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El Carmen de Bolívar, Colombia

Navarrete-Aldana N.,Burn Intensive Care Unit | Cooper M.A.,University of Illinois at Chicago | Holle R.L.,Holle Meteorology and Photography
Natural Hazards

National lightning fatality information has been gathered and published for Australia, Canada, the USA, and Western Europe, but few such studies have taken place and been published in the formal literature during the last decade in other areas. National lightning fatality data are difficult to collect in many countries, especially in tropical regions, despite a high frequency of lightning. To partially fill this gap, the current paper provides the first comprehensive national summary of lightning deaths in Colombia. Data from the National Administrative Department of Statistics were gathered for 2000 through 2009 and were classified according to the number of fatalities by year, month, gender, age, and location of the fatality. These data were assigned to geographical departments to determine the fatality rates per type of population. Comparison was also made with the population percentage in rural areas where the outdoor lightning risk may be greater than in cities due to labor-intensive agricultural practices, housing that is unsafe from the lightning threat, lack of access to weather forecasts and lightning safety knowledge, and other factors. Data from an international lightning locating system also were used to determine the annual lightning frequency and monthly totals in Colombia. During the ten study years, 757 deaths were identified. The highest mortality rates were in rural areas with a maximum of 7.69 deaths per million per year in the Vaupes Department of eastern Colombia. The death rate for all of Colombia was 1.78 per million per year during the same period. © Springer Science+Business Media Dordrecht 2014. Source

Rowley-Conwy G.,Burn Intensive Care Unit
Nursing standard (Royal College of Nursing (Great Britain) : 1987)

Management of major burns is complex and challenging because of the serious and often life-threatening nature of the injuries and associated systemic complications. Therefore, the burn care practitioner requires comprehensive knowledge of the treatment options and procedures that may be used to maximise patient rehabilitation and recovery. This article aims to discuss the latest evidence in burn care, and the treatments and interventions that a patient may receive following a major burn injury. Source

Aldana M.C.D.R.,El Rosario University | Navarrete N.,Burn Intensive Care Unit

Background Burns represent a serious problem around the world especially in low- and middle-income countries. The aim was to determine the epidemiological characteristics, causes and mortality rate of burn deaths in the Colombian pediatric population as well as to guide future education and prevention programs. Methods We conducted an observational, analytical, retrospective population-based study. It was based upon official death certificate data using diagnosis codes for burns (scalds, thermal, electrical, intentional self-harm and not specified), that occurred between January 1, 2000 and December 31, 2009. Official death certificates of the pediatric population of up to 15 years of age were obtained from the National Administrative Department of Statistics. Results A total of 1197 fatal pediatric injuries related to burns were identified. The crude and adjusted mortality rate for burns in the pediatric population in Colombia during the length of the study was 0.899 and 0.912 per 100,000, respectively. The mortality rate tended to decrease (-5.17% annual) during the duration of the study. Children under 5 years of age were the most affected group (59.5%). Almost half of them died before arriving at a health facility (47.1%). Fire is the principal cause of death attributable to burns in Colombia, followed by electric burns and hot liquids. Conclusions This is a first step study in researching the epidemiological features of pediatric deaths after burns. The Public Health's strategies should be oriented toward community awareness about these kind of injuries, and to teach children and families about risk factors and first aid. © 2015 Elsevier Ltd and ISBI. All rights reserved. Source

Smailes S.T.,Burn Intensive Care Unit | Smailes S.T.,Anglia Ruskin University | McVicar A.J.,Anglia Ruskin University | Martin R.,Burn Intensive Care Unit

The aim of this study was to develop a clinical prediction model to inform decisions about the timing of extubation in burn patients who have passed a spontaneous breathing trial (SBT). Rapid shallow breathing index, voluntary cough peak flow (CPF) and endotracheal secretions were measured after each patient had passed a SBT and just prior to extubation. We used multiple logistic regression analysis to identify variables that predict extubation outcome. Seventeen patients failed their first trials of extubation (14%). CPF and endotracheal secretions are strongly associated with extubation outcome (p < 0.0001). Patients with CPF ≤ 60 L/min are 9 times as likely to fail extubation as those with CPF > 60 L/min (risk ratio = 9.1). Patients with abundant endotracheal secretions are 8 times as likely to fail extubation compared to those with no, mild and moderate endotracheal secretions (risk ratio = 8). Our clinical prediction model combining CPF and endotracheal secretions has strong predictive capacity for extubation outcome (area under receiver operating characteristic curve = 0.96, 95% confidence interval 0.91-0.99) and therefore may be useful to predict which patients will succeed or fail extubation after passing a SBT. © 2012 Elsevier Ltd and ISBI. Source

Giavaresi G.,Rizzoli Orthopaedic Institute | Bondioli E.,Burn Intensive Care Unit | Melandri D.,Burn Intensive Care Unit | Giardino R.,Rizzoli Orthopaedic Institute | And 8 more authors.
BMC Musculoskeletal Disorders

Background: Although progress has been made in the treatment of articular cartilage lesions, they are still a major challenge because current techniques do not provide satisfactory long-term outcomes. Tissue engineering and the use of functional biomaterials might be an alternative regenerative strategy and fulfill clinical needs. Decellularized extracellular matrices have generated interest as functional biologic scaffolds, but there are few studies on cartilage regeneration. The aim of this study was to evaluate in vitro the biological influence of a newly developed decellularized human dermal extracellular matrix on two human primary cultures. Methods. Normal human articular chondrocytes (NHAC-kn) and human mesenchymal stromal cells (hMSC) from healthy donors were seeded in polystyrene wells as controls (CTR), and on decellularized human dermis batches (HDM-derm) for 7 and 14 days. Cellular proliferation and differentiation, and anabolic and catabolic synthetic activity were quantified at each experimental time. Histology and scanning electron microscopy were used to evaluate morphology and ultrastructure. Results: Both cell cultures had a similar proliferation rate that increased significantly (p < 0.0005) at 14 days. In comparison with CTR, at 14 days NHAC-kn enhanced procollagen type II (CPII, p < 0.05) and aggrecan synthesis (p < 0.0005), whereas hMSC significantly enhanced aggrecan synthesis (p < 0.0005) and transforming growth factor-beta1 release (TGF-β1, p < 0.0005) at both experimental times. Neither inflammatory stimulus nor catabolic activity induction was observed. By comparing data of the two primary cells, NHAC-kn synthesized significantly more CPII than did hMSC at both experimental times (p < 0.005), whereas hMSC synthesized more aggrecan at 7 days (p < 0.005) and TGF-β1 at both experimental times than did NHAC-kn (p < 0.005). Conclusions: The results obtained showed that in in vitro conditions HDM-derm behaves as a suitable scaffold for the growth of both well-differentiated chondrocytes and undifferentiated mesenchymal cells, thus ensuring a biocompatible and bioactive substrate. Further studies are mandatory to test the use of HDM-derm with tissue engineering to assess its therapeutic and functional effectiveness in cartilage regeneration. © 2013 Giavaresi et al.; licensee BioMed Central Ltd. Source

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