at baseline. Time to initiation was similar (6.8 vs 9.4 hours; P = .226), however, goal rate was achieved much sooner in the study group (11.2 vs 20.9 hours; P < .001). Number of hours spent at goal was different on days 1 and 2 (6.62 vs 2.74, P = .003 and 17.24 vs 13.18, P = .032) with no difference thereafter. Residual volumes in the study group were higher from day 2 onward, and remained increased throughout the study period (401 vs 234 ml average; P = .449). Clinical ileus was much more common in the study group (8 cases vs 1, P = .037). There was no difference in length of stay or mortality. The protocol was successfully implemented and resulted in early achievement of goal tube feed rates. However, this resulted in tube feed intolerance as manifested by more cases of clinical ileus. PMID:23966117

  9. Burning vasculitis.

    PubMed

    Chadha, Priyanka; Hobday, Dorian; Fitzgerald O'Connor, Edmund; D'Cruz, David

    2016-01-01

    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn. PMID:27118745

  10. 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

  11. 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

  12. 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

  13. Biomass Burning

    Atmospheric Science Data Center

    2015-07-27

    Projects:  Biomass Burning Definition/Description:  Biomass Burning: This data set represents the geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ...

  14. [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

  15. Severe burn injury induces a characteristic activation of extracellular signal-regulated kinase 1/2 in spinal dorsal horn neurons.

    PubMed

    White, John P M; Ko, Chin Wing; Fidalgo, Antonio Rei; Cibelli, Mario; Paule, Cleoper C; Anderson, Peter J; Cruz, Celia; Gomba, Szabolcs; Matesz, Klara; Veress, Gabor; Avelino, Antonio; Nagy, Istvan

    2011-08-01

    We have studied scalding-type burn injury-induced activation of extracellular signal-regulated kinase 1/2 (ERK1/2) in the spinal dorsal horn, which is a recognised marker for spinal nociceptive processing. At 5min after severe scalding injury to mouse hind-paw, a substantial number of phosphorylated ERK1/2 (pERK1/2) immunopositive neurons were found in the ipsilateral dorsal horn. At 1h post-injury, the number of pERK1/2-labelled neurons remained substantially the same. However, at 3h post-injury, a further increase in the number of labelled neurons was found on the ipsilateral side, while a remarkable increase in the number of labelled neurons on the contralateral side resulted in there being no significant difference between the extent of the labelling on both sides. By 6h post-injury, the number of labelled neurons was reduced on both sides without there being significant difference between the two sides. A similar pattern of severe scalding injury-induced activation of ERK1/2 in spinal dorsal horn neurons over the same time-course was found in mice which lacked the transient receptor potential type 1 receptor (TRPV1) except that the extent to which ERK1/2 was activated in the ipsilateral dorsal horn at 5 min post-injury was significantly greater in wild-type animals when compared to TRPV1 null animals. This difference in activation of ERK1/2 in spinal dorsal horn neurons was abolished within 1h after injury, demonstrating that TRPV1 is not essential for the maintenance of ongoing spinal nociceptive processing in inflammatory pain conditions in mouse resulting from at least certain types of severe burn injury. PMID:21371920

  16. 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

  17. 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. PMID:12792237

  18. Early postoperative alterations of ventilation parameters after tracheostomy in major burn injuries

    PubMed Central

    Namdar, Thomas; Stollwerck, Peter Leonard; Stang, Felix Hagen; Klotz, Karl-Friedrich; Lange, Thomas; Mailänder, Peter; Siemers, Frank

    2010-01-01

    Purpose: In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS) plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS. Materials: A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered. Results: A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52±19 years. Mean abbreviated burned severity index (ABSI) was 8.3±2.2. A mechanical ventilation was required for 14.3±4.8 days. TS was performed on day 7±4. Inspiratory oxygen concentration (FiO2) (p<0.001), peak inspiratory pressure (p<0.001), positive end-expiratory pressure (p=0.003) and pulmonary resistance (p<0.001) were reduced significantly after TS. The arterial partial pressure of oxygen/FiO2-ratio increased significantly after TS (p<0.001). Conclusions: We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy. PMID:20577645

  19. 21 CFR 1002.12 - Abbreviated reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products §...

  20. 21 CFR 1002.12 - Abbreviated reports.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products §...

  1. 21 CFR 1002.12 - Abbreviated reports.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products §...

  2. 21 CFR 1002.12 - Abbreviated reports.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Abbreviated reports. 1002.12 Section 1002.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS Required Manufacturers' Reports for Listed Electronic Products §...

  3. 40 CFR 86.1203-85 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 20 2013-07-01 2013-07-01 false Abbreviations. 86.1203-85 Section 86.1203-85 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Evaporative...

  4. 40 CFR 86.1203-85 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 20 2012-07-01 2012-07-01 false Abbreviations. 86.1203-85 Section 86.1203-85 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Evaporative...

  5. 40 CFR 86.1203-85 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Abbreviations. 86.1203-85 Section 86.1203-85 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Evaporative...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 40 CFR 600.003 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... energy equivalent of one gallon of gasoline. (c) SCF means standard cubic feet. (d) SUV means sport... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Abbreviations. 600.003 Section 600.003 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY...

  12. 14 CFR 34.2 - Abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 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...

  13. 40 CFR 86.000-3 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Regulations for 1977 and Later Model Year New Light-Duty Vehicles, Light-Duty Trucks and Heavy-Duty Engines, and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas... continue to apply to 1998 and later model year vehicles. The abbreviations in this section apply...

  14. 40 CFR 86.703-94 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Abbreviations. 86.703-94 Section 86.703-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Provisions for In-Use Emission Regulations for 1994...

  15. 40 CFR 86.000-3 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Regulations for 1977 and Later Model Year New Light-Duty Vehicles, Light-Duty Trucks and Heavy-Duty Engines, and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas... continue to apply to 1998 and later model year vehicles. The abbreviations in this section apply...

  16. 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...

  17. 40 CFR 86.090-3 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.090-3 Section 86.090-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES General Provisions for Emission Regulations for 1977 and Later Model Year...

  18. 7 CFR 1945.5 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Abbreviations. 1945.5 Section 1945.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... National Agricultural Statistics Service. (n) OMB—Office of Management and Budget. (o) SBA—Small...

  19. 40 CFR 600.103-78 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 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 and Carbon-Related...

  20. 40 CFR 600.403-77 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Abbreviations. 600.403-77 Section 600.403-77 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...

  1. 16 CFR 500.22 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Abbreviations. 500.22 Section 500.22 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENT OF GENERAL POLICY OR INTERPRETATION AND EXEMPTIONS UNDER THE FAIR PACKAGING AND LABELING ACT REGULATIONS UNDER SECTION 4 OF THE...

  2. 40 CFR 86.403-78 - Abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 19 2012-07-01 2012-07-01 false Abbreviations. 86.403-78 Section 86.403-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Emission Regulations for 1978 and Later New Motorcycles, General Provisions §...

  3. 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...

  4. 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...

  5. 40 CFR 86.403-78 - Abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 18 2011-07-01 2011-07-01 false Abbreviations. 86.403-78 Section 86.403-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Emission Regulations for 1978 and Later New Motorcycles, General Provisions §...

  6. 40 CFR 86.403-78 - Abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Abbreviations. 86.403-78 Section 86.403-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Emission Regulations for 1978 and Later New Motorcycles, General Provisions §...

  7. 40 CFR 86.403-78 - Abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.403-78 Section 86.403-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... volume sampler. EGR—Exhaust gas recirculation. EP—End point. EPA—Environmental Protection Agency....

  8. 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...

  9. Indonesian Basic Course: Abbreviations and Acronyms.

    ERIC Educational Resources Information Center

    Defense Language Inst., Monterey, CA.

    In this unit of the Basic Course in Indonesian for the official use of faculty, staff, and students of the Defense Language Institute, a glossary of Indonesian abbreviations and acronyms, taken from Indonesian newspapers and magazines, is presented. An adequate command of these terms is necessary to comprehend written works in Indonesian. No…

  10. 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...

  11. [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

  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. PMID:23545350

  13. 32 CFR 245.6 - Abbreviations and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Abbreviations and acronyms. 245.6 Section 245.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS PLAN FOR THE EMERGENCY SECURITY CONTROL OF AIR TRAFFIC (ESCAT) Explanation of Terms, Acronyms and Abbreviations § 245.6 Abbreviations...

  14. 40 CFR 96.303 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 96.303 Section 96.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts...

  15. 40 CFR 91.303 - 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. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart....

  16. 40 CFR 1042.905 - 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... Definitions and Other Reference Information § 1042.905 Symbols, acronyms, and abbreviations. The following symbols, acronyms, and abbreviations apply to this part: ABTAveraging, banking, and trading....

  17. 40 CFR 90.303 - Symbols, acronyms, abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in §...

  18. 32 CFR 245.6 - Abbreviations and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Abbreviations and acronyms. 245.6 Section 245.6...) MISCELLANEOUS PLAN FOR THE EMERGENCY SECURITY CONTROL OF AIR TRAFFIC (ESCAT) Explanation of Terms, Acronyms and Abbreviations § 245.6 Abbreviations and acronyms. AADC—Area Air Defense Commander ADE—Air Defense Emergency...

  19. 40 CFR 91.303 - Acronyms and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart....

  20. 40 CFR 90.303 - Symbols, acronyms, abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in §...

  1. 40 CFR 91.303 - Acronyms and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart....

  2. 40 CFR 90.303 - Symbols, acronyms, abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in §...

  3. 32 CFR 245.6 - Abbreviations and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Abbreviations and acronyms. 245.6 Section 245.6...) MISCELLANEOUS PLAN FOR THE EMERGENCY SECURITY CONTROL OF AIR TRAFFIC (ESCAT) Explanation of Terms, Acronyms and Abbreviations § 245.6 Abbreviations and acronyms. AADC—Area Air Defense Commander ADE—Air Defense Emergency...

  4. 40 CFR 90.303 - Symbols, acronyms, abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in §...

  5. 40 CFR 90.303 - Symbols, acronyms, abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in §...

  6. 40 CFR 91.303 - Acronyms and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart....

  7. 32 CFR 245.6 - Abbreviations and acronyms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Abbreviations and acronyms. 245.6 Section 245.6...) MISCELLANEOUS PLAN FOR THE EMERGENCY SECURITY CONTROL OF AIR TRAFFIC (ESCAT) Explanation of Terms, Acronyms and Abbreviations § 245.6 Abbreviations and acronyms. AADC—Area Air Defense Commander ADE—Air Defense Emergency...

  8. 40 CFR 91.303 - Acronyms and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart....

  9. 32 CFR 245.6 - Abbreviations and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Abbreviations and acronyms. 245.6 Section 245.6...) MISCELLANEOUS PLAN FOR THE EMERGENCY SECURITY CONTROL OF AIR TRAFFIC (ESCAT) Explanation of Terms, Acronyms and Abbreviations § 245.6 Abbreviations and acronyms. AADC—Area Air Defense Commander ADE—Air Defense Emergency...

  10. 40 CFR 96.303 - 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. 96.303 Section 96.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts...

  11. 40 CFR 96.303 - 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... IMPLEMENTATION PLANS CAIR NOX Ozone Season Trading Program General Provisions § 96.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts...

  12. 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... IMPLEMENTATION PLANS CAIR NOX Annual Trading Program General Provisions § 96.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II...

  13. 40 CFR 97.303 - 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... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined...

  14. 40 CFR 96.303 - 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 CAIR NOX Ozone Season Trading Program General Provisions § 96.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts...

  15. 40 CFR 96.303 - 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 CAIR NOX Ozone Season Trading Program General Provisions § 96.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts...

  16. 40 CFR 97.303 - 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... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined...

  17. 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... IMPLEMENTATION PLANS CAIR SO 2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III...

  18. 40 CFR 60.4103 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 60.4103 Section 60.4103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR....4103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in...

  19. 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:...

  20. 40 CFR 96.103 - 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 CAIR NOX Annual Trading Program General Provisions § 96.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II...

  1. 40 CFR 96.103 - 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 CAIR NOX Annual Trading Program General Provisions § 96.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II...

  2. 40 CFR 96.3 - 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... 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:...

  3. 40 CFR 97.103 - 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... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined...

  4. 40 CFR 97.103 - 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... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined...

  5. 40 CFR 96.203 - 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 CAIR SO 2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III...

  6. 40 CFR 97.303 - 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... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined...

  7. 40 CFR 96.203 - 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... IMPLEMENTATION PLANS CAIR SO2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III...

  8. 40 CFR 97.103 - 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... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined...

  9. 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:...

  10. 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...

  11. 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...

  12. 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

  13. 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

  14. Tracking sources of severe haze episodes and their physicochemical and hygroscopic properties under Asian continental outflow: Long-range transport pollution, postharvest biomass burning, and Asian dust

    NASA Astrophysics Data System (ADS)

    Jung, Jinsang; Kim, Young J.

    2011-01-01

    Aerosol physicochemical and hygroscopic properties were measured from 12 October to 21 November 2005 at a downwind area of the Asian continental outflow (Gwangju, Korea) to characterize severe haze episodes. Using optically measured elemental carbon (EC) at 660 nm (Opt.EC) and 880 nm (BC) wavelengths and Mie theory, it was estimated that the higher BC/Opt.EC ratio during the cloudy day of the long-range transport (LTP) period was mainly due to EC particle growth from in-cloud processing with secondary aerosols such as sulfate and organic aerosols. Single scattering albedo (SSA) of biomass burning (BB) aerosol increased sharply from 0.89 to 0.94 under a relative humidity >70%, suggesting that organic aerosols emitted from rice straw burning contained high amounts of hydrophilic compounds. The contribution of aerosol water content to the total light extinction coefficient (bext) was determined as 51.4% and 68.4% during the BB and BB + LTP periods, respectively, indicating that the haze episodes were highly enhanced by an increase in aerosol water content. The Asian dust event was characterized by the highest SSA (0.92 ± 0.02), the lowest mass scattering efficiency of fine particles (2.5 ± 1.0 m2 g-1), and the lowest hygroscopic nature (humidity-dependent light scattering enhancement factor, f(80%), which is defined by the ratio of light scattering coefficient at 80% relative humidity to that at dry condition, = ˜1.37). Based on the Ångström exponent (α) values observed at the source region of the Asian continent and the downwind area of South Korea during the BB + LTP period, it was found that the α value of urban aerosols decreased ˜11% for 1-2 days of the transport, probably due to the increase in particle size through water uptake. Increasing rates of surface PM10 mass concentrations at western coastal areas of the South Korean peninsula were in the range 2.4-14.4 μgm-3 h-1 at the beginning of the BB + LTP period (24 October 2005, 0700-2300 LT). Based on

  15. Long-Term Outcomes in Patients Surviving Large Burns: The Musculoskeletal System.

    PubMed

    Holavanahalli, Radha K; Helm, Phala A; Kowalske, Karen J

    2016-01-01

    The authors have previously described long-term outcomes related to the skin in patients surviving large burns. The objective of this study was to describe the long-term musculoskeletal complications following major burn injury. This is a cross-sectional descriptive study that includes a one-time evaluation of 98 burn survivors (mean age = 47 years; mean TBSA = 57%; and mean time from injury = 17 years), who consented to participate in the study. A comprehensive history and physical examination was conducted by a senior and experienced Physical Medicine and Rehabilitation physician. In addition to completing a Medical Problem Checklist, subjects also completed the Burn-Specific Health Scale (Abbreviated 80 item), a self-report measure used to review the level of functional adaptation. Joint pain, joint stiffness, problems walking or running, fatigue, and weak arms and hands are conditions that continue to be reported at an average of 17 years from the time of burn injury. Seventy-three percent (68 of 93) of the study sample were found to have a limitation of motion and areas most affected were the neck (47%), hands (45%), and axilla (38%). The global (Burn-Specific Health Scale-total) score for the overall sample was 0.78. Subjects with limitation of motion had significant difficulty in areas of mobility, self-care, hand function, and role activities. This study underscores the importance of long-term follow-up care and therapeutic interventions for survivors of major burn injury, as they continue to have significant and persistent burn-related impairments even several years following injury. PMID:26056761

  16. Using UMLS Lexical Resources to Disambiguate Abbreviations in Clinical Text

    PubMed Central

    Kim, Youngjun; Hurdle, John; Meystre, Stéphane M.

    2011-01-01

    Clinical text is rich in acronyms and abbreviations, and they are highly ambiguous. As a pre-processing step before subsequent NLP analysis, we are developing and evaluating clinical abbreviation disambiguation methods. The evaluation of two sequential steps, the detection and the disambiguation of abbreviations, is reported here, for various types of clinical notes. For abbreviations detection, our result indicated the SPECIALIST Lexicon LRABR needed to be revised for better abbreviation detection. Our semi-supervised method using generated training data based on expanded form matching for 12 frequent abbreviations in our clinical notes reached over 90% accuracy in five-fold cross validation and unsupervised approach produced comparable results with the semi-supervised methods. PMID:22195128

  17. 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...

  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. 40 CFR 60.3 - Units and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false Units and abbreviations. 60.3 Section 60.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES General Provisions § 60.3 Units and abbreviations....

  3. 7 CFR 718.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Definitions and abbreviations. 718.302 Section 718.302... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.302 Definitions and abbreviations. In addition to the definitions provided in § 718.2 of this part, the following terms apply to this...

  4. 7 CFR 718.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Definitions and abbreviations. 718.302 Section 718.302... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.302 Definitions and abbreviations. In addition to the definitions provided in § 718.2 of this part, the following terms apply to this...

  5. 7 CFR 718.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Definitions and abbreviations. 718.302 Section 718.302... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.302 Definitions and abbreviations. In addition to the definitions provided in § 718.2 of this part, the following terms apply to this...

  6. Sequenced Contractions and Abbreviations for Model 2 Reading.

    ERIC Educational Resources Information Center

    Cronnell, Bruce

    The nature and use of contractions and abbreviations in beginning reading is discussed and applied to the Southwest Regional Laboratory (SWRL) Mod 2 Reading Program, a four-year program (K-3) for teaching reading skills to primary-grade children. The contractions and abbreviations are listed and sequenced for the reading program. The results of…

  7. 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.…

  8. 40 CFR 90.403 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Symbols, acronyms, and abbreviations. 90.403 Section 90.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms...

  9. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu-British thermal unit....

  10. 40 CFR 97.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... acronyms. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are defined as follows:...

  11. 40 CFR 96.103 - 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. 96.103 Section 96.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II...

  12. 40 CFR 97.303 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... acronyms. 97.303 Section 97.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined...

  13. 40 CFR 90.403 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Symbols, acronyms, and abbreviations. 90.403 Section 90.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms...

  14. 40 CFR 97.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... acronyms. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are defined as follows:...

  15. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu-British thermal unit....

  16. 40 CFR 96.103 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 96.103 Section 96.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II...

  17. 40 CFR 97.303 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... acronyms. 97.303 Section 97.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined...

  18. 40 CFR 96.3 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 96.3 Section 96.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows:...

  19. 40 CFR 97.103 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... acronyms. 97.103 Section 97.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined...

  20. 40 CFR 90.403 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols, acronyms, and abbreviations. 90.403 Section 90.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms...

  1. 40 CFR 87.2 - Acronyms and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Acronyms and abbreviations. 87.2 Section 87.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) Definitions. § 87.2 Acronyms and abbreviations. Link to an amendment published at 77 FR 36381, June 18,...

  2. 40 CFR 96.3 - 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. 96.3 Section 96.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows:...

  3. 40 CFR 96.203 - 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. 96.203 Section 96.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III...

  4. 40 CFR 97.703 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... acronyms. 97.703 Section 97.703 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... 2 Trading Program § 97.703 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart are defined as follows: Btu—British thermal unit CO2—carbon...

  5. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Measurements, abbreviations, and acronyms. 96.203 Section 96.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III...

  6. 40 CFR 90.403 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Symbols, acronyms, and abbreviations. 90.403 Section 90.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms...

  7. 40 CFR 90.403 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Symbols, acronyms, and abbreviations. 90.403 Section 90.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms...

  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 Measurements, abbreviations, and acronyms....

  9. 27 CFR 19.612 - Authorized abbreviations to identify marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... to identify marks. 19.612 Section 19.612 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Containers and Marks Marks § 19.612 Authorized abbreviations to identify marks. In addition to the abbreviations and...

  10. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defects General § 21.8010 Definitions and abbreviations. (a) Program-specific definitions and 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

    ... Defects General § 21.8010 Definitions and abbreviations. (a) Program-specific definitions and 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, 2014 CFR

    2014-07-01

    ... Defects General § 21.8010 Definitions and abbreviations. (a) Program-specific definitions and 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. 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...

  14. 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...

  15. 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...

  16. 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 ditto marks prohibited. In disclosing...

  17. 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 ditto marks prohibited. In disclosing...

  18. 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....

  19. 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....

  20. 40 CFR 97.703 - 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. 97.703 Section 97.703 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... 2 Trading Program § 97.703 Measurements, abbreviations, and acronyms. Measurements,...

  1. 40 CFR 97.203 - 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. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms....

  2. 40 CFR 97.203 - 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. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms....

  3. 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....

  4. 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....

  5. 40 CFR 97.703 - 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. 97.703 Section 97.703 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... 2 Trading Program § 97.703 Measurements, abbreviations, and acronyms. Measurements,...

  6. 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…

  7. 40 CFR 92.102 - Definitions and abbreviations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Definitions and abbreviations. 92.102 Section 92.102 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Test Procedures § 92.102 Definitions and abbreviations. The definitions...

  8. 40 CFR 92.102 - Definitions and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Definitions and abbreviations. 92.102 Section 92.102 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Test Procedures § 92.102 Definitions and abbreviations. The definitions...

  9. 48 CFR 3402.101-70 - Abbreviations and acronyms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Abbreviations and acronyms. 3402.101-70 Section 3402.101-70 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions 3402.101-70 Abbreviations...

  10. 7 CFR 4274.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Definitions and abbreviations. 4274.302 Section 4274... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE DIRECT AND INSURED LOANMAKING Intermediary Relending Program (IRP) § 4274.302 Definitions and abbreviations. (a) General definitions. The...

  11. 76 FR 65735 - Draft Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of... entitled ``Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire and.... The draft guidance document recognizes the abbreviated donor history questionnaire and...

  12. 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... appropriate, and other forms of information technology. ] Abbreviated New Animal Drug...

  13. 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

  14. 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.

  15. 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

  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. 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…

  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. 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

  20. Burning rubber

    SciTech Connect

    Not Available

    1987-09-01

    Mario Andretti, look out You are about to be surpassed in the burning rubber category by a joint venture between Oxford Energy Company and General Electric. The two companies are building the first whole tire-to-energy facility in the US in Modesto, California. This $41 million facility does not require tires to be shredded prior to incineration; it has the capacity to burn 700 tires per minute. The electricity generated will be provided to a utility company. Oxford says there are two billion waste tires on the ground and this number is increasing by 220 million a year. Of that amount, only 18 million a year are recycled.

  1. 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…

  2. 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

  3. 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…

  4. 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

  5. [Chemical and electrical burns].

    PubMed

    Sanchez, Raymond

    2002-12-15

    Chemical burns are less frequent in routine practice, but could be very serious owing to the complexity and severity of their actions. Influx of casualty after a civil disaster (industrial explosion) or military (war or terrorism) is possible. The action of these agents could be prolonged and deep. In addition to the skin, respiratory lesions and general intoxication could be observed. The urgent local treatment rely essentially on prolonged washing. Prevention and adequate emergency care could limit the serious consequences of these accidents. Accidents (thermal burns or electrisations) due to high or low voltage electricity are frequent. The severity is linked with the affected skin but especially with internal lesions, muscular, neurological or cardiac lesions. All cases of electrisation need hospital care. Locally, the lesions are often deep with difficult surgical repairs and often require amputation. Aesthetic and functional sequela are therefore frequent. Secondary complications could appear several months after the accident: cataract, dysesthesia and hypotonia. PMID:12621941

  6. 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

  7. 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

  8. 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

  9. Medication safety issue brief. Eliminating dangerous abbreviations, acronyms and symbols.

    PubMed

    2005-06-01

    The use of abbreviations, acronyms and symbols in prescribing and transcribing medication orders too often results in the misinterpretation of the order's intent. Busy health care practitioners often use these shortcuts to indicate drug names, dosages, the patient's condition and route of administration. The result can be omission errors, extra or improper doses, administering the wrong drug, or giving a drug in the wrong manner. Stopping the use of unapproved abbreviations, acronyms and symbols can go a long way toward preventing these errors, but that's proven difficult to accomplish. This briefing examines ways that hospitals can put an end to the practice. PMID:16047621

  10. MSFC Space Station Program Commonly Used Acronyms and Abbreviations Listing

    NASA Technical Reports Server (NTRS)

    Gates, Thomas G.

    1988-01-01

    The Marshall Space Flight Center maintains an active history program to assure that the foundation of the Center's history is captured and preserved for current and future generations. As part of that overall effort, the Center began a project in 1987 to capture historical information and documentation on the Marshall Center's roles regarding Space Shuttle and Space Station. This document is MSFC Space Station Program Commonly Used Acronyms and Abbreviations Listing. It contains acronyms and abbreviations used in Space Station documentation and in the Historian Annotated Bibliography of Space Station Program. The information may be used by the researcher as a reference tool.

  11. Animal models in burn research.

    PubMed

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

    2014-09-01

    Burn injury is a severe form of trauma affecting more than 2 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 to 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 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

  12. 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

  13. Aztreonam pharmacokinetics in burn patients.

    PubMed Central

    Friedrich, L V; White, R L; Kays, M B; Brundage, D M; Yarbrough, D

    1991-01-01

    The pharmacokinetics of aztreonam in eight adult patients with severe burn injuries (total body surface area burn, 49% +/- 21% [mean +/- standard deviation]) were studied. The time of initiation of study following burn injury was 7.0 +/- 1.4 days. Four patients at first dose and at steady state were studied. Aztreonam concentrations were measured by high-performance liquid chromatography, and a two-compartment model was used to fit the data. No significant differences in any pharmacokinetic parameters between first dose and steady state were observed. Volume of distribution of the central compartment after first dose (0.14 liters/kg) and volume of distribution at steady state (0.31 liters/kg) were approximately 30% higher than those reported for other patient populations. Total drug clearance and renal drug clearance when normalized to creatinine clearance (CLCR) were similar to those previously reported for other critically ill patients. CLCR was strongly correlated with renal drug clearance (r = 0.94) and total drug clearance (r = 0.95). The extent and degree of burn (percent second or third degree burn) were poorly correlated with all pharmacokinetic parameters with the exception of the volume of distribution at steady state, which was correlated with both total body surface area burn (r = 0.95) and percent second degree burn (r = 0.83). Aztreonam pharmacokinetics are altered as a result of thermal injury; however, CLCR can be used to assess the clearance of aztreonam in burn patients. PMID:2014982

  14. 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

  15. 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

  16. 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

  17. 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

  18. 75 FR 77897 - Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... National Park Service Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental... National Historic Trail Feasibility Study. SUMMARY: Pursuant to the National Environmental Policy Act of... Abbreviated Final Environmental Impact Statement for the Long Walk National Historic Trail Feasibility...

  19. 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...

  20. 40 CFR 1037.805 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 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,...

  1. 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,...

  2. 7 CFR 1980.302 - Definitions and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Definitions and abbreviations. 1980.302 Section 1980.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

  3. 24 CFR 58.2 - Terms, abbreviations and definitions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... provided in 40 CFR part 1508: (1) Activity means an action that a grantee or recipient puts forth as part... definitions. 58.2 Section 58.2 Housing and Urban Development Office of the Secretary, Department of Housing... RESPONSIBILITIES Purpose, Legal Authority, Federal Laws and Authorities § 58.2 Terms, abbreviations and...

  4. 24 CFR 58.2 - Terms, abbreviations and definitions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... provided in 40 CFR part 1508: (1) Activity means an action that a grantee or recipient puts forth as part... definitions. 58.2 Section 58.2 Housing and Urban Development Office of the Secretary, Department of Housing... RESPONSIBILITIES Purpose, Legal Authority, Federal Laws and Authorities § 58.2 Terms, abbreviations and...

  5. 48 CFR 3402.101-70 - Abbreviations and acronyms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Abbreviations and acronyms. 3402.101-70 Section 3402.101-70 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION... acronyms. CAO—Chief Acquisition Officer. CO—Contracting Officer. COR—Contracting Officer's...

  6. 48 CFR 3402.101-70 - Abbreviations and acronyms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Abbreviations and acronyms. 3402.101-70 Section 3402.101-70 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION... acronyms. CAO—Chief Acquisition Officer. CO—Contracting Officer. COR—Contracting Officer's...

  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. 48 CFR 3402.101-70 - Abbreviations and acronyms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Abbreviations and acronyms. 3402.101-70 Section 3402.101-70 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION... acronyms. CAO—Chief Acquisition Officer. CO—Contracting Officer. COR—Contracting Officer's...

  9. 40 CFR 87.2 - Acronyms and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 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...

  10. 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 AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort...

  11. 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 AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort...

  12. 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 AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort...

  13. 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 AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Land Use Policy for Fort...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 40 CFR 60.4103 - Measurements, abbreviations, and acronyms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 60.4103 Section 60.4103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and...

  20. 40 CFR 310.4 - What abbreviations should I know?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Pollution Contingency Plan also known as the National Contingency Plan (40 CFR part 300). NRC—National... 40 Protection of Environment 27 2010-07-01 2010-07-01 false What abbreviations should I know? 310..., EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS REIMBURSEMENT TO LOCAL GOVERNMENTS FOR...

  1. 40 CFR 310.4 - What abbreviations should I know?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Pollution Contingency Plan also known as the National Contingency Plan (40 CFR part 300). NRC—National... 40 Protection of Environment 28 2011-07-01 2011-07-01 false What abbreviations should I know? 310..., EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS REIMBURSEMENT TO LOCAL GOVERNMENTS FOR...

  2. 40 CFR 97.503 - 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. 97.503 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...

  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 97.403 - 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. 97.403 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...

  5. 40 CFR 97.503 - 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. 97.503 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...

  6. 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...

  7. 40 CFR 97.603 - 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. 97.603 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...

  8. 40 CFR 97.603 - 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. 97.603 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...

  9. 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...

  10. 40 CFR 97.403 - 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. 97.403 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...

  11. 27 CFR 19.499 - Authorized abbreviations to identify marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... to identify marks. 19.499 Section 19.499 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Containers and Marks Marking Requirements for Spirits § 19.499 Authorized abbreviations to identify marks. In addition to...

  12. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  13. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  14. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  15. 27 CFR 19.499 - Authorized abbreviations to identify marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... to identify marks. 19.499 Section 19.499 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Containers and Marks Marking Requirements for Spirits § 19.499 Authorized abbreviations to identify marks. In addition to...

  16. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  17. 27 CFR 19.499 - Authorized abbreviations to identify marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... to identify marks. 19.499 Section 19.499 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Containers and Marks Marking Requirements for Spirits § 19.499 Authorized abbreviations to identify marks. In addition to...

  18. 27 CFR 19.499 - Authorized abbreviations to identify marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... to identify marks. 19.499 Section 19.499 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Containers and Marks Marking Requirements for Spirits § 19.499 Authorized abbreviations to identify marks. In addition to...

  19. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  20. 38 CFR 21.8010 - Definitions and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Definitions and abbreviations. 21.8010 Section 21.8010 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Training and Rehabilitation for Certain Children of Vietnam Veterans and Veterans...

  1. 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.

  2. 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…

  3. 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...

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for Insular Area grantees pursuant to 24 CFR 570.440. (c) What is an abbreviated plan?—(1) Assessment... CFR 570.441. (Approved by the Office of Management and Budget under control number 2506-0117) ... 24 CFR part 570, subpart D, and is not expected to be a participating jurisdiction in the...

  5. 24 CFR 91.235 - Special case; abbreviated consolidated plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for Insular Area grantees pursuant to 24 CFR 570.440. (c) What is an abbreviated plan?—(1) Assessment... CFR 570.441. (Approved by the Office of Management and Budget under control number 2506-0117) ... 24 CFR part 570, subpart D, and is not expected to be a participating jurisdiction in the...

  6. 7 CFR 1951.852 - Definitions and abbreviations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Definitions and abbreviations. 1951.852 Section 1951.852 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS...

  7. 7 CFR 1951.852 - Definitions and abbreviations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Definitions and abbreviations. 1951.852 Section 1951.852 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS...

  8. 7 CFR 770.2 - Abbreviations and definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE SPECIAL PROGRAMS INDIAN TRIBAL LAND ACQUISITION LOANS § 770.2 Abbreviations and definitions. (a... personnel and any successor Agency. ITLAP Indian Tribal Land Acquisition Program. USPAP Uniform Standards of... is Farm Service Agency (FSA). Appraisal is an appraisal for the purposes of determining the...

  9. 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...

  10. 7 CFR 4274.302 - 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. 4274.302 Section 4274.302 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE DIRECT AND INSURED LOANMAKING Intermediary Relending Program (IRP) §...

  11. 40 CFR 1037.805 - Symbols, acronyms, and abbreviations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 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,...

  12. Toward an Abbreviated Internal-External Locus of Control Scale.

    ERIC Educational Resources Information Center

    Harris, Robert M., Jr.; Salomone, Paul R.

    1981-01-01

    Integrates a review of Rotter's theory with an analysis of the design and development of locus of control scales, and tests the reliability and validity of an abbreviated version of Rotter's Locus of Control Scale which provides practitioners with an instrument less confusing than other locus of control scales. (Author)

  13. 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…

  14. 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. PMID:25085093

  15. 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.

  16. Does Bronchoscopic Evaluation of Inhalation Injury Severity Predict Outcome?

    PubMed

    Spano, Stefania; Hanna, Steven; Li, Zeyu; Wood, Donna; Cartotto, Robert

    2016-01-01

    Although fiber-optic bronchoscopy is essential in the diagnosis of smoke inhalation injury (INH), controversy still exists over whether or not the visualized severity of the mucosal injury predicts clinically meaningful outcomes. The purpose of this study was to assess whether the grade of mucosal INH severity was associated with various outcomes among adult burn patients. We conducted a retrospective review of all patients requiring greater than or equal to 48 hours of mechanical ventilation who were admitted between January 1, 2007 and June 1, 2014 to an adult regional American Burn Association-verified burn center. Bronchoscopy was performed on all subjects at burn center admission and grading of severity was documented using the grades 0 to 4 abbreviated injury score (AIS). Subjects with grade 1 or 2 injury formed the low-grade INH group, whereas those with grade 3 or 4 injury formed the high-grade INH group. Values are shown as the median (first to third quartiles). A P value less than .05 was considered significant. The study population consisted of 160 subjects (age, 48 [35-60] years; %TBSA burn, 28 [19-39.9]; % full thickness burn, 12.8 [0-30]; and 61% with INH). There were no significant differences in age, %TBSA burn, or % full thickness burn between subjects with different individual INH severity grades. Oxygenation on the day of injury worsened significantly as the severity of INH increased, but otherwise there were no significant differences in 24 and 48-hour fluid requirements, duration of ventilation, ventilator free days, incidence of acute respiratory distress syndrome, or mortality between subjects with different individual grades of INH severity. Subjects with high-grade INH showed statistically insignificant trends toward larger 48-hour fluid volumes (P = .07), poorer oxygenation over the first 3 post burn days (P = .055), longer duration of ventilation (P = .08), and fewer ventilator free days (P = .047) than low-grade INH. High-grade and low

  17. 21 CFR 314.127 - Refusal to approve 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 Refusal to approve an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.127 Refusal to approve an abbreviated new...

  18. 21 CFR 314.127 - Refusal to approve an abbreviated new drug application.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Refusal to approve an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.127 Refusal to approve an abbreviated new...

  19. Ram Burn Observations (RAMBO)

    NASA Astrophysics Data System (ADS)

    2002-12-01

    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.

  20. 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

  1. 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. PMID:12479505

  2. Burns and beauty nails

    PubMed Central

    Bélanger, Richard E; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. The beauty nail adhesive contained cyanoacrylate. In addition to its well-appreciated adhesive capacity, cyanoacrylate, in the presence of cotton or other tissues, is known to produce an exothermic reaction that may cause burns. Cyanoacrylate-based products, due to their possible adverse effects, should be kept away from children as advised. Odd injuries should always raise concerns about the possibility of inflicted injury. PMID:24421671

  3. 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

  4. 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

  5. Burns, hypertrophic scar and galactorrhea.

    PubMed

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro

    2013-07-01

    An 18-year-old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected.She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients. PMID:23456048

  6. 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

  7. [Primary care and assessment of extended burn].

    PubMed

    Shimamoto, Minoru; Kawai, Makoto; Yamamoto, Yasuhiro

    2005-12-01

    Extended burn is a severe trauma makes patients easily critical status without appropriate cure and assessment. In order to ride out hypovolemic shock, it is necessary to manage the internal water, the state of respiration and wound treatment and assess the depth of burn wound. Initialy we assess the burned area and it's depth, then we calculate the amount of water which will be necessary on acute phase for the patient We will resect the part of deep dermal burn immediately to reduce the causes of infection. The patient will need a graft operation as soon as we can to avoid the severe infection. PMID:16869125

  8. 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

  9. Burns in diabetic patients

    PubMed Central

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical analysis software SPSS 10.05. Differences between the two groups were evaluated using Student's t-test and the chi square test. P < 0.05 was considered as significant. RESULTS: The major mechanism of injury for the diabetic patients was scalding and flame burns, as was also the case in the nondiabetic burn patients. The diabetic burn patients were significantly older, with a lower percentage of total burn surface area (TBSA) than the nondiabetic burn population. There was significant difference between the diabetic and nondiabetic patients in terms of frequency of infection. No difference in mortality rate between diabetic and nondiabetic burn patients was observed. The most common organism in diabetic and nondiabetic burn patients was methicillin-resistant staphylococcus. Increasing %TBSA burn and the presence of inhalation injury are significantly associated with increased mortality following burn injury. CONCLUSIONS: Diabetics have a higher propensity for infection. Education for diabetic patients must include caution about potential burn mishaps and the complications that may ensue from burns. PMID:19902035

  10. 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.

  11. 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

  12. How to manage a minor burn.

    PubMed

    Rowley-Conwy, Gabrielle

    2016-07-20

    Rationale and key points This article outlines the technique for dressing a minor burn. The nurse should be aware of national burn care referral guidance, and have the knowledge and skills to establish the severity and extent of a burn. The nurse should also be able to determine whether referral to a regional specialist centre is required. » The extent and severity of a burn determines its ongoing management. » The burn wound requires regular evaluation, since its appearance and management needs can change over time. » Competence in general wound care is essential for nurses undertaking this procedure. Reflective activity 'How to' articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: » The classification of burn depth and guidelines for specialist referral. » How you think this article will change your practice. Subscribers can update their reflective accounts at rcni.com/portfolio. PMID:27440365

  13. Burns: an update on current pharmacotherapy

    PubMed Central

    Rojas, Yesinia; Finnerty, Celeste C.; Radhakrishnan, Ravi S.; Herndon, David N.

    2013-01-01

    Introduction The world-wide occurrence of burn injuries remains high despite efforts to reduce injury incidence through public awareness campaigns and improvements in living conditions. In 2004, almost 11 million people experienced burns severe enough to warrant medical treatment. Advances over the past several decades in aggressive resuscitation, nutrition, excision, and grafting have reduced morbidity and mortality. Incorporation of pharmacotherapeutics into treatment regimens may further reduce complications of severe burn injuries. Areas covered Severe burn injuries, as well as other forms of stress and trauma, trigger a hypermetabolic response that, if left untreated, impedes recovery. In the past two decades, use of anabolic agents, beta adrenergic receptor antagonists, and anti-hyperglycemic agents has successfully counteracted post-burn morbidities including catabolism, the catecholamine-mediated response, and insulin resistance. Here we review the most up-to-date information on currently used pharmacotherapies in the treatment of these sequelae of severe burns and the insights that have expanded our understanding of the pathophysiology of severe burns. Expert opinion Existing drugs offer promising advances in the care of burn injuries. Continued gains in our understanding of the molecular mechanisms driving the hypermetabolic response will enable the application of additional existing drugs to be broadened to further attenuate the hypermetabolic response. PMID:23121414

  14. Comparison of tokamak burn cycle options

    SciTech Connect

    Ehst, D.A.; Brooks, J.N.; Cha, Y.; Evans, K. Jr.; Hassanein, A.M.; Kim, S.; Majumdar, S.; Misra, B.; Stevens, H.C.

    1985-01-01

    Experimental confirmation of noninductive current drive has spawned a number of suggestions as to how this technique can be used to extend the fusion burn period and improve the reactor prospects of tokamaks. Several distinct burn cycles, which employ various combinations of Ohmic and noninductive current generation, are possible, and we will study their relative costs and benefits for both a commerical reactor as well as an INTOR-class device. We begin with a review of the burn cycle options.

  15. Scald Burns From Hair Braiding.

    PubMed

    Meizoso, Jonathan P; Ramaley, Stephen R; Ray, Juliet J; Allen, Casey J; Guarch, Gerardo A; Varas, Robin; Teisch, Laura F; Pizano, Louis R; Schulman, Carl I; Namias, Nicholas

    2016-01-01

    Only one previous case report has described scald burns secondary to hair braiding in pediatric patients. The present case study is the largest to date of scald burns as a result of hair braiding in children and adults. Charts of all 1609 female patients seen at a single burn center from 2008 to 2014 were retrospectively reviewed to identify patients with scald burns attributed to hair braiding. Demographics, injury severity, injury patterns, and complications were analyzed. Twenty-six patients (1.6%) had scald burns secondary to hair braiding with median TBSA 3%. Eighty-five percent of patients were pediatric with median age 8 years. Injury patterns were as follows: back (62%), shoulder (31%), chest (15%), buttocks (15%), abdomen (12%), arms (12%), neck (12%), and legs (4%). No patients required operative intervention. Three patients were admitted to the hospital. Two patients required time off from school for 6 and 10 days post burn for recovery. Complications included functional limitations (n = 2), hypertrophic scarring (n = 1), cellulitis requiring antibiotics (n = 1), and anxiety requiring medical/psychological therapy (n = 2). This peculiar mechanism of injury not only carries inherent morbidity that includes the risks of functional limitations, infection, and psychological repercussions but also increases usage of resources through hospital admissions and multiple clinic visits. Further work in the form of targeted outreach programs is necessary to educate the community regarding this preventable mechanism of injury. PMID:26594857

  16. Pathophysiology of burns.

    PubMed

    Keck, Maike; Herndon, David H; Kamolz, Lars P; Frey, Manfred; Jeschke, Marc G

    2009-01-01

    Burn injury represents a significant problem worldwide. Advances in therapy strategies, based on better understanding of the pathophysiologic responses after burn injury have improved the clinical outcome of patients with burn injuries over the past years. This article describes the present understanding of the pathophysiology of a burn injury including both the local and systemic responses, focusing on the many facets of organ and systemic effects directly resulting from hypovolemia and circulating mediators following burn trauma. PMID:19652939

  17. Investigation of abbreviated 4 and 8 item versions of the PTSD Checklist 5.

    PubMed

    Price, Matthew; Szafranski, Derek D; van Stolk-Cooke, Katherine; Gros, Daniel F

    2016-05-30

    Posttraumatic stress disorder (PTSD) is a significant public health concern associated with marked impairment across the lifespan. Exposure to traumatic events alone, however, is insufficient to determine if an individual has PTSD. PTSD is a heterogeneous diagnosis such that assessment of all 20 symptoms is problematic in time-limited treatment settings. Brief assessment tools that identify those at risk for PTSD and measure symptom severity are needed to improve access to care and assess treatment response. The present study evaluated abbreviated measures of PTSD symptoms derived from the PTSD Checklist for DSM-5 (PCL-5) - a 20-item validated measure of PTSD symptoms - across two studies. In the first, using a community sample of adults exposed to a traumatic event, 4-and 8-item versions of the PCL-5 were identified that were highly correlated with the full PCL-5. In the second, using a sample of combat veterans, the 4-and 8-item measures had comparable diagnostic utility to the total-scale PCL-5. These results provide support for an abbreviated measure of the PCL-5 as an alternative to the 20-item total scale. PMID:27137973

  18. 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

  19. Nutrition in Burns: Galveston Contributions

    PubMed Central

    Rodriguez, Noe A.; Jeschke, Marc G.; Williams, Felicia N.; Kamolz, Lars-Peter; Herndon, David N.

    2013-01-01

    Aggressive nutrition support is recommended following severe burn injury. Initially, such injury results in a prolonged and persistent hypermetabolic response mediated by a 10- to 20-fold elevation in plasma catecholamines, cortisol, and inflammatory mediators. This response leads to twice-normal metabolic rates, whole-body catabolism, muscle wasting, and severe cachexia. Thus, it is relevant to review the literature on nutrition in burns to adjust/update treatment. Failure to meet the increased substrate requirements may result in impaired wound healing, multiorgan dysfunction, increased susceptibility to infection, and death. Therefore, aggressive nutrition support is essential to ensure adequate burn care, attenuate the hypermetabolic response, optimize wound healing, minimize devastating catabolism, and reduce morbidity and mortality. Here, the authors provide nutrition recommendations gained from prospective trials, retrospective analyses, and expert opinions based on the authors' practices in Galveston, Texas, and Vienna, Austria. PMID:21975669

  20. 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