RESUMO
Acute pain represents a crucial alarm signal to protect us from injury. Whereas the nociceptive neurons that convey pain signals were described more than a century ago, the molecular sensors that detect noxious thermal or mechanical insults have yet to be fully identified. Here we show that acute noxious heat sensing in mice depends on a triad of transient receptor potential (TRP) ion channels: TRPM3, TRPV1, and TRPA1. We found that robust somatosensory heat responsiveness at the cellular and behavioural levels is observed only if at least one of these TRP channels is functional. However, combined genetic or pharmacological elimination of all three channels largely and selectively prevents heat responses in both isolated sensory neurons and rapidly firing C and Aδ sensory nerve fibres that innervate the skin. Strikingly, Trpv1-/-Trpm3-/-Trpa1-/- triple knockout (TKO) mice lack the acute withdrawal response to noxious heat that is necessary to avoid burn injury, while showing normal nociceptive responses to cold or mechanical stimuli and a preserved preference for moderate temperatures. These findings indicate that the initiation of the acute heat-evoked pain response in sensory nerve endings relies on three functionally redundant TRP channels, representing a fault-tolerant mechanism to avoid burn injury.
Assuntos
Temperatura Alta/efeitos adversos , Dor Nociceptiva/fisiopatologia , Canal de Cátion TRPA1/metabolismo , Canais de Cátion TRPM/metabolismo , Canais de Cátion TRPV/metabolismo , Sensação Térmica/fisiologia , Animais , Queimaduras/fisiopatologia , Queimaduras/prevenção & controle , Temperatura Baixa/efeitos adversos , Feminino , Masculino , Camundongos , Camundongos Knockout , Terminações Nervosas/fisiologia , Fibras Nervosas/fisiologia , Nociceptividade/fisiologia , Células Receptoras Sensoriais/fisiologia , Pele/inervação , Pele/fisiopatologia , Canal de Cátion TRPA1/deficiência , Canal de Cátion TRPA1/genética , Canais de Cátion TRPM/deficiência , Canais de Cátion TRPM/genética , Canais de Cátion TRPV/deficiência , Canais de Cátion TRPV/genética , Sensação Térmica/genéticaRESUMO
INTRODUCTION: Burns are a frequent injury in children and can cause great physical and psychological impairment. Studies have identified positive effects of prevention measures based on increase in knowledge or reduction in hazards. The main goal of burn prevention campaigns, however, is to prevent burns. Therefore, this review is focused on the effectiveness of prevention programmes on the rates of burns in children. METHODS: A literature search was performed on PubMed, Embase, CINAHL, Web of Science, Google Scholar and Scopus, including a reference-check. Included were studies which evaluated burn prevention programmes in terms of burn injury rate in children up to 19 years old. Studies specifically focused on non-accidental burns were excluded as well as studies with only outcomes such as safety knowledge or number of hazards. RESULTS: The search led to 1783 articles that were screened on title and abstract. 85 articles were screened in full text, which led to 14 relevant studies. Nine of them reported a significant reduction in burn injury rate. Five others showed no effect on the number of burn injuries. In particular, studies that focused on high-risk populations and combined active with passive preventive strategies were successful. CONCLUSION: Some prevention programmes appear to be an effective manner to reduce the number of burn injuries in children. However, it is essential to interpret the results of the included studies cautiously, as several forms of biases may have influenced the observed outcomes. The research and evidence on this subject is still very limited. Therefore, it is of great importance that future studies will be evaluated on a decrease in burns and bias will be prevented. Especially in low-income countries, where most of the burns in children occur and the need for effective prevention campaigns is vital.
Assuntos
Queimaduras , Criança , Humanos , Queimaduras/epidemiologia , Queimaduras/prevenção & controle , Fatores de RiscoRESUMO
Background & objectives To assess the pattern of non-compliance to childhood safety practices among parents of children between one and five yr of age and to determine the reasons behind the same. Methods A descriptive, cross-sectional study was conducted on 120 children between one and five yr of age through a questionnaire-based interview of the primary carer. Poor compliance was defined as compliance to <85 per cent of the recommended practices. Results Of the total 48 injuries, 32 were serious (66.6%). Falls and burns/scalds were the two common types of injuries. Nearly three-fourths (72.5%) of families showed overall poor compliance. Poorest compliance was observed towards four safety practices namely, helmet wearing, restricting number of pillion riders to two on a two-wheeler, seatbelt wearing in a car and avoiding food items with a high risk of choking in children <3 yr. Parental perception of 'unnecessary' and 'lack of knowledge' were the main reasons behind non-compliance. Interpretation & conclusions Low compliance among families occurred with respect to safety on motor vehicles and avoidance of choking hazards. Change of parental perception and improved awareness is necessary for the prevention of unintentional childhood injuries.
Assuntos
Pais , Humanos , Masculino , Pais/psicologia , Feminino , Pré-Escolar , Lactente , Inquéritos e Questionários , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Segurança , Conhecimentos, Atitudes e Prática em Saúde , Cintos de Segurança/estatística & dados numéricos , Estudos Transversais , Acidentes por Quedas/prevenção & controle , Adulto , Queimaduras/prevenção & controle , Queimaduras/epidemiologiaRESUMO
BACKGROUND: Burn injuries are a significant public health concern, closely linked to housing conditions and socioeconomic status. Residents in socioeconomically deprived neighbourhoods are at increased risk of exposure to hazards due to older and poorer housing conditions and limited access to fire protection measures. Individual behaviours such as substance use, smoking, and hoarding are often highlighted as primary causes of residential fires, overshadowing the broader socioeconomic and structural factors that also play a significant role in housing safety. This paper explores the correlation between inadequate housing conditions and heightened fire risks leading to burn injuries, focusing on the contextual factors shaping everyday urban fire risks, experiences, and responses of residents living in Single-Room Occupancy (SRO) housing in Vancouver's Downtown East Side (DTES) and staff working in the fire, health, housing (social and private), and non-profit sectors. METHODS: As part of an ongoing ethnographic study, we partnered with the Vancouver Fire Rescue Services (VFRS) to conduct participant observations in private, non-profit, and government-owned SROs, modular homes, and a temporary shelter. This paper synthesizes insights from participant observations from the first author's self-reflexive journals, including informal conversations with approximately fifty-nine individuals such as SRO tenants, SRO managers/caretakers, health workers, burn survivors, municipal staff, not-for-profit staff, and firefighters. RESULTS: Urgent housing-related issues contributing to inequitable everyday urban fire risks were identified, such as structural deficiencies in SRO buildings and systems, inadequate waste management and storage, and inequitable approaches to addressing hoarding. Additionally, disparities in access to information and the interaction between interpersonal and structural stigmas were significant factors, underscoring the pressing need for intervention. CONCLUSION: Communities like DTES, facing precarious housing conditions, disadvantaged neighbourhoods, and complex health and social challenges, necessitate a comprehensive and holistic approach to fire prevention and safety. Recognizing the interplay between housing instability, mental and physical health issues, unregulated toxic drug supply, drug criminalization, and structural inequities allows practitioners from various sectors to develop contextually driven fire prevention strategies. This multifaceted approach transcends individual-level behaviour change and is crucial for addressing the complex issues contributing to fire risks in underserved communities.
Assuntos
Antropologia Cultural , Incêndios , Habitação , Humanos , Habitação/estatística & dados numéricos , Incêndios/prevenção & controle , Incêndios/estatística & dados numéricos , Colúmbia Britânica , População Urbana/estatística & dados numéricos , Masculino , Feminino , Queimaduras/prevenção & controle , Adulto , Fatores SocioeconômicosRESUMO
BACKGROUND: Web-based short-form videos are increasingly popular for disseminating fire and burn prevention information, but their content quality is unknown. OBJECTIVE: We aimed to systematically assess the characteristics, content quality, and public impact of web-based short-form videos offering primary and secondary (first aid) prevention recommendations for fires and burns in China between 2018 and 2021. METHODS: We retrieved short-form videos offering both primary and secondary (first aid) information to prevent fire and burn injuries published on the 3 most popular web-based short-form video platforms in China: TikTok, Kwai, and Bilibili. To assess video content quality, we calculated the proportion of short-form videos that included information on each of the 15 recommendations for burn prevention education from the World Health Organization (WHO; P1) and that correctly disseminated each recommendation (P2). High P1 and P2 indicated better content quality. To assess their public impact, we calculated the median (IQR) of 3 indicators: the number of comments, likes, and saves as a favorite by viewers. Chi-square test, trend chi-square test, and Kruskal-Wallis H test examined differences in indicators across the 3 platforms, years, content, and time duration of videos and between videos disseminating correct versus incorrect information. RESULTS: Overall, 1459 eligible short-form videos were included. The number of short-form videos increased by 16 times between 2018 and 2021. Of them, 93.97% (n=1371) were about secondary prevention (first aid) and 86.02% (n=1255) lasted <2 minutes. The proportion of short-form videos including each of the 15 WHO recommendations ranged from 0% to 77.86% (n=1136). Recommendations 8, 13, and 11 had the highest proportions (n=1136, 77.86%; n=827, 56.68%; and n=801, 54.9%, respectively), whereas recommendations 3 and 5 were never mentioned. Among the short-form videos that included the WHO recommendations, recommendations 1, 2, 4, 6, 9, and 12 were always disseminated correctly, but the other 9 recommendations were correctly disseminated in 59.11% (120/203) to 98.68% (1121/1136) of videos. The proportion of short-form videos including and correctly disseminating the WHO recommendations varied across platforms and years. The public impact of short videos varied greatly across videos, with a median (IQR) of 5 (0-34) comments, 62 (7-841) likes, and 4 (0-27) saves as a favorite. Short-form videos disseminating correct recommendations had larger public impact than those disseminating either partially correct or incorrect knowledge (median 5 vs 4 comments, 68 vs 51 likes, and 5 vs 3 saves as a favorite, respectively; all P<.05). CONCLUSIONS: Despite the rapid increase in the number of web-based short-form videos about fire and burn prevention available in China, their content quality and public impact were generally low. Systematic efforts are recommended to improve the content quality and public impact of short-form videos on injury prevention topics such as fire and burn prevention.
Assuntos
Queimaduras , Humanos , Queimaduras/prevenção & controle , China , Emoções , Conhecimento , InternetRESUMO
BACKGROUND: Inflicted burns on children are a particularly difficult medical and psychosocial issue. Pediatric nonaccidental burns (PNABs) are unfortunately relatively common. In our study, we aim to present the key findings on PNABs with the intention of raising awareness, improving early, and recognizing accurately by identifying red flags, developing triage tools, and establishing prevention strategies for this sensitive issue. METHODS: A computerized literature search was conducted on PubMed, Google Scholar, and Cochrane for articles published until November 2020. The online screening process was performed by 3 independent reviewers with the Covidence tool against set inclusion/exclusion criteria. The protocol was reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO). RESULTS: A total of 12 studies were included for analysis. Scald burns via forced immersion accounted for the majority of reported PNABs affecting both feet and hands. Complications included wound infection, sepsis, requiring systemic antibiotics, or intensive care. Abused children's parents had a history of mental illness, unemployment, substance abuse, incarceration, and/or low annual income. CONCLUSIONS: Scalds via forced immersion remain the most common mechanism of PNABs. All health care professionals must remain vigilant, be able to recognize subtle signs of abuse, triage patients appropriately, report to police and/or social services, and ensure no further harm is made to the child or children. Repeated abuse with burns can lead to death. Prevention and education are the cornerstones for addressing this social phenomenon.
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Queimaduras , Maus-Tratos Infantis , Criança , Humanos , Queimaduras/diagnóstico , Queimaduras/etiologia , Queimaduras/prevenção & controle , Maus-Tratos Infantis/prevenção & controleRESUMO
OBJECTIVE: To evaluate the effects of child burn prevention campaigns on medically attended burn injuries in Ulaanbaatar, Mongolia. METHODS: We conducted an interrupted time-series analysis using data on patients aged<5 years who were treated for burn injuries at the Emergency Department of the National Trauma and Orthopaedic Center from January 2009 to December 2018. Since the campaigns focused on scald prevention, we calculated the monthly rate of scald injuries per 10 000 children aged<5 years by sex and injury severity, regressing it on the number of months after January 2009 (the beginning of the study), after June 2014 (the first nationwide campaign started) and after January 2017 (the second facility-based campaign started). RESULTS: During the 10-year study period, there were 23 459 patients, of whom 18 433 (79%) were treated for scald injuries, including 6920 severe injuries. The monthly rate of overall scald injuries started to decrease after the first campaign, with a relative change of -32% at the end of the intervention. However, the rate started increasing before the initiation of the second campaign; this trend continued during and after the campaign. The rate of severe scald injuries did not show any significant changes throughout the study period. The results were consistent for both sexes. CONCLUSIONS: The nationwide burn prevention campaign was effective in reducing non-severe burn injuries among young children. Since the campaign was primarily aimed at increasing public awareness of child burn injury risks, further interventions should be considered with passive measures to prevent severe burn injuries.
Assuntos
Queimaduras , Queimaduras/epidemiologia , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Humanos , Lactente , Análise de Séries Temporais Interrompida , Masculino , Mongólia/epidemiologiaRESUMO
Urban governance implies that state authorities and other actors (including private and social sectors) work together with authentic community participation as needed to meet the challenges to achieve urban health. In this context, addressing the problem of injury is critical. In urban space, injuries can occur for various external causes (falls, burns, even interpersonal violence, etc). This paper includes a discussion and analysis of governance mechanisms on urban areas, in terms of the implementation of the safe system approach which has been proposed as the best preventive strategy, to assure road safety, mostly at urban spaces, for injury prevention. The existence of governance mechanisms needs to be considered as a primary issue to be included on injury research to evaluate the implementation for preventive programmes on the injury field in general, especially those occurred at urban spaces.
Assuntos
Saúde da População Urbana , Ferimentos e Lesões , Queimaduras/prevenção & controle , Cidades , Participação da Comunidade , Humanos , Violência/prevenção & controle , Ferimentos e Lesões/prevenção & controleRESUMO
PURPOSE: To determine the effectiveness of a novel cast-saw alarm system in minimizing the number and duration of cast-saw blade-to-skin contacts. METHODS: Twenty orthopaedic residents removed a pair of long-arm casts applied to instrumented pediatric upper extremity models. The model and cast-saw were instrumented to detect blade to "skin" contact at a rate of 600 Hz. Each resident performed cast removal with and without the use of a cast-saw alarm, the order of which was randomized. Eleven additional "new" cast-saw users then removed pairs of casts, without and then with the cast alarm, to evaluate what effect the alarm would have on preventing blade-to-skin contact in users with no previous cast-saw experience. The number and duration of cast-saw touches were then evaluated. Statistical significance was determined paired 1-sided students t tests (number of touches). RESULTS: For the residents (n=20), the total number of blade-to-skin contacts was 233. One hundred eighty-one blade-to-skin contacts without the alarm and 52 with the alarm (71% reduction) (t(19)=-3.42, P=0.001), averaging 6.45 more blade-to-skin contacts per cast without the alarm. The median blade-to-skin contact duration was 0.166 seconds without the alarm and 0.087 seconds with the alarm. This was a 48% reduction in contact time (P=0.073). For the inexperienced users (n=11), the total number of blade-to-skin contacts was 356, 324 blade-to-skin contacts without the alarm and 32 with the alarm (90% reduction) (t(10)=-2.78, P=0.009), averaging 26.5 more blade-to-skin contacts without the alarm. The median blade-to-skin contact duration for the novice was 0.313 seconds without the alarm and 0.1 seconds with the alarm (68% reduction). Contact time was reduced in both groups but failed to reach statistical significance. However, alarm use significantly reduced the number of touches of >0.5 seconds duration (62 vs. 3) in the novice group, P=0.0176. Blade-to-skin contact of >0.5 seconds were felt to represent touches that were more likely to result in thermal injury to a living patient. CONCLUSION: Blade-to-skin contact can be reduced with the use of a cast-saw alarm. These effects appear most amplified in users with little prior cast-saw experience. LEVEL OF EVIDENCE: Not applicable.
Assuntos
Queimaduras , Ortopedia , Queimaduras/prevenção & controle , Moldes Cirúrgicos , Criança , Humanos , Pele/lesões , Extremidade SuperiorRESUMO
BACKGROUND: Burn injury and operating room fires are significant risks for both surgical patients and staff. The purpose of this study was to examine the fire and burn risks associated with two types of fiberoptic light cables and evaluate the efficacy of a novel device in reducing the risk of these fire and burn injuries. METHODS: A 300-W light source was connected sequentially to two standard fiberoptic cables (Storz and Olympus). The distal ends were buried in, or rested on, standard operating room materials including a cotton green towel and a blue propylene drape to assess the risk of fire formation or burn injury. The Gloshield device was then attached to the ends of the cables and the experiment was repeated. Trials simulating improper use of the device were then conducted with the Gloshield device placed either too deep or too shallow on the end of the light cable. All trials were conducted for a maximum of 10 min or until a positive result (burn or fire) was achieved. Trials were conducted in room air or with supplemental 100% oxygen and repeated for accuracy. RESULTS: Both the Storz and Olympus fiber optic cables were capable of producing burns in standard operating room towels and drapes in control trials. The Gloshield device prevented thermal injury when properly attached in all conditions. Improper use trials demonstrated that the device may be ineffective when not applied properly. CONCLUSIONS: The Gloshield device is effective in reducing the risk of thermal burn injury by protecting the distal ends of endoscopic light cables from operating room materials. However, the device needs to be attached appropriately in order to provide protective benefits.
Assuntos
Queimaduras , Incêndios , Queimaduras/etiologia , Queimaduras/prevenção & controle , Eletrocirurgia , Endoscopia , Incêndios/prevenção & controle , Humanos , Salas CirúrgicasRESUMO
OBJECTIVES: SafeTea is a multifaceted intervention delivered by community practitioners to prevent hot drink scalds to young children and improve parents' knowledge of appropriate burn first aid. We adapted SafeTea for a national multimedia campaign, and present a mixed-methods process evaluation of the campaign. METHODS: We used social media, a website hosting downloadable materials and media publicity to disseminate key messages to parents/caregivers of young children and professionals working with these families across the UK. The SafeTea campaign was launched on National Burns Awareness Day (NBAD), October 2019, and ran for 3 months. Process evaluation measurements included social media metrics, Google Analytics, and quantitative and qualitative results from a survey of professionals who requested hard copies of the materials via the website. RESULTS: Findings were summarised under four themes: 'reach', 'engagement', 'acceptability' and 'impact/behavioural change'. The launch on NBAD generated widespread publicity. The campaign reached a greater number of the target audience than anticipated, with over 400 000 views of the SafeTea educational videos. Parents and professionals engaged with SafeTea and expressed positive opinions of the campaign and materials. SafeTea encouraged parents to consider how to change their behaviours to minimise the risks associated with hot drinks. Reach and engagement steadily declined after the first month due to reduced publicity and social media promotion. CONCLUSION: The SafeTea campaign was successful in terms of reach and engagement. The launch on NBAD was essential for generating media interest. Future campaigns could be shorter, with more funding for additional social media content and promotion.
Assuntos
Queimaduras , Primeiros Socorros , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Multimídia , PaisRESUMO
PURPOSE: The pulsed-electron avalanche knife (PEAK) PlasmaBlade TnA (Medtronic, n.d.) is a relatively new electrosurgical technology that is used widely in head and neck surgery (Medtronic Manuals, n.d.). This study aims to summarize device malfunctions, patient complications, and subsequent interventions related to PEAK PlasmaBlade TnA during tonsillectomy and adenoidectomy. MATERIALS AND METHODS: The US Food and Drug Administration's Manufacture and User Facility Device Experience database was queried for reports of PlasmaBlade TnA adverse events from June 6, 2009, to August 30, 2020. Data were extracted from reports pertaining to tonsillectomy with or without adenoidectomy. RESULTS: 128 reports were identified, from which 163 adverse events were extracted. Of these, 23 (14.6%) were related to patients, and 140 (85.4%) were related to device malfunction. The most frequently reported patient-related adverse event was a burn injury (17 [73.9%]). The most common device malfunctions were dislodgment of device component (39 [27.9%]), followed by tip ignition (32 [22.9%]), damaged tip or wire during operation (28 [20%]), and melted device (24 [17.1%]). CONCLUSIONS: PEAK PlasmaBlade TnA have demonstrated utility in tonsillectomy with or without adenoidectomy but are associated with adverse events. Interventions aimed at improving both physician and patient education may help reduce adverse events attributed to improper use. Further study is needed to clarify optimal approaches to education.
Assuntos
Adenoidectomia/instrumentação , Eletrocirurgia/instrumentação , Falha de Equipamento/estatística & dados numéricos , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Medição de Risco , Instrumentos Cirúrgicos/efeitos adversos , Tonsilectomia/instrumentação , Adenoidectomia/efeitos adversos , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/prevenção & controle , Eletrocirurgia/efeitos adversos , Feminino , Educação em Saúde , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Masculino , Segurança do Paciente , Tonsilectomia/efeitos adversosRESUMO
BACKGROUND: The incidence of injuries from cast saws during cast removal ranges from 0.12% to 4.3%. With 1 second or less of exposure time, a temperature of 65°C can cause partial thickness burns. Despite numerous studies that recommend avoiding the use of a dull blade, there is no objective measure of what defines dullness. METHODS: Plaster and fiberglass casts were collected and measured after removal from patients in the clinic. A series of slabs were constructed based on these measurements. To simulate our emergency department setting, a Stryker 940 cast saw without an attached vacuum was used to split plaster slabs. A thermocouple was used to directly measure the 940-23 ion-nitride saw blade temperature after each use. To simulate our orthopaedic clinic setting, a Stryker 940 cast saw with an attached vacuum was used to split fiberglass and plaster slabs. Three blades were tested in each setting, bivalving 50 slabs each. RESULTS: For the plaster slabs split without a vacuum, average blade temperature of the 3 blades reached 65°C on the 42nd cast. However, the individual blades exceeded 65°C on the 33rd, 31st, and 38th casts, respectively. For the fiberglass and plaster slabs split with a vacuum, average blade temperature reached a maximum of 57.5°C in the first 50 trials. Extrapolating from this data, the blade is predicted to exceed 65°C on the 104th cast. CONCLUSIONS: When a Stryker 940 cast saw without vacuum is used to cut plaster casts, the ion-nitride blade should be changed frequently, at minimum after 60 casts have been split, or 30 casts have been bivalved. When a Stryker 940 cast saw with vacuum is used to remove fiberglass and plaster casts, the ion-nitride blade should be changed after removing 103 casts. A cast saw with an attached vacuum should be used whenever possible to minimize the risk of burning patients. CLINICAL RELEVANCE: Determine how often a cast saw blade should be changed to minimize risk of burning patients.
Assuntos
Queimaduras , Ortopedia , Queimaduras/etiologia , Queimaduras/prevenção & controle , Moldes Cirúrgicos/efeitos adversos , Humanos , TemperaturaRESUMO
OBJECTIVES: The relationship between fireworks and patient characteristics is not known. Our objective was to examine how severe fireworks-related injuries in children and teens compare to adults. METHODS: We conducted a retrospective case series (2005-2015) study of patients who sustained consumer fireworks-related injuries requiring hospital admission and/or operation at a single level 1 trauma/burn center. The distribution of race, use behavior, injury type, body region injured, and firework type was examined by age groups, 1 to 10 years, 11 to 17 years, and 18 years or older. RESULTS: Data from 294 patients 1 to 61 years of age (mean, 24 years) were examined. The majority (91%) were male. The proportion of injuries from different firework types varied by age, with rockets causing the highest proportion in children aged 1 to 10 years, homemade fireworks in those aged 11 to 17 years, and shells/mortars in adults 18 years or older. Compared with adults, children aged 1 to 10 years were more frequently American Indian/Alaska Native, Hispanic, or Asian than White. Compared with adults, children aged 1 to 10 years and 11 to 17 years were more frequently bystanders than active users. Compared with adults, children aged 1 to 10 years and 11 to 17 years had a greater proportion of burn and face injuries. Children aged 1 to 10 years had a decreased proportion of hand injuries. Three patients, 2 adults and 1 child aged 11 to 17 years, died. CONCLUSIONS: Children, teens, and adults experience severe fireworks-related injuries differently, by demographic characteristics, injury patterns, and firework types. Tailored public health interventions could target safety messaging and injury prevention outreach efforts to reduce firework injuries among children and adolescents.
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Traumatismos por Explosões/epidemiologia , Queimaduras/epidemiologia , Substâncias Explosivas/efeitos adversos , Prevenção de Acidentes/métodos , Adolescente , Adulto , Fatores Etários , Traumatismos por Explosões/etiologia , Traumatismos por Explosões/mortalidade , Traumatismos por Explosões/prevenção & controle , Queimaduras/etiologia , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Traumatismos Oculares/epidemiologia , Traumatismos Faciais/epidemiologia , Feminino , Traumatismos da Mão/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Traumatologia , Adulto JovemRESUMO
OBJECTIVE: To compare the prevalence of esophageal and periesophageal thermal injury in patients undergoing radiofrequency (RF) atrial fibrillation (AF) ablation using 8 mm tip catheters during three different esophageal protection strategies. METHODS: Forty-five consecutive patients with paroxysmal or persistent AF underwent first ablation procedure, besides esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS) performed before and after the pulmonary vein (PV) isolation. Before the procedure, patients were randomly assigned to one of three esophageal lesion protection strategies: group I-without any protective or monitoring dispositive and limiting RF applications to 30 W for 20 seconds, in left atrium posterior wall (LAPW); group II-power and time of RF delivery, up to 50 W for 20 seconds at LAPW, limited by esophageal temperature monitoring; group III-applications of RF in LAPW with fixed power application of 50 W for 20 seconds during continuous esophageal cooling. RESULTS: Baseline characteristics of patients were similar in all groups. The four PVs were isolated in 14 (93.3%), 13 (86.7%), and 15 (100%) patients, respectively in groups I, II, and III. The mean RF power was significantly higher (P < .001) in the posterior side of PVs in group III. Post-AF ablation EGD and EUS revealed two esophageal wall ulcerations and two periesophageal mediastinal edemas only in the esophageal cooling group (P = .008). CONCLUSION: Esophageal cooling balloon strategy resulted in a higher RF power energy delivery when ablating at the LA posterior wall, using 8 mm nonirrigated tip catheters under temperature mode control. Despite that, patients presented a relatively low incidence of esophageal and periesophaeal injuries.
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Fibrilação Atrial/cirurgia , Queimaduras/prevenção & controle , Ablação por Cateter , Esôfago/lesões , Veias Pulmonares/cirurgia , Adulto , Brasil , Queimaduras/diagnóstico por imagem , Queimaduras/epidemiologia , Cateteres Cardíacos , Ablação por Cateter/efeitos adversos , Ablação por Cateter/instrumentação , Desenho de Equipamento , Esôfago/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Resultado do TratamentoRESUMO
Catheter ablation has emerged as an effective treatment for atrial fibrillation (AF). Atrial esophageal fistula (AEF) is a rare, but feared complication. With increasing utilization of ablation therapy for AF, the understanding of the relationship between AEF and ablation has been improved in recent years. Efforts to reduce the risk of AEF have focused on decreasing the risk of severe esophageal injury (EI) and the presumed subsequent progression from EI to AEF, including esophageal temperature monitoring, esophageal cooling systems, esophageal deviation devices, and decreasing and/or curtailing ablation energy delivery. Periprocedural assessment may help identify higher risk patients and detect early esophageal lesions. This review systematically summarizes and evaluates the current strategies and techniques utilized to reduce the risk of AEF in the clinical workflow for AF ablation. We expect that this review will help clinicians to better understand the principles, advantages, and disadvantages of these methods, and to find suitable strategies using current available tools.
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Queimaduras/prevenção & controle , Ablação por Cateter , Fístula Esofágica/prevenção & controle , Esôfago/lesões , Átrios do Coração/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Fibrilação Atrial/cirurgia , Queimaduras/etiologia , Fístula Esofágica/etiologia , Humanos , Complicações Pós-Operatórias/etiologiaRESUMO
OBJECTIVE: Despite the high prevalence of preventable hot drink scalds in preschool children, there is a paucity of research on effective prevention interventions and a serious need to improve parents' knowledge of first aid. This study investigates the feasibility of 'Safe-Tea', an innovative multifaceted community-based intervention delivered by early-years practitioners. METHODS: 'Safe-Tea' was implemented at Childcare, Stay&Play and Home Visit settings in areas of deprivation in Cardiff, UK. A mixed-methods approach was used, including preintervention and postintervention parent questionnaires and focus groups with parents and practitioners to test the acceptability, practicality and ability of staff to deliver the intervention, and parents' knowledge and understanding. RESULTS: Intervention materials, activities and messages were well received and understood by both parents and community practitioners. Interactive and visual methods of communication requiring little to no reading were most acceptable. Parents' understanding of the risk of hot drink scalds in preschool children and knowledge of appropriate first aid improved postintervention. Parents knew at baseline that they 'should' keep hot drinks out of reach. Focus group discussions after intervention revealed improved understanding of likelihood and severity of scald injury to children, which increased vigilance. Parents gained confidence to correct the behaviours of others at home and pass on first aid messages. CONCLUSION: This feasibility study is a vital step towards the development of a robust, evidence-based behaviour change intervention model. Work is underway to refine intervention materials based on improvements suggested by parents, and test these more widely in communities across the UK.
Assuntos
Acidentes Domésticos/prevenção & controle , Bebidas , Queimaduras/prevenção & controle , Pais/educação , Adulto , Pré-Escolar , Feminino , Grupos Focais , Humanos , Masculino , Inquéritos e Questionários , Reino UnidoRESUMO
The present study has been undertaken in order to highlight the healing effect of Zizyphus lotus vegetable oil. The seeds of this plant contain an oil rate of 30%. The obtained results on the main elements composing the vegetable oil have shown that Zizyphus lotus vegetable oil has a low value of acidity index and it presents a not negligible degree of unsaturation. The value of the peroxide index of Zizyphus lotus vegetable oil is less than 10 which characterizes the most of conventional oils. Furthermore, the spectral analysis by gas chromatography has shown the presence of 53 majority and minority molecules. Thus, the evaluation of the healing activity of Z. lotus seed vegetable oil has demonstrated a highly significant effect against the negative control and silver sulfadiazine was used as conventional treatment for burns. Based on the obtained results, we can suggest that the oil extracted from the seeds of the studied plant could be used to cure wounds.
Assuntos
Queimaduras/prevenção & controle , Óleos de Plantas/farmacologia , Sementes/química , Cicatrização/efeitos dos fármacos , Ziziphus/química , Animais , Queimaduras/etiologia , Queimaduras/fisiopatologia , Cromatografia Gasosa , Temperatura Alta/efeitos adversos , Camundongos , Óleos de Plantas/análise , Óleos de Plantas/isolamento & purificaçãoRESUMO
OBJECTIVES: To test maternal voice alarm effectiveness under residential conditions and determine whether personalizing the maternal voice alarm message with the child's first name improves effectiveness. STUDY DESIGN: Using a randomized, nonblinded, repeated measures design, we compared 3 maternal voice smoke alarms with respect to their ability to awaken 176 children 5-12 years old from stage 4 slow-wave sleep and prompt their performance of an escape procedure. A conventional residential high-frequency tone smoke alarm was used as a comparative reference. Children's sleep stage was monitored in a residence-like research setting. RESULTS: Maternal voice alarms awakened 86%-91% of children and prompted 84%-86% to escape compared with 53% awakened and 51% escaped for the tone alarm. A sleeping child was 2.9-3.4 times more likely to be awakened by each of the 3 voice alarms than the tone alarm. The median time to awaken was 156 seconds for the tone alarm and 2 seconds for each voice alarm. The proportions of children who awakened and escaped differed significantly between the tone alarm and each voice alarm, but no significant differences were found between each pair of the voice alarms, regardless of whether the child's first name was included in the alarm message. CONCLUSIONS: The maternal voice alarms significantly outperformed the tone alarm under residential conditions. Personalizing the alarm message with the child's first name did not increase alarm effectiveness. These findings have important implications for development of an effective and practical smoke alarm for children. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01169155.
Assuntos
Queimaduras/prevenção & controle , Incêndios/prevenção & controle , Utensílios Domésticos/instrumentação , Habitação , Equipamentos de Proteção/normas , Sono/fisiologia , Lesão por Inalação de Fumaça/prevenção & controle , Queimaduras/epidemiologia , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Incêndios/estatística & dados numéricos , Humanos , Incidência , Masculino , Polissonografia , Fumaça , Lesão por Inalação de Fumaça/epidemiologia , Estados Unidos/epidemiologiaRESUMO
AIM: The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive campaigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention campaign 'Cool Runnings'. This paper provides baseline data for this randomised controlled trial (RCT). METHOD: Queensland-based mothers aged 18+ years with at least one child aged 5-12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. RESULTS: In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32; 95% CI 1.8 to 6.1) and smoking status (OR=0.17; 95% CI 0.04 to 0.7). CONCLUSION: In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children; there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6-24 months, it is important to target future burn prevention/first aid campaigns at parents of young children. TRIAL REGISTRATION NUMBER: ACTRN12616000019404; Pre-results.