Long hair, smoking, and deep facial burns.

The purpose of this article is to describe deep facial burn injuries by cigarette lighters in longhaired adults and to report our experience in their treatment. Eight consecutive cigarette lighter burn victims are treated in the Helsinki Burn Center in the year 2006. Seven of the patients were women; their mean age was 50 years. All were under the influence of alcohol at the time of injury. The mean burnt area was 3.5% TBSA. The burnt areas were primarily forehead, cheek, and ipsilateral ear. After a conservative treatment, all the patients underwent an operation, whereby the nonhealing burns were excised and covered with autologous split thickness skin grafts. Postoperative period was uneventful in all the patients. Besides having severe detrimental effects on general health status and wound healing, smoking is the leading cause of residential and total fire deaths worldwide. The patients in this article suffered deep facial burns because of cigarette lighters.     

Gut microbiota affects lens and retinal lipid composition

The gut microbiota affects host lipid metabolism and is considered an environmental factor that contributes to development of obesity. To investigate whether the gut microbiota affects the eye lipidome, we performed comprehensive lipidomic profiling of lens and retina from conventionally raised and germ-free mice. Conventionally raised mice had diminished phosphatidylcholines in the lens and elevated ethanolamine plasmalogens in the retina. Diminishment of lens phosphatidylcholines in the presence of gut microbiota suggests that the conventionally raised mice are exposed over time to more oxidative stress than germ-free mice. Consistent with this, their lifespan is also shorter. Our findings may open a new area of investigation how modulation of gut microbiota affects the eye health.     

Intervention to improve level of overall functioning and mental condition of adolescents at high risk of developing first-episode psychosis in Finland

Aim: Being at high risk of developing psychosis has been suggested to be a result of a combination of acute life stressors and trait‐like vulnerability to psychosis. Reducing levels of stress could support overall functioning and mental condition in those at risk. Methods: The Jorvi Early Psychosis Recognition and Intervention (JERI) project at Helsinki University Central Hospital, Jorvi Hospital, Finland, is an early intervention team for adolescents at risk of developing first‐episode psychosis. The project is based on the idea of multiprofessional, community, home, family and network‐oriented, stress‐reducing, overall functioning‐supporting, low‐threshold care. The JERI team meets multiprofessionally with adolescents in their natural surroundings, for example, at school or at home, together with their parents, network and community co‐worker, who has originally contacted the JERI team because of unclear mental health problems. Subjects were assessed with the PROD‐prodromal screen to identify those at risk of developing first‐episode psychosis. Results: Statistically significant difference between baseline and follow‐up measures was found in at risk subjects (n = 28) in scales of overall functioning (P = 0.000), depression (P = 0.001), anxiety (P = 0.001), quality of life (QOL) and pre‐psychotic symptoms. Conclusions: JERI‐type intervention may improve level of overall functioning and support mental condition in adolescents at risk of developing first‐episode psychosis, even though further study with larger numbers of subjects, with a control group and with a longer follow‐up time, is needed.     

Paediatric ICU burns in Finland 1994-2004

INTRODUCTION: The paediatric burn population requiring intensive care in Finland has never been examined before. The aim of this study was firstly to determine the aetiology, incidence and prognosis of paediatric burns requiring intensive care in Finland and secondly to compare the possible differences between the two national burn centres. METHODS: All burn patients' charts were retrospectively reviewed in two national burn centres from an 11-year-period. Patients whose ICU stay was more than 48h, were included. RESULTS: Forty-five children who were hospitalized in the two burn centres during the study period met the inclusion criteria. They represent 2.4% (45/1898) of all burns victims hospitalized in these burn centres during that time giving an incidence of 0.1/100,000 per year in Finland. The median age was 5 years, every third patient was 0-2 years old and 75.6% were male. Most burns were scalds (42.2%), which caused all burns (100%) in age group 0-2 years. Flame burns were most frequent (83%) in the age group 6-10 years. In the 11-16 years old patients, high voltage/electric burns caused 50% of all burns and flame the other 50%. The overall median TBSA in all burns was 26%. The median (range) hospital stay was 12 days (2-193) (0.88 days/% burned) and the median (range) ICU days was 7 (2-64) (0.29 days/%). Intubation and respirator therapy was needed in 31 (46%) patients. There were no patients who needed haemofiltration or haemodialysis and no mortality. Only six patients (13%) were treated conservatively and 39 (87%) surgically. Dressing changes under general anaesthesia were preferred in Helsinki (37 times) and especially in the paediatric hospital (32 times) compared to Kuopio (7 times). Allografts were used only in Helsinki in 4 patients whereas artificial skin was used only in Kuopio in 15 patients. The overall cost of care was very similar in both centres being 1292-1425 euros per hospital day. CONCLUSIONS: There were some small differences between the two burn centres in treatment policies. Most patients were male and most common aetiology was scald. The prognosis of these patients was excellent with no mortality.     

Comparison of premortem clinical diagnosis and autopsy findings in patients with burns

INTRODUCTION: Despite the diagnostic advancements, some clinically important diagnoses remain undetected during intensive care in burn patients. The aim of this study was to compare the premortem clinical diagnoses and autopsy findings. PATIENTS AND METHODS: A retrospective review of all burn deaths during 1995-2005 was conducted. The clinical diagnoses and autopsy reports were reviewed, and diagnostic discrepancies were classified into four categories, according to the impact on the treatment. RESULTS: Overall mortality during the study period was 5.4%. Altogether 74 deaths were recorded, of which 71 were included in the study. Typical patient was a 58-year-old male with flame burn of %TBSA 49, ABSI 10. Clinical diagnostic discrepancies were found in 14.1% of the patients; one diagnostic discrepancy was recorded in each of the patients. Of these diagnostic discrepancies, 8.5% were considered major, and 5.6% would have altered the clinical outcome or therapy, if known at the time. Diagnostic discrepancies consisted of one cardiovascular, seven respiratory and two gastrointestinal missed diagnosis. The most common missed diagnosis was pneumonia. CONCLUSION: This study emphasizes the usefulness of autopsies to provide valuable clinical data for the treatment of burn patients. It also highlights the few missed diagnoses which may occur in burn patients.     

Allergy in marathon runners and effect of Lactobacillus GG supplementation on allergic inflammatory markers

OBJECTIVE: We studied the prevalence of asthma and allergy in non-elite marathon runners and investigated the effects of probiotic supplementation on allergic inflammatory markers. METHODS: Asthma and allergies were surveyed by questionnaire, and blood eosinophils, serum eosinophil cationic protein (ECP), total IgE, and Phadiatop were measured in 141 Finnish marathon runners who took part in the Helsinki City Marathon. They were also randomized to receive either Lactobacillus GG (LGG) or placebo during the 3 months of the pollen season prior to the marathon. RESULTS: Lifetime prevalence of physician-diagnosed asthma was 4.3% (six out of 139 athletes), of allergic rhinitis 17.3% (24/139), of food allergy 5.0% (7/139), and of atopic eczema 4.3% (6/139). Prevalence of atopy was 31% (35/112), and 21% (24/112) of the athletes were sensitized to birch pollen. Asthma or allergy medication was used by 20% (28/139) of the athletes. During pollen season, serum ECP increased significantly in all athletes, and total IgE and Phadiatop in atopics. The marathon induced a significant eosinopenia but had no effect on serum ECP or total IgE. No differences in changes were seen between groups receiving LGG or placebo. CONCLUSION: Non-elite marathon runners have asthma and allergies similar to Finnish general population. LGG supplementation did not prevent the increase of allergic markers during the pollen season, or the eosinopenia induced by the marathon.