International journal of burns and trauma
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To investigate the characteristics and causes of self burning among married women in the capital of Iran. ⋯ Married women who attempted to burn their lives were young wives from low socioeconomic status living in a traditional environment. Time and place of the burning showed that they attempt suicide more likely while they are doing daily routines.
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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. ⋯ 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.
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A 3-year old male who sustained 2(nd) and 3(rd) degree burns that covered approximately 60% TBSA presented to a large adult and pediatric verified burn center. On hospital day (HD) 26 of his stay, Candida fungemia was identified by blood culture, delaying operative management until HD 47. On HD 47, after his first operative intervention, the patient developed a persistent metabolic and lactic acidosis. ⋯ When propylene glycol is present systemically, it is metabolized to lactic acid in the liver, which can cause a lactic acidosis. Several commonly used drugs also use propylene glycol as an emulsifier, including IV preparations of lorazepam, pentobarbital, phenobarbital, and phenytoin. In all of these clinical scenarios, including severe burn patients that are being treated with silver sulfadiazine, both lactic acid and propylene glycol levels should be measured to monitor for this rare, potentially serious co-morbidity.
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Total intravenous anesthesia (TIVA) is frequently used for major operations requiring general anesthesia in critically ill burn patients. We reviewed our experience with this approach. ⋯ TIVA was used in patients whose inhalation injury rate and TBSA were greater than those of non-TIVA patients. TIVA cases were not associated with increased hemodynamic instability. TIVA is a viable approach to general anesthesia in critically ill burn patients.
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Conventional therapy for burns has always produced a nightmarish illness for patients. The lack of the ability to prevent contractures often produces dysfunctional limbs and the ugly scars resulting from severe burns are an ongoing reminder of this lengthy painful illness. This study is to determine the effectiveness of topical heparin in burns management among some patients at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. ⋯ Heparin was observed to be very effective in the management of burn injuries in the patients studied. It was effective in reduction of pain and prevention of scars and contractures. However, due to the small number of patients and lack of control for the wound healing, a firm recommendation for the use of heparin therapy in burns cannot be made and further studies would be required to establish its use especially in the African population.