COVID-19 re-infection or persistent infection in patient with acute myeloid leukaemia M3: a mini review.

Coronavirus disease 2019 (COVID-19) pandemic has affected more than 40 million people worldwide. Some patients had episodes of symptom recurrence after the first episode of infection with variable intervals. There are multiple issues and hypotheses about re-infection or re-activation of the virus, especially in immunocompromised patients. In this paper, we present details of an individual with a recent history of COVID-19 who proceeded to acute myeloid leukaemia M3 and immunosuppression by chemotherapy, then we review some recently published articles about possible re-infection or re-activation.

Reconstructive outcomes of Mohs surgery compared with conventional excision: A 13-month prospective study.

Established in 2012, the Mersey Regional Centre for Mohs Surgery is the first UK Mohs service to be led by a Mohs trained Plastic & Reconstructive surgeon. We evaluate the resection requirements and reconstructive techniques of our patient group and compare their surgical outcome to that which would have been gained with conventional excision (CE) and reconstruction for the same lesions. 157 patients were analysed over 13 months. Had CE and reconstruction been used, 56% of patients would have received a more invasive or cosmetically less desirable reconstruction, and 24% of margins would remain incomplete. The outcome was unchanged in 20% of patients. A small but significant subgroup (9%) of patients would have lost fundamental structures e.g. orbital exenteration, or undergone reconstructions unnecessarily crossing aesthetic subunits. Whilst in its infancy, the Plastic & Reconstructive Mohs surgery service has provided a valuable contribution to the care given to patients in the Mersey and Cheshire Skin Cancer Network. Detailed referral criteria, thorough preoperative patient evaluation, and appreciation of the abilities and limits of CE have enabled the service to produce a demonstrable reconstructive benefit in 80% of patients when compared to non-Mohs resection and reconstruction.

The plastic & reconstructive Mohs surgery service.

Mohs Micrographic Surgery (MMS) is the current 'gold-standard' for excision of a number of cutaneous lesions and provides a valuable addition to a skin cancer service. The Mersey Regional Centre for Mohs Surgery is the first MMS service in the UK to be led by an MMS trained Plastic and Reconstructive surgeon, and this article describes an overview of the processes involved in establishing such a service.

Effect of compatible and noncompatible osmolytes on the enzymatic activity and thermal stability of bovine liver catalase.

Catalase is an important antioxidant enzyme that catalyzes the disproportionation of H2O2 into harmless water and molecular oxygen. Due to various applications of the enzyme in different sectors of industry as well as medicine, the enhancement of stability of the enzyme is important. Effect of various classes of compatible as well as noncompatible osmolytes on the enzymatic activity, disaggregation, and thermal stability of bovine liver catalase have been investigated. Compatible osmolytes, proline, xylitol, and valine destabilize the denatured form of the enzyme and, therefore, increase its disaggregation and thermal stability. The increase in the thermal stability is accompanied with a slight increase of activity in comparison to the native enzyme at 25 °C. On the other hand, histidine, a noncompatible osmolyte stabilizes the denatured form of the protein and hence causes an overall decrease in the thermal stability and enzymatic activity of the enzyme. Chemometric results have confirmed the experimental results and have provided insight into the distribution and number of mole fraction components for the intermediates. The increase in melting temperature (Tm) and enzymatic rate could be further amplified by the intrinsic effect of temperature enhancement on the enzymatic activity for the industrial purposes.

Kinetic and conformational studies of adenosine deaminase upon interaction with oxazepam and lorazepam.

Oxazepam and lorazepam inhibit the adenosine deaminase (ADA) differently. In the case of lorazepam temperature increment causes an increase in the inhibition potency whereas higher temperature reduces the inhibitory effect of oxazepam; which proposes the overall profounder structural changes in the case of lorazepam relative to those caused by oxazepam.

The risk of eye splash in burn surgery.

Although the incidence of eye splash injury has been assessed for a number of surgical specialities, such risks posed to the burn surgeon have not been previously quantified. During 100 consecutive procedures the operating burns team wore a clean set of goggles, counting the number of blood splashes on the goggles after each procedure. During this study there were 47 cases of potential eye splash injury, although the individual was only aware of 2 of these intra-operatively. Seven of the splashes involved more than 6 blood droplets on the goggles. The consultant burn surgeon was the most likely to be splashed, sustaining a potential injury in over half cases operated upon. Procedures greater than 45 min in length were more likely to result in a splash than those shorter than 45 min. We recommend that eye protection should be used either in the form of goggles or a visor and should encompass all burn theatre cases as a matter of policy.

Abdominoplasty as an adjunct to the management of peri-Caesarian section necrotising fasciitis.

Necrotising fasciitis is a rare but potentially lethal condition, often requiring extensive soft tissue debridement and complex reconstructive surgery. The disease has been noted to complicate Caesarian section wounds, and our department has recently managed three such patients. They all required extensive abdominal wall debridements which would traditionally be closed initially by split skin grafting. We report on the clinical course of three patients, two of whom had their defects closed successfully by abdominoplasty without recourse to initial skin grafting.

A novel imaging technique as an adjunct to the in vivo diagnosis of nonmelanoma skin cancer.

BACKGROUND: Spectrophotometric intracutaneous analysis (SIAscopy) is a light-based imaging system capable of producing rapid images of melanin, blood and collagen of the skin. Although the SIAscope has been investigated for melanoma diagnosis, no formal study has been conducted to determine its use in the diagnosis of nonmelanoma skin cancer (NMSC). OBJECTIVES: A prospective study was conducted to investigate the potential for the SIAscope to diagnose NMSC. METHODS: In total, 302 consecutive patients were recruited into the study, 363 lesions being scanned. Logistic regression analysis was used to construct a predictive model for NMSC diagnosis and receiver-operator characteristic curves were used to assess overall accuracy of the model. RESULTS: A sensitivity of 98.0%, specificity of 95.7% and overall accuracy of 98.2% was found for NMSC diagnosis by the SIAscope model. CONCLUSIONS: Results suggest that the SIAscope may be a useful adjunct in the diagnosis of NMSC.

Ocular contamination during lesional surgery-a hazard for the plastic surgeon.

UNLABELLED: Protective glasses reduce the risk of transconjunctival virus transmission although this has never been characterised for local anaesthetic skin lesion surgery. This study investigated the use of, and need for, protective eyewear during Plastic Surgery and the surgeons' attitude to risk. MATERIALS AND METHODS: Study 1. A multi-center questionnaire recorded the attitudes of Plastic Surgeons' regarding google use and ocular viral transmission. Study 2. A single surgeon performed local anaesthetic skin lesion surgery over 8 months whilst wearing clean goggles. After each procedure the goggles were inspected for macroscopic splashes ans a record made of whether the operator had been aware of the splash occurrence. RESULTS: Study 1. There were 36 respondents to the questionnaire (response rate of 84%). All grades recognised the risk of conjunctival contamination but most respondents did not wear goggles. Respondents changed their behavior, however, in 'high risk' cases. Study 2. 143 procedures resulted in 42 splashes. The surgeon was only aware of the splash in 6 cases. CONCLUSION: Despite widespread recognition of the importance of eye protection, goggle use is still infrequent. Our study stresses the frequency of potential splashes to the eye and need for routine use of goggles to prevent viral transmission.