Langer's lines: to use or not to use

Thirty-six differently named guidelines have developed as surgeons have searched for an ideal guide for elective incisions. Many surgeons prefer Langer's lines. These lines were developed by Karl Langer, an anatomy professor, from cadavers in rigor mortis. However, Kraissl preferred lines oriented perpendicular to the action of the underlying muscles. Later, Borges described relaxed skin tension lines, which follow furrows formed when the skin is relaxed and are produced by pinching the skin. However, these are only guidelines; there are many contributors to the camouflaging of scars, including wrinkle and contour lines. Borges's and Kraissl's lines (not Langer's) may be the best guides for elective incisions of the face and body, respectively.     

Clinical use of hirudin

The pharmacokinetics and the effects on the haemostatic system of hirudin were assessed in healthy volunteers after single doses of 1,000 AT-U/kg administered intravenously respectively subcutaneously. First clinical experiences on hirudin treatment in chronic DIC are reported.     

BMI and seatbelt use

Objective: Seatbelt use among obese persons may be reduced because seatbelts are uncomfortable. We investigated the association between obesity and seatbelt use with data from the 2002 Behavioral Risk Factor Surveillance System Survey. Research Methods and Procedures: Multivariable logistic regression was used to calculate odds ratios and 95% confidence intervals (CIs) for seatbelt use among overweight (BMI, 25.0 to 29.9), obese (BMI, 30.0 to 39.9), and extremely obese (BMI ≥ 40.0) persons, relative to a non‐overweight/non‐obese reference group (BMI ≤ 24.9), adjusted for age, race, gender, education, and state seatbelt law. Results: Adjusted odds ratios for seatbelt use were 0.89 (95% CI, 0.85 to 0.93) for overweight, 0.69 (0.66 to 0.73) for obese, and 0.45 (95% CI, 0.40 to 0.50) for extremely obese persons. Interaction effects were evident for all covariates, with stronger associations between increasing BMI and decreasing seatbelt use for women, increasing age, higher education, and residence in states with a secondary seatbelt law. There was a linear decrease in seatbelt use with increasing BMI for all subgroups except persons 18 to 24 years old. Discussion: Lack of seatbelt can be added to the list of risk factors associated with obesity. Effective preventive interventions are needed to promote seatbelt use among overweight and obese persons.     

Drug use among youths

The levels of drug use among youths under 14 have remained extremely low for the past few years, as well as in most European countries. Yet, patterns of early drug use are often related to high-risk behaviours that require specific public policy strategies. Over the last years, the Government has set the target of reducing levels of drug use among specific groups such as young people: an awareness-raising media campaign has been launched and a specific outpatients clinics setting has been implemented for cannabis users in particular. This paper examines the relationship between health service providers and criminal justice authorities underlying the effectiveness of the current system. It underlines the need for an early screening and early interventions so as to avoid the shift from simple use to misuse or dependence.     

Nitrogen use efficiency revisited

Nitrogen use efficiency (NUE) was originally defined as the dry mass productivity per unit N taken up from soil. The term was subsequently redefined as the product of nitrogen productivity (NP) and mean residence time of nitrogen (MRT). However, this redefinition was found to contradict the original definition under certain conditions, and confusion arose when the MRT defined for a steady-state system was applied to a system that was actually not at steady state. As MRT is the expected length of time that a unit of N newly taken up from soil is retained before being lost, it can be translated into the plant nitrogen duration (PND) divided by the total N uptake. This MRT is determined equally well for a steady state- and a non-steady state system and is in accordance with the original definition of NUE. It can be applied to a herbaceous perennial stand (that was at a steady state) and to an annual stand (that was not at a steady state) to determine NUE. NUE is also applicable when plant growth and reproduction are analyzed in relation to N use.     

The use of chlorhexidine

Summary An investigation was carried out on the therapeutic value of chlorhexidine (I.C.I.). We are of the opinion that this substance, which has very few toxic side-effects, may prove to be of great importance as a general disinfectant in surgical practice, of prophylactic value in paediatrics, in urogical practice, in the treatment of burns, and generally to prevent cross infection. Further, it was established that chlorhexidine possesses fungistatic and fungicidal action. A preliminary investigation with chlorhexidine showed a favourable therapeutic response in skin diseases due to fungi andCandida albicans. In vitro tests suggest that chlorhexidine may be of value in the mouth to combat β-haemolytic streptococci, without influencing the oral flora.