Burns : journal of the International Society for Burn Injuries
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Burn injuries impose a considerable burden on healthcare systems. It is among the top ten causes of mortality and a major cause of disability. This study aimed to calculate and compare the lethal area fifty percent (LA50) and standardized mortality ratio (SMR) in patients with burns. ⋯ The trend of LA50 in these five years declined by 12%, whereas the SMR was below 100%. Improvement in burn management quality in high-risk groups including the elderly, females, and patients with extensive burns may improve LA50 in burn units. However, LA50 alone is not a conclusive index for the performance of a burn department, and it should be interpreted alongside with SMR.
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Burn injuries are a debilitating cause of morbidity and mortality associated with the long-term impact of psychological factors on quality of life. Accurate assessment of the differential impact of burn sequelae and anxiety is often complicated by the overlap between psychological and somatic symptoms in burns patients. The Beck Anxiety Inventory (BAI) is one validated psychometric tool for anxiety assessment. The primary objective of this study is to investigate whether utilising the BAI as a tool to assess for anxiety in burns patients is biased due to the confounding of symptoms of anxiety with the physical sequelae of a burn injury. ⋯ This feasibility study found preliminary evidence suggesting that the BAI may, in part, represent misattributed symptoms of cutaneous injury from burns. However, whilst our findings suggest an attribution bias, there is not enough evidence from this data to comment on whether its use should be restricted in burns patients. Further research is needed to formally quantify convergent and divergent validity through structured interviews. In addition, further research using other self-report tools of anxiety in burns patients would be useful to corroborate the prospect of biased and confounded anxiety scores.
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This systematic review investigated the effectiveness and safety of intensive insulin therapy (IIT), insulin secretagogues and sensitisers in burn patients. PubMed, Embase, clinicaltrials.gov and Cochrane central were searched from 1990 to 2016. Title/abstract screening, full-text review, critical appraisal and data extraction were carried out by two independent reviewers. ⋯ Meta-analyses could not be performed for sensitisers or secretagogues. These findings support recommendations that moderate insulin administration (130-150mg/dL) is the prudent approach in burn patients. The evidence is relatively sparse and further research is warranted.
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Aromatherapy is often used to manage several conditions, including pain, psychological distress, and burn-related symptoms. The objective of this review was to assess the current evidence regarding the efficacy of aromatherapy as a treatment for burn wounds. ⋯ The evidence from the above trials is not sufficient to conclude that aromatherapy effectively relieves symptoms in patients with burns. However, the findings of the trials do not seem very plausible, and the trials themselves were of low quality and included only small numbers of patients. Studies that are adequately powered and feature better designs are needed to investigate the potential mechanisms underlying the effects of aroma therapy on pain and anxiety.
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Randomized Controlled Trial
The efficacy of excision followed by intralesional 5-fluorouracil and triamcinolone acetonide versus excision followed by radiotherapy in the treatment of ear keloids: A randomized control trial.
The ear is the common site for keloid formation especially in women after ear piercing. Surgery is the main stay of treatment in these lesions but there are large numbers of treatment failures in surgery alone. ⋯ Excision and intralesional 5-FU/TAC is an effective treatment for keloids on the ears.