Nicole Alden - Academia.edu (original) (raw)
Papers by Nicole Alden
Investigative Ophthalmology & Visual Science, 2005
The Journal of burn care & rehabilitation, 2005
Current literature has reported an increase in the rates of morbidity and mortality in elderly de... more Current literature has reported an increase in the rates of morbidity and mortality in elderly dementia patients who have suffered from illnesses such as pneumonia or traumatic injuries such as falls, motor vehicle collisions, and other insults. The role of dementia in elderly burn patients has not been studied in depth. To assess the extent of this problem, a retrospective, case-control study of patients with dementia who were admitted to a large urban burn center was performed. The demographics, circumstance and severity of injury, critical care use, and discharge disposition of those patients admitted with dementia were reviewed and compared with the findings of age/burn size-matched controls. The results support the premise that burn injuries in this patient population can be severe. Although not statistically significant, 22.2% of the study group patients required ventilatory support, and 75% required monitoring in the intensive care unit compared with the 15.3% and 61.6% of co...
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Introduction: Treatment of pain associated with burn injury is a major clinical challenge, which ... more Introduction: Treatment of pain associated with burn injury is a major clinical challenge, which is particularly complicated due to changes in drug metabolism associated with thermal injury. In the present study, we have examined drug metabolism in mice subjected to thermal injury. Methods: Mice (CD-1, Charles River, male, 28 grams) were anesthetized with ether, the dorsum shaven and subjected to thermal injury (20 % TBSA, 90 o C, 9 seconds) followed by saline resuscitation (2 mL, IP). Drug induced sleep times were determined by treating mice at 24 hours post burn with pentobarbital (60 mg/kg, IP), ketamine (40 mg/kg, IP), or ether, in which case the mice were placed in a bell jar with ether saturated atmosphere. In another group of mice at 24 hours post burn, exhaled 14 CO2 was collected in vivo to determine oxidation of 14 C-aminopyrine. Mice were injected with 0.5 microcuries of 14 C-aminopyrine and immediately placed in sealed jars. Results: Thermal injury caused approximately a 3 fold increase in both pentobarbital and Ketamine induced sleep times, while no significant change was observed with ether. Burn injury also resulted in a 33% reduction in the in vivo oxidation of 14 C-aminopyrine. Conclusions: Burn injury produced a significant decrease in drug metabolism 24 hours after injury, which was associated with an increase in drug induced sleep time. This model will allow an examination of the mechanism(s) involved in burn induced changes in drug metabolism.
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Much of the success of burn camps is supported by the growing body of evidence concerning the pos... more Much of the success of burn camps is supported by the growing body of evidence concerning the positive impacts on the physical and emotional health of the pediatric burn survivor attendees. Camp activities challenge the children to succeed, encourage participation in recreation outside of normal routines, and provide for the development of independent and team-building skills and interests. 1-4 As a result, campers report increased self-esteem and autonomy, reevaluate preconceived ideas of limitations, "feel normal," and find comfort in sharing their experiences of living with the physical and emotional sequelae of a serious burn injury. 2-4 Often, after camp, children apply personal successes achieved within the camp environment to other contexts, such as school and home. 2,4 The nurturing environment of burn camp is created and maintained by many influences, including the camper-counselor relationships. The impact of these relationships upon the campers is well documented: children report feeling that counselors see them as individuals and not for their scars and that they receive unconditional support from these adults. 3 In camps such as the Connecticut Burns Care Foundation Children's Burn Camp (CBCFCBC; Union, CT), many of the volunteer counselors are members of the burn community: firefighters, nurses, therapists, and/or burn survivors. These adult counselors are seen as role models by the campers. 3 Although the benefits of the burn camp experience for campers are well documented, the impact of the burn camp experience upon the counselors remains unexplored. We hypothesized that as the positive burn camp experience carries over into academic, family, and social aspects of the campers' lives, it will similarly influence the personal and professional aspects of the counselors' lives. The purpose of this study was to evaluate the impact of camp upon the counselor experience.
Journal of Burn Care & Research, 2006
Journal of Burn Care & Rehabilitation, 2004
Scald burns continue to be the major cause of injury to patients admitted to the burn center. Sca... more Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Tr...
Journal of Burn Care & Rehabilitation, 2005
Previously, our Burn Center at the New-York Presbyterian/Weill Cornell Medical Center reported a ... more Previously, our Burn Center at the New-York Presbyterian/Weill Cornell Medical Center reported a decline during a 10-year period in the number of firefighters requiring hospitalization for burn injuries, from 53 patients per year to 15 patients per year. Because the incidence of structural fires continued at a constant rate of 26,240 to 30,841 per year during this time, it was postulated that an improvement in protective gear accounted for the decrease in injuries. However, it also was possible that more firefighters were being treated on an outpatient basis. Therefore, our Burn Center's outpatient treatment of firefighter burn injuries was reviewed to determine the epidemiology of firefighter burn injuries. On the basis of this study, the overall incidence of burn injuries in firefighters has continued at a constant level. These findings, however, demonstrate that the extent of injury has decreased in this population and suggest that the protective gear used by firefighters has contributed to these findings. These injuries, although minor to moderate, preclude the use of personal protective equipment until the burns are completely healed and contribute to a delayed return to full-duty status. These findings are consistent with nationally reported findings.
Journal of Burn Care & Rehabilitation, 2005
burn-related disasters. The limited number of patients treated from the terrorist attacks on the ... more burn-related disasters. The limited number of patients treated from the terrorist attacks on the World Trade Center and Pentagon, though taxing individual institutions, did not stress the burn care system on a national level. Burn centers are in limited supply, and in contrast to trauma centers, burn centers continue to close because of economic pressures. They are a unique national resource with highly specialized burn care systems to address the complex nature of these injuries. This selection outlines the unique, critical role that burn centers play in local, regional, and federal responses to mass burn casuality situations and defines the important role of the ABA in interacting with federal agencies regarding mass burn casualty disaster preparedness.
The Journal of Burn Care & Rehabilitation, 2004
Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 ... more Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 fire-related incidents per year. It is inevitable that some of these firefighters will suffer burn injuries. This 10-year retrospective review describes the epidemiology of firefighters with burn injuries who were treated at our burn center. From 1992 to 2002, 987 firefighters were treated at our burn center. The total number of firefighters treated for burn injuries and the number of firefighters who were treated for burn injuries to the lower extremities occurred in a bimodal distribution. Injury prevention efforts will continue to further reduce the incidence of burn injuries in the firefighters of our community.
Journal of Burn Care & Rehabilitation, 2002
Investigative Ophthalmology & Visual Science, 2005
The Journal of burn care & rehabilitation, 2005
Current literature has reported an increase in the rates of morbidity and mortality in elderly de... more Current literature has reported an increase in the rates of morbidity and mortality in elderly dementia patients who have suffered from illnesses such as pneumonia or traumatic injuries such as falls, motor vehicle collisions, and other insults. The role of dementia in elderly burn patients has not been studied in depth. To assess the extent of this problem, a retrospective, case-control study of patients with dementia who were admitted to a large urban burn center was performed. The demographics, circumstance and severity of injury, critical care use, and discharge disposition of those patients admitted with dementia were reviewed and compared with the findings of age/burn size-matched controls. The results support the premise that burn injuries in this patient population can be severe. Although not statistically significant, 22.2% of the study group patients required ventilatory support, and 75% required monitoring in the intensive care unit compared with the 15.3% and 61.6% of co...
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Introduction: Treatment of pain associated with burn injury is a major clinical challenge, which ... more Introduction: Treatment of pain associated with burn injury is a major clinical challenge, which is particularly complicated due to changes in drug metabolism associated with thermal injury. In the present study, we have examined drug metabolism in mice subjected to thermal injury. Methods: Mice (CD-1, Charles River, male, 28 grams) were anesthetized with ether, the dorsum shaven and subjected to thermal injury (20 % TBSA, 90 o C, 9 seconds) followed by saline resuscitation (2 mL, IP). Drug induced sleep times were determined by treating mice at 24 hours post burn with pentobarbital (60 mg/kg, IP), ketamine (40 mg/kg, IP), or ether, in which case the mice were placed in a bell jar with ether saturated atmosphere. In another group of mice at 24 hours post burn, exhaled 14 CO2 was collected in vivo to determine oxidation of 14 C-aminopyrine. Mice were injected with 0.5 microcuries of 14 C-aminopyrine and immediately placed in sealed jars. Results: Thermal injury caused approximately a 3 fold increase in both pentobarbital and Ketamine induced sleep times, while no significant change was observed with ether. Burn injury also resulted in a 33% reduction in the in vivo oxidation of 14 C-aminopyrine. Conclusions: Burn injury produced a significant decrease in drug metabolism 24 hours after injury, which was associated with an increase in drug induced sleep time. This model will allow an examination of the mechanism(s) involved in burn induced changes in drug metabolism.
Journal of Burn Care & Research, 2006
Journal of Burn Care & Research, 2006
Much of the success of burn camps is supported by the growing body of evidence concerning the pos... more Much of the success of burn camps is supported by the growing body of evidence concerning the positive impacts on the physical and emotional health of the pediatric burn survivor attendees. Camp activities challenge the children to succeed, encourage participation in recreation outside of normal routines, and provide for the development of independent and team-building skills and interests. 1-4 As a result, campers report increased self-esteem and autonomy, reevaluate preconceived ideas of limitations, "feel normal," and find comfort in sharing their experiences of living with the physical and emotional sequelae of a serious burn injury. 2-4 Often, after camp, children apply personal successes achieved within the camp environment to other contexts, such as school and home. 2,4 The nurturing environment of burn camp is created and maintained by many influences, including the camper-counselor relationships. The impact of these relationships upon the campers is well documented: children report feeling that counselors see them as individuals and not for their scars and that they receive unconditional support from these adults. 3 In camps such as the Connecticut Burns Care Foundation Children's Burn Camp (CBCFCBC; Union, CT), many of the volunteer counselors are members of the burn community: firefighters, nurses, therapists, and/or burn survivors. These adult counselors are seen as role models by the campers. 3 Although the benefits of the burn camp experience for campers are well documented, the impact of the burn camp experience upon the counselors remains unexplored. We hypothesized that as the positive burn camp experience carries over into academic, family, and social aspects of the campers' lives, it will similarly influence the personal and professional aspects of the counselors' lives. The purpose of this study was to evaluate the impact of camp upon the counselor experience.
Journal of Burn Care & Research, 2006
Journal of Burn Care & Rehabilitation, 2004
Scald burns continue to be the major cause of injury to patients admitted to the burn center. Sca... more Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Tr...
Journal of Burn Care & Rehabilitation, 2005
Previously, our Burn Center at the New-York Presbyterian/Weill Cornell Medical Center reported a ... more Previously, our Burn Center at the New-York Presbyterian/Weill Cornell Medical Center reported a decline during a 10-year period in the number of firefighters requiring hospitalization for burn injuries, from 53 patients per year to 15 patients per year. Because the incidence of structural fires continued at a constant rate of 26,240 to 30,841 per year during this time, it was postulated that an improvement in protective gear accounted for the decrease in injuries. However, it also was possible that more firefighters were being treated on an outpatient basis. Therefore, our Burn Center's outpatient treatment of firefighter burn injuries was reviewed to determine the epidemiology of firefighter burn injuries. On the basis of this study, the overall incidence of burn injuries in firefighters has continued at a constant level. These findings, however, demonstrate that the extent of injury has decreased in this population and suggest that the protective gear used by firefighters has contributed to these findings. These injuries, although minor to moderate, preclude the use of personal protective equipment until the burns are completely healed and contribute to a delayed return to full-duty status. These findings are consistent with nationally reported findings.
Journal of Burn Care & Rehabilitation, 2005
burn-related disasters. The limited number of patients treated from the terrorist attacks on the ... more burn-related disasters. The limited number of patients treated from the terrorist attacks on the World Trade Center and Pentagon, though taxing individual institutions, did not stress the burn care system on a national level. Burn centers are in limited supply, and in contrast to trauma centers, burn centers continue to close because of economic pressures. They are a unique national resource with highly specialized burn care systems to address the complex nature of these injuries. This selection outlines the unique, critical role that burn centers play in local, regional, and federal responses to mass burn casuality situations and defines the important role of the ABA in interacting with federal agencies regarding mass burn casualty disaster preparedness.
The Journal of Burn Care & Rehabilitation, 2004
Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 ... more Our metropolitan area employs approximately 11,000 firefighters who respond to more than 435,000 fire-related incidents per year. It is inevitable that some of these firefighters will suffer burn injuries. This 10-year retrospective review describes the epidemiology of firefighters with burn injuries who were treated at our burn center. From 1992 to 2002, 987 firefighters were treated at our burn center. The total number of firefighters treated for burn injuries and the number of firefighters who were treated for burn injuries to the lower extremities occurred in a bimodal distribution. Injury prevention efforts will continue to further reduce the incidence of burn injuries in the firefighters of our community.
Journal of Burn Care & Rehabilitation, 2002