Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers

Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs

Septic hip abscess due to Fusobacterium nucleatum and Actinomyces turicensis in an immunocompetent SARS-CoV-2 positive patient

A 42-year-old man was referred to the Department of Orthopedic Surgery with pain over his right greater trochanter and signs of systemic infection. CT showed an enhanced mass in his gluteus maximus as well as gas in the biceps femoris over the underlying hip joint. Tissue biopsy yielded Fusobacterium nucleatum and Actinomyces turicensis. The patient was successfully treated for 6 weeks with amoxicillin/clavulanic acid 875mg/125mg and metronidazole 500mg

Odontocetes of the Southern Ocean sanctuary

Twenty-eight odontocete species were identified as occupying sub-Antarctic and Antarctic habitat covered by the 1994 IWC established Southern Ocean Sanctuary. Toothed whales evidently play an important part in the Antarctic polar ecosystem. Twenty-two species are autochthonous in showing a regular, apparently year-round, presence in the Sanctuary: Physeter macrocephalus, Kogia breviceps, Orcinus orca, Globicephala melas edwardii, Pseudorca crassidens, Lagenorhynchus cruciger, Lagenorhynchus obscurus, Lissodelphis peronii, Cephalorhynchus commersonii, Cephalorhynchus hectori, Tursiops truncatus, Delphinus delphis, Phocoena dioptrica, Hyperoodon planifrons, Berardius arnuxii, Ziphius cavirostris, Tasmacetus shepherdi, Mesoplodon layardii, Mesoplodon traversii, Mesoplodon grayi, Mesoplodon bowdoini and Mesoplodon hectori. Six species are considered vagrants into the Sanctuary: Kogia sima, Grampus griseus, Steno bredanensis, Mesoplodon peruvianus, Mesoplodon densirostris and Mesoplodon mirus. However, vagrant status of these three mesoplodonts is only provisionally assigned, considering that improved knowledge of diagnostic features of beaked whales should, as in recent years, continue to facilitate at sea identification. Two species are considered as having a ‘contiguous’ range (records less than 2° north of Sanctuary boundaries): Mesoplodon ginkgodens (at 39°S) and Mesoplodon mirus (at 38°24’S). The habitual southern range of at least four odontocetes extends significantly farther poleward than expected. G. melas edwardii is regularly encountered south of the Antarctic Polar Front, much like M. grayi which is known to reach the Ross Sea ice edge (ca. 67°S). Z. cavirostris and L. obscurus cross the Polar Front occasionally. The distribution of M. peruvianus and M. traversii and their relation to SST are unclear. Their southernmost records, 42°31’S and 44°17’S respectively, may either be extralimital or, more likely, reflect ordinary austral range. Temporally non-aligned distribution patterns of Hyperoodon planifrons in Antarctic and South African waters may suggest stock segregation

Using historical data to detect temporal changes in the abundances of intertidal species on Irish shores

An historical data set, collected in 1958 by Southward and Crisp, was used as a baseline for detecting change in the abundances of species in the rocky intertidal of Ireland. In 2003, the abundances of each of 27 species was assessed using the same methodologies (ACFOR [which stands for the categories: abundant, common, frequent, occasional and rare] abundance scales) at 63 shores examined in the historical study. Comparison of the ACFOR data over a 45-year period, between the historical survey and re-survey, showed statistically significant changes in the abundances of 12 of the 27 species examined. Two species (one classed as northern and one introduced) increased significantly in abundance while ten species (five classed as northern, one classed as southern and four broadly distributed) decreased in abundance. The possible reasons for the changes in species abundances were assessed not only in the context of anthropogenic effects, such as climate change and commercial exploitation, but also of operator error. The error or differences recorded among operators (i.e. research scientists) when assessing species abundance using ACFOR categories was quantified on four shores. Significant change detected in three of the 12 species fell within the margin of operator error. This effect of operator may have also contributed to the results of no change in the other 15 species between the two census periods. It was not possible to determine the effect of operator on our results, which can increase the occurrence of a false positive (Type 1) or of a false negative (Type 2) outcom

Effect of processing variables and bulk composition on the surface composition of spray dried powders of a model food system

Abstract The surface compositions of food powders created from spray drying solutions containing various ratios of sodium caseinate, maltodextrin and soya oil have been analysed by Electron Spectroscopy for Chemical Analysis. The results show significant enrichment of oil at the surface of particles compared to the bulk phase and, when the non-oil components only are considered, a significant surface enrichment of sodium caseinate also. The degree of surface enrichment of both oil and sodium caseinate was found to increase with decreasing bulk levels of the respective components. Surface enrichment of oil was also affected by processing conditions (emulsion drop size and drying temperature), but surface enrichment of sodium caseinate was relatively insensitive to these. The presence of "pock marks" on the particle surfaces strongly suggests that the surface oil was caused by rupturing of emulsion droplets at the surface as the surrounding matrix contracts and hardens

International Whaling Commission–Southern Ocean GLOBEC/CCAMLR collaboration. Scientific Committee document SC/55/E10, International Whaling Commission, May-June 2003, Berlin, Germany

Collaboration between the International Whaling Commission, and national programs conducting multidisciplinary ecosystem research in the Antarctic under Southern Ocean Global Ecosystem Dynamics (SO GLOBEC) program and the Commission for the Convention on Antarctic Marine Living Resources (CCAMLR) occurred during five research cruises between April 2002 and April 2003. Visual survey, passive acoustic and tissue biopsy work was conducted by IWC observers and collaborating passive acoustics scientists. Reported here are the preliminary results from these cruises: mapped distribution patterns of cetaceans from visual survey sighting data; individual photo identification records; species identification and positions of animals recorded on sonobuoys; and descriptions of environmental conditions observed or recorded as part of the multidisciplinary effort