Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment.

OBJECTIVE: To determine the prevalence and risk factors of foot ulceration in patients receiving hemodialysis treatment. METHODS: A total of 180 patients who received hemodialysis treatment in two state hospitals and a private health center between April 2017 and September 2017 were included in the study. The researchers collected data using a patient information form and by conducting physical evaluation of the lower extremities. They used the diabetic foot risk assessment algorithm to classify risk according to the data obtained. RESULTS: Of the patients receiving hemodialysis treatment, 6.7% had foot ulceration, 19.4% had a history of foot ulceration, and 8.3% had a history of hospitalization associated with ulceration in a lower extremity. Infected foot ulceration was the most common (6.1%) cause of hospitalizations. In the group with current or past foot ulceration, diabetic nephropathy was the most common etiologic factor of end-stage kidney disease (48.6%); there was a significant between-group difference in diabetic nephropathy (P < .05). Etiologic factors had a significant effect on foot ulcerations: As determined by univariate logistic regression, diabetes (odds ratio [OR], 2.727; P < .05), presence of neuropathy (OR, 4.208; P < .05), low-density lipoprotein cholesterol (OR, 1.013; P < .05), and serum albumin (OR, 0.302; P < .036) all had a statistically significant effect on the presence of foot ulcerations. CONCLUSIONS: Patients receiving hemodialysis treatment are at high risk for foot ulceration. Therefore, patient awareness strategies should be expanded to include individuals with end-stage renal disease regardless of diabetes status. Clinical and dialysis nurses should educate these patients about foot ulcerations and foot health to prevent ulcer development.

Evaluation of risk factors for foot ulceration in individuals with chronic kidney disease.

INTRODUCTION: CKD, like DM, is an independent risk factor for the development and course of foot ulcers. OBJECTIVE: The authors studied the incidence and risk factors of foot ulceration in patients with CKD and with or without DM and in patients receiving or not receiving HD. MATERIALS AND METHODS: Patients with or without DM and with renal failure were divided into 4 groups of 40 patients each according to whether or not they were receiving HD. Data were collected using a patient information form, physical examination of the foot, and risk assessment forms. RESULTS: Lower extremity ulceration was highest in group 3 (HD+DM+) (15% [6 of 40]), that is, in patients with CKD and DM receiving HD (P = .421). Patients in group 3 were at highest risk for foot ulcers (72.5%) compared with other groups (P = .001). Risk factors associated with foot ulceration were advanced stage (ie, stage 4 or 5) CKD, HD treatment, age, BMI, history of lower extremity ulceration and/or amputation, foot deformities, skin and nail pathology, neuropathy, and vascular insufficiency. CONCLUSIONS: Patients with CKD receiving HD are at high risk for foot ulcers, and this risk increases with the presence of DM.

Does the anesthesia technique of cesarean section cause persistent low back pain after delivery? A retrospective analysis.

OBJECTIVE: Cesarean sections (CS) under spinal anesthesia may lead to newly developed low back pain (LBP) after anesthesia. The cause of this pain is still unknown. This subject was investigated. METHODS: The persistent LBP after the section was retrospectively analyzed in patients who were operated on under spinal or general anesthesia between January 1, 2018, and January 1, 2020. RESULT: General anesthesia was used in 52 women, but 251 women were operated on under spinal anesthesia. Newly developed persistent LBP was detected in 57 (18,8%) of a total of 303 patients. Of those patients with LBP, general anesthesia was used in 14 of 52 (26,9%) patients, but 43 of 251 (17.1%) patients received spinal anesthesia. Baby weight after CS was the only variable associated with persistent LBP after 3 and 6 months (P < 0.05) in multiple logistic regression analysis. Patient age and anesthesia type were not associated with persistent LBP (P > 0.05). CONCLUSION: This study shows anesthesia type as spinal or general was not associated with increased persistent LBP. Performing more spinal than general anesthesia in the cesarean section may be false data about the increased rate of LBP after CS.

The relationship between mean platelet volume and the mortality of patient severe head trauma; first study.

BACKGROUND: Prediction of mortality in a patient with head trauma is essential. In this study, the effect of mean platelet volume (MPV) on the mortality rate of patients with severe head trauma was studied. MATERIAL AND METHODS: The relationship between mortality and mean platelet volumes of patient with cranial trauma was retrospectively analyzed. RESULTS: 43 patients with head trauma were admitted to the intensive care unit during the study period. While 17 patients died (Group I), 26 patients survived (Group II). Cox regression analysis showed that late MPV (at exitus or discharged date), WBC at admission, and age increase the mortality rate 1,770, 1,202, 1,052 times, respectively. CONCLUSIONS: The present study shows that MPV may be a useful predictor of mortality in patients with severe head trauma.

What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?

PURPOSE/AIM OF THE STUDY: Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship. MATERIAL AND METHODS: Spectral-domain OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed. RESULTS: The mean RNFL thicknesses at the left side (91.8 µm) were significantly smaller than the right side (94.5 µm) (P = 0.040). However, the mean left sinus volume (44.5 cm) is larger than the right side, (34.5 mm) (P < 0.005). Left and right differences of both parameters are statistically significant (P < 0.05). CONCLUSION: There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes.

Interesting different survival status of musicians with malignant cerebral tumors.

Introduction: The education of a musician may have an effect on the neuronal functions and organization of the brain, promote brain plasticity, resulting in functional and structural changes. A variety of malign cerebral tumors have affected the musician, instrumentalist or singer, at some time during their lives. No comprehensive investigation for musicians with malignant tumors has been performed yet. The aims of the study are to investigate if there is a relationship between the performed music style (classic or pop/rock) and the malignancy of the tumor.Patients and methods: The key words were 'neurosurgery and music' and the names of composers. We used digital catalogs like 'Pubmed' as well as the libraries of universities. We investigated a list of people with brain tumors from the English Wikipedia. (https://en.wikipedia.org/wiki/List_of_people_with_brain_tumors).We divided musicians into two groups according to their performing of classic or rock-pop music, and their gender.Results: We found 27 classic and rock/pop musicians who suffered from malign cerebral tumors. The median survival time estimations were 18 (mean 22.33, 95% CI ranged from 7.49 to 37.17) months for pop-rock musicians and 8 (mean 8.67, 95% CI ranged from 4.13 to 12.19) months for classical music performers. However, in Cox regression analysis, performed classical music type was associated with an increased risk of early death, lesser survival time age associated with an adjusted hazard ratio (aHR) of 1.06 [95% confidence interval (CI) 1.020 to 1.111; p = .004),Conclusion: In musicians with malign cerebral tumors, music type performed by musician may affect the survival status, classical musicians have a worse outcome than rock-pop musicians.

The Effect of Neuroscientists on the Studies of Autonomic Nervous System Dysfunction Following Experimental Subarachnoid Hemorrhage.

OBJECTIVE: The autonomic nervous system dysfunctions following subarachnoid hemorrhage (SAH) are common in neurosurgical clinical practice. The aim of the study is to investigate the effect of Asian neuroscientists on the studies of autonomic nervous system dysfunction following experimental subarachnoid hemorrhage. METHODS: A systematic search was conducted using the MEDLINE and Web of Science databases for studies pertaining to SAH and autonomic nervous system dysfunction. The searched terms contained "experimental subarachnoid hemorrhage," "autonomic nervous system," and "Ganglion." RESULTS: There are many animal studies because the live human brain vessels cannot be used in investigations. The considerable efforts have been made to investigate the effect of SAH on the autonomic nervous system in laboratory animals. Seventy-four studies were published by various authors. Most of the articles came from Asian Countries 49 studies (66.2% of the total studies). The most preferred animals were rabbits (in 43 studies, 58.1% of the total studies). CONCLUSION: Asian neuroscientists published enormous contributions in SAH-related autonomic nervous system dysfunction. It was shown that there is a great interest of Asian neuroscientists for autonomic nervous system changes secondary to SAH.

Analyzing of dark past and bright present of neurosurgical history with a picture of musicians.

AIM: Currently, neurosurgery has gone through moments of great renewal, however, in the first half of the 20th century, unwanted outcome after surgical approach had occurred. The aim of this historical overview of a picture of the musicians is to show the development of Neurosurgery in 20 century. METHODS: History of neurosurgery in the first half of the 20th century and the current was investigated through PubMed. A brief tour of some of the major landmarks of contemporary neurosurgery was also made. RESULTS: A musician picture was found which taken in 1928. Two of the musicians suffered neurosurgical disorder, and operated in 1937, both immediately died without gaining conscious at early postoperative period. CONCLUSION: We described the role of neurosurgery in the lives of two famous musicians, George Gershwin and Maurice Ravel. A picture taken 1928, shows the developing of Neurosurgery from first half of 20th century to current.