Burns : journal of the International Society for Burn Injuries
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We assessed whether a home fire safety intervention targeting families with newborn children in Jefferson County, Kentucky, reached those at severe risk using a cartographic model. Demographic and economic factors of 61 families were compared by census tract. Using geographic information systems (GIS), families were assigned a risk level (low, medium, high, or severe) based on the risk model. ⋯ Sixty-five tracts were identified as high or severe risk and in need of future intervention. The model yielded a way to prioritize at-risk families. GIS is a useful tool for examining whether prevention interventions reached those in the severe risk category.
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The spiny mouse, Acomys cahirinus, shows remarkable regenerative abilities after excisional skin wounding by regrowing hair, sebaceous glands, smooth muscle, skeletal muscle and dermis without scarring. We have asked here whether this same regeneration can be seen after full thickness thermal burn injuries. Using a brass rod thermal injury model we show that in contrast to the lab mouse, Mus musculus, which forms a thick scar covered by a hairless epidermis, the spiny mouse regenerates all the tissues injured - skeletal muscle, dermis, hairs, sebaceous glands such that the skin is externally indistinguishable from its original appearance. ⋯ After 3 weeks the wound epithelium of Acomys has developed a covering of new hair follicles in contrast to Mus. The skeletal muscle of the panniculus carnosus in Mus shows some regeneration but it is incomplete and fibrotic whereas the Acomys muscle is replaced perfectly. There are differences in the macrophage profiles which invade the damaged tissues such as the absence of F4/80 or MOMA-2 +ve cells in Acomys which likely reflect different cytokine profiles resulting from the same injury in these two species.
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Randomized Controlled Trial Comparative Study
Comparison of intralesional verapamil versus intralesional corticosteroids in treatment of keloids and hypertrophic scars: A randomized controlled trial.
Keloids and hypertrophic scars are due to overgrowth of dermal collagen following trauma to the skin that usually cause major physical, psychological and cosmetic problems. ⋯ Our results did not support verapamil's capability in treatment of keloid nor hypertrophic scars.
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Recent reports on the use of extracorporeal membrane oxygenation (ECMO) in critically ill burn patients with Acute Respiratory Distress Syndrome (ARDS) recommended against the use of ECMO. The authors cited the high mortality rates associated with the use of ECMO in these patients with no appreciable benefit. Accumulating evidence from referral centers suggests improved survival in patients with ARDS receiving ECMO. We report our recent experience treating patients with severe ARDS with ECMO in a burn intensive care unit. ⋯ To our knowledge, this is the lowest mortality rate reported to date in burn patients with ARDS place on ECMO. ECMO is a viable therapy that can be utilized successfully as a rescue modality when conventional interventions are unsuccessful.
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Burn injuries are a debilitating cause of morbidity and mortality associated with the long-term impact of psychological factors on quality of life. Accurate assessment of the differential impact of burn sequelae and anxiety is often complicated by the overlap between psychological and somatic symptoms in burns patients. The Beck Anxiety Inventory (BAI) is one validated psychometric tool for anxiety assessment. The primary objective of this study is to investigate whether utilising the BAI as a tool to assess for anxiety in burns patients is biased due to the confounding of symptoms of anxiety with the physical sequelae of a burn injury. ⋯ This feasibility study found preliminary evidence suggesting that the BAI may, in part, represent misattributed symptoms of cutaneous injury from burns. However, whilst our findings suggest an attribution bias, there is not enough evidence from this data to comment on whether its use should be restricted in burns patients. Further research is needed to formally quantify convergent and divergent validity through structured interviews. In addition, further research using other self-report tools of anxiety in burns patients would be useful to corroborate the prospect of biased and confounded anxiety scores.