Twenty-four patients who were referred to our outpatient clinic for treatment of burns were included in a study to evaluate the clinical effectiveness of a new hydrocolloid dressing (HCD). The depth of their burns ranged from superficial partial thickness to full thickness burns and the average size was 1.63 per ...

The iso-shunt diagram was introduced in 1973 to simplify the selection of the optimal inspired oxygen concentration in patients undergoing intensive therapy. A further study of 25 patients in a District General Hospital showed that plots of arterial PO2 against inspired oxygen concentration closely follow predicted iso-shunt lines. There was ...

The severely burned patient responds differently to starvation ketosis in the early stage of injury as compared to the normal individual. A similar response has been observed in the patient after skeletal trauma and sepsis. In order to determine the extent of muscle protein contribution and the mechanism(s) involved, 11 ...

Victims of major burns may be at risk for selenium (Se) depletion because increased postinjury nutrient needs are often met by total parental nutrition and tube feedings which contain little Se. This study compared Se status of 17 burn patients and 191 healthy control subjects. Se intake of burn patients ...

Oxygen therapy is one of the most frequently ordered therapies for patients with chronic obstructive pulmonary disease (COPD). In a large percentage of these cases, oxygen therapy is supplied via nasal cannula. With the rising cost of medical care and the search for more effective means of oxygen delivery, a ...

Thirty-three patients with acute or subacute eczematous dermatitis were treated for two weeks in a double-blind, parallel-group study to compare the efficacy and cosmetic acceptability of 0.1 percent amcinonide cream and 0.1 percent halcinonide cream. Patients in both treatment groups showed significant (p less than 0.05) improvement from baseline for ...

Evidence for oral shedding of herpes simplex virus Type I (HSV) indicating endogenous viral reactivation as a measure of depressed host defense was sought in 44 critically ill surgical patients. Eighteen (41%) of these showed persistent HSV shedding. None of 50 controls showed HSV shedding, but 4 (10%) of 42 ...

It is suspected, but still unproven, that the increased capillary permeability which accompanies sepsis and contributes to the development of pulmonary edema (PE) involves systemic as well as pulmonary capillaries. We investigated the relationship between the colloid osmotic pressure of serum (COPS) and edema fluid (COPE) in 16 septic and ...

The burning mouth complaint of each of fifty-seven patients was thoroughly studied. Psychogenesis was found to be the most frequent cause, followed by geographic tongue and moniliasis. Multiple causative factors, such as psychogenesis and moniliasis and psychogenesis and geographic tongue, were found in some patients. The purely psychogenic group was ...

The incidence of psychological morbidity associated with delirium was compared between burn patients isolated in a bed-size plenum laminar air flow ventilation unit (PLAFVU) and matched control burn patients treated in standard open cubicles. In patients with burn sizes of less than 60 per cent of body surface area, delirium ...

A series of 22 patients with full-skin thickness burns had skin grafting operations in a Piekenrood-Vinitex BV open-topped laminar air-flow enclosure, and a parallel control series of 18 patients were grafted in the same operating room without the use of the laminar flow unit; the operating room in which both ...

Hyperlactatemia is frequently observed in critically ill patients. A correlation of blood lactate concentrations and outcome of patients has been proven in circulatory shock, circulatory arrest, acute myocardial infarction, acute hypnotic drug poisoning and severe pancreatitis. However, the prognostic relevance of hyperlactatemia yields from statistical examinations in larger groups of ...

Complement activation and neutropenia have been observed in thermally injured animals. In burn patients, granulocyte chemotaxis and morphological loss of specific granules occur. We conjectured that complement is activated in humans and, in turn, induces granulocytes to secrete lactoferrin (LF), a marker of granulocyte activation. Twenty burn patients were evaluated ...

The present study includes seventeen patients with second and third degree fresh burns involving 15-50 per cent total body surface area (TBSA). Surface swabs and quantitative burn wound biopsy cultures were obtained during postburn weeks 1, 2 and 3 and correlation was studied. To obtain bacterial counts the technique described ...

To study the effect of prolonged irrigation in the treatment of chemical eye injuries we reviewed the case records of 172 patients. Most of the patients were men in working age. The injury was caused by acid in 57 patients (33%). Of the acid burns, 28 were due to AIV ...

Which treatment, acute excision or exposure, is the method of choice in the treatment of patients with small, medium-sized or large burns, and superficial or deep burns respectively? In an attempt to give an answer to this question a Randomized, Controlled, Clinical Trial was carried out by the Burns Unit ...

Fifty patients with high-tension electrical injuries referred for primary treatment to the Burn Center at the University of Uppsala, Sweden during the period 1969 to 1982, have been investigated with special regard to the resuscitation and early complications from internal organs. Seven patients (14%) died, five of them prior to ...

We classified 41 patients in septic shock on the basis of cardiac index (CI) after volume expansion with plasma protein solution, in order to obtain adequate filling pressures. Five had decreased CI (less than 3.5 1/min per m2), 31 had moderately increased CI (3.5 - 7.0 1/min per m2) and ...

Sixty patients undergoing third molar removal were used to evaluate the efficacy of supplemental oxygen administration when administered via nasal cannula or nasal mask. Arterial oxygen concentration was estimated by transcutaneous oxygen measurement. Both methods of oxygen administration resulted in increased levels of oxygen during surgery, with the nasal mask ...

The remarkable progress achieved in control of infections in burned patients has significantly increased survival rates. Nevertheless, septic complications are still the leading cause of death in these patients. The immunologic disturbances present after severe burns certainly play a key role in susceptibility to infection, and in particular the impairments ...

Clinical description was made of a series of hypotensive patients resuscitated with and without an algorithm. Of 603 hypotensive patients, there were 114 (19%) deaths and 169 (28%) patients with complications; the average low MAP was 53 +/- 25 mm Hg. Of 169 patients with complications, 48 (28%) had shock-related ...

Fourteen thermally injured patients with severe inhalation injury were sequentially studied with the thermal-green dye double indicator dilution technique of extravascular lung water (EVLW) measurement. Eight females and six males (average age, 49 years, and average thermal burn, 37% body surface) were studied for 2-31 days postinjury. All were burned ...

Long-term oxygen therapy appears to be a safe means of treating hypoxemia. It can provide many physiologic improvements and prolongs life in persons with severe chronic arterial hypoxemia at rest. Recent studies suggest that arterial hypoxia is common during exercise and sleep, and it is likely that some patients with ...

Two patients are reported in whom severe toxicity developed about 4 days after relatively minor burn injuries and in whom the burn areas then appeared to enlarge. In both patients, B. cereus and Staph. aureus were isolated and the affected burn areas had subcutaneous thrombosis and necrosis. The management is ...

An acute depletion of plasma fibronectin or FN has been observed in critically ill, surgical, or trauma patients, but there is little information on the relationships between FN levels and the final outcome in such cases, and on the simultaneous behaviour of other serum proteins. The daily values of FN, ...

One hundred and six patients found at operation to have intra-abdominal sepsis were prospectively followed up to determine the incidence of organ malfunction and death. These outcomes were correlated with age, preexisting disease, underlying cause of sepsis, shock, nutritional status, and alcoholism. Organ malfunction occurred in 31 patients (29%), 19 ...

The effect of GIK (glucose-insulin-potassium) therapy, as an adjunctive treatment, on cardiac function and urine excretion in the early phase of extensive burn injury was investigated. In early postburn patients, within 48 hours after injury, the GIK therapy resulted in a prominent and continued elevation of cardiac index (CI) (p ...

Details are given of 25 severely ill patients in whom atracurium was used to produce neuromuscular blockade. In view of the good operating conditions and absence of effects on the cardiovascular system it is concluded that atracurium is an excellent nondepolarizing neuromuscular blocking agent for use in the severely ill, ...

A simple system for grading the severity of sepsis has been developed by scoring the attributes of sepsis under four headings: local effects of infection, pyrexia, secondary effects of sepsis and laboratory data. The information needed should be readily available at district general hospital level. The system produces a number ...

The Limulus amoebocyte lysate assay was used as one of a series of laboratory and clinical investigations on a group of 31 patients suffering from septic shock in order to assess the clinical significance of this assay for the detection of circulating endotoxin in clinical gram-negative sepsis. Four patients with ...

Total oxygen delivery (cardiac output X arterial oxygen content) and oxygen consumption were determined in 22 patients undergoing one-lung ventilation (OLV) during thoracotomy. In 11 patients, anaesthesia was maintained with halothane-oxygen and in another 11 patients with nitrous oxide-oxygen-analgesic combination (FIO2 0.5). During OLV, oxygen delivery was greater in the ...

Septic shock continues to be a serious problem with a mortality ranging from 11% to 82%, depending upon the cause, the time of diagnosis, and the type of treatment. The condition is seen in pregnant patients with postabortal or postpartal endometritis, chorioamnionitis, and pyelonephritis. In gynecology patients it is seen ...

The relationship of silver sulfadiazine therapy to leukopenia has been controversial. In our burn unit the incidence of leukopenia increased dramatically in 1978. Leukopenia was observed only in silver sulfadiazine-treated patients and not in patients treated with other agents. Because cimetidine had been introduced at about that time, the possibility ...

Whole serum complement (CH50) and C3, C4, and C3PA plasma values were studied in 48 patients: 9 with nonseptic shock; 20 with sepsis; 14 with septic shock caused by gram-negative bacteria; 5 with septic shock caused by gram-positive bacteria. All were compared with a control group of 25 healthy individuals. ...

The ventilatory response in acute lactic acidosis was assessed in 39 patients. In 18 patients, the acidosis was associated with phenformin ingestion and in 21, with other causes such as shock and sepsis, but not pulmonary edema. Arterial blood CO2 tensions and plasma bicarbonate concentrations were compared to those previously ...

An evaluation has been made on the effectiveness and feasibility of the individualized fluid replacement programme based on intensive haemodynamic monitoring using a Swan-Ganz catheter. Twenty-one extensively burned patients with an average burn of 60.8 per cent BSA were resuscitated with lactated Ringer's and colloid solutions. The rate of fluid ...

Adherence of polymorphonuclear leukocytes (PMNLs) to nylon in patients with bacteremia was studied using a whole-blood assay. Adherence of PMNLs was studied in blood obtained from patients who were not in shock; the results did not differ from the control values (70.9% +/- 4.9% vs 72.1% +/- 2.8%, respectively; P ...

Both serum opsonic capacity and granulocyte oxygenation activity were measured in 35 burn patients during their course of therapy. The microbicidal action of granulocytes is effected via the metabolic generation of oxygenating agents; introduction of chemoluminigenic substrates, such as luminol or dimethyl biacridinium dinitrate, allows ultrasensitive measurement of phagocyte oxygenation ...

Hypermetabolic burn patients are frequently in negative nitrogen balance despite provision of estimated caloric needs. We studied 18 thermally injured adult patients in order to evaluate the relationship of burn wound size to urea production and nitrogen balance. We selected data from 147 patient-days when the patients received 100 +/- ...

Measurement of 24-h urinary cyclic AMP and cyclic GMP levels in 19 patients for up to nine days after thermal injury has revealed differences in cyclic nucleotide excretion patterns between "severe" and "mild to moderate" groups of burned patients, classified according to a predictive index of burn mortality. Cyclic AMP ...

Studies were performed to further investigate an abnormality of the alternative complement pathway associated with burn injury. C3 conversion by inulin and cobra venom factor was measured in serial serum samples from 18 burned patients and in the sera from 25 normal controls. C3 conversion by both activating substances in ...

A group of patients presenting with dermatological complaints but with no significant objective dermatological pathology on examination are described. Twenty-eight patients, twelve male and sixteen female, age range 16--76 years, mean 46 years, were seen. Symptomatology was confined to three main body areas: the face--eight patients; scalp--nine patients; perineum--eight patients. ...

Of 167 patients with major burns, fatal respiratory distress developed in ten. Fluid overload caused fatal respiratory failure within 48 hours of admission in five patients with anuria, whereas late deaths were due to fluid overload and pulmonary sepsis. Three of the four patients who had a tracheostomy died of ...

We gave described a previously healthy patient with marked metabolic acidosis secondary to alcohol ingestion. An abnormal LDH isoenzyme (LDH6) located on the cathodic side of LDH5 after several episodes of shock was found in the patient's serum. We believe that the presence of LDH6 may occur as a result ...

A rigid transparent face mask of cellulose acetate butyrate was developed for the control of scar hypertrophy in the burned face. Excellent patient acceptance has been found in a six-year series of 97 patients. Use of the device for at least twenty hours a day for an average of one ...

Patients with protein calorie malnutrition (PCM) or burn injury have a high incidence of infection, partly related to a secondary deficiency of cell-mediated immunity. We have studied sera from 37 patients with PCM, 19 burns patients, and 8 uremic patients, and results were compared with those obtained in 12 healthy ...

Fourteen burn patients and four normal controls were studied for the plasma activity of a myocardial depressant factor (MDF). The mean age of the burn patients was 40.4 years and the burn area was 61.9% of body surface. MDF activities were 28 +/- 3 units in the burn patients on ...

Torture sequelae and associated diagnostic problems within the field of dermatology are reported. Patient 1 claimed to have been subjected to torture in 1973 in South America and reported that he had a thick rubber-like rope tied around each thigh just above the knees. Six years later a linear zone ...

Monitoring the central peripheral temperature gradient in critically ill surgical patients is a simple, sensitive, noninvasive and inexpensive method that can accurately reflect the state of peripheral circulation. It serves as an early warning sign, and its return to normal is a good measure of the efficacy o f therapy. ...

The oxyhaemoglobin dissociation curve (ODC) was investigated in 15 patients with Eales's disease and 11 controls to test the hypothesis that Eales's disease is caused by retinal hypoxia secondary to impaired oxygen release from the blood. Patients with the peripheral form of Eales's disease did not have any significant difference ...