The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jan 1999
Contribution of the regulatory gene lasR to the pathogenesis of Pseudomonas aeruginosa infection of burned mice.
Pseudomonas aeruginosa is a gram-negative opportunistic pathogen that causes severe infections in patients with burns. The P aeruginosa regulatory gene, lasR, regulates the expression of several virulence factors. The specific lasR isogenic mutant, PAO-R1, is defective in the synthesis of the 2 elastases (LasB and LasA) and produces low levels of exotoxin A and alkaline proteases. ⋯ Furthermore, at 8 hours postinfection, equivalent numbers of PAO1 and PAO-R1 were detected at the inoculation site of the burned skin. However, only PAO1 microorganisms were detected at other sites of the burned skin. These results suggest that the lasR gene contributes (directly and indirectly) to the dissemination of P aeruginosa within the body of burned mice and its horizontal spread within the burned skin.
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Outcome measures have become an important tool to assist with monitoring the efficacy of burn care. One such measurement for children is the time required for them to return to school, as well as their behavior and academic performance in school after a burn injury. The purpose of this study was to relate demographic data with return-to-school time and school performance. ⋯ These children returned to school rather rapidly after discharge and functioned as well or better after injury. Little loss of grade was noted, and only those children with problems in school before the burn injury had problems after the burn injury. Contact with the child's school before reentry might have assisted with the smooth transition.
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Current problems in the assessment of scars are discussed. The concept of subjective and objective aspects of scar assessment is introduced. ⋯ Although the Vancouver Scar Scale has been used as the standard for objective measurements, there are problems with both the validity and reliability of this instrument. Various imaging techniques may permit more reliable and accurate methods for measuring the quantitative aspects of scars.
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Gas fireplaces have become popular in recent years. This article presents the first reported case of a burn injury from contact with the glass front of a gas fireplace. An investigation of the surface temperature of the glass fronts of gas fireplaces was undertaken to clarify the risks posed by these units. ⋯ The temperatures of the glass fronts of glass fireplaces are sufficient to cause cutaneous burns within seconds of contact both while the fireplace is in use and up to one half hour after it has been turned off. Current industry safety standards are not directed at the prevention of contact burns. We recommend that (1) mechanical guards be installed to create a barrier in front of the glass; (2) strict warning labels be applied to the units and ignition switches; and (3) burn prevention information be distributed with the owner's manual for these products.
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Self-inflicted burns are uncommon yet disturbing. A 9-year retrospective review of all admissions to the Mercy Hospital of Pittsburgh Burn Center from 1987 to 1995 found 11 out of 1135 patients to have self-inflicted burns. Ten of these patients had a psychiatric diagnosis prior to injury: major depression in 6 cases, schizophrenia in 3 cases, and a personality disorder in 1 case. ⋯ Two were actually attempting suicide and 2 were motivated by hallucinations/delusions. On the basis of this review, we recommend that patients with an abnormal psychological profile--including suicidal ideation--be adequately monitored and regularly followed by appropriate mental health professionals. It is hoped that an awareness of the phenomena of self-destruction by burning will prevent these injuries in the future.