Value-based healthcare in management of chronic back pain: A multidisciplinary- and lean-based approach.

Background: Chronic back pain stands as the most common musculoskeletal disorder and a primary cause of disability in people under 45 years old. Multidisciplinary consultation offers an efficient approach to chronic back pain management compared to traditional therapeutic-rehabilitative paths. This paper aims to show the benefit of a diagnostic-therapeutic multidisciplinary program pathway for patients with chronic back pain.

Predicting the pregnancy outcome: Uncovering the link between β-hCG, patient factors and live birth in IVF.

Objective: The objectives of the study were to correlate live birth rate with the initial level of β-hCG in all patients undergoing embryo transfer and develop a predictive model of live birth based on patients' and assisted reproductive technology (ART) characteristics.

Study Design: Single-center retrospective cohort study, including a total of 7587 positive first serum β-hCG from women who performed fresh and frozen embryo transfer. Twenty-one variables related to patient characteristics and treatment modalities were analyzed by step-wise univariate analysis followed by multivariate analysis.

A Machine Learning Approach Unveils the Relationships between Sickness Behavior and Interoception after Vaccination: Suggestions for Psychometric Indices of Higher Vulnerability.

Objective: Prior research has suggested a possible connection between vaccination and manifestations of Sickness Behavior; however, a need remains to first delve deeper into this association and second examine how Interoceptive Awareness and emotional factors may modulate individuals' perceptions of their health status post vaccination.

Method: An online retrospective cross-sectional survey of 647 individuals who received a COVID-19 vaccination was conducted. Together with vaccination side effects, socio-demographic characteristics, health status, level of concern about vaccination, and Interoceptive Awareness were collected at the baseline level.

Steps forward in embryo transfer technique: a retrospective study comparing direct versus afterload catheters at different time frames.

Purpose: To assess whether embryo transfer (ET) technique can influence the clinical pregnancy rate (CPR) and its correlation with the embryo transfer difficulty.

Design: This single center retrospective cohort analysis of fresh and frozen single blastocyst transfers performed between January 2016 and December 2021 included fresh and frozen single blastocyst transfers performed during the study timeframe. Direct technique was the only one used from January 2016 to September 2017.

Investigating Resistance to Carbapenems in Enterobacterales: A Descriptive Epidemiological Study of 2021 Screening in an Italian Teaching Hospital.

Antimicrobial resistance (AMR) presents a growing threat to global healthcare. This descriptive epidemiological study investigates the prevalence and characteristics of Enterobacterales with AMR factors in a tertiary teaching hospital in Italy over the course of the year 2021. In 2021, the prevalence of colonisation by Enterobacterales with AMR factors in patients was 1.

Renovation and creation of a Biocontainment Unit: the experience of Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy).

Infectious diseases are a major public health concern. In recent decades, there has been a succession of bacterial and viral diseases, which when added to the endemic diseases found in certain areas of the world, can become a global health problem. In emergency medicine we talk a lot about Mass Casualty Incident (MCI) preparedness, but the main focus today is bio-preparedness.

Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic.

Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany.

Methods: Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021.

Implementation of an Environmental Cleaning Protocol in Hospital Critical Areas Using a UV-C Disinfection Robot.

Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two successive patients was evaluated. Twenty high-touch surfaces in different critical areas were sampled according to ISO 14698-1, both immediately pre- and post-cleaning and disinfection standard operating protocol (SOP) and after UV-C disinfection (160 sampling sites in each condition, 480 in total).

Evaluation, Description and Magnitude of Readmission Phenomenon in Azienda Ospedaliero Universitaria Pisana (AOUP) for Chronic-Degenerative Diseases in the Period 2018-2021.

Background: Readmissions are hospitalizations following a previous hospitalization (called index hospitalization) of the same patient that occurred in the same facility or nursing home. They may be a consequence of the progression of the natural history of a disease, but they may also reveal a previous suboptimal stay, or ineffective management of the underlying clinical condition. Preventing avoidable readmissions has the potential to improve both a patient's quality of life, by avoiding exposure to the risks of re-hospitalization, and the financial well-being of health care systems.

Role of environmental sanitization in health clinics: evaluation of potassium peroxymonosulfate (KMPS) efficacy at two different concentrations.

Background: Healthcare-associated infections (HAI) are closely related to several factors, such as prolonged hospital stay in high-risk areas and intensive care units, potentially predisposing underlying conditions. It has also been demonstrated that HAI incidence may be related to non-respected standards of assistance, such as not adequately cleaned structures or medical devices contaminated by environmental bacteria and multidrug resistant enterobacteria.

Objective: In this case it has been carried on an efficacy evaluation of a microionization system using potassium peroxymonosulfate (KMPS) for outpatient clinics indoor air disinfection.

Why are they not coming back? A single-center follow-up study on oncological women oocyte's storing for fertility preservation.

Introduction: Oocyte cryopreservation is a valid option for female cancer patients to preserve fertility. The number of patients undergoing fertility preservation (FP) cycles has increased over the past years. Nevertheless, the rates of patients returning to use their cryopreserved material have shown to be considerably low, ranging from 5-8%, but significant data regarding the reasons of such low return rates are scarce.

Adoption of Improved Reprocessing Decreased Microbiological Non-Compliance for Bronchoscopes.

Background: In the past few decades, the inadequate reprocessing of bronchoscopes has been associated with several serious outbreaks caused by multidrug-resistant microorganisms. In this study we evaluated the improvement in the quality of reprocessing in a Bronchoscopy Unit (BU), after the introduction of a new procedure.

Methods: In 2019, observational and clinical audits were conducted in the BU.

Effectiveness of a Water Disinfection Method Based on Osmosis and Chlorine Dioxide for the Prevention of Microbial Contamination in Dental Practices.

In dental clinics, the infections may be acquired through contaminated devices, air, and water. Aerosolized water may contain bacteria, grown into the biofilm of dental unit waterlines (DUWLs). We evaluated a disinfection method based on water osmosis and chlorination with chlorine dioxide (O-CD), applied to DUWL of five dental clinics.

Efficacy of Plant Sterol-Enriched Food for Primary Prevention and Treatment of Hypercholesterolemia: A Systematic Literature Review.

Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia.

Screening for antimicrobial-resistant Gram-negative bacteria in hospitalised patients, and risk of progression from colonisation to infection: Systematic review.

Background: Transmission of antimicrobial-resistant Gram-negative bacteria (AMR-GNB) amongst hospitalised patients can lead to new cases of carriage, infection and outbreaks, hence the need for early carrier identification. We aim to explore two key elements that may guide control policies for colonisation/infection in hospital settings: screening practices on admission to hospital wards and risk of developing infection from colonisation.

Methods: We searched on PubMed, Scopus and Cochrane databases for studies published from 2010 up to 2021 reporting on adult patients hospitalised in high-income countries.

Covid-19 vaccine management (Comirnaty and mrna-1273 Moderna) in a teaching hospital in Italy: a short report on the vaccination campaign.

Objectives: In this article, we aim to share our experience in the hospital reorganization made to conduct the SARS-CoV-2 vaccination campaign, based on the principles of flexibility and adaptability.

Study Design: A descriptive study.

Methods: The data concerning the organization of the vaccination campaign were taken from the operative protocol developed by the hospital dedicated task force, composed by experts in hygiene, public health, occupational medicine, pharmacists, nurses, hospital quality, and disaster managers.

Effectiveness of Disinfection with Chlorine Dioxide on Respiratory Transmitted, Enteric, and Bloodborne Viruses: A Narrative Synthesis.

A viral spread occurrence such as the SARS-CoV-2 pandemic has prompted the evaluation of different disinfectants suitable for a wide range of environmental matrices. Chlorine dioxide (ClO) represents one of the most-used virucidal agents in different settings effective against both enveloped and nonenveloped viruses. This narrative synthesis is focused on the effectiveness of ClO applied in healthcare and community settings in order to eliminate respiratory transmitted, enteric, and bloodborne viruses.

First trimester pregnancy outcomes in a large IVF center from the Lombardy County (Italy) during the peak COVID-19 pandemic.

At the beginning of 2020, the Italian Lombardy region was hit by an "epidemic tsunami" which was, at that point in time, one of the worst pandemics ever. At that moment the effects of SARS-COV 2 were still unknown. To evaluate whether the pandemic has influenced ART (Assisted Reproduction Techniques) outcomes in an asymptomatic infertile population treated at one of the major COVID-19 epicentres during the weeks immediately preceding lockdown.

Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years' Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic.

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient's safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital.

[Digitization and Virtual Healthcare in a teaching hospital (Pisa, Italy) during COVID-19 emergency].

The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on tele-triage, tele-consultation and tele-visits procedures. This led, in the following months, the integration of virtual healthcare services applicable to the Azienda Ospedaliero Universitaria Pisa (AOUP).

One step further: randomised single-centre trial comparing the direct and afterload techniques of embryo transfer.

Study Question: What are the differences in ease of use between two different embryo transfer (ET) techniques: the preload direct approach and the afterload approach.

Summary Answer: The afterload technique seems to reduce the rate of difficult ETs.

What Is Known Already: Numerous published trials now document that the ET procedure has an impact on pregnancy and delivery rates after IVF.

[Skills tracing and activation of multi-professional teams in response to COVID-19 pandemic].

The rapid spread of Covid-19 epidemic led to a change in the organizational strategies of all Italian healthcare facilities. From January 31, 2020 (starting date of the state of national health emergency) Asst Valle Olona has prepared a reorganization of the supply units passing from a traditional division system to a structure that foresees the presence of traditional wards and a set of areas dedicated exclusively to the of Covid 19 treatments.The study aims to represent the method used for the redistribution of human capital in the new areas for identified, mapped, evaluated and reordered skills.

Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation.

Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region.

Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes.

Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase ()-producing infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed.

Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis.

The aim of the present systematic review and meta-analysis was to assess the effect of the different therapeutic options for repeated embryo implantation failure (RIF) on a subsequent IVF cycle outcome. Twenty-two RCTs and nineteen observational studies were included. Pooling of results showed a beneficial effect of intrauterine PBMC infusion on both CPR (RR 2.