Burns : journal of the International Society for Burn Injuries
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This paper reviews the literature on deliberate self-burning (DSB) and compares patterns in various countries. Fifty-five studies of deliberate self-harm or suicide by fire published in the last 20 years were reviewed. They reported on 3351 cases of DSB, including 2296 deaths. ⋯ The use and nature of fire accelerants, the possible roles of ethnicity, religion/faith and imitation are discussed. Three broad groups of victims were identified: psychiatric patients (Western and Middle-Eastern countries); those committing DSB for personal reasons (India, Sri Lanka, Papua-New Guinea, Zimbabwe); and those who are politically motivated (India, South Korea). Self-mutilators and self-immolators seem to be fairly distinct groups of people.
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Review Case Reports
Temporary henna tattooing--a risky procedure. Case report and literature review.
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Nitric oxide (NOz.rad;) is a diatomic mediator liberated on oxidation of L-arginine by the nitric oxide synthase (NOS) family of enzymes. It has complex and wide ranging functions in vivo and has been implicated in the development of the profound inflammatory response that occurs as a result of cutaneous burn injury. ⋯ This review focuses on the role of NOz.rad; in inflammation, with particular emphasis on the acute post-burn inflammatory response. Specific areas of discussion include the maintenance of microvascular haemostasis, leukocyte recruitment and remote organ dysfunction following thermal injury.
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Much of the morbidity and mortality of severely burned patients is connected with hypermetabolism and catabolism with its accompanying impairment of wound healing and increased infection risks. In order to prevent the erosion of body mass, nutritional support and other strategies to prevent catabolism have become a major focus in the care of severely burned patients. ⋯ From the clinical literature, total enteral nutrition starting as early as possible without any supplemental parenteral nutrition is the preferred feeding method for burned patients. Using a duodenal approach, especially in the early postburn phase, seems to be superior to gastric feeding. Administration of high calorie total enteral nutrition in any later septic phase should be critically reviewed due to possible impairment of splanchnic oxygen balance. Therefore, measurement of CO(2)-gap should be considered as a monitoring method during small bowel nutrition. The impact on the course of disease of supplements such as arginine, glutamine and vitamins as well as the impact of the use of anabolic and anticatabolic agents is not yet evident. Furthermore, the effect of insulin administration and low blood sugar regimes on wound healing and outcome in burned patients should be evaluated in future studies.
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Review Case Reports
Shabbes burn, a burn that occurs solely among Jewish orthodox children; due to accidental shower from overhead water heaters.
From January 1990 to January 2000, 35 children were treated in our department for Shabbes burn, a unique scald burn that occurred mainly among orthodox Jews during the Sabbath. A retrospective review was conducted to determine the extent of the problem, to understand the burn mechanism and to suggest a prevention program. A shower of hot water from the Sabbath heater is the cause of this burn. ⋯ Education programs using the media directed to the Jewish orthodox population have been conducted, this combined with redesigned of the heater, have reduced significantly the incidence of the burn as seen in our institute. However, even though efforts have been supported widely, there remains a need for educational and governmental regulations on a national level. This could aid orthodox Jews not only in Israel but globally, as well.