Burns : journal of the International Society for Burn Injuries
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Multicenter Study
Considerations for the provision of psychosocial services for families following paediatric burn injury--a quantitative study.
The purpose of the study was to quantify and report levels of psychosocial distress in a sample of parents of burned children to inform evidence-based recommendations for psychosocial support programmes. This paper reports on the cross-sectional quantitative strand of a mixed-methodology study. Standardised instruments measuring anxiety, depression, family functioning, personality, child behaviour and social experience were administered to 72 parents at different points after burn. ⋯ Potential vulnerability markers for parental distress included lower emotional stability, younger age of mother and poorer family functioning. The wide range and high proportion of parents reporting clinically significant distress support the recommendation that screening should be a routine part of care. The relative importance of social factors over objective measurements of injury, such as TBSA, in explaining the observed levels of distress, supports the recommendation that routine assessment and a family-centred approach to the delivery of psychosocial support should be adopted and be offered to all parents, irrespective of the size of their child's burn.
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The goal of this study was to analyse expression profiles of human epithelial host defence peptides in burned and unburned skin tissue, samples of which were obtained during debridements and snap-frozen in liquid nitrogen. Total RNA was isolated, and cDNA of epithelial host defence peptides and proteins (hCAP-18/LL-37, hBD1-hBD4, dermcidin, S100A7/psoriasin and RNAse7) was quantified by qRT-PCR. In situ hybridisation and immunohistochemical staining localised gene expression of hCAP-18/LL-37, hBD2 and hBD3 in histological sections. ⋯ In situ hybridisation revealed expression of hCAP-18/LL-37, hBD2 and hBD3 at the surface of burns that was independent of burn depth. However, the finding of higher host defence peptide gene expression rates does not correlate with the incidence of wound infection in burns. We hypothesise that the epithelial innate immune response in burns is complex.
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Many burn patients experience psychosocial problems such as personality change, post-traumatic stress disorder, family trouble, and financial burden. The purpose of this study was to identify the risk factors of these psychosocial problems that prevented burn patients from developing appropriate adjustments after burn. Six hundred eighty-six adult burn inpatients were interviewed. ⋯ Lack of family support and living expense burden were the two significant risk factors for psychosocial problems including, burn treatment problems, rehabilitation problems, and welfare information problems on both acute and chronic burn patients. Medical expense burden was the risk factor among chronic burn patients. These findings suggested that active interventions by the burn team including mental health professionals (psychologist, psychiatrist or social worker) might reduce psychosocial problems of burn patients and encourage social rehabilitation.
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Electrical burn is less common nowadays but still has complications and requires therapeutic interventions especially in developing countries. It occurs more in males and in industrial sites. The importance of electrical burn led us to study a 30 months history of electrical burn in Shiraz, Southern Iran. ⋯ The mean hospitalization period was 11.5 days and the mean burn extent was 27.5%. Half of the victims were employees and 59.3% of the electrical burns occurred at their work site. 67.2% of burns were due to high voltage electrical current (more than 1000 V) and 4.6% of the patients died due to the direct cause of electrical burn. The high prevalence of electrical burn in males and workers emphasizes on the essence of standardization of occupational areas and use of trained workers to prevent electrical burns.
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A prospective study to investigate first aid and initial management for 247 paediatric burn patients from 1 June, 2004 to 31 June, 2006 at the Burn Intensive Care Unit, National Institute of Burns (NIB), Hanoi. Data were collected from documents from referring hospitals and direct interview of patients, relative and transport team as guided by the International Society for Burn Injury (ISBI) and the World Health Organization (WHO). Results showed that cooling the burn surface by cold water was applied in 27.17%. ⋯ Burn surface area was accurately diagnosed in only 21.90% of total cases. In conclusion, first aid and initial management in Vietnam are still far from ideal. Further public education and continuing medical education should be applied in Vietnam.