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As he is affected less by the distortions , Data is sent down alone and disables the remaining security measures before entering Manheim 's laboratory . He finds a column of energy emanating from a dimensional matrix , the source of the time distortions . Data , though briefly affected by the time distortions , is able to add anti @-@ matter to the matrix , causing the matrix to stabilize and halt the time distortions . Dr. Manheim fully recovers , and he and Jenice thank Picard and the crew for their help . Picard and Jenice use the holodeck to recreate one more encounter at a Paris café , before she returns with her husband to the planet .
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= = Production = =
| faaebcbbaf42e685bce2a1bbbaaad33b | 21,600 |
" We 'll Always Have Paris " is named in reference to the Humphrey Bogart and Ingrid Bergman film Casablanca . As well as the title of the episode and the love triangle in the story , the Blue Parrot Café from the film is directly mentioned by Captain Picard . Casablanca was also the basis for the earlier Star Trek : The Original Series novel The Entropy Effect , and would be so again in the Deep Space Nine episode " Profit and Loss " .
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The story was originally pitched by Hannah Louise Shearer and Deborah Dean Davis , who were also given the job of developing the script . The writing of the episode suffered from the timing of the 1988 Writers Guild of America strike , with Shearer and Dean Davis completing the script in five days . The premise of the story was a combination of their idea of a story " about a professor whose work wasn 't appreciated and had to go off on his own " and that of Maurice Hurley who wanted a story with a time anomaly . The final draft was dated 22 February and featured numerous differences from the filmed version , including Jenice being called Laura , a number of different interactions for the crew , and Riker , Worf and Data all being involved in shutting down Manheim 's equipment . The script was finalised a week before the episode was filmed , but the writers strike caused further issues when it was discovered during filming that the scene where Data was to fix the time distortions hadn 't been completed .
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Robert Legato and Rick Berman spent forty minutes on the telephone with Shearer during the strike . While she refused to write the lines during the strike , Berman suggested dialogue and Shearer would give opinions with Legato taking down handwritten notes . Legato decided on the directing notes himself , and used a whip pan shot instead of an effects shot to film the three Datas as director Robert Becker had never used effects shots previously . Shearer wasn 't happy with the final result , saying " we were writing the most romantic episode in the world " but that " it was toned down 75 % " .
| ec0c08038e4234d70b5a7971ef108158 | 21,604 |
Shearer later complained of a lack of chemistry between Michelle Phillips and Patrick Stewart , which Phillips blamed on the conflicted nature of the character in that she was committed to her husband but also wanted to see Picard once more . Phillips , a Star Trek fan , is better known for being a member of the 1960s group The Mamas & the Papas . Rod Loomis ' previous science fiction outing was in Bill and Ted 's Excellent Adventure as Sigmund Freud , and Lance Spellerberg would later return in " The Icarus Factor " where his transporter chief gained the name Ensign Herbert . The image of 24th century Paris was a matte painting which was re @-@ used in Star Trek VI : The Undiscovered Country where it was hung outside the office of the Federation president .
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= = Reception = =
| f8d79e3fcb54590ed5efe8209a7826d9 | 21,607 |
" We 'll Always Have Paris " aired in broadcast syndication during the week commencing May 5 , 1988 . It received Nielsen ratings of 9 @.@ 7 , reflecting the percentage of all households watching the episode during its timeslot . This was the same ratings received as the previous episode , " Skin of Evil " .
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Several reviewers re @-@ watched the episode after the end of the series . Michelle Erica Green reviewed the episode on behalf of TrekNation in September 2007 , comparing certain elements of the episode to Casablanca and the series finale " All Good Things ... " . These included the ending where time distortions caused Data to be replicated three time in " We 'll Always Have Paris " compared to the similar situation with three Picards in " All Good Things ... " . Overall she thought that the episode was better than she recalled previously . Jamahl Epsicokhan at his website " Jammer 's Reviews " described the episode as too simple , especially the ending which he said was " they give Data a canister , which he sticks into a hall of mirrors ; problem solved " .
| 1a3feb064bcdb11e4f22eacb13088a4b | 21,610 |
Zack Handlen , reviewing the episode for The A.V. Club in May 2010 , said that he enjoyed the " time blips " in the episode , but that he wasn 't a fan of the romance between Jenice and Picard . He also felt that there wasn 't much follow up on Manheim 's experiments and that he seemed to be left to cause a more serious accident in the future . Keith DeCandido watched the episode for Tor.com in July 2011 . He thought that Michele Phillips was " incredibly radiant " , and said , " there ’ s nothing I can point to at this episode and say is wrong , but it ’ s one of the more forgettable episodes " , giving it a score of four out of ten .
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= = Home media release = =
| 76d62d52ef16c04aa5cfbc7c1b1f8fdf | 21,613 |
The first home media release of " We 'll Always Have Paris " was on VHS cassette was on July 1 , 1992 in the United States and Canada . The episode was later included on the Star Trek : The Next Generation season one DVD box set , released in March 2002 , and was released as part of the season one Blu @-@ ray set on July 24 , 2012 .
| 3da03471e246675b4fbf3231643fd84e | 21,615 |
= Burn =
| ecdf8f63586f4f831c1e302873be62ee | 21,618 |
A burn is a type of injury to skin , or other tissues , caused by heat , cold , electricity , chemicals , friction , or radiation . Most burns are due to heat from hot liquids , solids , or fire . Among women in many areas of the world the risk is related to the use of open cooking fires or unsafe cook stoves . Alcoholism and smoking are other risk factors . Burns can also occur as a result of self harm or violence between people .
| f8f00460cd8e73f2acd942490fbb86a2 | 21,620 |
Burns that affect only the superficial skin layers are known as superficial or first @-@ degree burns . They appear red without blisters and pain typically lasts around three days . When the injury extends into some of the underlying skin layer , it is a partial @-@ thickness or second @-@ degree burn . Blisters are frequently present and they are often very painful . Healing can require up to eight weeks and scarring may occur . In a full @-@ thickness or third @-@ degree burn , the injury extends to all layers of the skin . Often there is no pain and the burn area is stiff . Healing typically does not occur on its own . A fourth @-@ degree burn additionally involves injury to deeper tissues , such as muscle , tendons , or bone . The burn is often black and frequently leads to loss of the burned part .
| f9968d42bdaab726e95f538b9f6445bf | 21,621 |
Burns are generally preventable . Treatment depends on the severity of the burn . Superficial burns may be managed with little more than simple pain medication , while major burns may require prolonged treatment in specialized burn centers . Cooling with tap water may help pain and decrease damage ; however , prolonged cooling may result in low body temperature . Partial @-@ thickness burns may require cleaning with soap and water , followed by dressings . It is not clear how to manage blisters , but it is probably reasonable to leave them intact if small and drain them if large . Full @-@ thickness burns usually require surgical treatments , such as skin grafting . Extensive burns often require large amounts of intravenous fluid , due to capillary fluid leakage and tissue swelling . The most common complications of burns involve infection . Tetanus toxoid should be given if not up to date .
| 1f72878b1d590b67b9f1497d545bcdfb | 21,622 |
In 2013 , fire and heat resulted in 35 million injuries . This resulted in about 2 @.@ 9 million hospitalizations and 238 @,@ 000 dying . Most deaths due to burns occur in the developing world , particularly in Southeast Asia . While large burns can be fatal , treatments developed since 1960 have improved outcomes , especially in children and young adults . In the United States , approximately 96 % of those admitted to a burn center survive their injuries . Burns occur at similar frequencies in men and women . The long @-@ term outcome is related to the size of burn and the age of the person affected .
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= = Signs and symptoms = =
| e73a6339951e88c9dff94ab8621ff527 | 21,625 |
The characteristics of a burn depend upon its depth . Superficial burns cause pain lasting two or three days , followed by peeling of the skin over the next few days . Individuals suffering from more severe burns may indicate discomfort or complain of feeling pressure rather than pain . Full @-@ thickness burns may be entirely insensitive to light touch or puncture . While superficial burns are typically red in color , severe burns may be pink , white or black . Burns around the mouth or singed hair inside the nose may indicate that burns to the airways have occurred , but these findings are not definitive . More worrisome signs include : shortness of breath , hoarseness , and stridor or wheezing . Itchiness is common during the healing process , occurring in up to 90 % of adults and nearly all children . Numbness or tingling may persist for a prolonged period of time after an electrical injury . Burns may also produce emotional and psychological distress .
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= = Cause = =
| 3a9d88ce2c2d8b3b16113001bfc622a6 | 21,629 |
Burns are caused by a variety of external sources classified as thermal ( heat @-@ related ) , chemical , electrical , and radiation . In the United States , the most common causes of burns are : fire or flame ( 44 % ) , scalds ( 33 % ) , hot objects ( 9 % ) , electricity ( 4 % ) , and chemicals ( 3 % ) . Most ( 69 % ) burn injuries occur at home or at work ( 9 % ) , and most are accidental , with 2 % due to assault by another , and 1 @-@ 2 % resulting from a suicide attempt . These sources can cause inhalation injury to the airway and / or lungs , occurring in about 6 % .
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Burn injuries occur more commonly among the poor . Smoking is a risk factor , although alcohol use is not . Fire @-@ related burns are generally more common in colder climates . Specific risk factors in the developing world include cooking with open fires or on the floor as well as developmental disabilities in children and chronic diseases in adults .
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= = = Thermal = = =
| 981d14927f08fb698527b985cba34a4d | 21,634 |
In the United States , fire and hot liquids are the most common causes of burns . Of house fires that result in death , smoking causes 25 % and heating devices cause 22 % . Almost half of injuries are due to efforts to fight a fire . Scalding is caused by hot liquids or gases and most commonly occurs from exposure to hot drinks , high temperature tap water in baths or showers , hot cooking oil , or steam . Scald injuries are most common in children under the age of five and , in the United States and Australia , this population makes up about two @-@ thirds of all burns . Contact with hot objects is the cause of about 20 @-@ 30 % of burns in children . Generally , scalds are first- or second @-@ degree burns , but third @-@ degree burns may also result , especially with prolonged contact . Fireworks are a common cause of burns during holiday seasons in many countries . This is a particular risk for adolescent males .
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= = = Chemical = = =
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Chemicals cause from 2 to 11 % of all burns and contribute to as many as 30 % of burn @-@ related deaths . Chemical burns can be caused by over 25 @,@ 000 substances , most of which are either a strong base ( 55 % ) or a strong acid ( 26 % ) . Most chemical burn deaths are secondary to ingestion . Common agents include : sulfuric acid as found in toilet cleaners , sodium hypochlorite as found in bleach , and halogenated hydrocarbons as found in paint remover , among others . Hydrofluoric acid can cause particularly deep burns that may not become symptomatic until some time after exposure . Formic acid may cause the breakdown of significant numbers of red blood cells .
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= = = Electrical = = =
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Electrical burns or injuries are classified as high voltage ( greater than or equal to 1000 volts ) , low voltage ( less than 1000 volts ) , or as flash burns secondary to an electric arc . The most common causes of electrical burns in children are electrical cords ( 60 % ) followed by electrical outlets ( 14 % ) . Lightning may also result in electrical burns . Risk factors for being struck include involvement in outdoor activities such as mountain climbing , golf and field sports , and working outside . Mortality from a lightning strike is about 10 % .
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While electrical injuries primarily result in burns , they may also cause fractures or dislocations secondary to blunt force trauma or muscle contractions . In high voltage injuries , most damage may occur internally and thus the extent of the injury cannot be judged by examination of the skin alone . Contact with either low voltage or high voltage may produce cardiac arrhythmias or cardiac arrest .
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= = = Radiation = = =
| de1bfa30e0748a3dc2af46daebbff853 | 21,647 |
Radiation burns may be caused by protracted exposure to ultraviolet light ( such as from the sun , tanning booths or arc welding ) or from ionizing radiation ( such as from radiation therapy , X @-@ rays or radioactive fallout ) . Sun exposure is the most common cause of radiation burns and the most common cause of superficial burns overall . There is significant variation in how easily people sunburn based on their skin type . Skin effects from ionizing radiation depend on the amount of exposure to the area , with hair loss seen after 3 Gy , redness seen after 10 Gy , wet skin peeling after 20 Gy , and necrosis after 30 Gy . Redness , if it occurs , may not appear until some time after exposure . Radiation burns are treated the same as other burns . Microwave burns occur via thermal heating caused by the microwaves . While exposures as short as two seconds may cause injury , overall this is an uncommon occurrence .
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= = = Non accidental = = =
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In those hospitalized from scalds or fire burns , 3 – 10 % are from assault . Reasons include : child abuse , personal disputes , spousal abuse , elder abuse , and business disputes . An immersion injury or immersion scald may indicate child abuse . It is created when an extremity or the lower body ( buttock or perineum ) is held under the surface of hot water . It typically produces a sharp upper border and is often symmetrical . Other high @-@ risk signs of potential abuse include : circumferential burns , the absence of splash marks , a burn of uniform depth , and association with other signs of neglect or abuse .
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Bride burning , a form of domestic violence , occurs in some cultures , such as India where women have been burned in revenge for what the husband or his family consider an inadequate dowry . In Pakistan , acid burns represent 13 % of intentional burns , and are frequently related to domestic violence . Self @-@ immolation ( setting oneself on fire ) is also used as a form of protest in various parts of the world .
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= = Pathophysiology = =
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At temperatures greater than 44 ° C ( 111 ° F ) , proteins begin losing their three @-@ dimensional shape and start breaking down . This results in cell and tissue damage . Many of the direct health effects of a burn are secondary to disruption in the normal functioning of the skin . They include disruption of the skin 's sensation , ability to prevent water loss through evaporation , and ability to control body temperature . Disruption of cell membranes causes cells to lose potassium to the spaces outside the cell and to take up water and sodium .
| 868a93c7d0a7bfb0689064d6b3356f6c | 21,658 |
In large burns ( over 30 % of the total body surface area ) , there is a significant inflammatory response . This results in increased leakage of fluid from the capillaries , and subsequent tissue edema . This causes overall blood volume loss , with the remaining blood suffering significant plasma loss , making the blood more concentrated . Poor blood flow to organs such as the kidneys and gastrointestinal tract may result in renal failure and stomach ulcers .
| 372c4c9dbafa8d652888ef649b795d68 | 21,659 |
Increased levels of catecholamines and cortisol can cause a hypermetabolic state that can last for years . This is associated with increased cardiac output , metabolism , a fast heart rate , and poor immune function .
| f1901992661a6b73225e0f0c5a2a4582 | 21,660 |
= = Diagnosis = =
| e973706bd7f6717cf1720522d110c11e | 21,662 |
Burns can be classified by depth , mechanism of injury , extent , and associated injuries . The most commonly used classification is based on the depth of injury . The depth of a burn is usually determined via examination , although a biopsy may also be used . It may be difficult to accurately determine the depth of a burn on a single examination and repeated examinations over a few days may be necessary . In those who have a headache or are dizzy and have a fire @-@ related burn , carbon monoxide poisoning should be considered . Cyanide poisoning should also be considered .
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= = = Size = = =
| 59400171f636efad2752a3094ae74d3b | 21,666 |
The size of a burn is measured as a percentage of total body surface area ( TBSA ) affected by partial thickness or full thickness burns . First @-@ degree burns that are only red in color and are not blistering are not included in this estimation . Most burns ( 70 % ) involve less than 10 % of the TBSA .
| 3968257d9573182396e6535ef6a6e7c5 | 21,668 |
There are a number of methods to determine the TBSA , including the Wallace rule of nines , Lund and Browder chart , and estimations based on a person 's palm size . The rule of nines is easy to remember but only accurate in people over 16 years of age . More accurate estimates can be made using Lund and Browder charts , which take into account the different proportions of body parts in adults and children . The size of a person 's handprint ( including the palm and fingers ) is approximately 1 % of their TBSA .
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= = = Severity = = =
| 87f0051e27efdabdef4879dad48c66f3 | 21,671 |
To determine the need for referral to a specialized burn unit , the American Burn Association devised a classification system . Under this system , burns can be classified as major , moderate and minor . This is assessed based on a number of factors , including total body surface area affected , the involvement of specific anatomical zones , the age of the person , and associated injuries . Minor burns can typically be managed at home , moderate burns are often managed in hospital , and major burns are managed by a burn center .
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= = Prevention = =
| 6dcc28c80aa98a1ddff216647aae4474 | 21,675 |
Historically , about half of all burns were deemed preventable . Burn prevention programs have significantly decreased rates of serious burns . Preventive measures include : limiting hot water temperatures , smoke alarms , sprinkler systems , proper construction of buildings , and fire @-@ resistant clothing . Experts recommend setting water heaters below 48 @.@ 8 ° C ( 119 @.@ 8 ° F ) . Other measures to prevent scalds include using a thermometer to measure bath water temperatures , and splash guards on stoves . While the effect of the regulation of fireworks is unclear , there is tentative evidence of benefit with recommendations including the limitation of the sale of fireworks to children .
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= = Management = =
| 52d29fdb0c4dc8e954cd297db2b372a8 | 21,679 |
Resuscitation begins with the assessment and stabilization of the person 's airway , breathing and circulation . If inhalation injury is suspected , early intubation may be required . This is followed by care of the burn wound itself . People with extensive burns may be wrapped in clean sheets until they arrive at a hospital . As burn wounds are prone to infection , a tetanus booster shot should be given if an individual has not been immunized within the last five years . In the United States , 95 % of burns that present to the emergency department are treated and discharged ; 5 % require hospital admission . With major burns , early feeding is important . Hyperbaric oxygenation may be useful in addition to traditional treatments .
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= = = Intravenous fluids = = =
| 81a002b8c6f533ef0738eac6eab3481a | 21,683 |
In those with poor tissue perfusion , boluses of isotonic crystalloid solution should be given . In children with more than 10 @-@ 20 % TBSA burns , and adults with more than 15 % TBSA burns , formal fluid resuscitation and monitoring should follow . This should be begun pre @-@ hospital if possible in those with burns greater than 25 % TBSA . The Parkland formula can help determine the volume of intravenous fluids required over the first 24 hours . The formula is based on the affected individual 's TBSA and weight . Half of the fluid is administered over the first 8 hours , and the remainder over the following 16 hours . The time is calculated from when the burn occurred , and not from the time that fluid resuscitation began . Children require additional maintenance fluid that includes glucose . Additionally , those with inhalation injuries require more fluid . While inadequate fluid resuscitation may cause problems , over @-@ resuscitation can also be detrimental . The formulas are only a guide , with infusions ideally tailored to a urinary output of > 30 mL / h in adults or > 1mL / kg in children and mean arterial pressure greater than 60 mmHg .
| de3801ee6bde689a7b520b6fe8e3cf70 | 21,685 |
While lactated Ringer 's solution is often used , there is no evidence that it is superior to normal saline . Crystalloid fluids appear just as good as colloid fluids , and as colloids are more expensive they are not recommended . Blood transfusions are rarely required . They are typically only recommended when the hemoglobin level falls below 60 @-@ 80 g / L ( 6 @-@ 8 g / dL ) due to the associated risk of complications . Intravenous catheters may be placed through burned skin if needed or intraosseous infusions may be used .
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= = = Wound care = = =
| 9ac4a0613788f8d4a6e117bfffcbe28e | 21,688 |
Early cooling ( within 30 minutes of the burn ) reduces burn depth and pain , but care must be taken as over @-@ cooling can result in hypothermia . It should be performed with cool water 10 – 25 ° C ( 50 @.@ 0 – 77 @.@ 0 ° F ) and not ice water as the latter can cause further injury . Chemical burns may require extensive irrigation . Cleaning with soap and water , removal of dead tissue , and application of dressings are important aspects of wound care . If intact blisters are present , it is not clear what should be done with them . Some tentative evidence supports leaving them intact . Second @-@ degree burns should be re @-@ evaluated after two days .
| 580456b9418ff7c1c6854f9b612117de | 21,690 |
In the management of first and second @-@ degree burns , little quality evidence exists to determine which dressing type to use . It is reasonable to manage first @-@ degree burns without dressings . While topical antibiotics are often recommended , there is little evidence to support their use . Silver sulfadiazine ( a type of antibiotic ) is not recommended as it potentially prolongs healing time . There is insufficient evidence to support the use of dressings containing silver or negative @-@ pressure wound therapy .
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= = = Medications = = =
| 482597d291c6baa4a31728730e4d952a | 21,693 |
Burns can be very painful and a number of different options may be used for pain management . These include simple analgesics ( such as ibuprofen and acetaminophen ) and opioids such as morphine . Benzodiazepines may be used in addition to analgesics to help with anxiety . During the healing process , antihistamines , massage , or transcutaneous nerve stimulation may be used to aid with itching . Antihistamines , however , are only effective for this purpose in 20 % of people . There is tentative evidence supporting the use of gabapentin and its use may be reasonable in those who do not improve with antihistamines . Intravenous lidocaine requires more study before it can be recommended for pain .
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Intravenous antibiotics are recommended before surgery for those with extensive burns ( > 60 % TBSA ) . As of 2008 , guidelines do not recommend their general use due to concerns regarding antibiotic resistance and the increased risk of fungal infections . Tentative evidence , however , shows that they may improve survival rates in those with large and severe burns . Erythropoietin has not been found effective to prevent or treat anemia in burn cases . In burns caused by hydrofluoric acid , calcium gluconate is a specific antidote and may be used intravenously and / or topically . Recombinant human growth hormone ( rhGH ) in those with burns that involve more than 40 % of their body appears to speed healing without affecting the risk of death .
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= = = Surgery = = =
| fb2ec829fea4ed7c6cf9978319ee7db5 | 21,698 |
Wounds requiring surgical closure with skin grafts or flaps ( typically anything more than a small full thickness burn ) should be dealt with as early as possible . Circumferential burns of the limbs or chest may need urgent surgical release of the skin , known as an escharotomy . This is done to treat or prevent problems with distal circulation , or ventilation . It is uncertain if it is useful for neck or digit burns . Fasciotomies may be required for electrical burns .
| bbc80b3d7b4e266823301609417f8036 | 21,700 |
= = = Alternative medicine = = =
| aee5421fbc117ef047ac65ff2fee3f4e | 21,702 |
Honey has been used since ancient times to aid wound healing and may be beneficial in first- and second @-@ degree burns . There is tentative evidence that honey helps heal partial thickness burns . The evidence for aloe vera is of poor quality . While it might be beneficial in reducing pain , and a review from 2007 found tentative evidence of improved healing times a subsequent review from 2012 did not find improved healing over silver sulfadiazine . There were only three randomized controlled trials for the use of plants for burns , two for aloe vera and one for oatmeal .
| 08b58ede5cbc8be7379dc440f2202a79 | 21,704 |
There is little evidence that vitamin E helps with keloids or scarring . Butter is not recommended . In low income countries , burns are treated up to one @-@ third of the time with traditional medicine , which may include applications of eggs , mud , leaves or cow dung . Surgical management is limited in some cases due to insufficient financial resources and availability . There are a number of other methods that may be used in addition to medications to reduce procedural pain and anxiety including : virtual reality therapy , hypnosis , and behavioral approaches such as distraction techniques .
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= = Prognosis = =
| 14c9106555a656af95b51d8e0ee2c561 | 21,707 |
The prognosis is worse in those with larger burns , those who are older , and those who are females . The presence of a smoke inhalation injury , other significant injuries such as long bone fractures , and serious co @-@ morbidities ( e.g. heart disease , diabetes , psychiatric illness , and suicidal intent ) also influence prognosis . On average , of those admitted to United States burn centers , 4 % die , with the outcome for individuals dependent on the extent of the burn injury . For example , admittees with burn areas less than 10 % TBSA had a mortality rate of less than 1 % , while admittees with over 90 % TBSA had a mortality rate of 85 % . In Afghanistan , people with more than 60 % TBSA burns rarely survive . The Baux score has historically been used to determine prognosis of major burns . However , with improved care , it is no longer very accurate . The score is determined by adding the size of the burn ( % TBSA ) to the age of the person , and taking that to be more or less equal to the risk of death . Burns in 2013 resulted in 1 @.@ 2 million years lived with disability and 12 @.@ 3 million disability adjusted life years .
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= = = Complications = = =
| 560b632a5a9ca0d796ad0a28d5852c1c | 21,711 |
A number of complications may occur , with infections being the most common . In order of frequency , potential complications include : pneumonia , cellulitis , urinary tract infections and respiratory failure . Risk factors for infection include : burns of more than 30 % TBSA , full @-@ thickness burns , extremes of age ( young or old ) , or burns involving the legs or perineum . Pneumonia occurs particularly commonly in those with inhalation injuries .
| bb25ac3e8af6feb71e1ca7aab3b5a287 | 21,713 |
Anemia secondary to full thickness burns of greater than 10 % TBSA is common . Electrical burns may lead to compartment syndrome or rhabdomyolysis due to muscle breakdown . Blood clotting in the veins of the legs is estimated to occur in 6 to 25 % of people . The hypermetabolic state that may persist for years after a major burn can result in a decrease in bone density and a loss of muscle mass . Keloids may form subsequent to a burn , particularly in those who are young and dark skinned . Following a burn , children may have significant psychological trauma and experience post @-@ traumatic stress disorder . Scarring may also result in a disturbance in body image . In the developing world , significant burns may result in social isolation , extreme poverty and child abandonment .
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= = Epidemiology = =
| 2a6e11a56c74db42c2c7456b47b2bcbe | 21,716 |
In 2013 fire and heat resulted in 35 million injuries . This resulted in about 2 @.@ 9 million hospitalizations and 238 @,@ 000 dying . This is down from 300 @,@ 000 deaths in 1990 . This makes it the 4th leading cause of injuries after motor vehicle collisions , falls , and violence . About 90 % of burns occur in the developing world . This has been attributed partly to overcrowding and an unsafe cooking situation . Overall , nearly 60 % of fatal burns occur in Southeast Asia with a rate of 11 @.@ 6 per 100 @,@ 000 . The number of fatal burns has increased from 280 @,@ 000 in 1990 to 338 @,@ 000 in 2010 .
| d57abdc0afc0c8b5d31fe6b33d77d994 | 21,718 |
In the developed world , adult males have twice the mortality as females from burns . This is most probably due to their higher risk occupations and greater risk @-@ taking activities . In many countries in the developing world , however , females have twice the risk of males . This is often related to accidents in the kitchen or domestic violence . In children , deaths from burns occur at more than ten times the rate in the developing than the developed world . Overall , in children it is one of the top fifteen leading causes of death . From the 1980s to 2004 , many countries have seen both a decrease in the rates of fatal burns and in burns generally .
| dcf92d9bdf54c057a7124e049d8a7d76 | 21,719 |
= = = Developed countries = = =
| d02ea0c0eb4ce74b8e3f9c9530a58f33 | 21,721 |
An estimated 500 @,@ 000 burn injuries receive medical treatment yearly in the United States . They resulted in about 3 @,@ 300 deaths in 2008 . Most burns ( 70 % ) and deaths from burns occur in males . The highest incidence of fire burns occurs in those 18 – 35 years old , while the highest incidence of scalds occurs in children less than five years old and adults over 65 . Electrical burns result in about 1 @,@ 000 deaths per year . Lightning results in the death of about 60 people a year . In Europe , intentional burns occur most commonly in middle aged men .
| 7be75e80e387d671f4ee2aa175daa5f6 | 21,723 |
= = = Developing countries = = =
| ac25aa89e97ee10b55be1be50bb34142 | 21,725 |
In India , about 700 @,@ 000 to 800 @,@ 000 people per year sustain significant burns , though very few are looked after in specialist burn units . The highest rates occur in women 16 – 35 years of age . Part of this high rate is related to unsafe kitchens and loose @-@ fitting clothing typical to India . It is estimated that one @-@ third of all burns in India are due to clothing catching fire from open flames . Intentional burns are also a common cause and occur at high rates in young women , secondary to domestic violence and self @-@ harm .
| e7a559fbeadd9abf295291e8f43a682c | 21,727 |
= = History = =
| fd3fc667e330e6e3944a4f085f9ef39d | 21,729 |
Cave paintings from more than 3 @,@ 500 years ago document burns and their management . The earliest Egyptian records on treating burns describes dressings prepared with milk from mothers of baby boys , and the 1500 BCE Edwin Smith Papyrus describes treatments using honey and the salve of resin . Many other treatments have been used over the ages , including the use of tea leaves by the Chinese documented to 600 BCE , pig fat and vinegar by Hippocrates documented to 400 BCE , and wine and myrrh by Celsus documented to 100 CE . French barber @-@ surgeon Ambroise Paré was the first to describe different degrees of burns in the 1500s . Guillaume Dupuytren expanded these degrees into six different severities in 1832 .
| a6ed598053d8de5c5257251324fc036a | 21,731 |
The first hospital to treat burns opened in 1843 in London , England and the development of modern burn care began in the late 1800s and early 1900s . During World War I , Henry D. Dakin and Alexis Carrel developed standards for the cleaning and disinfecting of burns and wounds using sodium hypochlorite solutions , which significantly reduced mortality . In the 1940s , the importance of early excision and skin grafting was acknowledged , and around the same time , fluid resuscitation and formulas to guide it were developed . In the 1970s , researchers demonstrated the significance of the hypermetabolic state that follows large burns .
| ccc8867187a6a51b0449c4bc698887a7 | 21,732 |
= Tropical Storm Brenda ( 1960 ) =
| efdd9235665bf4ce3eaff3f224c62c1f | 21,735 |
Tropical Storm Brenda was the second named storm of the 1960 Atlantic hurricane season . It developed in the northeastern Gulf of Mexico on July 28 , and after moving ashore over the Florida Peninsula , it attained tropical storm status . Brenda accelerated northeast along the U.S. East Coast , ultimately peaking as a moderate storm with winds of 60 mph ( 97 km / h ) before crossing the Mid @-@ Atlantic states and New England ; it dissipated on July 31 over southern Canada . The storm inflicted moderate damage in Florida , the worst since Hurricane Easy of 1950 , and dropped heavy rainfall as far north as New York City . Total damage is estimated at US $ 5 million , and only indirect deaths are blamed on the cyclone .
| 4a1f8510a0bf22b6905a1eff03dfe1aa | 21,737 |
= = Meteorological history = =
| fe82527ae426423900c55a793eed715f | 21,739 |
A weak low @-@ pressure area that organized in the northeast Gulf of Mexico began to intensify on July 28 , while located west of the Tampa Bay . Early in its life , the system had a broad circulation with primarily light winds , similar to that of a subtropical storm . The storm is estimated to have become a tropical depression earlier the previous day as it moved toward the northeast . It made landfall along the Florida coast near Cross City and continued inland , gradually accelerating . It likely attained tropical storm status at around 1200 UTC on July 28 while its center was situated west of Tampa . The cyclone was named Brenda after reconnaissance aircraft confirmed that it had reached tropical storm strength .
| 8974cf1156b315c4a46ffa1c94134fb0 | 21,741 |
Brenda tracked northward , hugging the Georgia and South Carolina coasts before moving inland over North Carolina . It attained its peak winds of 60 mph ( 97 km / h ) in the late evening of July 29 , while situated south of Wilmington . Several hours later , the storm emerged over the Chesapeake Bay moving northeast at about 30 mph ( 48 km / h ) . Brenda crossed the Delmarva Peninsula and rapidly tracked into southern New Jersey . The storm crossed the state and eventually made another landfall on Long Island before making yet another landfall in coastal Connecticut .
| 3a11282c1bfd62637ce3430691f501dc | 21,742 |
At around 0000 UTC on July 31 , Brenda moved into Massachusetts . Shortly thereafter , it lost its tropical characteristics and transitioned into an extratropical cyclone . It dissipated by August 1 over southern Canada . Because Brenda was in the vicinity of land for most of its course , it was not able to intensify beyond tropical storm status .
| a5662f8fe5c03c00a0a2e5aa1ca26888 | 21,743 |
= = Preparations and impact = =
| ba91aa14c8be2dd24cea83e65d7dc741 | 21,745 |
In advance of the storm , tropical storm advisories and wind warnings were issued from Florida to Maine .
| 3e94434d9b95e9cfc1f8ca0faa334a4d | 21,747 |
Rainfall from Tropical Storm Brenda affected at least 16 states . The heaviest precipitation fell in western Florida near Tampa , east of the storm 's center ; the Tampa International Airport recorded 14 @.@ 57 in ( 370 mm ) of rainfall . Extensive flooding occurred in the west @-@ central Florida Peninsula . Wind gusts exceeded 60 mph ( 97 km / h ) , and the storm produced 10 ft ( 3 @.@ 0 m ) high waves along the coast , leading to considerable erosion . However , storm tides were not severe . Around the Naples area , Brenda 's effects were primarily light , although small boat and dock facilities and roads sustained some damage . A private seawall at Clearwater was breached in two places by the cyclone .
| 8f6137b477df4879f33b19b2afd0145f | 21,748 |
Brenda was considered the worst storm to strike the area since Hurricane Easy in 1950 . While no casualties are directly blamed on the storm , at least one traffic @-@ related death took place . According to an American Red Cross Disaster Service report encompassing eight Florida counties , 11 houses sustained significant damage , while 567 suffered more minor damage . Around 590 families were affected overall . Total monetary damage is placed at near $ 5 million .
| 7ec64b9036aa11e3402e0f5a9c67319b | 21,749 |
Tides along the Outer Banks of North Carolina were generally reported at 2 ft ( 0 @.@ 61 m ) above @-@ normal . In and around Wilmington , the storm caused minor damage to roofs and windows of some beachfront structures . Power was temporarily interrupted due to fallen tree limbs . Heavy rainfall caused flooding on streams and rivers , and in some areas the precipitation helped to end a serious drought . Some boats were swamped , and the winds ripped the roof off a cottage at Long Beach . The heavy rain and high tides flooded tobacco fields .
| 2a96ee324c2a5aeb396a460746a7bf48 | 21,750 |
Moderate rains extended northward into the Mid @-@ Atlantic states , with lighter totals reported farther north in New York . At New York City , 4 @.@ 79 in ( 122 mm ) of precipitation fell , beating the one @-@ day July record of 3 @.@ 80 in ( 97 mm ) set in 1872 . The heavy rains flooded parts of LaGuardia Airport . Elsewhere , reports of 3 to 5 in ( 76 to 127 mm ) were common throughout New Jersey , Delaware , Maryland and Virginia . High winds also affected portions of the northeastern United States , gusting to 55 mph ( 89 km / h ) across southern New England . Tides often ran 3 to 4 ft ( 0 @.@ 91 to 1 @.@ 22 m ) above @-@ normal throughout the region . The storm caused travel delays and ran several ships aground , but otherwise inflicted little serious damage . The storm forced the cancellation of two American League baseball games and the postponement of several other sporting events .
| f080197ae4c4d2e510e945cf1dae256e | 21,751 |
= Stanley Price Weir =
| 2fd55a938b0a7a8c76d9ac6ff945bed7 | 21,754 |
Brigadier General Stanley Price Weir , DSO , VD , JP ( 23 April 1866 – 14 November 1944 ) was a public servant and Australian Army officer . During World War I , he commanded the 10th Battalion of the Australian Imperial Force ( AIF ) during the landing at Anzac Cove and the subsequent Gallipoli Campaign , and during the Battles of Pozières and Mouquet Farm in France .
| b50d79e885d1b456932f9308bc4a6119 | 21,756 |
Weir returned to Australia at his own request in late 1916 at the age of 50 , and in 1917 he was awarded the Distinguished Service Order and was mentioned in dispatches for his performance at Pozières and Mouquet Farm . He went on to become the first South Australian Public Service Commissioner . He was given an honorary promotion to brigadier general on his retirement from the Australian Military Forces in 1921 . Weir was retired as public service commissioner in 1931 . In retirement he contributed to various benevolent and charitable organisations , and died in 1944 .
| d2032f78e61a5f2e5787f7e6f0308ac4 | 21,757 |
= = Early life = =
| b536b642460eb47d0633950c6043cf5f | 21,759 |
Weir was born in Norwood , South Australia , on 23 April 1866 , a son of Alfred Weir and Susannah Mary ( née Price ) . His father was a carpenter , who had emigrated to South Australia from Aberdeen , Scotland , in 1839 , two years after the colony was founded . Weir attended Moore 's School , the Norwood Public School , and Pulteney Street Grammar School . In 1879 , at the age of 13 , he joined the Surveyor General 's Department as an office assistant . He assisted the surveyor who pegged out the land at the rear of Government House , Adelaide , for the Torrens Parade Ground , and was later promoted to clerk . On 14 May 1890 , he married Rosa Wadham at the Christian Chapel , Norwood . He rose through the department to be appointed Survey Storekeeper , Custodian of Plans and Custodian of Government Motor Cars , on 1 July 1911 . He was appointed a justice of the peace on 10 September 1914 .
| 707b759fbd8d05d3f4407fbecd90fc29 | 21,761 |
= = Early military service = =
| 81e037a8b737993e7de7cc12f8d0234b | 21,763 |
Weir enlisted in the part @-@ time South Australian Volunteer Military Force in March 1885 , joining the 1st Battalion , Adelaide Rifles , as a private . By 1890 , he had been promoted to colour sergeant . He was commissioned as a lieutenant in the 3rd Battalion , Adelaide Rifles , on 19 March 1890 , and was promoted to captain on 25 May 1893 . When the South African War broke out he volunteered for service with the South Australian Bushmen 's Corps , but mounted officers were preferred , and he was not selected .
| ae847ff1b992230a365a97617a5f4370 | 21,765 |
On 1 July 1903 , the Adelaide Rifles became the 10th Infantry Regiment of the Commonwealth Military Forces , and Weir was appointed adjutant . He was promoted to major on 1 January 1904 , and appointed as regimental second @-@ in @-@ command . He was awarded the Long Service and Good Conduct Medal in 1905 , and the Volunteer Officers ' Decoration in 1908 . On 22 June 1908 , Weir was promoted to lieutenant colonel and appointed the commanding officer of the 10th Infantry Regiment . On 1 January 1912 , he was transferred to the unattached list but this only lasted until 1 July , when the universal training scheme was introduced . He was soon appointed to command the 19th Infantry Brigade , and on 9 September 1913 he was promoted to colonel .
| 6738da09954cce17b2dbc87ce2ac3e2f | 21,766 |
= = World War I = =
| 3329566c8a54bb640c195f468235b74c | 21,768 |
On 12 August 1914 , Weir received a telegram from Colonel Ewen Sinclair @-@ Maclagan , the designated commander of the 3rd Brigade , offering him the command of the 10th Battalion . Weir promptly accepted , and on 17 August was appointed as a lieutenant colonel in the Australian Imperial Force ( AIF ) , making him the first South Australian to be commissioned in the AIF . He retained his rank of colonel in the part @-@ time forces in an honorary capacity .
| 3799f9a2fcf448ef37e734911341a0dc | 21,770 |
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