Search

BackgroundResearch has demonstrated that increases in palliative homecare nursing are associated with a reduction in the rate of subsequent hospitalizations. However, little evidence is available about the cost-savings potential of palliative nursing when accounting for both increased nursing costs and potentially reduced hospital costs.MethodsOur retrospective cohort study included cancer decedents from British Columbia, Ontario, and Nova Scotia who received any palliative nursing in the last 6 months of life. A Poisson regression analysis was used to determine the association of increased nursing costs (in 2-week blocks) on the relative average hospital costs in the subsequent 2-week block and on the overall total cost (hospital costs plus nursing costs in the preceding 2-week block).ResultsThe cohort included 58,022 cancer decedents. Results of the analysis for the last month of life showed an association between increased nursing costs and decreased relative hospital costs in comparisons with a reference group (>0 to 1 hour nursing in the block): the maximum decrease was 55% for Ontario, 31% for British Columbia, and 38% for Nova Scotia. Also, increased nursing costs in the last month were almost always associated with lower total costs in comparison with the reference. For example, cost savings per person-block ranged from $376 (>10 nursing hours) to $1,124 (>4 to 6 nursing hours) in British Columbia.ConclusionsIn the last month of life, increased palliative nursing costs (compared with costs for >0 to 1 hour of nursing in the block) were associated with lower relative hospital costs and a lower total cost in a subsequent block. Our research suggests a cost-savings potential associated with increased community-based palliative nursing.

Essential oils (EOs) are concentrated, hydrophobic volatile compounds derived from different parts of plants. They are recognized for their diverse and versatile functional properties. Approximately 90% of EOs are administered via topical or transdermal routes. However, EOs are susceptible to oxidation, and their high volatility often poses a challenge to the transdermal delivery of their bioactive constituents. Additionally, the direct application of pure EOs on the skin may result in irritating effects. Hence, various novel carrier systems have been explored for the topical application of EOs. Among these, nanoemulgel has received particular attention from the cosmeceutical industry. It is a hybrid technology combining nanoemulsion and a gelling phase, which can enhance the bioadhesivity of EOs, at the same time minimizing their irritating effects. This review summarizes the methods of EO extraction, steps and factors influencing the preparation of EO nanoemulgel, and characterization parameters for nanoemulgel studies. The potential cosmeceutical applications of EO nanoemulgels as an anti-inflammatory, antimicrobial, antioxidant, and penetration enhancer are also compiled and discussed.

Background Pancreatic cancer (pcc) is one of the most lethal types of cancer, and surgery remains the optimal treatment modality for patients with resectable tumours. The objective of the present study was to examine and compare trends in the survival rate based on treatment modality in patients with pcc. Background Pancreatic cancer (pcc) is one of the most lethal types of cancer, and surgery remains the optimal treatment modality for patients with resectable tumours. The objective of the present study was to examine and compare trends in the survival rate based on treatment modality in patients with pcc. Results The study included 6437 patients. We found no noticeable improvement in survival for patients with stage iii or iv tumours; however, for stage i disease, the 1-, 2-, and 5-year survival rates increased over time to 81% from 51%, to 71% from 35%, and to 61% from 22% respectively. Most improvements were seen for surgical modalities, with 2-year survivals increasing to 89% from 65% for distal pancreatectomy (dp) without radiation (rt) or chemotherapy (ctx), to 65% from 37% for dp plus rt or ctx, to 60% from 44% for Whipple-only, and to 50% from 36% for Whipple plus rt or ctx. Lastly, 5-year survival improved to 81% from 52% for dp only, to 41% from 12% for dp plus rt or ctx, to 49% from 25% for Whipple-only, and to 26% from 12% for Whipple plus rt or ctx. Conclusions Most cases of pcc continue to be diagnosed at a late stage, with poor short-term and long-term prognoses. After adjustment for patient age, sex, and year of diagnosis, the survival for stage i tumours and for surgical modalities increased over time. Further research is needed to identify the reasons for improvement in survival during the study period. [ABSTRACT FROM AUTHOR]

Femoral shaft fractures are correlated with frequent morbidity and mortality. It is a major musculoskeletal disorder caused by tremendous force applied to the femur. One of the most common surgical treatments for fixation is intramedullary nailing (IM), which utilises a specially designed metal rod and screws to be implanted into the medullary canal. However, severe bowing of the femur can result in a mismatch between the IM nail and the alignment of the femur. Such mismatch is a risk factor for anterior cortical perforation off the distal femur with subtrochanteric fractures and leg length discrepancy with fractures of the femoral shaft. Therefore, accurate three-dimensional (3D) preoperative planning is mandatory to facilitate the implant’s design based on the obtained geometric data, especially for the fractured bowed femur. This paper presents an automatic 3D femur shape analysis system (3D-FSA) based on the extracted skeleton of each individual patient to provide an accurate 3D preoperative simulation. The structure of the 3D femur was generated using a set of computed tomography (CT) images. By using the maximum-minimum centre approach for skeletonization, significant geometric and topological information was captured. The proposed approach can potentially assist in implant measurements.

ObjectiveSynovitis with increased infiltration of immune cells is observed in osteoarthritis (OA). Given the inflammatory condition of synovitis, we explored the protein profile of OA synovium (OAS) and its effect on circulating monocytes activation, migration, and functional commitments.MethodsKnee-synovium was acquired from end-stage OA (N = 8) and trauma patients (Trauma baseline control: TBC; N = 8) for characterization using H&E histology, IHC (iNOS), LCMS-QTOF, and MALDI-imaging. Response of peripheral blood monocytes to OAS conditioned-media (OACM) was observed using transwell (n = 6). The migrated cells were captured in SEM, quantified using phase-contrast microphotographs, and their activation receptors (CCR2, CXCR2, CX3CR1, and CD11b), pro-inflammatory genes, and phagocytic potential were studied using flow cytometry, gene expression array/qPCR, and latex beads (LB) phagocytosis assay, respectively.ResultsThe Venn diagram displayed 119 typical proteins in OAS, while 55 proteins in TBCS. The STRING protein network analysis indicated distinctive links between proteins and gene ontology (GO) and revealed proteins associated with leukocyte-mediated immunity in OAS as compared to TBC. The MALDI-imaging showed typical localized proteins at 2234.97, 2522.61, 2627.21, 3329.50, and 3539.69 m/z and IHC confirmed pro-inflammatory iNOS expression in OA synovium. CD14++CD16– classical monocytes significantly migrated in OACM and expressed CCR2, CXCR2, and CD11b receptors, TNFRSF11A, MAPK1, S100A8, HSPB1, ITGAL, NFATC1, IL13RA1, CD93, IL-1β, TNF-α, and MYD88 genes and increased LB uptake as compared to SFM.ConclusionOur findings suggest that the differential protein profile of OA synovium and the classical monocytes migrated, activated, and functionally committed in response to these mediators could be of therapeutic advantage.