RESUMO
INTRODUCTION: Children 5 and younger are at risk for sustaining serious burn injuries. The causes of burns vary depending on demographic, cultural and socioeconomic variables. At this pediatric burn center we provided medical care to children from Mexico with severe injuries. The purpose of this study was to understand the impact of demographic distribution and modifiable risk factors of burns in young children to help guide prevention. METHODS: A retrospective chart review was performed with children 5 and younger from Mexico who were injured from 2000-2013. The medical records of 447 acute patients were reviewed. Frequency counts and percentages were used to identify geographic distribution and calculate incidence of burns. Microsoft Powermap software was used to create a geographical map of Mexico based on types of burns. A binomial logistic regression was used to model the incidence of flame burns as opposed to scald burns in each state with relation to population density and poverty percentage. In all statistical tests, alpha=0.05 for a 95% level of confidence. RESULTS: Burns were primarily caused by flame and scald injuries. Admissions from flame injuries were mainly from explosions of propane tanks and gas lines and house fires. Flame injuries were predominantly from the states of Jalisco, Chihuahua, and Distrito Federal. Scalds were attributed to falling in large containers of hot water or food on the ground, and spills of hot liquids. Scald injuries were largely from the states of Oaxaca, Distrito Federal, and Hidalgo. The odds of a patient having flame burns were significantly associated with poverty percentage (p<0.0001) and population density (p=0.0085). Increasing levels of poverty led to decrease in odds of a flame burn, but an increase in the odds of scald burns. Similarly, we found that increasing population density led to a decrease in the odds of a flame burn, but an increase in the odds of a scald burn. CONCLUSIONS: Burns in young children from Mexico who received medical care at this pediatric burn center were attributed to flame and scalds. Potential demographic associations have been identified. Different states in Mexico have diverse cultural and socioeconomic variables that may influence the etiology of burns in young children and this information may help efficiently tailor burn prevention campaigns for burn prevention efforts in each region. APPLICABILITY OF RESEARCH TO PRACTICE: This information will be used to develop and help modify existing prevention campaigns.
Assuntos
Queimaduras/epidemiologia , Densidade Demográfica , Pobreza/estatística & dados numéricos , Unidades de Queimados , Pré-Escolar , Explosões/estatística & dados numéricos , Feminino , Incêndios/estatística & dados numéricos , Humanos , Incidência , Lactente , Modelos Logísticos , Masculino , México/epidemiologia , Razão de Chances , Estudos Retrospectivos , Fatores Socioeconômicos , Estados UnidosRESUMO
OBJECTIVES: To compare physical capacity and body composition between children with burn injuries at approximately 4 years postburn and healthy, fit children. STUDY DESIGN: In this retrospective, case-control study, we analyzed the strength, aerobic capacity, and body composition of children with severe burn injuries (n = 40) at discharge, after completion of a 6- to 12-week rehabilitative exercise training program, and at 3-4 years postburn. Values were expressed as a relative percentage of those in age- and sex-matched children for comparison (n = 40 for discharge and postexercise; n = 40 for 3.5 years postburn). RESULTS: At discharge, lean body mass was 89% of that in children without burn injuries, and exercise rehabilitation restored this to 94% (P < .01). At 3.5 years postburn, lean body mass (94%), bone mineral content (89%), and bone mineral density (93%; each P ≤ .02) remained reduced, whereas total body fat was increased (148%, P = .01). Cardiorespiratory fitness remained lower in children with burn injuries both after exercise training (75%; P < .0001) and 3.5 years later (87%; P < .001). Peak torque (60%; P < .0001) and average power output (58%; P < .0001) were lower after discharge. Although exercise training improved these, they failed to reach levels achieved in healthy children without burns (83-84%; P < .0001) but were maintained at 85% and 82%, respectively, 3.5 years later (P < .0001). CONCLUSIONS: Although the benefits of rehabilitative exercise training on strength and cardiorespiratory capacity are maintained at almost 4 years postburn, they are not restored fully to the levels of healthy children. Although the underlying mechanism of this phenomenon remains elusive, these findings suggest that future development of continuous exercise rehabilitation interventions after discharge may further narrow the gap in relation to healthy adolescents.
Assuntos
Composição Corporal , Queimaduras/fisiopatologia , Queimaduras/reabilitação , Aptidão Cardiorrespiratória , Terapia por Exercício/métodos , Tolerância ao Exercício , Força Muscular , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: Young children are the most vulnerable for sustaining burns. At this pediatric burn hospital we have provided medical care to young children with severe burns from Mexico for many years. This study identified modifiable risk factors that could be used to assist in prevention of burns in this age group. METHODS: A retrospective chart review was performed with children <5 years of age from Mexico who were injured from 2000 to 2013. The medical records of 447 acute patients were reviewed. RESULTS: There were 187 females and 260 males with large burns >20% total body surface area (TBSA) burned. Primary causes of burns were flame and scalds. Children with flame injuries were older (3.0±1.5 years of age) than those with scalds (2.6±1.2 years of age). Admissions attributed to flame burns were largely from explosions by propane tanks, gas line leaks, and house fires. Most admissions for scalds were predominantly from falling in large containers of hot water, food, or grease; and fewer were attributed to spills from hot liquids. Most cases reported to a social service agency were to find resources for families. Mortality rate for flame and scald burns was low. CONCLUSIONS: It is important take into account demographic, cultural, and socioeconomic variables when developing and implementing prevention programs. Burn prevention instruction for parents is crucial.
Assuntos
Queimaduras/epidemiologia , Explosões , Incêndios , Acidentes por Quedas , Acidentes Domésticos/prevenção & controle , Superfície Corporal , Unidades de Queimados , Queimaduras/etiologia , Queimaduras/prevenção & controle , Pré-Escolar , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Masculino , México/etnologia , Estudos Retrospectivos , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: To investigate whether propranolol administration blocks the benefits induced by exercise training in severely burned children. STUDY DESIGN: Children aged 7-18 years (n = 58) with burns covering ≥30% of the total body surface area were enrolled in this randomized trial during their acute hospital admission. Twenty-seven patients were randomized to receive propranolol, whereas 31 served as untreated controls. Both groups participated in 12 weeks of in-hospital resistance and aerobic exercise training. Muscle strength, lean body mass, and peak oxygen consumption (VO2 peak) were measured before and after exercise training. Paired and unpaired Student t tests were used for within and between group comparisons, and χ(2) tests for nominal data. RESULTS: Age, length of hospitalization, and total body surface area burned were similar between groups. In both groups, muscle strength, lean body mass, and VO2 peak were significantly greater after exercise training than at baseline. The percent change in VO2 peak was significantly greater in the propranolol group than in the control group (P < .05). CONCLUSIONS: Exercise-induced enhancements in muscle mass, strength, and VO2 peak are not impaired by propranolol. Moreover, propranolol improves the aerobic response to exercise in massively burned children.
Assuntos
Queimaduras/reabilitação , Terapia por Exercício/métodos , Exercício Físico , Propranolol/uso terapêutico , Absorciometria de Fóton , Administração Oral , Adolescente , Fatores Etários , Queimaduras/terapia , Criança , Método Duplo-Cego , Teste de Esforço , Feminino , Hospitalização , Humanos , Masculino , Força Muscular/efeitos dos fármacos , Consumo de Oxigênio , Projetos de PesquisaRESUMO
La inhalación de humo frío en la oveja produce cambios severos en las vías aereas, con descamación epitelial, necrosis, formación de moldes y frecuente infección secundaria. La oclusión progresiva de las vías aéreas y la severa reacción inflamatoria conducen a un colapso multifocal, bronconeumonía, edema intersticial i intraalveolar, y hemorragias. Existe una marcada y persistente infiltración de leucocitos polinucleares. La secuencia básica de eventos que ocurren en este modelo experimental parecen ser similares a los observados en las lesiones humanas por inhalación de humano y productos de la combustión
Assuntos
Animais , Queimaduras por Inalação/fisiopatologia , Queimaduras por Inalação/patologia , OvinosRESUMO
La inhalación de humo frío en la oveja produce cambios severos en las vías aereas, con descamación epitelial, necrosis, formación de moldes y frecuente infección secundaria. La oclusión progresiva de las vías aéreas y la severa reacción inflamatoria conducen a un colapso multifocal, bronconeumonía, edema intersticial i intraalveolar, y hemorragias. Existe una marcada y persistente infiltración de leucocitos polinucleares. La secuencia básica de eventos que ocurren en este modelo experimental parecen ser similares a los observados en las lesiones humanas por inhalación de humano y productos de la combustión (AU)