BackgroundA home based tele-monitoring system was developed to assess the effects of heat stress (days > 25°C) on clinical and functional status in patients with chronic obstructive pulmonary disease (COPD).MethodsSixty-two COPD patients (GOLD II–IV) were randomized into a tele-monitoring Group (TG, N = 32) or Control Group (CG, N = 30). Tele-monitoring included 1) daily clinical status (COPD Assessment Test-CAT), 2) daily lung function and 3) weekly 6-minute walk test (6MWT). Duration of monitoring lasted a total of nine months (9 M).ResultsFrom June 1st–August 31st 2012, 32 days with heat stress (29.0 ± 2.5°C) were recorded and matched with 32 thermal comfort days (21.0 ± 2.9°C). During heat stress, the TG showed a significant reduction in lung function and exercise capacity (FEV1% predicted: 51.1 ± 7.2 vs. 57.7 ± 5.0%; P <0.001 and 6MWT performance: 452 ± 85 vs. 600 ± 76 steps; P <0.001) and increase in CAT scores (19.2 ± 7.9 vs. 16.2 ± 7.2; P <0.001).Over summer, significantly fewer TG patients suffered exacerbation of COPD compared to CG patients (3 vs. 14; P = 0.006). Over entire 9 M follow-up, the TG group had fewer exacerbations compared to CG (7 vs. 22; P = 0.012), shorter cumulative hospital stay (34 vs. 97 days) and 43% fewer specialist consultations (24. vs. 42; P = 0.04).ConclusionHeat stress affects clinical and functional status in COPD. Tele-monitoring reduces exacerbation frequency and health care utilization during heat stress and other periods of the year. Trial registrationDRKS-ID: DRK00000705.

Heat stress is associated with a compromised clinical status in patients with PAH. Adaptation strategies must be implemented to prevent heart-related morbidity, including therapeutic adjustments and adequate room cooling in the patient's home and at the hospital.

Diabetic foot is one of the most significant complications of diabetes, Chronic infections are caused by Enterococci, various Enterobacteriaceae obligate anaerobes, Pseudomonas aeruginosa. To study bacteriological profile and antibiotic susceptibility in diabetic foot infection. Cross sectional study was done in 110 diabetic foot infection cases in the Department of Microbiology, Prathima Institute of Medical Sciences, Nagunuru, Karimnagar, Telangana. The grading of diabetic foot ulcers was done according to Wagner’s Classification system. The samples were collected from the exudates and ulcers. Gram stain was done and standard protocol for culture and sensitivity was followed for all the cases.A total of 110 cases were studied. The patient age ranged from 35 to 75 years and the male to female ratio was 2:1. Out of 110 isolates, 72.7% isolates were Gram negative bacilli with P. aeruginosa 31.8% being the predominant followed by E.coli 27.2%, K.pneumoniae 10%, P.mirabilis 4.5%, S.aureus 12.7% was the predominant isolate followed by Enterococci spp 4.5% and Coagulase negative staphylococci (CONS) 4.5% and S. pyogenes were 5.4%. Both Gram positive cocci and Gram negative bacilli can cause dia­betic foot infections and this study showed a preponderance of Gram negative bacilli. Early culture and sensitivity test of the bacterial isolates helps in guiding the treatment plan