Browsing by Subject "Burns"
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Item Functional, Psychological and Community Integration Changes Over Time in Persons With Major Burn Injury(2006-05-15) Grace, Sheila Ann Isom; Cromes, G. FredThe purpose of the present study was to measure prospectively the functional, psychological and community integration status of individuals with major burn injury in order to determine the extent of changes over time and how functional and community integration status relates to emotional distress. This study was part of the North Texas Burn Model System Grant funded by the National Institute on Disability and Rehabilitation Research. Subjects in this study included adults over 14 years of age who met the American Burn Association's criteria for a major burn injury. The Total Body Surface Area burn across the measurement periods in these subjects ranged from 22.4 to 25.2 percent. Data was collected from 356 participants at discharge, 199 participants at 2 months, 255 participants at 6 months, 193 participants at 12 months, 114 participants at 24 months and 41 participants at 36 months. The instruments used in this study were the Brief Symptom Inventory (BSI), the Burn Specific Health Scale (BSHS), The Community Integration Questionnaire (CIQ), the Pain Analog Scale (PAS) and the Functional Assessment Screening Questionnaire (FASQ). It was hypothesized that 1) both areas of functioning and community integration would improve as emotional distress abated and that 2) the functional improvement and community integration as well as the lessening of emotional distress would continue over time. A repeated measures ANOVA was used to measure changes over time and a Bonferroni Multiple Comparison Test was used to compare results at different time intervals. FASQ and CIQ total scores for individuals exhibiting high versus low measures of emotional distress (with median split of BSI global scores) were compared at each measurement period using the Student's T-test. A statistically significant interaction was found between the variables as predicted; however, the participants in this study appeared to reach a plateau at 24 months after which little change in outcomes was noted.Item The contribution of quorum sensing to the pathogenesis of pseudomonas aeruginosa in burn wound infections(Texas Tech University, 2001-05) Rumbaugh, Kendra P.Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes severe infections in burned patients. In this work, we examined the contribution ofthe cell-to-cell communication systems or quorum sensing (QS) systems to the pathogenesis of P aeruginosa infection of burn wounds. For these studies, we used the thermally-injured mouse model and specific mutants that carry deletions in genes encoding specific components of the P aeruginosa QS systems {lasR, rhlR, lasl and rhll). In comparison with their parent strain (PAOl), all mutants displayed decreased lethality. The mutants were defective in their ability to spread systemically throughout the body of the mice. In addition, the lasR (PAO-Rl) and the lasl/rhll (PAO-JP2) mutants were defective in their ability to spread locally within the burned skin at 8 and 16 hours post-bum/infection. The defects in the PAO-JP2 strain were complemented upon the introduction of a plasmid carrying intact lasl and rhll genes. To determine if the defect in PAO-JP2 is due to the loss of one or more of the QScontrolled virulence factors, isogenic mutants that carry deletions in lasA, lasB, lasAAasB, toxA, lasB/toxA or rpoS were examined. With the exception of the rpoS mutant, all mutants were defective in their in vivo virulence. However, none was as severely defective as PAO-JP2. Our attempt to ascertain the role of autoinducers as virulence factors was confounded by the influence of the solvent used to purify them. Host production of cytokines in response to P aeruginosa infection in bum wounds was examined using the Multi-Probe Template/RNase protection assay. The expression of several proinflammatory and hematopoietic cytokines was up-regulated in burned mice infected with PAOl at 40 hours post-bum/infection. In contrast, the expression of most of these cytokines was not enhanced in burned mice infected with PAO-JP2. These results suggest that: (1) the QS systems play an important role in the pathogenesis of P aeruginosa in bum wound infections; (2) their effects may be contributed to by autoinducers or other, yet undefined, QS-controlled factors; and (3) QS may play a role in modulating the host immune system in response to P. aeruginosa.Item The wrong kind of general: the resignation of union brigadier general William W. Burns(Texas A&M University, 2005-08-29) Ward, David EarlThis study examines the career of Union Brigadier General William Wallace Burns, focusing on the circumstances surrounding his mysterious resignation of his volunteer rank in March 1863, at the height of the Civil War. General Burns, a rising star in the Army of the Potomac, seemingly assured of rapid promotion to major general, relinquished his field rank and returned to his Regular Army rank of major in the Commissary Department. Why would a well-regarded officer, not suffering from any debilitating physical problems, choose to destroy his career in such a manner? General Burns claimed in his personal letters that he was forced out through the duplicity of Secretary of War Edwin M. Stanton. A War Department inquiry found no evidence to support Burns?? allegation. This thesis, after a thorough examination of the subject, offers a conclusion as to whether General Burns was wronged or if he was the victim of his own paranoia.