IntroductionAccurate and early detection of sepsis poses a significant challenge in burn populations. Our objective was to assess whether procalcitonin is a marker of blood culture positive sepsis in moderate to severe paediatric burns. MethodsWe analysed procalcitonin levels in 27 children admitted with burns of 15–65% total body surface area. Procalcitonin was measured at admission (baseline), 24 and 48 h post-admission and during periods of suspected sepsis (diagnosed against pre-defined criteria). Patients were categorised into controls with no episodes of suspected sepsis (n = 10) and those with episodes of suspected sepsis (n = 17). The latter were split into two groups based on blood culture results: culture positive (bacteraemia) and culture negative patients. ResultsBaseline procalcitonin levels increased with burn size (odds ratio (95% confidence interval): 1.15 (1.02–1.29)). Suspected sepsis patients had larger burns than controls (median 31 vs. 20%; p = 0.003). Only 5/23 suspected sepsis episodes were blood culture positive. Procalcitonin levels were similar in culture positive and culture negative patients (p = 0.43). Sensitivity for predicting positive blood culture was 100% (95% confidence interval: 47.8–100.0%) but specificity was only 22.2% (95% confidence interval: 6.4–47.6%). Area under the curve was poor at 0.62 (95% confidence interval: 0.33–0.90). There was no significant change in procalcitonin levels from baseline to septic episode in either group (positive: p = 0.35; negative: p = 0.95). ConclusionWe conclude that evidence for the use of procalcitonin to diagnose bacteraemia in this population is poor, with burn size playing a significant role implying a correlation with systemic inflammation rather than sepsis.

The extraction, partial purification and assay of a dehydroascorbatase from guinea-pig liver is described. There was no evidence that changes in dehydroascorbatase activity could account for the modified tissue ascorbic acid concentrations associated with ageing or with the ingestion of fluoride, flavonoids or anthocyanin material.

The influence of experimentally induced rhinovirus infection on the excretion of ascorbic acid (AA) and two of its possible metabolites, diketogulonic acid (DKG) and oxalic acid was determined in human volunteers receiving a controlled daily intake of AA. There was a significant fall in the excretion of both AA and DKG in the infected subjects but no change in the oxalic acid excretion. A simple absorption test provided no evidence of any impairment of gastrointestinal absorption of AA during infection. Possible mechanisms of this infection-induced change in AA metabolism are discussed.

A controlled study was made of the effects of natural orange juice, synthetic orange juice, and placebo in the prevention of the common cold; both natural and synthetic orange juices contained 80 mg of ascorbic acid daily. Three-hundred sixty-two healthy normal young adult volunteers, ages 17 to 25 years, were studied for 72 days with 97% of participants completing the trial. There was a 14 to 21% reduction in total symptoms due to the common cold in the supplemented groups that was statistically significant (P less than 0.05). Ascorbic acid supplementation also increased the number of "episode-free" subjects. However, the clinical usefulness of the results does not support prophylactic ascorbic acid supplements in the well-nourished adult. The results in this study with both natural and synthetic orange juice of physiological content of ascorbic acid, are similar to those obtained using a "megadose" of ascorbic acid.

Fluoride added to drinking water at concentrattions of 50 and 70 ppm provided highly significant increases in the ascorbic acid concentration in tissues but was without effect on the serum alkaline phosphatase and cholesterol.