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As with any other sector, the healthcare industry is also prone to cyber threats. Though the nature of threats is similar to any other industries, it does need to address sector-specifics risks along with security risks in its operating environments. Every day the Hospitals need to ensure that the information is adequately secured. Currently Chief Information Officer (CIOs) and Chief Information Security Officer (CISOs) are trying to protect their hospital Information Systems (IS) departments from security threats. It's imperative to take necessary measures to ensure risk management and business continuity. The paper addresses some of the challenges faced by healthcare organizations in the selection of a cyber-security framework by reviewing some of the common standards and frameworks that are used by healthcare organizations. The also paper highlights the advantages and disadvantages of each of the standards as: international organization for standardization (ISO)/IEC 27799, Health Insurance Portability and Accountability Act (HIPAA), HITRUST, Nation Institute of Standards and Technology (NIST) has developed the Cyber Security Framework (CSF) and General Data Protection Regulation (GDPR) and compare and the additional directives provided by this standards. [ABSTRACT FROM AUTHOR]

Postoperative hypocalcemia incidence range after thyroid surgery from 1-2% to 61.9%. Such a wide oscillation of values in literature cannot fail to raise doubts about the method of detection and the composition of the different experiences. We here refer to the personal experience gained over the course of 3 years from January 2020 to December 2022; 320 consecutive thyroid surgeries: 79 M, 241 F, mean 49.11 Amino Acid (AA), 59 near total thyroidectomies, 213 total thyroidectomies, 48 recurrence interventions of which 18 for neoplastic pathology with central or later-cervical emptying performed in 258 cases for benign pathology and in 62 cases for cancer. In a smaller group of 50 cases of low parathyroid vascularization after dissection, we selected 12 cases of absolutely no color signal of parathyroid vascularization at early and late acquisition and in those cases, we proceeded to a homolateral sternocleidomastoid muscle implant. The entire sample of 320 patients can therefore be subdivided, according to the extent of the demolition, to the method of opotherapy substitution with L-Thyroxine and to Parathyroid ICGA (Indo-Cyanine Green Angiography) in 4 groups: I group 59 patients near total thyroidectomy; II group 155 total thyroidectomies with L-Thyroxine from 15th-30th Parathyroidectomy (PO) day; III group 94 patients total thyroidectomy with L-Thyroxine from the first PO day and finally IV group 12 patients total thyroidectomy with a muscle parathyroid implant. In the first group the incidence of early hypocalcemia was 5 cases, equal to 8.47%, the incidence of protracted hypocalcemia was 0 cases, equal to 0%. In the second group the incidence of early hypocalcemia was 33 cases, equal to 21.29%, the incidence of protracted hypocalcemia was 7 cases, equal to 4.51%. In the third group (94 cases) the overall incidence of hypocalcemia was practically nil, with only 2 cases of early hypocalcemia, equal to 2.12% and no case of protracted hypocalcemia. In the fourth group the incidence of hypocalcemia is 1 case of early hypocalcemia 12.0% and no case of protracted hypocalcemia. We suggest that Parathyroidectomy (PO) hypoparathyroidism doesn't look to be influenced by total or near total thyroidectomy and that an early thyroid hormonal replacement therapy should be started, whenever possible, post total thyroidectomy. The surgical muscle implant of a completely devascularized parathyroid gland approach is certainly an interesting method, not without limits and criticisms, in an attempt to limit the iatrogenic impact in the determinism of post-thyroidectomy hypocalcemia. [ABSTRACT FROM AUTHOR]

The authors report their experience on the use of Endo-Vascular Laser Treatment modified type 2 CHIVA (Conservatrice et Hémodynamique de l'Insuffisance Veineuse en Ambulatoire) in patients with Chronic Venous insufficiency with a type 3 Shunts in patients with severe obesity (BMI>40). The authors affirm that Laser type 2 CHIVA in type 3 shunts still offers several advantages, for the echo guided localization of the vein in bariatric patients, resulting a time saving procedure with better compliance and lower rate of mayor complications. Since January 2021 to December 2022, we have treated 30 patients, all of them with a confirmed echography diagnosis of Chronic Venous Insufficiency-type 3 shunt, m.a. 45.2 years old, with a medium BMI of 42.3 with a medium follow up of 52.2 months. We selected patients with pathological obesity and chronic venous insufficiency who presented a type 3 SHUNT on the hemodynamic examination with echo-color-Doppler. It has been observed varicose vein recurrence only in 5 patients after six months 16.6% and in 9 patients two years later 30%. Bruises was the prevalent side effect observed in 14 patients 46.6%, we didn't observe any limb infections, no superficial vein thrombosis and of course no nerve damages. The procedure was less invasive than surgical preparation in bariatric patients. 18 patients received a laparoscopic sleeve gastrectomy in the 2 years from our treatment and in none of them we have observed any complication related to chronic venous insufficiency. It's well known the advantages of CHIVA vs. Traditional Stripping in term of recurrence, side effects like bruises and especially nerve damages; the Endo-Vascular Laser Treatment in this kind of modified type 2 CHIVA seems to improve limb infections incidence, especially in bariatric patients, reducing for this complication the gap versus stripping and of course improving the traditional EVLT (Endovenous Laser Ablation Therapy) with the Hemodynamic principles of CHIVA treatment. We suggest this type of technique especially in patients with severe obesity, where the clinical and metabolic condition added to local more complicated conditions, and due especially to the enormous fat panicle, make difficult any surgical approach. [ABSTRACT FROM AUTHOR]