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Stability and dynamics of the fractured zygomaticomaxillary complex fixed using non-resorbable and resorbable 2- and 3-point miniplates, under physiological and maximal occlusal loads: a finite element analysis 在生理和最大咬合负荷下,使用不可吸收和可吸收的2点和3点微型钢板固定骨折颧颌复合体的稳定性和动力学:有限元分析
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-29 DOI: 10.30491/TM.2020.214430.1046
Farzin Sarkarat, M. Khosravi, R. Kahali, Amirparham Pirhadi Rad, S. Ebrahimi, V. Rakhshan
Introduction: Given that zygoma fractures are the second most common facial trauma, knowledge of their treatments is of clinical value. Among these are fixations methods, which despite their importance are neglected in many aspects. Therefore, for the first time in the literature, the present finite element analysis evaluated displacements and dynamics of the zygoma fixed using four 2- and 3-point resorbable and four non-resorbable plates under normal and maximal mastication loads. Methods: A maxillofacial CT scan of a man with linear fractures without severe displacements was used to model the zygoma and its adjacent bones. Seven combinations of resorbable and seven combinations of non-resorbable mini-plates 2mm thick were fixed on the zygoma (orbital rim, zygomaticomaxillary buttress [ZMB], and frontozygomatic [FZ]) using 6mm miniscrews. ZMB was fixed using an L-shaped 4-hole plate. The infraorbital rim was fixed with a curved 5-hole miniplate. The FZ suture area was fixed with a 4-hole miniplate. The model underwent 150N and 750N loads. Minimum and maximum displacements, rotational displacements, stresses, and strains of the zygoma models were calculated. Results: Non-resorbable fixation methods can yield much smaller stresses, strains, and displacements compared to resorbable fixations. Also the parameters were much smaller under the 150N load compared to the 750N load. The worst results belonged to the fixation of Rim and ZMB and the best results belonged to the fixation of ZMB-Rim, and especially FZ-ZMB, Rim-FZ, and FZ-ZMB-Rim. Conclusions: In patients with heavy masticatory forces, it is not recommended to use resorbable plates.
简介:鉴于颧骨骨折是第二常见的面部创伤,了解其治疗方法具有临床价值。其中有固定方法,尽管它很重要,但在很多方面却被忽视了。因此,本文首次在文献中采用4块2点和3点可吸收钢板和4块不可吸收钢板对正常和最大咀嚼负荷下固定颧骨的位移和动力学进行了有限元分析。方法:颌面部CT扫描的线性骨折没有严重移位的人被用来模拟颧骨及其邻近的骨头。将7组可吸收和7组不可吸收的2mm厚微型钢板用6mm微型螺钉固定在颧骨(眶缘、颧腋扶壁[ZMB]和额颧骨[FZ])上。使用l型4孔板固定ZMB。用弯曲的5孔微型钢板固定眶下缘。用4孔微型钢板固定FZ缝合区。模型承受150N和750N载荷。计算颧骨模型的最小和最大位移、旋转位移、应力和应变。结果:与可吸收固定相比,不可吸收固定方法产生的应力、应变和位移要小得多。此外,与750N负载相比,150N负载下的参数要小得多。结果以Rim和ZMB固定效果最差,ZMB-Rim固定效果最好,尤其是FZ-ZMB、Rim- fz和FZ-ZMB-Rim固定效果最好。结论:咀嚼力大的患者不建议使用可吸收板。
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引用次数: 0
Evaluation of Metacarpal Compression Test for Diagnosis of Metacarpal Fracture 掌骨压缩试验对掌骨骨折诊断价值的评价
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-01 DOI: 10.30491/TM.2020.217846.1064
N. Karimi, Mohsen Mohyeddini, F. Zeinali, Mehrnaz Nikouyeh, M. Sobhan, Mohamadali Jafari, Alireza Esmaeili
Background: There are many methods for evaluating a traumatized metacarp. Objectives: This study sought to evaluate the accuracy of the metacarpal compression test for the diagnosis of metacarpal fracture. Methods: All patients with metacarpal trauma were tested via placement of axial load (compression) on the metacarpal; induction or exacerbation of pain on each metacarp was recorded upon applying axial pressure. Then, an X-Ray imaging system was used to identify and record the presence of fracture. All data were entered into a 2x2 table, and then negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity of the test were calculated. Results: After careful physical examination and application of the axial pressure on the metacarpal bone, 16(23.68%) patients did not experience any pain during axial loading (none had fracture). According to the statistical analyses of the data, the proposed method had a 69% specificity, 100% sensitivity, 86% PPV and 100% NPV. Conclusion: Our findings showed that axial loading applied on the metacarpal bone, when it leads to pain, is a good marker for fracture. On the other hand, patients with negative test results had no fracture on radiography, which emphasized 100% NPV of the test.
背景:有许多评估创伤后掌骨的方法。目的:本研究旨在评估掌骨压缩试验诊断掌骨骨折的准确性。方法:对所有掌骨外伤患者进行掌骨轴向负荷(压迫)测试;在施加轴向压力时记录每个掌骨的疼痛诱导或加重情况。然后,使用x射线成像系统来识别和记录裂缝的存在。将所有数据录入2x2表格,然后计算阴性预测值(NPV)、阳性预测值(PPV)、检测的敏感性和特异性。结果:16例(23.68%)患者经仔细体格检查并施加轴向压力于掌骨,在轴向负荷过程中无疼痛(无骨折)。经统计分析,该方法特异性69%,敏感性100%,PPV 86%, NPV 100%。结论:我们的研究结果表明,当掌骨受到轴向载荷导致疼痛时,是骨折的良好标志。另一方面,阴性检测结果的患者在x线上没有骨折,这强调了100%的NPV检测。
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引用次数: 0
The Prevalence of Internalizing and Externalizing Behavior Problems and Their Relationship with Demographic Characteristics in Children Surviving the 2017 Earthquake in West of Iran 2017年伊朗西部地震幸存儿童内化和外化行为问题的患病率及其与人口统计学特征的关系
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-01 DOI: 10.30491/TM.2020.213838.1034
V. Farnia, O. Davarinejad, M. Khanegi, T. A. Jouybari, S. Salemi, Shima Pajouhinia, M. Alikhani, Sara Hookari, B. Behrouz
Background: Natural disasters may lead to personal and social dysfunction in children. Objectives: The present study was conducted to determine the prevalence of behavioral problems and their relationship with demographic characteristics in children surviving the 2017 earthquake in western Iran. Methods: This was a cross-sectional-analytical study. The statistical population included all children surviving the 2017 earthquake in western Iran. The sample size included 335 subjects selected by convenience sampling. The Achenbach Child Behavior Checklist (Parent Form) was the tool used to collect data and chi-square and Fisher’s exact tests were used to analyze the data. Results: The rule breaking (5.3%) and somatic complaints (2.4%) were the most and least prevalent behavioral problems in children, respectively. General behavior problems (8.3%), internalizing behavior problems (7.4%), and externalizing behavior problems (7.1%) were the most prevalent, respectively. Gender had a significant statistical relationship with somatic complaints and attention problems; loss of home with rule breaking, internalizing behavior problems, and general behavior problems; the number of children in a family with anxiety; age of the father with social problems, aggression, internalizing and externalizing behavior problems; the father’s educational level with withdrawal; mother’s educational level with attention problems, aggression, externalizing behavior problems and general behavior problems; and economic status with aggression (p<0.05) were apparent. Conclusion: Given the significant prevalence of behavioral and psychiatric disorders in children who survived the earthquake, identifying children at risk is important for the prevention, early diagnosis, and treatment of aforementioned problems in these children.
背景:自然灾害可能导致儿童的个人和社会功能障碍。目的:本研究旨在确定2017年伊朗西部地震幸存儿童中行为问题的患病率及其与人口统计学特征的关系。方法:采用横断面分析方法。统计人口包括2017年伊朗西部地震中幸存的所有儿童。样本量采用方便抽样法选取335名受试者。Achenbach Child Behavior Checklist (Parent Form)是收集数据的工具,使用卡方检验和Fisher精确检验来分析数据。结果:违反规则(5.3%)和躯体抱怨(2.4%)分别是儿童行为问题中发生率最高和最低的。一般行为问题(8.3%)、内化行为问题(7.4%)和外化行为问题(7.1%)分别最为普遍。性别与躯体抱怨和注意问题有显著的统计学关系;因违反规则、内化行为问题和一般行为问题而失去家;一个家庭中有多少孩子焦虑;年龄的父亲存在社会问题、攻击性、内化和外化行为问题;父亲的受教育程度与退缩;母亲受教育程度与注意力问题、攻击性、外化行为问题和一般行为问题的关系;经济状况具有明显的侵略性(p<0.05)。结论:鉴于地震幸存儿童中行为和精神障碍的显著患病率,识别这些儿童的风险对于这些儿童上述问题的预防、早期诊断和治疗至关重要。
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引用次数: 0
Achilles Tendon Ossification Treated Without Medication or Surgery 无药物或手术治疗跟腱骨化
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-01 DOI: 10.30491/TM.2020.217330.1068
M. Azar, Iman Sadeghian, Soroosh Fateh, M. Gharib
Ossification of the Achilles tendon is a rare disease and seen more frequently in men than in women. Most patients present with pain caused by local inflammation. It is a disease of physically active people, and   management of these patients is important. Many pathologic and molecular studies have been conducted to determine the cause of this disease. Minor trauma and microdamages may be the most important factors related to Achilles tendinopathy or Achilles tears. Sometimes, in cases without significant symptoms, no treatment is need; in symptomatic ones, however, relief of pain is the main treatment objective. Treatment of this disease varies from conservative treatment, including NSAIDs or physiotherapy, to electrotherapy, ionotherapy, and surgical strategies. Herein we report of a patient with Achilles tendon ossification, diagnosed by physical and radiographic evaluation treated with a foot brace without any drugs or surgery. The relation between radiographic changes and patient symptoms was important and helpful in choosing the mode of treatment.
跟腱骨化是一种罕见的疾病,男性比女性更常见。大多数患者表现为局部炎症引起的疼痛。这是一种体力活动人群的疾病,对这些患者的管理很重要。已经进行了许多病理和分子研究来确定这种疾病的病因。轻微创伤和微损伤可能是与跟腱病变或跟腱撕裂相关的最重要因素。有时,在没有明显症状的情况下,不需要治疗;然而,在有症状的情况下,缓解疼痛是主要的治疗目标。这种疾病的治疗方法多种多样,从保守治疗,包括非甾体抗炎药或物理治疗,到电疗、离子疗法和手术策略。在此,我们报告了一位患有跟腱骨化症的患者,通过物理和影像学评估诊断,使用足撑治疗,没有任何药物或手术。影像学改变与患者症状的关系对选择治疗方式有重要的帮助。
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引用次数: 0
The role of tissue engineering and regenerative medicine in the treatment of sport injuries a review study 组织工程和再生医学在运动损伤治疗中的作用综述
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-01 DOI: 10.30491/TM.2020.213410.1000
A. Abdolmaleki, S. Zahri, A. Asadi, R. Wassersug
Managing sports injuries is clinically challenging. Although new techniques can delay musculoskeletal deterioration and promote tissue restoration, they are not widely used. Thus, there is a critical need to promulgate these new methods. In recent years, “tissue engineering” approaches have been developed for improving the regeneration of cartilage by transplanting cells or engineered constructs into injured tissue. The mechanical environment affects the biology of a tissue and is necessary for the development and maintenance of load-bearing tissues. Platelets can be combined with other healing factors as a new therapeutic modality. Platelet-rich plasma (PRP) can be introduced as an autologous blood product that may improve wound healing. In this regard, stem cell therapy that focuses on mesenchymal stem cells (MSCs) has been proposed as a new treatment method in sports medicine. MSCs are multipotent; they have the ability to differentiate into other cells, notably osteoblasts, chondrocytes, adipocytes, myoblasts, and fibroblasts, depending on a variety of factors. In summary, recent advances in tissue regeneration have provided new perspectives for the use of tissue engineering to enhance tissue healing after sports injuries namely the microfracture method, the mechanical stimuli method, PRP therapy, and stem cell therapy
治疗运动损伤在临床上具有挑战性。虽然新技术可以延缓肌肉骨骼退化和促进组织修复,但它们并没有被广泛使用。因此,迫切需要颁布这些新方法。近年来,“组织工程”方法已经发展起来,通过将细胞或工程构建体移植到损伤组织中来改善软骨的再生。机械环境影响组织的生物学特性,对承载组织的发育和维持是必要的。血小板可与其他愈合因子联合作为一种新的治疗方式。富血小板血浆(PRP)可以作为一种自体血液制品引入,可以改善伤口愈合。因此,以间充质干细胞(MSCs)为核心的干细胞治疗已被提出作为一种新的运动医学治疗方法。间充质干细胞是多能的;它们有能力分化成其他细胞,特别是成骨细胞、软骨细胞、脂肪细胞、成肌细胞和成纤维细胞,这取决于各种因素。综上所述,组织再生的最新进展为利用组织工程技术促进运动损伤后组织愈合提供了新的前景,即微骨折法、机械刺激法、PRP疗法和干细胞疗法
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引用次数: 1
Postoperative Outcomes of Single and Double Plating Osteosynthesis for Proximal Metaphyseal Tibial Fractures 胫骨近端干骺端骨折单钢板和双钢板接骨术的术后疗效
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-05-01 DOI: 10.30491/TM.2020.228779.1107
S. Ghaffari, Alireza Kazemi, Mehran Razavipour, M. Shayestehazar, S. Talebi, Zahra Mardanshahi
Background: Optimal management of proximal tibial fractures remains to be a clinical challenge. Most studies on this condition have been conducted on cadaver specimens, and few have compared the clinical outcomes of single and double plating methods in these fractures. Objectives: The current study aimed to compare the postoperative outcomes and complications of the single and double plating methods in the treatment of metaphysical proximal tibial fracture. Methods: We treated 40 patients with metaphyseal tibial fracture with single or double plating methods (20 in each group). Patients were followed after 2 and 6 weeks, and 3 and 6 months; all were assessed for malunion, nonunion, and malalignment deformities. Results: In the double plating group, numerically better flexion and extension range was not significant (p >0.05). However, in the interpretation of the Lysholm Knee Score questionnaire, a significantly higher proportion of good and excellent postoperative outcomes were found in the double plating group (p=0.041). In the double plating group, 15%, 15%, 40%, and 30% of patients were categorized as having poor, fair, good, and excellent outcomes, respectively. These proportions were 30%, 45%, 15%, and 10% among the single plating group respectively. Moreover, we detected positive valgus stress test in the single plating method in 30% of the cases, compared with 5% in the double plating method (p=0.037). Similarly, we observed that 20% of the cases with positive varus stress test in the single plating method, compared with the double plating method that had no cases who tested positive (p=0.035). The observed significant differences survived after we controlled for the positive stress test using regression models. It should be noted that in the single plating group, one case of valgus malalignment with 10° and one case of varus malalignment with 5° were observed. Conclusion: Our results highlight that the choice of the double plating method to be associated with significantly better outcomes and fewer complications in the treatment of proximal tibial metaphyseal fracture.
背景:胫骨近端骨折的最佳治疗仍然是一个临床挑战。大多数关于这种情况的研究都是在尸体标本上进行的,很少有比较单钢板和双钢板方法在这些骨折中的临床结果。目的:比较单钢板和双钢板治疗胫骨近端骨折的术后疗效和并发症。方法:对40例胫骨干骺端骨折采用单钢板或双钢板治疗,每组20例。随访时间分别为2周、6周、3月、6月;评估所有患者的不愈合、不愈合和不对准畸形。结果:双钢板组屈伸幅度明显优于双钢板组,差异无统计学意义(p >0.05)。然而,在Lysholm膝关节评分问卷的解释中,双钢板组术后良好和优的比例明显更高(p=0.041)。在双镀组中,分别有15%、15%、40%和30%的患者被归类为预后差、一般、良好和极好。单镀组的比例分别为30%、45%、15%和10%。此外,我们在30%的病例中检测到外翻应力试验阳性,而在两次电镀中为5% (p=0.037)。同样,我们观察到单次电镀法内翻应力测试阳性病例占20%,而双次电镀法无阳性病例(p=0.035)。在我们使用回归模型对正压力测试进行控制后,观察到的显著差异仍然存在。值得注意的是,在单钢板组中,观察到1例外翻对准10°,1例外翻对准5°。结论:我们的研究结果表明,选择双钢板方法治疗胫骨近端干骺端骨折的疗效更好,并发症更少。
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引用次数: 0
Protection of Prisoners of War from Torture with Proper Selection of Soldiers Taking Care of POWs: An Ethical View 保护战俘免受酷刑与正确选择照顾战俘的士兵:一个伦理的观点
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-03-01 DOI: 10.30491/TM.2020.213548.1020
A. Khaji, S. Tabatabaei, Ahmad Mashkoori
Background: Prisoners of War (POWs) undergo different physical and/or psychological tortures. According to the Third Geneva Convention, each government is obliged to protect POWs from any harm, especially torture. Although torture of POWs has been considered in international documents such as the 3rd Red Cross Convention for Prevention of Torture, this issue seems to have been ignored so far. Thus, the current article discusses this issue. Objectives: This review aimed to describe an important, yet neglected, way to protect POWs from torture. Methods: The behaviors of Iraqi and Iranian authorities toward the soldiers that were selected to take care of POWs were compared. This review study is based on a narrative search that included articles published on the Iraq-Iran war (1980-88). Results: According to international laws, there is no ethical justification for the torture of POWs, especially after many years of captivity. During the Iraq-Iran war, Iraqi authorities recruited soldiers who had been harmed in some way by the war to handle Iranian POWs. The presence of war victims as care providers to POWs in detention camps may provide grounds for the torture and maltreatment of POWs. Conclusion: Prohibiting the presence of war victims in detention camps could be one important and effective way to protect POWs from torture and maltreatment.
背景:战俘经历不同的身体和/或心理折磨。根据《日内瓦第三公约》,各国政府有义务保护战俘免受任何伤害,尤其是酷刑。虽然在《第三届红十字会防止酷刑公约》等国际文件中讨论了战俘的酷刑问题,但迄今为止,这个问题似乎一直被忽视。因此,本文将讨论这个问题。目的:本综述旨在描述一种重要但被忽视的保护战俘免受酷刑的方法。方法:比较伊拉克和伊朗当局对被选派照顾战俘的士兵的行为。本综述研究是基于对伊拉克-伊朗战争(1980- 1988)发表的文章的叙述性检索。结果:根据国际法,对战俘施以酷刑是没有道德依据的,尤其是在被囚禁多年之后。两伊战争期间,伊拉克当局招募了在战争中受到某种伤害的士兵来处理伊朗战俘。战争受害者作为拘留营中战俘的照顾提供者的存在可能为对战俘的酷刑和虐待提供了理由。结论:禁止在拘留营中安置战争受害者可能是保护战俘免受酷刑和虐待的一种重要而有效的方法。
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引用次数: 1
Epidemiological Study of 1938 Burn Patients from 2014-2016 in Qazvin, Iran 伊朗加兹温地区2014-2016年1938例烧伤患者流行病学研究
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-03-01 DOI: 10.30491/TM.2020.213422.1004
A. Ahmadi, Ameneh Bagheri Ruchi, Nazanin Soltani, Jamileh Amirzadeh Iranagh, S. Motalebi
Background: Many people suffer from burn injuries annually. Epidemiologic studies are necessary to reveal the prevalence and related factors of burns to assist in designing an appropriate plan to reduce its mortality and morbidity. Objectives: This study aimed to analyze the epidemiology and etiological factors of 1938 burn patients admitted to a burn unit in Qazvin, Iran. Methods: This was a retrospective study of medical records of patients admitted to the burn unit of Shahid Rajaee Hospital from March 21, 2014 to March 20, 2016. The collected data included age, gender, percentage of burns, etiology, date of admission, date of discharge, and total burn surface area (TBSA). Descriptive statistics were used to describe the basic features of the studied variables. Results: The mean age of the 1938 burn patients was 29.08±20.52 years. The results showed that more males (n=1391, 71.8%) than females (n=547, 28.2%) were involved in burn injuries. Fire flame (n=1019, 52.6%) and scald (n=529, 27.3%) were major etiological factors of burns. Adult males (n=458, 23.6%), and preschool boys (n= 407, 21.0%) were at the highest risk for burn through the study period. The mean total body surface area (TBSA) was 13.34 (SD ±12.40) ranging from 1% to 9%, and burns of less than 20% TBSA represent the large majority of burns (n=1653, 85.3%). Conclusion: This study indicates that the majority of burn injuries were of the fire flame and scald types. Preventive programs targeting the population under higher risk of burns are needed to reduce the burden of burns.
背景:每年都有许多人遭受烧伤。流行病学研究是必要的,以揭示烧伤的患病率和相关因素,以协助制定适当的计划,以降低其死亡率和发病率。目的:分析伊朗Qazvin烧伤科收治的1938例烧伤患者的流行病学和病因。方法:回顾性分析2014年3月21日至2016年3月20日沙希德·拉贾伊医院烧伤科收治的患者病历。收集的数据包括年龄、性别、烧伤百分比、病因、入院日期、出院日期和总烧伤表面积(TBSA)。描述性统计用于描述研究变量的基本特征。结果:1938例烧伤患者平均年龄29.08±20.52岁。结果显示,男性(1391人,71.8%)多于女性(547人,28.2%)。火焰(n=1019, 52.6%)和烫伤(n=529, 27.3%)是烧伤的主要病因。在整个研究期间,成年男性(n=458, 23.6%)和学龄前男孩(n= 407, 21.0%)发生烧伤的风险最高。平均体表面积(TBSA)为13.34 (SD±12.40),范围为1% ~ 9%,其中TBSA小于20%的烧伤占绝大多数(n=1653, 85.3%)。结论:烧伤类型以火焰型和烫伤型为主。需要针对烧伤风险较高人群的预防规划,以减轻烧伤负担。
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引用次数: 2
An Overview of Health-Related Challenges in a Mass Gathering 大规模集会中与健康相关的挑战概述
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-03-01 DOI: 10.30491/TM.2020.213574.1022
M. Peyravi, M. Marzaleh, Hojatolah Najafi
Background: Arbaeen is one of the world’s largest religious gatherings. It is held in Karbala, Iraq, and can pose many significant challenges to the health of pilgrims and the host population as well as the health system of Iraq. Objectives: The present study was conducted to reflect an overview of the health-related challenges associated with the Arbaeen ceremonies. Methods: This qualitative study was conducted from October 6 (ten days before Arbaeen ceremonies) to October 16, 2019, in Najaf, Karbala, and the route pilgrims walk in Iraq. Semi-structured and in-depth interviews were conducted with disaster and emergency specialists, health experts, nurses, general physicians, and specialist doctors. Twelve experts and six pilgrims were interviewed. Thematic analysis was used to analyze the data. Results: The findings were categorized into three main groups: treatment issues, public health, and infrastructure. The main complaints pilgrims had were bone and joint pain, muscle spasms, headache, toothache, pharyngitis, rhinorrhea, and common cold, purulent throat, and gastrointestinal symptoms. The main problems of those with chronic conditions included having forgotten to take medications or running out of medications. Food and water safety and sanitary conditions were inappropriate. Iraq’s health system was not prepared to fulfill the health needs of the people at such a gathering. Conclusion: Arbaeen ceremonies impose a heavy burden on Iraq’s healthcare system and cause numerous health challenges. Moreover, Iraq’s healthcare system does not have the capacity or readiness to meet the challenges of this event; international aid from the countries whose citizens attend the event are needed. Although the Iranian Red Crescent cooperated extensively, the collaboration must be more coordinated and broadened.
背景:阿尔拜因是世界上最大的宗教集会之一。它在伊拉克卡尔巴拉举行,可能对朝圣者和东道国人口的健康以及伊拉克的卫生系统构成许多重大挑战。目的:本研究旨在概述与Arbaeen仪式相关的健康挑战。方法:本定性研究于2019年10月6日(Arbaeen仪式前10天)至10月16日在纳杰夫,卡尔巴拉和伊拉克朝圣者走过的路线进行。对灾害和急救专家、保健专家、护士、普通内科医生和专科医生进行了半结构化和深入的访谈。采访了12位专家和6位朝圣者。采用主题分析法对数据进行分析。结果:调查结果主要分为三大类:治疗问题、公共卫生和基础设施。朝圣者的主要症状是骨骼和关节疼痛、肌肉痉挛、头痛、牙痛、咽炎、鼻漏、普通感冒、喉咙化脓和胃肠道症状。慢性疾病患者的主要问题包括忘记服药或药物用完。食品和水的安全和卫生条件都不合适。伊拉克的卫生系统没有准备好满足人们在这样一次集会上的卫生需求。结论:Arbaeen仪式给伊拉克的医疗保健系统带来了沉重的负担,并造成了许多健康挑战。此外,伊拉克的保健系统没有能力或准备迎接这一事件的挑战;需要来自其公民参加活动的国家的国际援助。虽然伊朗红新月会进行了广泛的合作,但这种合作必须更加协调和扩大。
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引用次数: 2
Does Caring for Trauma Patients Admitted to Emergency Departments Need Advanced Communication Skills? A Quasi-Experimental Study of Nurses' Communication Audit 照顾急诊科收治的创伤患者需要高级沟通技巧吗?护士沟通审计的准实验研究
IF 0.5 Q4 EMERGENCY MEDICINE Pub Date : 2020-03-01 DOI: 10.30491/TM.2020.213517.1014
M. Ghorbanzadeh, H. Mahmoudi, M. S. Nir, M. Khoshnevis
Background: Communication increases awareness of patient problems, productivity and job satisfaction, improving decision-making in patient discharge and transfer, and reducing hospital stay duration, medical costs, and nurses’ stress and burnout. Objectives: This study aimed to audit the communication of nurses with trauma patients in the emergency department. Methods: This quasi‑experimental study was conducted at the Baqiyatallah University of Medical Sciences in 2018. The data collection tool was a valid and reliable checklist for nurses' communication skills with trauma patients with 3 subscales and 31 items. Before the intervention, 35 nurses who were randomly selected were evaluated based on the communication checklist, and then the collected data was analyzed. Based on the results and the assessment of weaknesses, the necessary training was provided to the nurses. After the intervention, the participants' communication skills were analyzed using the same checklist and the results were compared. Descriptive statistics and parametric tests such as paired T-test were used to analyze the data. Results: The means age of participants was 39.5±9.3 years, and the majority of them were males.The mean scores of communication status before and after intervention were (10.00±3.29) and (26.26±2.30), respectively, among the 35 participating nurses. There was a significant difference between pre-and post-intervention (p <0/001) in terms of total communication skills scores, indicating the effectiveness of the intervention. Conclusion: The audit of nurses' communications with patients in the emergency department as well as training based on the improvement of weaknesses may be effective in improving nurses’ communication skills, and this may promote the level of communication skills, behavioral changes, and positive effects on the clinical situation of trauma patients.
背景:沟通可以提高对患者问题的认识,提高工作效率和工作满意度,改善患者出院和转院的决策,减少住院时间、医疗费用和护士的压力和倦怠。目的:本研究旨在调查急诊护士与创伤患者的沟通情况。方法:本准实验研究于2018年在巴基亚塔拉医学大学进行。数据收集工具是一份有效可靠的创伤患者护士沟通技巧检查表,共有3个分量表31个项目。干预前,随机抽取35名护士根据沟通量表进行评估,并对收集到的数据进行分析。根据调查结果和对薄弱环节的评估,对护士进行了必要的培训。干预后,使用相同的检查表分析参与者的沟通技巧,并比较结果。采用描述性统计和参数检验(如配对t检验)对数据进行分析。结果:参与者平均年龄39.5±9.3岁,男性居多。35名参与护理人员干预前后沟通状况平均得分分别为(10.00±3.29)分和(26.26±2.30)分。干预前后沟通技巧总分差异有统计学意义(p <0/001),表明干预有效。结论:对急诊科护士与患者沟通情况进行审核,并针对弱点进行改进培训,可有效提高护士的沟通技巧,提高护士的沟通技巧水平和行为改变,对创伤患者的临床情况产生积极影响。
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引用次数: 1
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Trauma monthly
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