Neonatal Burns - A Romanian Experience From A Tertiary Care Burn Unit.

Burns in neonates is a unique pathology that poses management challenges, as, besides treating the burn injury, the medical team needs to be familiar with the unique physiology of the newborn. This study aimed to review our center's experience with the management of neonatal burns. A 7-year retrospective study of neonatal burns managed at a tertiary national referral unit in Bucharest, Romania, was performed. Patients were divided into two groups, preterm and term, based on gestational age. Collected data included demographics, treatment, complications and follow-up. Our center managed 13 neonates with burns (5 term and 8 preterm), with a mean age at injury of 8.6 days. All neonatal burns were thermal injuries. For preterm babies, all burns were iatrogenic, consisting of victims of a fire in a Maternity Hospital, while for the term group only one was iatrogenic. Burns were more extensive in the premature group (65% vs. 20% mean TBSA, p=0.0001). All premature patients had associated inhalation injuries. Surgical treatment was indicated for two term patients. Survival rate was 77% and was negatively influenced by inhalation injury, burn shock and TBSA >50%. In conclusion, the majority of hospitalized neonatal burns in Romania were the result of a fire disaster secondary to an infrastructure deficiency. Their management is complex, posing specific challenges, and needs to be led by a multidisciplinary team that can ensure an individualized continuum of acute burn care and recovery.

Les brûlures du nouveau- né (NN) posent une problème physiopathologique spécifique, tenant non seulement aux conséquences de la brûlure mais aussi à la physiologie particulière du NN. Cet article décrit notre expérience. Il s'agit d'une étude rétrospective reprenant les 13 NN pris en charge dans un CTB de référence de Bucarest, pour une brûlure survenue en moyenne à 8,6J. Les patients ont été répartis entres prématurés (P,8) et à terme (T,5). Toutes les brûlures étaient thermiques, toutes iatrogènes dans le groupe P, consécutives à un incendie à la maternité quand une seule était iatrogène dans le groupe T. Elles étaient plus étendues dans le groupe P (65% SCT) que dans le groupe T (20%, p= 0,0001). Tous les P avaient des lésions d'inhalation. Une greffe a été nécessaire pour 2 T. La mortalité était de 23%, influencée par la surface brûlée, l'inhalation et une surface atteinte >50 %. En conclusion, la plupart des brûlures de NN roumains ayant nécessité une hospitalisation étaient dues à l'incendie d'une maternité à l'architecture déficiente. Leur prise en charge est complexe et spécifique, ce qui nécessite une équipe entraînée, à même de proposer des soins adaptés, de la phase aiguë à la rééducation.

Somatosensory evoked response source localization using actual cortical surface as the spatial constraint.

We localized right median nerve somatosensory evoked responses in a normal human subject using an equivalent dipole method applied to magnetic field recordings. High resolution, 3-dimensional MRI data were used to confine source locations to the cortical surface. Results localized in Brodmann area 3b corresponding to location of hand somatosensory cortex derived from direct brain stimulation studies. The solution was unique and total computational time for an exhaustive, brute-force search was small and the results realistic due to applied anatomical constraints. This study demonstrates feasibility of accurate, non-invasive, realistic localization of dynamic human cortical function using spatial constraints provided by MRI images.