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Cimetidine and gastric pH
446
Burns (1985) 11,446-448
Printedin
GreatBritain
Abstracts CLINICAL STUDIES Self-inflicted
burns
A review of 42 patients with a mean age of 36 years who had attempted suicide by burning showed that over three-quarters of them had previous psychiatric illness and a quarter had previously attempted suicide. The overall mortality rate was 48 per cent which, however, was not significantly higher than for accidental burns of comparable severity. The number of patients of nonCaucasian origin was higher than expected from population statistics and fatal burns were more common in this group of patients. Apparently neither political nor religious protest were motives for the suicide attempts. Davidson T. K. and Brown L. C. (1985) Self inflicted burns; a S-year retrospective study. Burns 11, 157.
Cimetidine
and gastric pH
Attempts to control the gastric acidity in burned children have been made using cimetidine and antacid each alone or in combination. pH values of 3.5 or less were more commonly found in the cimetidine groups than in the antacid group and the combined therapy was not more effective than the individual. The low pH values were significantly associated with a high incidence of positive guaiac tests. In four patients 63 per cent of the administered dose of cimetidine was found in the urine 8 h later compared to the previously reported 24-h delay for normal healthy adults. Rapid clearance of cimetidine might explain the decreased efficacy of this drug in burned patients. Martvn J. A. (1985) Cimetidine and/or antacid for the control of gastric acidity in pediatric burn patients. Cn’r. Care Med. 13, I.
Polymorphoneutrophil
activity
Neutrophil migration and the ability of the cells to take up chromium were studied in cells taken from 20 patients with burns covering a wide range of body surface area (S-90 per cent). Compared with values from normal neutrophils, the cells from the burned patients showed a significantly reduced random and directed migration. Neutrophil lysozyme content was also reduced in these burn cells while serum lysozyme from the same patients was significantly elevated over control values suggesting a transfer of lysozyme from the cells to the plasma. The influx quantity and velocity of chromium into the cells from burned patients was
much greater than the influx into normal cells used for studies of chemotaxis, and may have depleted the cellular energy stores by a mechanism that is, as yet, unknown. Davis J. M., Illner H. and Dineen P. (1984) Increased chromium uptake in polymorphonuclear leukocytes from burned patients. J. Trauma 24, 1003.
Energy expenditure
in burned patients
Resting energy expenditure (REE) was measured in 35 patients with partial and full thickness skin loss burns covering between 10 and 75 per cent of the body surface area. The measured REEs were compared with those predicted from the Harris and Benedict and the Curreri formulae. The Harris and Benedict prediction underestimated (by 23 per cent) the measured energy expenditure while the Curreri prediction overestimated it by 58 per cent. The correlations between the measured and the two predicted estimates of energy expenditure were explored and it was found that the correlation was better with the Harris and Benedict formula than with the Curreri formula. Turner W. W., Ireton C. S., Hunt J. L. et al. (1985) Predicting energy expenditures in burned patients. J. Trauma 25, 11.
Immuno-suppression procedures
and surgical
The effects of major surgical procedures (eschar excision and skin grafting) on the degree of immunosuppression were assessed in 30 patients with a mean burn area covering 42.8 per cent of the body surface area. Immuno-suppression was measured using mixed lymphocyte cultures. Pre-operatively the serum from burned patients induced a mean of 42.2 per cent suppression of blastogenesis whereas post-operatively this was significantly reduced to only 29.1 per cent. The rate of restoration of immunocompetence was greatest when the operation achieved complete wound closure. When the wound was only partially closed the mean duration of improvement in lymphocyte function was 5.0 days. It is suggested that this temporary improvement may be related to the blood transfusions given pre- and post-operatively. Stratta R. J., Saffle J. R., Ninnemann J. L. et al. (1985) The effect of surgical excision and grafting procedures on postburn lymphocyte suppression. J. Trauma 25, 46.
Burns (1985) 11,446-448
Printedin
GreatBritain
Abstracts CLINICAL STUDIES Self-inflicted
burns
A review of 42 patients with a mean age of 36 years who had attempted suicide by burning showed that over three-quarters of them had previous psychiatric illness and a quarter had previously attempted suicide. The overall mortality rate was 48 per cent which, however, was not significantly higher than for accidental burns of comparable severity. The number of patients of nonCaucasian origin was higher than expected from population statistics and fatal burns were more common in this group of patients. Apparently neither political nor religious protest were motives for the suicide attempts. Davidson T. K. and Brown L. C. (1985) Self inflicted burns; a S-year retrospective study. Burns 11, 157.
Cimetidine
and gastric pH
Attempts to control the gastric acidity in burned children have been made using cimetidine and antacid each alone or in combination. pH values of 3.5 or less were more commonly found in the cimetidine groups than in the antacid group and the combined therapy was not more effective than the individual. The low pH values were significantly associated with a high incidence of positive guaiac tests. In four patients 63 per cent of the administered dose of cimetidine was found in the urine 8 h later compared to the previously reported 24-h delay for normal healthy adults. Rapid clearance of cimetidine might explain the decreased efficacy of this drug in burned patients. Martvn J. A. (1985) Cimetidine and/or antacid for the control of gastric acidity in pediatric burn patients. Cn’r. Care Med. 13, I.
Polymorphoneutrophil
activity
Neutrophil migration and the ability of the cells to take up chromium were studied in cells taken from 20 patients with burns covering a wide range of body surface area (S-90 per cent). Compared with values from normal neutrophils, the cells from the burned patients showed a significantly reduced random and directed migration. Neutrophil lysozyme content was also reduced in these burn cells while serum lysozyme from the same patients was significantly elevated over control values suggesting a transfer of lysozyme from the cells to the plasma. The influx quantity and velocity of chromium into the cells from burned patients was
much greater than the influx into normal cells used for studies of chemotaxis, and may have depleted the cellular energy stores by a mechanism that is, as yet, unknown. Davis J. M., Illner H. and Dineen P. (1984) Increased chromium uptake in polymorphonuclear leukocytes from burned patients. J. Trauma 24, 1003.
Energy expenditure
in burned patients
Resting energy expenditure (REE) was measured in 35 patients with partial and full thickness skin loss burns covering between 10 and 75 per cent of the body surface area. The measured REEs were compared with those predicted from the Harris and Benedict and the Curreri formulae. The Harris and Benedict prediction underestimated (by 23 per cent) the measured energy expenditure while the Curreri prediction overestimated it by 58 per cent. The correlations between the measured and the two predicted estimates of energy expenditure were explored and it was found that the correlation was better with the Harris and Benedict formula than with the Curreri formula. Turner W. W., Ireton C. S., Hunt J. L. et al. (1985) Predicting energy expenditures in burned patients. J. Trauma 25, 11.
Immuno-suppression procedures
and surgical
The effects of major surgical procedures (eschar excision and skin grafting) on the degree of immunosuppression were assessed in 30 patients with a mean burn area covering 42.8 per cent of the body surface area. Immuno-suppression was measured using mixed lymphocyte cultures. Pre-operatively the serum from burned patients induced a mean of 42.2 per cent suppression of blastogenesis whereas post-operatively this was significantly reduced to only 29.1 per cent. The rate of restoration of immunocompetence was greatest when the operation achieved complete wound closure. When the wound was only partially closed the mean duration of improvement in lymphocyte function was 5.0 days. It is suggested that this temporary improvement may be related to the blood transfusions given pre- and post-operatively. Stratta R. J., Saffle J. R., Ninnemann J. L. et al. (1985) The effect of surgical excision and grafting procedures on postburn lymphocyte suppression. J. Trauma 25, 46.