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PubMedDate not supplied

Hot beverage scalds in Australian children.

Our objective was to compile data on the mechanism and severity of injuries associated with hot beverage burns in children. We identified 152 children over a 3-year period who attended a tertiary level burns center, representing 18% of all children treated. Their median age was 17.5 months and median body surface area burned was 4% (range, 0.25% to 32%). Significantly, 52% of children required admission, 18% received a split skin graft, and 26% required long-term scar management. In 70% of all cases, the mechanism of injury was the child pulling the hot beverage over himself or herself. In 80% of incidents, a primary care giver witnessed the injury. These findings indicate that scalding from hot beverages carries significant morbidity and is an important pediatric public health issue. It is clear that further research towards effective education programs for primary caregivers is warranted.

Accidents, Home↗
PubMedDate not supplied

Effects of tumor necrosis factor-alpha on the 26S proteasome and 19S regulator in skeletal muscle of severely scalded mice.

The negative nitrogen balance after burns is an important factor in the rehabilitation and treatment of burn injury. It is known that the 26s protesome system plays a key role in the protein breakdown of skeletal muscle in some pathological situations, including burns, although the mechanism of which remains poorly understood. The present study surveyed the effect of tumor necrosis factor-alpha (TNF-alpha) on the 26S proteasome sysytem after burn injury, which is thought to be principally responsible for the proteolysis. The means of immuno-precipitation-deduction and enzyme-linked immunosorbent assay were used to test the change of activities and contents of 26S proteasome and 19S regulator in skeletal muscle of mice inflicted with 30% TBSA third-degree burns. The genes expression of 19S regulator's subunits Psmc2, Psmc5, Psmd1, and Psmd2 were examined by the use of reverse-transcription polymerase chain reaction. The results showed that TNF-alpha and burn can markedly increased the activities and contents of 26S proteasome and 19S regulator in mice skeletal muscle. In addition, the expression levels of the 19S regulator's subunits also were remarkably increased. The monoclonal antibody to TNF-alpha obviously can diminish the increment of the activities and contents of 26S proteasome and 19S regulator as much as the expression levels of the 19S regulator's subunits. The results suggested that TNF-alpha can activate the 26S proteasome system in skeletal muscle, thus enhancing the degradation of protein, which is associated with the development of negative nitrogen balance after scald.

Adenosine Triphosphatases↗
PubMed2005

Biobrane in the treatment of burn and scald injuries in children.

Eighty-four children with a burn (n = 7) or scald injury (n = 77), treated with Biobrane, were investigated in a retrospective and clinical study. In most patients (n = 71), the Biobrane was adherent and without any reactions or infections. An infection was seen in 10.7% (9 from 84 patients). Twenty-one of 49 patients of the follow-up had limited scar areas. In scarless healed areas, 54.3% had normopigmentation and 39.1% were hypopigmented. The skin quality of the scars was mostly hypopigmented with a softness between minimal and middle resistance, under 2-mm high, and of normal to pink skin color. Compared with other dressings, Biobrane is no more expensive than others. We conclude that when used on properly selected wounds, Biobrane is an effective and, for the children, less traumatic therapy for superficial partial-thickness burns without increasing the cost of outpatient burn care.

Burns↗
PubMed1977

The staphylococcal scalded skin syndrome. An experimental histochemical and electron microscopic study.

Histochemical and electron microscopic studies were carried out on the newborn mouse model of the staphylococcal scalded skin syndrome to investigate the mechanism of action of the staphylococcal epidermolytic toxin that causes it. Histochemical studies showed that an intra-epidermal split develops below the subcorneal zone which is rich in catabolic enzymes (the so-called esterase-acid phosphatase-rich band). However, histochemical alterations in the enzyme pattern could not be demonstrated. The earliest change revealed by electron microscopy was a widening of the intercellular space, with the formation of microvilli at the level between the stratum spinosum and stratum granulosum where the split later occurs. A clearing of the peripheral cytoplasm along the cell membranes was also revealed. In pre-split areas, adhesion between cell membranes of adjacent cells seems to be lost; desmosomes continue to hold the cells together but the split develops when these are broken by mechanical pressure. Later, damaged cell membranes may be seen. Extracellular keratinosomes remain unchanged. Although these findings do not agree with the already divergent results of other studies, they help support the findings of all groups that cases of the Lyell syndrome produced by staphylococci do not occur through necrolysis; it is therefore inappropriate to continue applying the term 'toxic epidermal necrolysis' to such cases.

Animals↗
PubMed1984

Bullous mastocytosis: diffuse cutaneous mastocytosis with extensive blisters mimicking scalded skin syndrome or erythema multiforme.

Bullous mastocytosis (diffuse cutaneous mastocytosis) is a rare form of mast cell disease that begins during the first month of life and causes extensive blisters that mimic scalded skin syndrome or bullous erythema multiforme. Discrete pigmented macules, papules, and nodules are absent and the characteristic leathery induration of skin may not develop until 6 months of age. Skin biopsy shows a subepidermal blister with mast cells at the base. The most serious complications are gastrointestinal hemorrhage and shock. The symptoms of bullous mastocytosis may be modified by a number of new therapeutic agents.

Burns↗
PubMed1975

Staphylococcal scalded skin syndrome. An ultrastructural study.

The authors investigated the ultrastructure of the epidermis of two children who suffered from the staphylococcal scalded skin syndrome (or the Ritter's type of toxic epidermal necrolysis). This syndrome is attributed to the action of an exfoliative toxin produced by Staphylococcus aureus phage group II. A characteristic bullous cleavage was selectively observed at the level of the granular layer, without any damage in other epidermal layers. This cleavage was the result of disruption of of desmosomes between granular cells in two halves, each half desmosome conserving the tonofilaments which were attached to its attachment plaque. No remarkable cytoplasmic alteration occurred in the granular layer, with the exception of the development of thickened tonofilaments among dilated endoplasmic reticulum. Odland bodies were particularly numerous in the areas of desmosomal disruption. This syndrome must be considered as an entity clinically, histologically and ultrastructurally separate from the drug form of toxic epidermal necrolysis.

Child, Preschool↗
PubMed1995

1 alpha,25-Dihydroxyvitamin D3 decreases scalding- and platelet-activating factor-induced high vascular permeability and tissue oedema.

We have previously demonstrated that 1,25-dihydroxyvitamin D3 decreases endotoxin-induced mortalities of rat and mouse from 80% and 70% to 14% and 10% (unpublished results). In the present study, pretreatment of 1,25-dihydroxyvitamin D3 decreased pad oedema and pulmonary vascular permeability induced by scalding and platelet-activating factor. 1,25-Dihydroxyvitamin D3 in a dose of 4 x 10(-9) mol/kg decreased pulmonary extravascular Evans blue concentration increased by platelet-activating factor from 6.32 +/- 0.63 ng/g to 2.57 +/- 0.28 ng/g (P < 0.01), and lung water/dry lung weight from 3.79 +/- 0.57 to 1.51 +/- 0.13 (P < 0.01). 1,25-Dihydroxyvitamin D3 of 4 x 10(-11) moles/kg and calcipotriol (a vitamin D analogue which has limited hypercalcaemic effect) of 4 x 10(-9) moles/kg had similar effects. Karyocyte counting of bronchoalveolar lavage fluid and the reduction of mean arterial pressure were also reduced to some extent. These results suggest that 1,25-dihydroxyvitamin D3 may be a new and effective drug to reduce vascular permeability and ameliorate oedema.

Animals↗
PubMed2004

Resistance to barley scald (Rhynchosporium secalis) in the Ethiopian donor lines 'Steudelli' and 'Jet', analyzed by partial least squares regression and interval mapping.

The resistance of barley (Hordeum vulgare L.) to Rhynchosporium secalis (scald) has been investigated in two crosses between the susceptible cv. 'Ingrid' and two resistant Ethiopian landraces, 'Steudelli' and 'Jet'. Doubled haploids were inoculated in replicated tests using two isolates of R. secalis, '4004' and 'WRS1872'. Expression of resistance differed widely between replicated tests. AFLP, SSR and RFLP markers were used to develop chromosome maps. Results have been analysed using partial least squares regression (PLSR) and interval mapping. In PLSR the major covariance structures or 'latent variables' between X (markers) and Y (isolates, tests) are modelled as principal components and their optimal number determined by cross-validation. In 'Steudelli' two QTL were detected, one on each of chromosomes 3H and 7H, in 4 out of 5 tests, while in 'Jet' only one (different) allele at the 3H locus was found. The validated R(2) varied between 11.0% and 64.9% in the replicated tests with '4004'.With isolate 'WRS1872' the 7H locus and another 3H locus were detected. By interval mapping the QTL detected were less stable and generally gave lower R(2) values than PLSR. PLSR does not depend on maps, but interval mapping based on values predicted by PLSR had R(2) around 90%. It is suggested that PLSR may be a useful tool in QTL analysis.

Chromosome Mapping↗
PubMed1981

Medium for isolation and growth of bacteria associated with plum leaf scald and phony peach diseases.

Rickettsia-like bacteria associated with plum leaf scald and phony peach diseases were isolated from diseased but not from healthy tissues and cultured on charcoal-yeast extract medium (BCYE) buffered with ACES (2-[(2-amino-2-oxoethyl) amino]-ethanesulfonic acid). Optimum conditions for isolation and growth on BCYE medium were pH 6.5 to 6.9 at 20 and 25 degrees C under normal atmosphere. Growth of primary colonies and first-passage subcultures was restricted, and colonies reached a maximum diameter of 0.6 mm in 60 days. After 12 passages, subcultures reached maximum growth in 21 days. The rickettsia-like bacteria from BCYE cultures were gram negative, serologically the same as those present in diseased peach and plum, and composed of rod-shaped cells measuring 0.35 by 5 mum (average diameter and maximum length) in a matrix of filamentous strands of similar width but of variable length.

Journal Article↗
PubMed1999

Clinical, microbial, and biochemical aspects of the exfoliative toxins causing staphylococcal scalded-skin syndrome.

The exfoliative (epidermolytic) toxins of Staphylococcus aureus are the causative agents of the staphylococcal scalded-skin syndrome (SSSS), a blistering skin disorder that predominantly affects children. Clinical features of SSSS vary along a spectrum, ranging from a few localized blisters to generalized exfoliation covering almost the entire body. The toxins act specifically at the zona granulosa of the epidermis to produce the characteristic exfoliation, although the mechanism by which this is achieved is still poorly understood. Despite the availability of antibiotics, SSSS carries a significant mortality rate, particularly among neonates with secondary complications of epidermal loss and among adults with underlying diseases. The aim of this article is to provide a comprehensive review of the literature spanning more than a century and to cover all aspects of the disease. The epidemiology, clinical features, potential complications, risk factors, susceptibility, diagnosis, differential diagnoses, investigations currently available, treatment options, and preventive measures are all discussed in detail. Recent crystallographic data on the toxins has provided us with a clearer and more defined approach to studying the disease. Understanding their mode of action has important implications in future treatment and prevention of SSSS and other diseases, and knowledge of their specific site of action may provide a useful tool for physiologists, dermatologists, and pharmacologists.

Child↗
PubMed1976

Staphylococcal scalded-skin syndrome: development of a primary binding assay for human antibody to the exfoliative toxin.

Exfoliative toxin (ET) from a phage group II Staphylococcus aureus strain causing staphylococcal scalded-skin syndrome was purified by electrofocusing. Ampholytes and salts were removed from the final product by column chromatography on G-50 Sephadex. Sodium dodecyl sulfate-polyacrylamide gels of the final product yielded a single band upon gel electrophoresis, even when 60 mug of protein was placed in the gels. Radiolabeling of the purified toxin with 125I yielded a product that still caused exfoliation of suckling mice, indicating that the toxin was still biologically active. A radioimmunobinding assay was developed and used to test rabbit and human sera for antibodies to exfoliative toxin. Although the maximum percentage of binding was not as high as expected (approximately 40%), it was postulated that either iodination had not been sufficiently vigorous or the toxin had sustained immunological damage. The assay was reproducible and more sensitive than the existing neutralization method and readily applicable to the testing of human sera for exfoliative toxin antibodies.

Animals↗
PubMed1971

Product of Staphylococcus aureus responsible for the scalded-skin syndrome.

Certain Staphylococcus aureus strains of phage group 2 produced a protein distinct from the alpha and delta toxins which was capable of causing generalized exfoliation in neonatal mice and presumably is responsible for the scalded-skin syndrome in humans. This protein, named "exfoliatin," was purified and found to have a molecular weight of approximately 24,000. Exfoliatin was acid-labile, rather heat-stabile, and antigenic.

Animals↗
PubMed2005

Scald injury from the Guthrie test: should the heel be warmed?

A 6 day old boy sustained scalds to his right foot from application of a "warm nappy" to increase blood flow to facilitate heel pricking for a routine Guthrie test. It is proposed that active warming of the heel in isolation is not necessary in heel blood sampling.

Ankle Injuries↗
PubMed1975

Inflicted burns and scalds in children.

Ten children who had been burnt and six who had been scalded by parents or those caring for them were seen over three years. In no case did the thermal injury affect more than 5% of the body surface and there were no deaths. In seven the perineum or buttocks were in the burnt area. In 12 children there was evidence of other inflicted injury including six recent fractures. Staff caring for burnt children should be aware of this type of inflicted injury. X-ray skeletal surveys should be carried out in doubtful cases and a case conference initiated with the appropriate social work services to consider supervising the family after the child's discharge or taking legal care proceedings.

Burns↗
PubMed1998

New Zealand children's involvement in home activities that carry a burn or scald risk.

OBJECTIVES: The self reported involvement of elementary schoolchildren from Auckland, New Zealand was measured from home activities that carry a burn or scald risk. METHOD: A survey was conducted with 421 children aged 7-13 years. The survey asked children whether they carried out specific home activities involving hot water, fire, or appliances that carry a burn risk. It also measured their knowledge of the three basic fire safety messages taught to New Zealand schoolchildren by the fire service. RESULTS: The results showed that although involvement levels increased with age, the majority of even the youngest children reported carrying out a number of the risky activities, such as preparing hot drinks, running their own baths, or using a microwave without help. No gender differences were found in the number of risky activities engaged in. Significant ethnic differences were found, with higher risk involvement by indigenous Maori and children of Pacific Island descent than children of European or Asian descent. Each of the three fire safety messages were correctly identified by between 79%-91% of the children. CONCLUSIONS: Investigation of children's involvement in household activities that carry an injury risk may help in the design of prevention strategies, including school based education. Prevention efforts need to acknowledge the ages at which children begin to undertake specific household tasks, including those that involve care for younger siblings, and be attuned to the needs of different ethnic groups.

Age Factors↗
PubMed1976

Plasma biotin levels in children with burns and scalds.

The plasma concentrations of biotin were measured for up to 49 days after injury in nine children with burns and scalds which involved from 12% to 50% of the surface area of the body. Biotin levels below the minimum of the control range were observed in eight of the nine injured children at some stage during the episode.

Biological Assay↗
PubMed2001

Construction of a YAC library from barley cultivar Franka and identification of YAC-derived markers linked to the Rh2 gene conferring resistance to scald (Rhynchosporium secalis).

The Rh2 resistance gene of barley (Hordeum vulgare) confers resistance against the scald pathogen (Rhynchosporium secalis). A high-resolution genetic map of the Rh2 region on chromosome I (7H) was established by the use of molecular markers. Tightly linked markers from this region were used to screen existing and a newly constructed yeast artificial chromosome (YAC) library of barley cv. Franka composed of 45,000 clones representing approximately two genome equivalents. Corresponding YAC clones were identified for most markers, indicating that the combined YAC library has good representation of the barley genome. The contiguous sets of YAC clones with the most tightly linked molecular markers represent entry points for map-based cloning of this resistance gene.

Chromosomes, Artificial, Yeast↗