|
| ||
|
|
||
Burns
Kinds of Burns Terms modified by Burns Selected AbstractsMulticenter Study of the Safety and Efficacy of a 585 nm Pulsed-Dye Laser for the Nonablative Treatment of Facial RhytidesDERMATOLOGIC SURGERY, Issue 1 2005T. S. Jeffrey Hsu MD Objective The objective of this study was to assess the safety and efficacy of a 585 nm flashlamp pulsed-dye laser for the nonablative treatment of facial rhytides. Methods A multicenter prospective randomized controlled study on 58 volunteers was performed. A split-face approach was adopted, with one periorbital region acting as a control and the other receiving either one or two treatments. Patients were photographed and imaged three-dimensionally before and after treatment. Histologic sections were analyzed. Results Three-dimensional topographic evaluation showed improvements of 9.8% (p= .0022) and 15% (p= .0029) in surface roughness for single and double treatments, respectively. Histology revealed an increase in type I collagen messenger ribonucleic acid expression, type III procollagen, chondroitin sulfate, and grenz zone thickness. Two treatments resulted in greater improvement than one treatment. Conclusion Clinical improvement was achieved following a single treatment. Further improvement was observed following a second treatment. The subjective evaluation of clinical improvement was consistent with both histologic and topographic quantitative measurements. SUZANNE KILMER, MD, AND JAY BURNS, MD, RECEIVED THE USE OF THE LASER FOR RESEARCH AND A DISCOUNTED PURCHASE AGREEMENT. THEY BOTH ACKNOWLEDGE RECEIVING HONORARIA FOR LECTURING FROM THE MANUFACTURER. BRIAN ZELICKSON, MD, RECEIVED RESEARCH GRANTS FROM ICN. [source] Seasonal patterns of growth, expenditure and assimilation in juvenile Atlantic salmonJOURNAL OF ANIMAL ECOLOGY, Issue 6 2002Wayne Jones Summary 1We report a modelling study of a data-set describing the growth of individual Atlantic salmon (Salmo salar L.) parr in the Girnock Burn (Scotland). A development of the compensatory growth model due to Broekhusien et al. (1994) was fitted to these data by numerical optimization. 2The model uses carbon mass as a surrogate for an energy currency. This mass is divided into structure and reserve components, so as to describe decoupled changes in length and wet-weight. 3Using the same parameters for all fish, our model explained 83% of the variability in length and weight at age. Adding a single additional parameter for each individual enabled the model to explain over 96% of length and weight variability. 4Weak negative correlation between size at first capture and within-study growth argues against genetic causality of observed growth variability. 5The energetic basis of our model enables us to infer time-series of net assimilation and basal maintenance rates for the observed individuals. Maximal growth occurs early in the season when high assimilation is accompanied by low temperatures and maintenance rates. In late season, continuing high assimilation is balanced by high maintenance rates consequent on summer temperatures. [source] Recovery of soil microbial community structure after fire in a sagebrush-grassland ecosystemLAND DEGRADATION AND DEVELOPMENT, Issue 5 2010S. R. Dangi Abstract Recovery of the soil microbial community after fire in a sagebrush-grassland ecosystem was examined using a chronosequence of four sites ranging in time since fire from 3,39 years. The successional stage communities examined included Recent Burn (3,years since fire, ysf), Establishment (7,ysf), Expansion (21,ysf), and Mature (39,ysf). Aboveground standing plant biomass increased with time since disturbance to the Mature stage where sagebrush became dominant over herbaceous species. Phospholipid fatty acid (PLFA) analysis was used to characterize the microbial community structure. Soil microbial community productivity generally appeared to be similar to the Mature site soil (39,ysf) within 7,years of fire. Diversity of PLFAs detected in soils, at both depths, increased from a low value of 29 at the Recent site to a high of 37 at the Establishment site and then decreased again to 31 at the Mature stage site. Canonical variates analysis indicated important disparities in microbial community structure at the four sites. Greatest disparities were observed in microbial community structure between the Recent and Establishment stages but greater similarity between the Recent stage and the sagebrush dominated Mature stage. This study emphasizes both short-term and long-term changes in the belowground community and suggests that soil microbial communities are highly resilient to disturbances after prescribed fire. Copyright © 2010 John Wiley & Sons, Ltd. [source] Spawning success in Atlantic salmon (Salmo salar L.): a long-term DNA profiling-based study conducted in a natural streamMOLECULAR ECOLOGY, Issue 4 2001J. B. Taggart Abstract Spawning success of Atlantic salmon (Salmo salar L.) was investigated, under near-natural conditions, in the Girnock Burn, an 8-km long tributary of the River Dee in Scotland. Employing minisatellite-based DNA profiling, mating outcomes were resolved over three spawning seasons by assigning parentage to progeny samples removed from spawning nests (,redds'). While individual spawning patterns differed markedly, consistent trends were present over the 3 years studied. Multiple spawning was found to be prevalent. More than 50% of anadromous spawners of both sexes contributed to more than one redd. Up to six redds for a single female and seven for a single male were detected. Both sexes ranged extensively. Distance between redds involving the same parent varied from a few metres to > 5 km. Distances > 1 km were common. Both males and females ranged to a similar extent. Range limit was not correlated to fish size. Pairs were not monogamous, both males and females mating with different partners at different sites. Size assortative mating was apparent among 1991 spawners but was not detected for 1992 or 1995. Redd superimposition was found to be common (17,22% of redds over the 3 years), although it was not correlated to the number of anadromous spawners present. High levels of nonanadromous mature parr mating success (40,50% of total progeny sampled) were recorded, and these likely contribute greatly to the effective population size. The relevance of these findings at the individual and population level is discussed, with particular reference to management implications. [source] Effects of Prescribed Fire and Season of Burn on Recruitment of the Invasive Exotic Plant, Potentilla recta, in a Semiarid GrasslandRESTORATION ECOLOGY, Issue 4 2003Peter Lesica Abstract Prescribed fire is often used to restore grassland systems to presettlement conditions; however, fire also has the potential to facilitate the invasion of exotic plants. Managers of wildlands and nature reserves must decide whether and how to apply prescribed burning to the best advantage in the face of this dilemma. Herbicide is also used to control exotic plants, but interactions between fire and herbicides have not been well studied. Potentilla recta is an exotic plant invading Dancing Prairie Preserve in northwest Montana. We used a complete factorial design with all combinations of spring burn, fall burn, no burn, picloram herbicide, and no herbicide to determine the effects of fire, season of burn, and their interaction with herbicide on the recruitment and population growth of P. recta over a 5-year period. Recruitment of P. recta was higher in burn plots compared with controls the first year after the fire, but this did not lead to significant population growth in subsequent years, possibly due to drier than normal conditions that occurred most years of the study. Effect of season of burn was variable among years but was higher in fall compared with spring burn plots across all years. Herbicide effectively eliminated P. recta from sample plots for 3,5 years. By the end of the study density of P. recta was greater in herbicide plots that were burned than those that were not. Results suggest that prescribed fire will enhance germination of P. recta, but this will not always lead to increased population growth. Prescribed fire may reduce the long-term efficacy of herbicide applied to control P. recta and will be most beneficial at Dancing Prairie when conducted in the spring rather than the fall. Results of prescribed fire on exotic plant invasions in semiarid environments will be difficult to predict because they are strongly dependent on stochastic climatic events. [source] Goddess of the Market: Ayn Rand and the American Right , By Jennifer BurnsECONOMIC AFFAIRS, Issue 2 2010Art Carden No abstract is available for this article. [source] Regional-scale spatial patterns of fire in relation to rainfall gradients in sub-tropical mountains, NW ArgentinaGLOBAL ECOLOGY, Issue 2 2001Héctor Ricardo Grau Abstract 1Spatial patterns of burns are described using Landsat TM images from the sub-tropical mountains of north-west Argentina, over a span of 6 degrees of latitude, and a precipitation range from 250 to 1300 mm/yr. Burns were discriminated easily from unburnt vegetation, mainly by using infrared spectral bands from images taken at the end of the fire season of 1986. 2Nineteen sampling units were defined on the basis of geographical proximity and relatively homogeneous rainfall as inferred from topography, and they were characterized in terms of percentage of burnt area and burn size distribution during one fire season. Regression and Correspondence Analysis were used to assess the relationship between rainfall and spatial descriptors of fire regime. 3Burnt size area was log-normally distributed with most fires in the small-size classes. Of a total of 643 burns, the five largest (more than 2000 hectares each) represented about 30% of the total burnt area. 4Percentage of burnt area, density of burns per unit area, and skewness of the burn-size frequency distribution showed a unimodal pattern along the rainfall gradient, peaking between 700 and 900 mm/yr. Mean and maximum burn size showed a negative but weak correlation with rainfall. The first axis of a Correspondence Analysis ordination of sampling units, on the basis of different descriptors of spatial patterns of fire, was significantly correlated with the rainfall of the sampling unit. 5The results suggest that climate is an important factor controlling fuel conditions and therefore fire regime at the spatial scale of this study, which includes different mountain ranges spanning , 700 km. [source] Evidence-based nursing: clarifying the concepts for nurses in practiceJOURNAL OF CLINICAL NURSING, Issue 8 2009Kay Scott Aim., To provide a critical analysis of key concepts associated with evidence-based nursing (EBN) to substantiate an operational definition for nurses to use in practice. Background., Despite the plethora of literature surrounding what evidence-based nursing is and is not and how it differs from its cousins, evidence-based medicine and evidence-based practice, nurses still struggle to get evidence into practice. Several reasons for this have been reported, for example, a lack of understanding about what evidence-based nursing means or time to engage with and apply the evidence into practice. Design., An in-depth critical review and synthesis of literature was undertaken. Method., Using the key words; evidence-based nursing, evidence-based medicine and evidence-based practice 496 articles were yielded. These articles were limited to 83. Using Burns and Grove's (2001) phased approach to reviewing the literature the articles were critically reviewed and categorised into key concepts and themes. Results., The in-depth critical review and synthesis of the literature demonstrated that evidence-based nursing could be defined as a distinct concept. The review clearly shows that for evidence-based nursing to occur, nurses need to be aware of what evidence-based nursing means, what constitutes evidence, how evidence-based nursing differs from evidence-based medicine and evidence-based practice and what the process is to engage with and apply the evidence. Conclusion., The in-depth critical review and synthesis of the evidence-based nursing literature reinforces the need to consolidate a position for nursing in the evidence-based field. The review confirms that evidence-based nursing can be defined and conceptualised; however, for nurses to engage and apply with the evidence-based processes they need to be informed of what these are and how to engage with them in practice. Relevance to clinical practice., This paper examines the concept of evidence-based nursing and its application to clinical practice. [source] Radiation Burns as a Severe Complication of Fluoroscopically Guided Cardiological InterventionsJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2004Ch.B., RONALD E. VLIETSTRA M.B. Radiation-induced skin burns can be produced by high doses of fluoroscopic X rays. Though uncommon, such injuries can cause considerable distress to the patient and they can lead to deep ulcers requiring skin grafts. Factors that increase the chance of a burn can be readily identified and in nearly all instances they can be avoided or minimized. We discuss these issues and use case illustrations to point out how burns can be avoided. (J Interven Cardiol 2004;17:131,142) [source] Contrasting Burns and Bass: Does the transactional-transformational paradigm live up to Burns' philosophy of transforming leadership?JOURNAL OF LEADERSHIP STUDIES, Issue 3 2007Dmitry Khanin Both proponents and critics view the transactional-transformational paradigm (Bass, 1997, 1998) as the brainchild of Burns' (1978) philosophy of transforming leadership. However, Burns (2003) has criticized the paradigm's narrow managerialist orientation and the claim that it is uniformly applicable to any culture and organization. In this article, I first summarize and articulate Burns' (1978, 2003) and Bass' (1985, 1998) approaches toward leadership, then compare them by using a new four-dimensional framework. Extending previous research (Yukl, 2006), the framework represents a useful tool for detecting the commonalities and differences between leadership theories with respect to the core dimensions, categories, and aspects of leadership. My inspection indicates that Burns' and Bass' conceptions stem from disparate contexts and differ in their applicability. Thus, Burns' (1978) ideas stem from political movements ideally characterized by mutual quest for shared meaning and active collaboration between leaders and followers. Conversely, Bass' (1985) approach springs from military training in which leaders transfer existing knowledge to followers and stimulate their activity by using a variety of tools from inspirational motivation to individualized consideration. This study has important practical implications as it delineates the boundary conditions of the transactional-transformational paradigm and warns against its uncritical adoption in incongruent leadership contexts. [source] Burns to persons suffering from diabetes: a systemic preventive approachJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 2 2009MScN (edu), Ma'en Zaid Abu-Qamar Dnurs Aims. To report the findings of an investigation of patients with diabetes and burns, with emphasis on implications for practice: primary and secondary preventions. Background. Diabetes and burns are complex conditions with multi-system involvements, which worsen outcomes for patients, and their management. This research investigated outcomes for patients and diabetes management. Methods. Data on outcomes were obtained from records of patients hospitalised for foot burns in an Australian hospital from 1999,2004. A questionnaire survey design was employed to obtain information on how clinicians in burns units manage diabetes. SPSS was used to analyse data obtained from both resources. Comments written in the questionnaire were analysed using relational analysis. Results. Of the 64 patients, 12 were with diabetes and 52 were without diabetes. Those with diabetes were more likely to sustain contact foot burns (58·3% Diabetes Mellitus vs. 13·5% non Diabetes Mellitus ,2 = 11·487, p = 0·002). The duration of hospitalisation was statistically significantly longer among patients with diabetes compared with those without diabetes (U = 169, p = 0·014); although the two groups were not statistically significant different in terms of severity of burns and received treatment. Of the 29 clinical leaders, 21 (72%) indicated that they regularly provided care to patients with diabetes. Most respondents (n = 15; 58%) reported that new plans need to be initiated to accommodate the combined insult of diabetes and burns. Diabetes centres were located in all participating sites; but not always involved in the process of care. Conclusion. The co-existence of diabetes and burns worsens outcomes for patients, and complicates management plans. Optimal management can be achieved via a multidisciplinary approach starting with glycaemic control, and continued to aggressive management of diabetes and burns. Relevance to clinical practice. Preventive measures should start with tight glycaemic control, identification and avoidance of sources of trauma, early detection and treatment, and continue to aggressive inpatient management of patients with both diabetes and a burn injury. [source] On the Coates,Sinnott ConjectureMATHEMATISCHE NACHRICHTEN, Issue 10 2009Cristian D. Popescu Abstract In [5], Coates and Sinnott formulated a far reaching conjecture linking the values ,F/k,S(1 , n) for even integers n , 2 of an S -imprimitive, Galois-equivariant L -function ,F/k,S associated to an abelian extension F/k of totally real number fields to the annihilators over the group ring ,[G (F/k)] of the even Quillen K -groups K2n,2 (OF) associated to the ring of integers OF of the top field F. In the same paper, Coates and Sinnott essentially prove the ,, -adic étale cohomological version of their conjecture, in which K2n,2(OF) is replaced by H2et(OF [1/,, ], ,(n)), for all primes ,, > 2, under the hypothesis that k = ,. Refinements of this result for k = ,, involving Fitting ideals rather than annihilators of H2et(OF [1/,,], ,,,(n)), were obtained in particular cases by Cornacchia,Østvaer [7] and in general by Kurihara [14]. More recently, Burns and Greither [3] proved the same type of refinements (involving Fitting ideals of étale cohomology groups) for arbitrary totally real base fields k, but working under the very strong hypothesis that the Iwasawa , -invariants ,F,,, vanish for all odd primes ,,. In this paper, we study a class of abelian extensions of an arbitrary totally real base field k including, for example, subextensions of real cyclotomic extensions of type k (,)+/k, where p is an odd prime. For this class of extensions, we prove similar refinements of the étale cohomological version of the Coates,Sinnott conjecture, under no vanishing hypotheses for the Iwasawa ,-invariants in question. Our methods of proof are different from the ones employed in [3], [14] and [7]. We build upon ideas developed by Greither in [10] and Wiles in [23] and [22], in the context of Brumer's Conjecture. If the Quillen,Lichtenbaum Conjecture is proved (and a proof seems tobe within reach), then we have canonical ,,,[G (F/k)]-module isomorphisms for all n , 2, all i = 1,2, and all primes ,, > 2, and all these results will yield proofs of the original K -theoretic version of the Coates,Sinnott Conjecture, in the cases and under the various hypotheses mentioned above (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Norman T. Burns 1930-2010MILTON QUARTERLY, Issue 3 2010Article first published online: 5 OCT 2010 No abstract is available for this article. [source] Methodological aspects of rigor in qualitative nursing research on families involved in intensive care units: A literature reviewNURSING & HEALTH SCIENCES, Issue 1 2007Sevald Høye rn, mnsc Abstract, Rigor has important ramifications for the entire qualitative research process. The aim of this study was to evaluate aspects of methodological congruence by focusing on four dimensions of rigor in qualitative nursing research related to the presence of patients' family members in the intensive care unit. Eight research papers covering the years 1990,2004 were analyzed by means of one of Burns and Grove's standards, methodological congruence, for critique and consistency. The results show that there are varying degrees of focus on procedural rigor, such as limitations and bias. Ethical rigor is described clearly in some papers, while others lack descriptions of confidentiality and the voluntary nature of participation. However, all papers contain descriptions of qualitative data analysis. In conclusion, there were strengths in procedural rigor and auditability, but also some limitations in the identification of theoretical development and the scientific tradition on which the article is based. [source] Empire, Patriotism and the Working-Class Electorate: The 1900 General Election in the Battersea ConstituencyPARLIAMENTARY HISTORY, Issue 3 2009IAIN SHARPE The extent to which the Unionist victory in the ,khaki' general election of 1900 was the result of patriotic sentiment arising from the South African war has long been a source of controversy among historians. Battersea has been cited as an area that was largely unaffected by patriotic and imperial fervour during this period. This article examines the general election campaign in the Battersea constituency. The sitting MP, John Burns, was re-elected despite his opposition to the war, but the Conservatives achieved their highest percentage vote of that at any parliamentary election between 1885 and 1918. While the war was not the only issue raised during the campaign, it was the most prominent and clearly benefited the imperialist and pro-war Conservative candidate. In order to retain his seat Burns had to fight a far more dynamic local campaign than his opponent, and even then he won only narrowly. Although imperial sentiment was not quite enough to oust Burns from this otherwise safe seat, it was the main reason for the strong Conservative performance. [source] A Practical Guide to Paediatric BurnsPEDIATRIC ANESTHESIA, Issue 1 2008John P. Keneally No abstract is available for this article. [source] Successful unsaturated zone treatment of PCE with sodium permanganateREMEDIATION, Issue 2 2009John R. Hesemann In situ chemical oxidation (ISCO) with permanganate has been widely used for soil and groundwater treatment in the saturated zone. Due to the challenges associated with achieving effective distribution and retention in the unsaturated zone, there is a great interest in developing alternative injection technologies that increase the success of vadose-zone treatment. The subject site is an active dry cleaner located in Topeka, Kansas. A relatively small area of residual contamination adjacent to the active facility building has been identified as the source of a large sitewide groundwater contamination plume with off-site receptors. The Kansas Department of Health and Environment (KDHE) currently manages site remedial efforts and chose to pilot-test ISCO with permanganate for the reduction of perchloroethene (PCE) soil concentrations within the source area. KDHE subsequently contracted Burns & McDonnell to design and implement an ISCO pilot test. A treatability study was performed by Carus Corporation to determine permanganate-soil-oxidant-demand (PSOD) and the required oxidant dosing for the site. The pilot-test design included an ISCO injection approach that consisted of injecting aqueous sodium permanganate using direct-push technology with a sealed borehole. During the pilot test, approximately 12,500 pounds of sodium permanganate were injected at a concentration of approximately 3 percent (by weight) using the methods described above. Confirmation soil sampling conducted after the injection event indicated PCE reductions ranging from approximately 79 to more than 99 percent. A follow-up treatment, consisting of the injection of an additional 6,200 pounds of sodium permanganate, was implemented to address residual soil impacts remaining in the soil source zone. Confirmation soil sampling conducted after the treatment indicated a PCE reduction of greater than 90 percent at the most heavily impacted sample location and additional reductions in four of the six samples collected. © 2009 Wiley Periodicals, Inc. [source] ,Mind the gap': false memories for missing aspects of an eventAPPLIED COGNITIVE PSYCHOLOGY, Issue 5 2006Matthew P. Gerrie Numerous eyewitness testimony studies have shown that people can falsely remember parts of an event after being exposed to misleading suggestion about it (Loftus, Miller, & Burns, 1978); however, few researchers have examined whether people falsely remember parts of an event when there is no such suggestion. Across two studies, we show that people systematically develop false memories for unseen aspects of an event. In Experiment 1, subjects saw a movie of a woman making a sandwich; some actions were missing. In a memory test, subjects confidently but falsely remembered 17% of unseen information from the event. In Experiment 2, subjects saw the same event, but the missing actions were either crucial or not crucial. Subjects were more likely to falsely remember the missing noncrucial than missing crucial information. Theoretically, our results fit with a source monitoring account of false memories. Practically, our results suggest a means by which we can predict what aspects of an event are likely to be falsely remembered. Copyright © 2006 John Wiley & Sons, Ltd. [source] Fiddling While the World BurnsARCHITECTURAL DESIGN, Issue 3 2010Neil Spiller Abstract Neil Spiller sharpens his claws and puts some bite into his final ,Bits' in this closing edition of AD+. He addresses the pressing question of climate change and politicians', architects' and the construction industry's general proclivity to bury their heads in the sand or to ,fiddle' tangentially in another direction. Copyright © 2010 John Wiley & Sons, Ltd. [source] Examining Management Accounting Change as Rules and Routines: The Effect of Rule PrecisionAUSTRALIAN ACCOUNTING REVIEW, Issue 2 2010Rodney Coyte This study examines change in management accounting practices as change in rules and routines. Informed by the institutional theory-inspired framework of,Burns and Scapens (2000),,the rules and routines relating to capital expenditure controls in a capital-intensive organisation are analysed. We explain how preciseness of rules affects not only the coupling of rules to routines, but also the emergence of multiple routines, enhancing the understanding of how management accounting practices remain stable and/or change over time. These results extend and refine recent research relating to management accounting change and offer new empirical insights into practice. [source] Attenuation of Flightless I, an actin-remodelling protein, improves burn injury repair via modulation of transforming growth factor (TGF)-,1 and TGF-,3BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2009D.H. Adams Summary Background, The pathophysiological mechanisms involved in burn injury repair are still not fully understood but include processes involving cellular proliferation, migration and adhesion. The actin cytoskeleton is intricately involved in these key wound repair processes. Flightless I (Flii), an actin-remodelling protein and transcriptional regulator, is an important regulator of wound healing. Objectives, To investigate the function of Flii gene expression in burn injury repair. Methods, Partial-thickness scald wounds were created on Flii heterozygous (Flii+/,), wild-type (WT) and Flii transgenic (FliiTg/+) mice. Burns were assessed using histology and immunohistochemistry, real-time quantitative polymerase chain reaction and biochemical analysis. Results, Flii expression, while upregulated in burn injuries, was significantly lower in the wounds of Flii+/, vs. WT vs. FliiTg/+ mice and healing was improved in Flii+/, mice with their burns healing faster than WT and FliiTg/+. Pro-scarring transforming growth factor (TGF)-,1 protein and gene expression were reduced in Flii+/, burns while antiscarring TGF-,3 was significantly elevated. Anti-,-smooth muscle actin (,-SMA) was decreased in Flii+/, burns suggesting a decrease in contractile myofibroblasts in the developing scars. Although Flii is primarily a nuclear and cytoplasmic protein it is also released by wounded cells. Intradermal injection of Flii-neutralizing antibodies (FliAbs) to WT burn wounds significantly improved their healing, indicating a potential novel approach for treating burns. Decreased TGF-,1 and elevated TGF-,3 expression were observed in FliAb-treated burns, which may contribute to their observed improvement in healing. Conclusions, Strategies aimed at reducing Flii expression, for example using neutralizing antibodies, may lead to improved burn outcomes. [source] Apoptosis and Necrosis in the Ischemic Zone Adjacent to Third Degree BurnsACADEMIC EMERGENCY MEDICINE, Issue 6 2008Adam J. Singer MD Abstract Objectives:, Burns are characterized by a central zone of necrosis surrounded by a zone of potentially reversible ischemia. The authors explored the contribution of necrosis and apoptosis to cell death in the zone of ischemia. Methods:, A previously established rat contact thermal injury model that utilizes a brass comb to produce four distinctive burns sites separated by three "interspaces" of unburned skin was used. The interspaces represent the zone of stasis or ischemia while the burn sites represent the zone of coagulation. With this model, most unburned interspaces progress to necrosis over 2 to 3 days. Full-thickness 3-mm biopsies were obtained from the interspaces, burns, and normal skin controls at 30 minutes, 24 hours, and 48 hours after injury. Slides were stained with hematoxylin and eosin as well as activated cleaved caspase-3 (CC3a) for evidence of apoptosis and high-mobility group box 1 (HMGB1) for evidence of necrosis. Results:, Necrosis was not seen at 30 minutes, but was found in a large number of cells within the epidermis, sebaceous glands, and follicles at 24 and 48 hours. Faint nuclear CC3a staining indicative of apoptosis was present in a minority of cells within the epidermis, dermal fibroblasts, dermal follicles, and dermal sebaceous glands at 30 minutes and to a lesser degree at 24 and 48 hours. Conclusions:, Both early apoptosis and delayed necrosis are present in the zone of ischemia, contributing to injury progression. Necrosis appears to play a larger role than apoptosis in injury progression in the comb burn model. [source] The Presence of B-type Natriuretic Peptide in Burns and the Responsiveness of Fibroblasts to BNP: Proof of PrincipleACADEMIC EMERGENCY MEDICINE, Issue 6 2007Adam J. Singer MD Background:B-type natriuretic peptide (BNP) released from cardiac myocytes plays an important role in cardiac homeostasis through cyclic guanosine monophosphate (cGMP) activation. BNP also reduces cardiac remodeling and fibrosis. The antifibrotic effects of BNP are mediated in part by blocking the effects of transforming growth factor ,, a profibrotic cytokine that plays a significant role in cutaneous wound healing. It is unclear if BNP plays any role in cutaneous wound healing.ObjectivesTo investigate if BNP levels would be elevated in thermally injured human skin and if human-derived fibroblasts would respond to BNP exposure by increasing levels of cGMP.MethodsThis was an in vitro analysis of human skin. Skin samples and cells were collected from patients with and without thermal injury. The authors stained three skin samples from normal skin (taken at the time of elective cosmetic surgery) with antibodies to BNP and compared these with three tissue samples obtained from burned human skin taken during tangential excision of deep burns. Normal human-derived fibroblasts and keratinocytes were exposed in triplicate to BNP in vitro, and cGMP accumulation was evaluated. Levels of cGMP were quantified and compared with analysis of variance.ResultsBNP was present in all specimens of thermally injured skin (especially around collagen, epithelial cells, and endothelial cells) but not in any uninjured skin samples (p = 0.05, single-tailed Fisher's exact test). In vitro grown fibroblasts showed significant increases of cGMP levels with increasing levels of BNP exposure (mean [±SD]: 0.6 [±0.3], 1.2 [±0.2], 4.6 [±0.1], and 5.0 [±0.9] pmol/mL with BNP concentrations of 0, 10, 500, and 1,000 nmol/L, respectively; p < 0.001). The effect of BNP on keratinocytes was minimal and below the level of quantification.Conclusions:These findings demonstrate proof of principle that human fibroblasts are responsive to the effects of BNP in vitro and that BNP is present in injured skin, suggesting that BNP may play a role in cutaneous wound healing. [source] A systematic review of the features that indicate intentional scalds in childrenCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2009Richard Reading A systematic review of the features that indicate intentional scalds in children . MaguireS., MoynihanS., MannM., PotokarT. & KempA. M. ( 2008 ) Burns , 34 , 1072 , 1081 . DOI: 10.1016/j.burns.2008.02.011 . Background Most intentional burns are scalds, and distinguishing these from unintentional causes is challenging. Aim To conduct a systematic review to identify distinguishing features of intentional and unintentional scalds. Methods We performed an all language literature search of 12 databases 1950,2006. Studies were reviewed by two paediatric/burns specialists, using standardized methodology. Included: Primary studies of validated intentional or accidental scalds in children 0,18 years old and ranked by confirmation of intentional or unintentional origin. Excluded: Neglectful scalds; management or complications; studies of mixed burn type or mixed adult and child data. Results A total of 258 studies were reviewed, and 26 included. Five comparative studies ranked highly for confirmation of intentional/unintentional cause of injury. The distinguishing characteristics were defined based on best evidence. Intentional scalds were commonly immersion injuries, caused by hot tap water, affecting the extremities, buttocks or perineum or both. The scalds were symmetrical with clear upper margins, and associated with old fractures and unrelated injuries. Unintentional scalds were more commonly due to spill injuries of other hot liquids, affecting the upper body with irregular margins and depth. Conclusions We propose an evidence-based triage tool to aid in distinguishing intentional from unintentional scalds, requiring prospective validation. [source] Disconnect between standardized field-based testing and mannitol challenge in Scottish elite swimmersCLINICAL & EXPERIMENTAL ALLERGY, Issue 5 2010K. L. Clearie Summary Background Elite swimmers have high rates of rhinoconjunctivitis and exercise-induced bronchoconstriction. Moreover, exposure to chlorine and chlorine metabolites is known to induce bronchial hyper-reactivity. Objective To assess the early and late effects of chlorine and exercise on the unified airway of elite swimmers, and to compare the response to mannitol and field-based exercise challenge. Methods The Scottish national squad underwent exhaled tidal (FENO) and nasal (NNO) nitric oxide measurement, peak nasal inspiratory flow (PNIF), and forced expiratory volume in 1 s before, immediately after, and 4,6 h post-swimming. A sport-specific exercise test was carried out during an intensive lactate set (8 min at 80% maximum hear rate). All swimmers underwent mannitol challenge, and completed a health questionnaire. Results N=61 swimmers were assessed: 8/59 (14%) of swimmers had a positive mannitol challenge. Nine out of 57 (16%) of swimmers had a positive exercise test. Only one swimmer was positive to both. Swimmers with a positive mannitol had a significantly higher baseline FENO (37.3 vs. 18.0 p.p.b., P=0.03) than those with a positive exercise challenge. A significant decrease in FENO was observed pre vs. immediate and delayed post-chlorine exposure: mean (95% CI) 18.7 (15.9,22.0) p.p.b. vs. 15.9 (13.3,19.1) p.p.b. (P<0.01), and 13.9 (11.5,16.7) p.p.b. (P<0.01), respectively. There were no significant differences in NNO. Mean PNIF increased from 142.4 L/min (5.8) at baseline to 162.6 L/min (6.3) immediately post-exposure (P<0.01). Delayed post-exposure PNIF was not significantly different from pre-exposure. Conclusions No association was found between mannitol and standardized field-based testing in elite swimmers. Mannitol was associated with a high baseline FENO; however, exercise/chlorine challenge was not. Thus, mannitol may identify swimmers with a ,traditional' inflammatory asthmatic phenotype, while field-based exercise/chorine challenge may identify a swimmer-specific bronchoconstrictor response. A sustained fall in FENO following chlorine exposure suggests that a non-cellular, perhaps neurogenic, response may be involved in this group of athletes. Cite this as: K. L. Clearie, P. A. Williamson, S. Vaidyanathan, P. Short, A. Goudie, P. Burns, P. Hopkinson, K. Meldrum, L. Howaniec and B. J. Lipworth, Clinical & Experimental Allergy, 2010 (40) 731,737. [source] X-ray Burns,Painful, Protracted, and PreventableCLINICAL CARDIOLOGY, Issue 4 2008Ronald E. Vlietstra MB CHB Abstract Very high doses of x-ray may produce deep burns in the backs of patients having fluoroscopically guided cardiac interventional procedures. While these incidents are uncommon they can be prevented by judicious limitation of fluoroscopy and timely repositioning of the x-ray tube. Better education and improved methods for dose mapping should make these distressing complications a thing of the past. Copyright © 2008 Wiley Periodicals, Inc. [source] Contrasting Burns and Bass: Does the transactional-transformational paradigm live up to Burns' philosophy of transforming leadership?JOURNAL OF LEADERSHIP STUDIES, Issue 3 2007Dmitry Khanin Both proponents and critics view the transactional-transformational paradigm (Bass, 1997, 1998) as the brainchild of Burns' (1978) philosophy of transforming leadership. However, Burns (2003) has criticized the paradigm's narrow managerialist orientation and the claim that it is uniformly applicable to any culture and organization. In this article, I first summarize and articulate Burns' (1978, 2003) and Bass' (1985, 1998) approaches toward leadership, then compare them by using a new four-dimensional framework. Extending previous research (Yukl, 2006), the framework represents a useful tool for detecting the commonalities and differences between leadership theories with respect to the core dimensions, categories, and aspects of leadership. My inspection indicates that Burns' and Bass' conceptions stem from disparate contexts and differ in their applicability. Thus, Burns' (1978) ideas stem from political movements ideally characterized by mutual quest for shared meaning and active collaboration between leaders and followers. Conversely, Bass' (1985) approach springs from military training in which leaders transfer existing knowledge to followers and stimulate their activity by using a variety of tools from inspirational motivation to individualized consideration. This study has important practical implications as it delineates the boundary conditions of the transactional-transformational paradigm and warns against its uncritical adoption in incongruent leadership contexts. [source] Chemical burn caused by glycidyl methacrylateCONTACT DERMATITIS, Issue 5 2008Ayako Shimizu No abstract is available for this article. [source] Chemical burn due to trifluoroacetic anhydrideCONTACT DERMATITIS, Issue 4 2002Motonobu Nakamura No abstract is available for this article. [source] Laser Hair Removal: Long-Term Results with a 755 nm Alexandrite LaserDERMATOLOGIC SURGERY, Issue 11 2001Sorin Eremia MD Background. Hypertrichosis is a common problem for which laser hair removal is becoming the treatment of choice. Optimal wavelength, pulse duration, spot size, fluence, and skin cooling parameters for various skin types have not yet been firmly established. Objective. To evaluate the long-term efficacy and safety of a 3-msec 755 nm alexandrite laser equipped with a cryogen cooling device for patients with Fitzpatrick skin types I,V. Methods. Eighty-nine untanned patients with skin types I,V underwent a total of 492 treatments of laser hair removal over a 15-month period. Each patient in the study underwent a minimum of three treatment sessions spaced 4,6 weeks apart (mean treatments 5.6). Retrospective chart review and patient interviews were used to establish hair reduction results. Treatment sites included the axillae, bikini, extremities, face, and trunk. A 3-msec pulse width, 755 nm alexandrite laser equipped with a cryogen spray cooling device was used in this study. Spot sizes of 10,15 mm were used. A spot size of 10 mm was used for fluences greater than 40 J/cm2, a spot size of 12 mm was used for fluences of 35,40 J/cm2, and spot sizes of 12 and 15 mm were used for fluences less than 30 J/cm2. Fluences ranging from 20 to 50 J/cm2 (mean fluence 36 J/cm2) were used. Results. The patients had a mean 74% hair reduction. Skin type I patients had an average of 78.5% hair reduction using a mean fluence of 40 J/cm2 (35,50 J/cm2) and a 10,12 mm spot size (12 mm in more than 95% of treatments). Skin type II patients had a mean 74.3% hair reduction using a mean fluence of 38 J/cm2 (30,40 J/cm2) and a 12,15 mm spot size. Skin type III patients had a mean 73.4% hair reduction using a mean fluence of 37 J/cm2 (25,40 J/cm2) and a 12,15 mm spot size. Skin type IV patients had a mean 71.0% hair reduction using a mean fluence of 31 J/cm2 (25,35 J/cm2) and a 12,15 mm spot size. A patient with skin type V had a 60% hair reduction using a mean fluence of 23 J/cm2 (20,25 J/cm2) and a 12,15 mm spot size. The efficiency of hair removal directly correlates significantly with the fluence used. Rare side effects included transient postinflammatory hyperpigmentation (n = 9; 10%), burn with blisters (n = 1; 1%), and postinflammatory hypopigmentation (n = 2; 2%). All complications resolved without permanent scarring. Conclusion. The 3-msec cryogen cooling-equipped alexandrite laser can safely and effectively achieve long-term hair removal in patients with skin types I,V. The best results are achieved in untanned patients with skin types I,IV. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||