Retraction: Ruptured Isolated Common Iliac Artery Aneurysm Masquerading as Renal Colic.

[This retracts the article DOI: 10.7759/cureus.19752.].

Quality of life in advanced renal disease managed either by haemodialysis or conservative care in older patients.

OBJECTIVE: Consideration of quality of life (QoL) in people with end-stage renal disease has become an important part of treatment decision-making. The aim of this study was to report on QoL and other functional outcomes in patients with advanced chronic kidney disease (CKD). METHOD: This was a cross-sectional study. Two samples of older patients (>60 years old) either conservatively managed (CM) or receiving hospital-based haemodialysis (HD), compared Kidney Disease Quality of Life (KDQoL-36) outcomes. RESULTS: Data from 263 CM patients (CKD 4 n=188, mean age 73.6 years, 48 women; CKD 5 n=75, mean age 74.4 years, 26 women) and 74 patients on HD (mean age 73.8 years, 24 women) were analysed. Significant group differences were identified for two subscales of KDQoL-36. Symptoms/Problems List subscale was significantly better for those receiving HD compared with those CM with CKD 5 (p=<0.001). Symptom/Problem List scores of CM CKD stage 4 patients were not significantly different compared with HD patients but were significantly better than CM CKD stage 5 patients (p<0.001). Burden of Kidney Disease subscale was significantly better for both CKD 4 (p<0.001) and CKD 5 (p<0.001) CM patients when compared with those receiving HD. CONCLUSION: Symptoms of advanced CKD significantly impact QoL for patients CM with CKD stage 5. Conversely, QoL is significantly impacted for those in receipt of HD due to the burden of treatment. These findings provide evidence for the use of QoL tools to help with clinical prognostication in advanced CKD. Using QoL tools will ensure specialist support is available for appropriate management of patients with CKD.

Effective nursing shift handover in critical care: A concept analysis.

To explore the concept of effective shift handover in critical care settings. Ineffective handover is one of the leading causes of adverse events in healthcare settings. Nursing shift handover in the intensive care unit (ICU) is more complex and detailed than in other in-patient wards due to the complexity of medical issues experienced by ICU patients. It is, therefore, critical that nurses be able to conduct handover effectively. Despite the importance of handover, the definition and attributes of effective handover are not clearly understood. Walker and Avant's eight-step approach to concept analysis. Effective handover in nursing is an interactive process between two nurses, resulting in the direct transfer of adequate patient-specific recent information in a manner that creates a shared understanding of information. Its defining attributes are (1) content-related and (2) process-related attributes. The antecedents of effective handover are organizational support, interpersonal relationship, and work environment. Its consequences include patient and nurse satisfaction, improved care, and continuity of care. Empirical referents include several tools developed to measure some of the effective handover attributes. The definition provides a connotative meaning and is the first step toward concept validation and instrument development to measure effective handover practice in the ICU.

Magnetic Resonance Imaging as a Prognostic Disability Marker in Clinically Isolated Syndrome and Multiple Sclerosis: A Systematic Review and Meta-Analysis.

To date, there are no definite imaging predictors for long-term disability in multiple sclerosis (MS). Magnetic resonance imaging (MRI) is the key prognostic tool for MS, primarily at the early stage of the disease. Recent findings showed that white matter lesion (WML) counts and volumes could predict long-term disability for MS. However, the prognostic value of MRI in the early stage of the disease and its link to long-term physical disability have not been assessed systematically and quantitatively. A meta-analysis was conducted using studies from four databases to assess whether MS lesion counts and volumes at baseline MRI scans could predict long-term disability, assessed by the expanded disability status scale (EDSS). Fifteen studies were eligible for the qualitative analysis and three studies for meta-analysis. T2 brain lesion counts and volumes after the disease onset were associated with disability progression after 10 years. Four or more lesions at baseline showed a highly significant association with EDSS 3 and EDSS 6, with a pooled OR of 4.10 and 4.3, respectively. The risk increased when more than 10 lesions were present. This review and meta-analysis confirmed that lesion counts and volumes could be associated with disability and might offer additional valid guidance in treatment decision making. Future work is essential to determine whether these prognostic markers have high predictive potential.

Ruptured Isolated Common Iliac Artery Aneurysm Masquerading as Renal Colic.

Urinary stone disease is a common problem globally. Ureteric colic typically presents with flank pain and hematuria. However, several conditions may give a similar clinical picture. Hence, imaging studies are essential to make the diagnosis of urinary stone disease and evaluate for possible complications. We present the case of a 64-year-old man who presented with severe left flank pain radiating to the groin for two days. In his first visit to the emergency department, he was prescribed conservative treatment, but it failed to give any clinical improvement. The patient does not have a previous history of urinary stone disease. He had a long-standing history of hypertension, diabetes mellitus, dyslipidemia, and coronary artery disease. Further, he had a 30 pack-years history of smoking. Upon examination, the abdomen was soft and lax with generalized tenderness. Subsequently, a non-contrast computed tomography scan for the kidneys, ureters, and bladder was performed, which demonstrated a large high attenuation fluid seen in the left side of the retroperitoneum. The scan was then repeated after the administration of intravenous contrast and showed an aneurysmal dilatation of the left common iliac artery with surrounding hematoma. The patient was taken for an emergency laparotomy for evacuation of the hematoma and graft repair of the aneurysm. The patient tolerated the operation without complications. The present case highlights the importance of considering the wide differential diagnoses of flank pain in emergency settings. Physicians should keep a high index of suspicion for aneurysmal disease when they encounter patients with risk factors for arterial wall degeneration.

Amblyopia and Routine Eye Exam in Children: Parent's Perspective.

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents' perspectives on amblyopia and routine examination of their children's eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35-50 years of age (61.5%), 20-34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents' awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.

Contemporary public image of the nursing profession in Saudi Arabia.

BACKGROUND: In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including; failure to recruit high school students into nursing education, poor nursing identity, and lack of awareness about the nursing profession. The level of community awareness and public image of the nursing profession are critical to recruit and retain students into nursing education, and to improve nurses' sense of identity. AIM: To explore the level of community awareness and public image of the nursing profession in Saudi Arabia. METHODS: We conducted a cross-sectional study with a convenient sample of 502 adults including106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-cultural data, gender preference in getting nursing care, awareness, and perceived socio-cultural barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0. RESULTS: Only 32.5% preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0-66.7)). The study highlighted a number of socio-cultural barriers to pursue a nursing career including; the gender-mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%). CONCLUSIONS: Half of the sample had a knowledge score below 50.0 out of 100. This level of poor awareness, in addition to socio-cultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding these factors could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.