Over the last decade, it has become clear that the role of angiotensin II extends far beyond recognized renal and cardiovascular effects. The presence of an autologous renin-angiotensin system has been demonstrated in almost all tissues of the body. It is now known that angiotensin II acts both independently and in synergy with TGF-beta to induce fibrosis via the angiotensin type 1 receptor (AT1) in a multitude of tissues outside of the cardiovascular and renal systems, including pulmonary fibrosis, intra-abdominal fibrosis, and systemic sclerosis. Interestingly, recent studies have described a paradoxically regenerative effect of the angiotensin system via stimulation of the angiotensin type 2 receptor (AT2). Activation of AT2 has been shown to ameliorate fibrosis in animal models of skeletal muscle, gastrointestinal, and neurologic diseases. Clinical reports suggest a beneficial role for modulation of angiotensin II signaling in cutaneous scarring. This article reviews current knowledge on the role that angiotensin II plays in tissue fibrosis, as well as current and potential therapies targeting this system.

The elemental (Si, Ti, Al, Mn, Ca, Zr) and carbon stable-isotope (δ 13 C) geochemistry of a biostratigraphically well-constrained Cenomanian–Turonian (Upper Cretaceous) Chalk succession on the Isle of Wight, southern England, shows systematic variation that corresponds closely to a published sequence stratigraphic model for the Cenomanian. Six sequences and their constituent systems tracts, defined elsewhere using sedimentological criteria, are clearly distinguishable from bulk-sediment elemental profiles, and an additional Upper Cenomanian sequence previously identified in Spain is recognized in England from these geochemical data. The manganese curve is particularly instructive, exhibiting minima around sequence boundaries and through lowstands, rising values from the transgressive surfaces through transgressive systems tracts, maxima around maximum flooding surfaces, and declining values through highstands. Silica and trace-element (Ti, Zr) aluminium ratios peak around transgressive surfaces and maximum flooding surfaces, indicating pulses of increased siliciclastic input. Positive δ 13 C excursions are confirmed at the base of the Middle Cenomanian and spanning the Cenomanian–Turonian boundary but are not evident in other sequences. Variation in Mn is related to bulk sedimentation rate and detrital versus biogenic supply, which control the Mn flux and the efficiency of the diagenetic Mn ‘pump’ that leads to elevated Mn contents in sediments. Manganese peaks do not generally correlate with positive δ 13 C excursions, and although near-coincident Mn and δ 13 C peaks occur around the Cenomanian–Turonian boundary, the former is not necessarily linked to the oceanic anoxic event occurring at that time. The global oceanic Mn flux may have been enhanced during the Cenomanian as a result of hydrothermal activity during rapid sea-floor spreading and oceanic plateau formation. Elemental chemostratigraphy provides a new tool for developing sequence stratigraphic models in pelagic and hemipelagic carbonate successions.

Negative pressure wound therapy (NPWT) promotes healing by evenly applying negative pressure on the surface of the wound. The system consists of a sponge, a semiocclusive barrier, and a fluid collection system. Its effectiveness is explained by four main mechanisms of action, including macrodeformation of the tissues, drainage of extracellular inflammatory fluids, stabilization of the environment of the wound, and microdeformation. Rarely will complications linked to NPWT occur, but special care must be taken to prevent events such as toxic shock syndrome, fistulization, bleeding, and pain. New NPWT modalities have been recently developed to make NPWT suitable for a wider variety of wounds. These include NPWT with instillation therapy (NPWTi-d), different cleansing options, and application of NPWT on primarily closed incisions. Finally, vacuum-assisted wound closure therapy has been demonstrated to be efficient for various clinical settings, such as the management of diabetic foot ulcers, pressure ulcerations, chronic wounds, and skin grafts.