The basic Z-plasty

Z-plasty is a plastic surgery technique that is used to improve the functional and cosmetic appearance of scars. With this technique, it is possible to redirect a scar into better alignment with a natural skin fold or the lines of least skin tension. Contracted scars may be lengthened with this technique. Z-plasty involves the creation of two triangular flaps of equal dimension that are then transposed. Basic z-plasty flaps are created using an angle of 60 degrees on each side, which can lengthen a scar by 50 to 70 percent and reorient the direction of the central wound by 90 degrees. Keeping the length and angle of each flap precisely the same is key to avoiding mismatched flaps that may be difficult to close. Some possible complications of z-plasty include flap necrosis, hematoma formation under the flaps, wound infection, trapdoor effect, and sloughing of the flap caused by high wound tension.     

Pretreatment with β‐adrenergic receptor agonists facilitates induction of LTP and sharp wave ripple complexes in rodent hippocampus

Norepinephrine, is involved in the enhancement of learning and memory formation by regulating synaptic mechanisms through its ability to activate pre‐ and post‐synaptic adrenergic receptors. Here we show that β‐agonists of norepinephrine facilitate the induction of both associational LTP and sharp wave ripples (SPW‐Rs) in acute slices of rat hippocampus in area CA3. Surprisingly, this facilitating effect persists when slices are only pretreated with β‐receptor agonists followed by wash out and application of the unspecific β‐adrenoreceptor (βAR) antagonist propranolol. During application of βAR agonists repeated stimulation resulted in facilitated induction of SPW‐Rs. Since SPW‐Rs are thought to be involved in memory replay we studied the effects of βAR‐agonists on spontaneous SPW‐Rs in murine hippocampus and found that amplitude and incidence of SPW‐Rs increased. These effects involve cyclic‐AMP and the activation of protein kinase A and suggest a supportive role in memory consolidation. © 2016 Wiley Periodicals, Inc.     

Effect of socio-demographic factors on endogenous biomarkers (cystatin C and creatinine) among elderly chronic kidney disease patients: a cross-sectional study

Purpose

Creatinine is normally used to evaluate kidney function among elderly patients in clinical practice, which has been reported to be affected by socio-demographic factors like BMI and age. Cystatin C a newly introduced biomarker may be more efficient in identifying kidney function in obese and aged CKD patients. The aim of the current study was to assess the effect of BMI on endogenous biomarkers (cystatin C and creatinine) among elderly CKD patients in Malaysia, a first such study in the country.

Methods

The current study was conducted at the Hospital University Sains Malaysia, Kelantan. A total of 300 elderly Malay participants ≥?65 years, with CKD, were taken in study. Demographic data, blood pressure, weight, and height were documented. Serum creatinine was assayed by Chemistry Analyzer Model Architect-C8000 (Jaffe Method), while serum cystatin C was examined by Human cystatin C ELISA kit (Sigma-Aldrich) using Thermo Scientific Varioskan Flash ELISA reader.

Results

The study participants were divided into three groups on the basis of age. There was a statistically significant difference at the p value?<?0.05 in serum creatinine level for the three age groups [F (2, 297)?=?1.98, p value 0.045]. Patients were divided into four groups on the basis of BMI. The results of one-way ANOVA revealed a statistically significant difference at the p value?<?0.05 in the mean serum creatinine level for the four groups [F (3, 396)?=?2.99, p value 0.032]. However, no statistically significant differences between mean serum cystatin C levels were observed on the basis of patient’s age and BMI.

Conclusion

Cystatin C is not related to BMI and age among elderly chronic kidney disease patients. The study clearly evaluates the role of serum cystatin C as a good competitor of creatinine among the elderly CKD patients.

     

Lipoma excision

Lipomas are adipose tumors that are often located in the subcutaneous tissues of the head, neck, shoulders, and back. Lipomas have been identified in all age groups but usually first appear between 40 and 60 years of age. These slow-growing, nearly always benign, tumors usually present as nonpainful, round, mobile masses with a characteristic soft, doughy feel. Rarely, lipomas can be associated with syndromes such as hereditary multiple lipomatosis, adiposis dolorosa, Gardner's syndrome, and Madelung's disease. There are also variants such as angiolipomas, neomorphic lipomas, spindle cell lipomas, and adenolipomas. Most lipomas are best left alone, but rapidly growing or painful lipomas can be treated with a variety of procedures ranging from steroid injections to excision of the tumor. Lipomas must be distinguished from liposarcoma, which can have a similar appearance.     

WHO guidelines for treatment of tuberculosis: the missing links

Worldwide, the treatment of tuberculosis is based on evidence-based guidelines developed by the World Health Organization (WHO) for national tuberculosis programs. However, the importance of health related quality of life, the adequate management of side effects associated with antituberculosis drugs and the elaboration of tuberculosis treatment outcome categories are a few issues that need to be addressed in forthcoming WHO guidelines for the treatment of tuberculosis.     

Purunusides A-C, α-glucosidase inhibitory homoisoflavone glucosides from <Emphasis Type="Italic">Prunus domestica</Emphasis>

Purunusides A-C (1–3), new homoisoflavone glucosides together with the known compounds β-sitosterol (4) and 6,7-methylenedioxy-8-methoxycoumarin (5) have been isolated from n-butanol and ethyl acetate soluble fractions of Prunus domestica. Their structures were assigned on the basis of spectral studies. The compounds 1–3 showed potent inhibitory activity against the enzyme α-glucosidase.     

New Delhi metallo-β-lactamase (NDM-1): an update

New Delhi metallo-β-lactamase (NDM-1) is a novel broad spectrum carbapenemase with ability to inactivate all β-lactams except aztreonam. However, most of the NDM-1-producers also produce aztreonam hydrolysing-β-lactamases thereby making these pathogens absolutely resistant to all β-lactams. The bla(NDM-1) gene encodes a 27.5 kDa protein of 269 amino acids. It shares very little identity with other metallo-β-lactamases. Maximum identity has been observed to VIM-1/VIM-2 (32.4%). This mini-review is an update of the scientific literature for the said enzyme. Following the recommendation of David livermore, we further propose to combine "aztreonam" and "inhibitor of the most frequently encountered aztreonam hydrolysing-β-lactamases in a given setting" as a possible strategy against NDM-1-producers. The inhibitor should be 'versatile' as well, i.e. it should have the ability to inhibit most of the variants of aztreonam hydrolysing-β-lactamases prevalent in the concerned setting. We strongly recommend surveillance studies using aztreonam/NXL-104-combination against NDM-1-producing pathogens in different geographical regions across the globe.