Study of Risk factors and bacteria that cause infections in chronic renal failure on hemodialysis patients with diabetic foot ulcers

Background: Studies indicate a prevalence of 39.2% diabetes mellitus (DM) as the most common underlying cause in patients with dialysis. Statistics showed that the rates of morbidity and mortality were higher in hemodialysis patients with diabetes compared with hemodialysis patients without diabetes. The aim of this study was to evaluate the risk factors responsible for infections in patient’s chronic renal failure on hemodialysis patients having diabetic foot ulcers. Methods: In this cross-sectional study, data were collected from 30 randomly selected hemodialysis patients who were referred to Imam Reza hospital, Tabriz from April 2016 to April 2017. The patients' records were taken according to inclusion and exclusion criteria and data were collected in designed questionnaires for further analysis. Results: 63.3% of patients were males and 36.7% were females. The average age of study population was 51.23±12.74. Duration of dialysis was 5.15±3.58 years. The average HBA1C was 9.08±1.48. Bacterial cause of feet ulcer was isolated only in 56.7% of cases. Isolated bacteria were anaerobic (47.05%), gram-positive (35.29%) and gram negative (17.64%). Amputation was performed in 26.7% of cases. Mortality was reported in 13.3% of patients. Low personal hygiene, presence of vasculopathy, mortality and amputation was higher in anaerobic infections. Most infections were seen in patients with inadequate dialysis. Low dialysis adequacy, amputation, vasculopathy, increased duration of dialysis, poor hygiene was seen in patients with higher HbA1C. Conclusion: These results indicate the importance of diabetic foot ulcers caused by anaerobic infections, because of the outcome of amputation and higher mortality rates in these patients, the prognosis is worse than other cases. Also, due to the direct relationship between personal hygiene and the development of anaerobic infections, it is possible to prevent these infections significantly by following these considerations. Most infections were found to be inappropriate in dialysis adequately. Therefore, accurate monitoring of patient's diabetes in the long run and the importance of this can control the complications of diabetes, including vasculopathy, followed by the need for amputation for fighting against diabetic foot ulcers. &nbsp

An Evolution of Reporting: Identifying the Missing Link

In recent years, radiologic imaging has undergone tremendous technological advances and is now a pillar of diagnostic and treatment algorithms in clinical medicine. The increased complexity and volume of medical imaging has led clinicians to become ever more reliant on radiologists to both identify and interpret patient studies. A radiologist’s report provides key insights into a patient’s immediate state of health, information that is vital when choosing the most appropriate next steps in management. As errors in imaging interpretation or miscommunication of results can greatly impair patient care, identifying common error sources is vital to minimizing their occurrence. Although mistakes in medical imaging are practically inevitable, changes to the delivery of imaging reporting and the addition of artificial intelligence algorithms to analyze clinicians’ communication skills can minimize the impact of these errors, keep up with the continuously evolving landscape of medical imaging, and ultimately close the communication gap

The Incidence and Risk Factors Associated with Posttraumatic Stress Disorders among Parents of NICU Hospitalized Preterm Neonates

Background: Parents of preterm neonates are exposed to great stress that can lead to posttraumatic stress disorder. The current study aimed to assess the incidence of posttraumatic stress disorders (PTSD) in both mothers and fathers of preterm infants.Methods: A prospective cohort study was done at two Iranian hospitals in 2016. One hundred and sixty parents of preterm neonates entered the study. A questionnaire related to acute stress disorder (ASD) was completed for parents at days 3-5 after birth. One month later, the parents were asked for the second interview. Prenatal posttraumatic stress questionnaire (PPQ) for mothers and posttraumatic stress disorder checklist (PCL) for fathers were completed. Prevalence of PTSD among the mothers and fathers was compared.Results: According to the results, 32.5% of all mothers and 4% of all fathers showed ASD. After a month, 40% of the mothers and 21.5% of the fathers showed PTSD. A significant correlation was seen between PPQ and PCL scores (PConclusion: The ASD and PTSD among mothers were more frequent than in fathers. Fathers indicated delayed onset of PTSD in comparison with mothers