Introduction: The prognosis of patients with Zenker`s diverticulum is dependent mainly on the type of procedure performed, either surgical or rigid/flexible endoscopy. Purpose - evaluation of the redo procedure by reviewing correlations in patients with iterative procedures. Material and Methods: We included in the study 36 patients with cervicomediastinal Zenker diverticula treated from 2010 to 2017 at two university hospitals: Clinic of General and Esophageal Surgery. Mary Clinical Hospital Bucharest and Department of Diagnostic and Interventional Digestive Endoscopy of the Regional Institute of Hepatology and Gastroenterology Prof. Dr. Octavian Fodor, Cluj-Napoca. For the patients included in the study we studied correlations of patients with symptoms persistence and to those with reintervention with epidemiological, clinical and the treatment criteria. Results: Postprocedural symptoms we observed in 5 patients of the 29 treated endoscopically and 6 of the seven treated surgically. Statistical correlations were noted in patients with persistent symptoms after surgical treatment (p <0.01) with patients with diverticulectomy (54.5%) (p <0.01), grade III diverticula (36.4%) (p <0.01) statistical association was noticed in patients who have required reoperation and those with persistent symptoms (63.6%) (p <0.01) and with remaining dysphagia (100%) (p <0.01) and those with grade 2 dysphagia persistence (71.4%) (p <0.01), grade 3 diverticula (42.9%) (p <0.03) and the high number of comorbidities. (p <0.04) Conclusion: Undoubtedly, endoscopic treatment is being used more and more even for those cases that require further treatment. Reoperation has been necessary for patients with persistent dysphagia with voluminous diverticula and a high number of comorbidities.
Introduction: Given fast grow and competition in the healthcare industry, managers and health activists in this sector need to adopt strategies for branding. The purpose of the study was to develop a conceptual model for branding in the healthcare industry to build brand advocacy and positive brand image. Methods: The study includes patients referred to a military hospital in May 2018. Data gathered by questionnaire, and 162 surveys were collected by simple random sampling method. To test the hypotheses, the conceptual model was analysed by structural equation modeling with SmartPLS® software. Results: The affective commitment and brand trust could predict brand advocacy. CSR significantly impacts brand image and affective commitment, furthermore brand attitude and COB significantly impact brand trust. There was no significant relationship between brand trust and affective commitment with brand image. Conclusion Organizations can improve brand image and establish brand support through investing resources on branding. This study contributes insights for marketing managers in developing successful branding strategies for health care organizations.
Fever of unknown origin (FUO) is a diagnosis that describes a prolonged febrile illness without an established cause, despite investigations. From the first definition of the medical condition (given by Petersdorf and Beeson in 1961) the diagnostic criteria have changed over time, intending to improve the management and outcome of these patients. The main causes of FUO fall into 4 categories: infectious, non-infectious (inflammatory), neoplastic and diverse causes. The etiology of FUO has changed over time, due to ever-changing disease patterns and the development of diagnostic techniques. A significant percentage of patients with FUO remain without an etiologic diagnosis, despite advanced diagnostic tests. Gathering potentially diagnostic clues through history, physical examination and nonspecific key paraclinical abnormalities is the basis for the diagnosis of FUO.
Background and Aim: Efficient manpower is the most important of military capital, and many studies have shown the relationship between personal health and organizational performance. The preparation of military cadet volunteers to enter aeronautical training and the provision of optimal services in the form of well-trained pilots requires many material spiritual resources that disabilities, make them waste. Methods: This is a descriptive, cross-sectional, retrospective study with target population of Iranian air force cadets with early and permanent medical disqualification from 1986 to 2016. Results: 80 cases were detected, including 25 kills and 55 early and permanent medical disqualification. The main causes were ear, nose and throat, psychiatry and cardiac, respectively. Common diseases include motion sickness, generalized anxiety disorder, adjustment disorder and epilepsy, respectively. The total number of lost service years was 1412 person years and the average of lost service years was 25.67 person years. Most of the lost service years were related to medical causes included ear, nose and throat, psychiatric and cardiac, and diseases included motion sickness, generalized anxiety disorder and adjustment disorder, respectively. Neurologic causes resulted in highest average of lost service years and high blood pressure was the major diseases, respectively. Conclusions: Due to the lack of similar studies, the results of this study were compared with the data, which extracted from previous studies in the pilot’s population. Because of occupational similarity between pilots and cadets, It was expected that the most common causes in pilots and cadets should be the same, but we found that the results are very different.
Non-compliance to diet and increased fluid intake can lead to unpleasant side effects and premature mortality in hemodialysis patients. Intervention strategies in educational and cognitive-behavioral domains can be used to improve diet compliance and restrict fluid intake in hemodialysis patients. The present study aimed to implement a participatory care model on diet compliance in patients undergoing hemodialysis referred to the Urmia Hemodialysis Center of Urmia in 1397. The present study is an experimental-randomized study that was performed on 60 patients undergoing diet without hemodialysis referring to Urmia Hemodialysis Center of Urmia. From 175 patients undergoing hemodialysis based on laboratory parameters of non-compliance patients and 60 patients were selected based on simple randomization and were randomly divided into intervention and control groups. After intervention steps of participatory care, diet compliance of the two groups was compared using the results of the comparable laboratory parameters. Analysis of the results of the present study showed that the collaborative care model significantly improved the results of laboratory parameters related to diet compliance in the intervention group compared to the results of the laboratory parameters before the intervention and the control group (p <0.05). Based on the results of the present study, it seems that participatory care intervention can be useful in improving diet compliance and fluid restriction in hemodialysis patients. The aim is to improve the quality of life of hemodialysis patients.
Artificial Intelligence (AI) has become an important tool for computer-aided diagnosis of medical imaging. This review aims to provide an overview for clinicians, explaining the relevant aspects of artificial intelligence and machine learning (ML) and presenting up-to-date applications of AI and ML techniques to medical imaging methods such as angiography, magnetic resonance, and echocardiography. For each imaging method, we present the acquisition process, the types of diagnostic test interpretation, and the challenges related to them, as well as how AI/ML techniques, have improved the process of decision making. A summary of selected works applying AI/ML techniques to medical imaging is organized into a table, which highlights the scope of the study, the dataset used, the details of each approach as well as the measured results, including objectives and criteria. The overall benefits of AI in medical imaging are extracted based on the diverse applications and high evaluation scores. In the end, cardiologists should have an advanced understanding of using AI to integrate clinical data and making the final decision in diagnosis.
Maintenance of efficient, highly specialized, and valuable forces in the present age is one of the most important concerns of organizations, especially organizations with advanced technologies. The importance of human resources planning and management in these organizations has greatly increased, and in the various areas of human resource management, the approach to occupational anchor planning has been very much considered. The purpose of this study was to investigate the role of the job path anchors in human resource strategy among the target community. Participants were selected randomly from among 3500 students at the Faculty of Management of Yadegar-e-Imam Khomeini (RAH) Shahre Rey Branch, Islamic Azad University in Tehran Province, Iran. The sample size was 346 by the Cochran method and the questionnaire was collected by electronic means. At the time of the study, 346 questionnaires were completed and the analysis was performed based on 346 questionnaires. To collect data, standard job anchor questionnaires, and Human Resources Strategic HR Questionnaire was used. The study population included 346 people, of whom 203 were male and 143 were female. The age of the people below the age of 20 was 38, from 20 to 25 years old, 94, between the ages of 26 and 30, 60, people aged 31 to 35, and 76 people over the age of 35 years. The reliability of the work anchors was 91% and the human resources strategy questionnaire was 80%. Investigations have shown that, on the anchors of the career path, the factors of creativity - entrepreneurship, autonomy-independence, pure challenges and public management with a committed strategy and public management, creativity-entrepreneurship, security-stability in the strategy of contracting businesses and creativity - entrepreneurship, Pure challenges, security with secondary jobs, and creativity- entrepreneurship, public management, pure challenges in parenting jobs. According to the results of this study, it seems that the emphasis on reducing organizational structures, empowerment, and participatory decision making can determine the necessary grounds for determining the type of human resources strategy in an organization.
Background: Preparation and hospital development estimated an essential part of the policies and strategic purposes of healthcare in each government. Today, applications of management to reduce the burden of natural and technical disasters appear are very necessary. Objectives: The study aimed to review the major relevant articles in the case of the application of telemedicine for trauma injuries in disaster and military situations. Methods: Original clinical trials investigating the effects of telemedicine on trauma injuries published before April 2018 were aggregated, and used in this study. We search the scientific sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI, and Scopus. The keywords that applied to identify these articles combined: Telemedicine, Mobile Health, Health, Mobile, mHealth, Telehealth, eHealth, Trauma, War, military, medicine, Wounds and Injuries, injuries. Results: The text of the articles and abstracts were examined from various aspects, the 21 articles were evaluated for quality, and then 10 papers entered in a systematic review. We found that the use of telemedicine in trauma injury, rural and the military is very helpful for high-quality trauma care; also the telemedicine and telephone consultations can be were demonstrated reducing the risk of physician-related medicine mistakes. The economic evaluation of telemedicine was demonstrated cost-saving and cost-effective of telemedicine consultations. We also realized the importance and practicable of telemedicine for improving rural trauma care. Conclusions: Ultimately, the telemedicine can help patients and health government organizations economically, the telemedicine consultations due to cost-saving and cost-effective. Further studies to evaluate the running of telemedicine need to abating the practical and high-efficiency method, that can be done everywhere and it's free from mistakes and defects.
Gallstones disease (GD) is a common pathology, with an incidence of approx. 20% in developed countries, a third of these cases being symptomatic. The paper aims to identify the diagnostic and therapeutic features of acute manifestations of gallstones during the COVID-19 pandemic. Materials and method: A retrospective, comparative study was performed of the cases presented to the emergency room (ER) and hospitalized for acute manifestations of gallstones in April-June 2020 vs similar period of 2019. The data regarding clinical form, associated pathology, therapeutic management were analyzed from the ER presentation register, hospitalization sheets and surgical protocols. Results: During the COVID-19 pandemic, the number of hospitalized cases for acute cholecystitis and other acute manifestations of GD was significantly lower than in the same period last year (21 vs 49 patients). In both study groups the main form of presentation was acute catarrhal cholecystitis (52.4% vs 63.2%). During the SARS-Cov-2 pandemic, we report an increased incidence of complicated forms, mainly hydrops (23.8% vs. 4.1%, p <0.05) and angiocholitis (19% vs. 4.1%, p <0.05). Conservative treatment was chosen more frequently during the pandemic (48% vs. 29%). For operated patients, laparoscopic cholecystectomy was the main option, performed in 85.7% in both groups. Conclusions: We maintain that laparoscopic cholecystectomy remains the gold standard for acute cholecystitis, even in the COVID-19 pandemic, as it guarantees the best outcomes for the patients. Conservative management may be an option for mild cases, but it carries the risk of recurrence of symptoms and increased incidence of severe complications.
Osteoporosis is a systemic skeletal condition, characterized by a microarchitectural degradation of bone density and quality, giving low resistance and an increased risk of fracture. Osteoporosis is an important public health problem, with considerable medical, social and economic impact. Data accumulated in recent years demonstrate a significant incidence of osteoporosis in the group of patients with major collagen diseases; of these, Systemic Lupus Erythematosus (SLE) is the prototype of autoimmune disease in which osteoporosis and associated complications have a significant clinical impact. Although additional studies are needed to deepen the relationship between SLE - osteoporosis - associated fractures, we believe that these patients should be managed from the early stages of the disease.
