Burns : journal of the International Society for Burn Injuries
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How do clinicians determine the acceptable level of recovery of quality of life (QoL) after a burn? Many use the Burn Specific Health Scale (BSHS). The aim of this study was to examine normative values of the BSHS-Brief (BSHS-B) questionnaire in the general population. ⋯ The study showed the non-burned population do not respond with full scores to all questions in the BSHS-B. The result was more notable in the non-physical questions related to the psychological and environmental factors. The data presented prompts clinicians to collect and define acceptable recovery of quality of life after a burn as measured by the BSHS-B for their local burn population.
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Discrimination in service delivery can interfere with follow-up care, service receipt, and return to normal quality of life. This study was conducted to assess and compare patients' perception of caregivers' behaviour and attitudes in two groups; self-immolation and cases of unintentional burn. This study was conducted at the burn unit of Taleqani Hospital in Ilam in 2008. ⋯ This inter-group difference was only dependent on the nature of burns (self-immolation vs. unintentional), and other studied variables did not significantly affect results. The stigma of self-immolation should not impair the quality of care or the behaviour and attitudes of caregivers. It is necessary to train and monitor staff in this regard so that cases of self-immolation can receive services without discrimination.
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Mammalian target of rapamycin (mTOR) is an important mediator for cross talk between nutritional signals and metabolic signals of insulin by downregulating insulin receptor substrate proteins. Therefore, mTOR inhibition could become a therapeutic strategy in insulin-resistant states, including insulin resistance induced by burn. We tested this hypothesis in the rat model of 30% TBSA full thickness burn, using the mTOR inhibitor rapamycin. ⋯ Inhibition of mTOR by rapamycin inhibited the phosphorylation of mTOR, reduced serine³⁰⁷ phosphorylation, elevated tyrosine phosphorylation and partly prevented the decrease of GIR after burn. However, TNF-α, insulin and C-peptide were not decreased by rapamycin treatment postburn. Taken together, these results indicate that the mTOR pathway is an important modulator of the signals involved in the acute regulation of insulin-stimulated glucose metabolism, and at least, partly contributes to burn-induced insulin resistance. mTOR inhibition may become a therapeutic strategy in insulin-resistant states after burn.
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Scar flexion contracture of fingers is one of the most serious consequences of hand burns and patient disability after burn. Many kinds of reconstructive techniques are currently used and new procedures are being investigated. The author presents a new method of finger contracture reconstruction developed in the process of burn reconstructive operations on hands of over a thousand patients. ⋯ Two hundred and seventy-five patients were operated upon. Scar contractures were satisfactorily addressed in all patients. Incomplete extension was found in 46 patients; this was caused by interphalangeal joint injuries (ligaments, capsule, cartilage), ankylosis or boutonniere deformity.