Arya Atherosclerosis
Volume:16 Issue: 5, Sep 2020

The issue of academic autonomy along with the reduced authority of the government for handling the service-providing section is considered an urgent demand for most of the organizations including hospitals.

The method of research was a combination of quantitative and qualitative methods from sequential exploratory studies type. In qualitative part, descriptive-phenomenological method using seven-step Colaizzi method and in quantitative part, survey method was used. Statistical population of research of the first part included key experts of the academic autonomy field who were selected purposefully and based on the criterion. With 8 persons, data were saturated. Data collection tool of this part was semi-structured and deep interview. Validation of data was performed by outsider auditors as well as through returning to the interviewees. In quantitative part, a 60-question questionnaire made by the authors was used for data collection which was distributed among officials including hospital managers and key stakeholders of the academic autonomy process in a heart hospital who were 98 persons. Superficial and content validity of the questionnaire was estimated as much as 0.70 for all items. Modeling analysis in inferential level was done through Akaike scale regression.

Academic autonomy is in three dimensions: economic, scientific, and organizational and inter-organizational, intra-organizational, and extra-organizational factors contribute to it from which scientific autonomy is more important compared to other factors. Moreover, intra-organizational factors have more contribution to the academic autonomy of these centers.

The results of this study will be a good guide for academic autonomy of medical centers. In order to achieve academic autonomy, it is more important to pay attention to factors such as autonomy culture capacity, independent signing treaties and international documents, and science-centered society.

 We evaluated to see if the algorithmic approach of pulmonary embolism (PE) [Wells’ score, followed by D-dimer test and computed tomography pulmonary angiography (CTPA)] is appropriately followed in teaching hospitals of Shiraz, Iran.

 From October 2012 to October 2013, we prospectively calculated Wells’ score for all patients who underwent CTPA with clinical suspicion to PE; patients with low probability who had not checked the D-dimer or had low level of D-dimer were considered as non-adherent to the guideline and those with high level of D-dimer or high probability of Wells’ score were labeled as adherent to the PE guideline. CTPA scans were independently reported by two radiologists.

 During study period, 364 patients underwent CTPA to rule out PE, of which 125 (34.3%) had Wells’ score > 4 (high probable risk) and 239 had Wells’ score ≤ 4. Amongst low probable risk patients (Wells’ score ≤ 4), only 32 patients had undergone the D-dimer test (23 patients had high level of D-dimer). Based on the algorithmic approach, patients with suspected PE, patients with high probability (125 patients), and patients with low probability with elevated D-dimer level
(23 patients) were considered as adherent to the PE guideline; consequently, the total adherence to PE guideline was 148 out of 364 (40.6%).

 We followed the algorithmic approach guideline in about 40.0% of cases; however, we should pay more attention to the algorithmic approach in patients with suspected PE.

 Digoxin is a drug for ventricular rate control in atrial fibrillation (AF). The major challenge in digoxin therapy is to adjust the appropriate concentration range for this drug due to its narrow therapeutic index. Unique physiochemical properties of drinking water affect the pharmacological actions and delivery of drugs to the body whether they are administered orally, topically, or by injection. The aim of this study was to evaluate water hardness effect on digoxin therapy in an experimental rat model.

 48 rats weighing 200-220 g were randomly assigned to three groups that received drinking water with 50, 400, and 800 mg/l hardness degrees for 28 days. Then each group was assigned into two groups. One received digoxin 0.2 mg/kg a day orally for four days. The other group received normal saline (as control group). Continuous recording of electrocardiogram (ECG) was performed by PowerLab system (AD Instruments Company) before and day 4 of digoxin treatment. Then serum samples were collected and assessed for digoxin, sodium, potassium, calcium, magnesium, blood urea nitrogen (BUN), and creatinine levels.

 Water hardness in the range of 50-800 mg/l had no effect on serum digoxin levels
(P > 0.050), but consuming hard drinking water (400 and 800 mg/l) could increase serum calcium levels and then cause mortality (37.5% in both groups), following changes in ECG due to digoxin consumption.

 Consuming hard drinking water probably interferes with digoxin pharmacodynamics in the way of toxicity induction.

Cardiovascular disease (CVD) includes a group of heart and coronary disorders that can be prevented by promoting the quality of an individual’s diet. The Recommended Food Score (RFS) and Healthy Nordic Food Index (HNFI) are suggested for the assessment of diet quality and as indicators of dietary exposures related to disease. The aim of this study was to systematically review the association of the RFS and the HNFI with CVD and stroke.

Articles were identified by searching PubMed, Google Scholar, and ScienceDirect using relevant keywords for articles published until December 2018. The inclusion criteria were all types of observational studies and English language. Non-English and irrelevant studies were excluded.

In total, 14 studies met the inclusion criteria. Of the 7 studies that investigated the association between the RFS and CVD, 6 articles showed a lower risk of CVD in individuals who obtained a higher RFS and lower non-RFS (n-RFS) score. Studies that investigated the relation between RFS and stroke (n = 2) showed that achieving a higher RFS could decrease the risk of stroke. Of the 4 studies that assessed the relationship between HNFI and CVD, 3 showed that adherence to HNFI were related with lower risk of CVD/stroke. However, one study did not show any relationship.

A higher RFS may result in a decrease in the risk of CVD and stroke. Due to the inconsistency of the findings related to HNFI, more studies are needed to approve the negative relationship between HNFI and CVD.

 A textiloma is a rare retained surgical swab with probable serious post-operation complications.

Here, we reported an asymptomatic patient who had past history of coronary artery bypass grafting (CABG) fourteen months ago and referred to our institute for left atrial mass removal. Echocardiography and chest computed tomography (CT) scan revealed a non-homogenous non-mobile mass and a heterogeneous lesion with low-density as well as high-density areas with spot calcification and gas bubbles at left atrium level, respectively.

 Despite being rare after CABG, textiloma should be considered in the differential diagnosis in case of any suspicious chest mass even in asymptomatic patients.