Comparative Analysis of the Measles Antibody Levels in Healthy Medical Personnel of Maternity Ward and Women in Labor

It has been proven that post-vaccination immunity to measles virus after two doses of vaccine is not able to persistently protect against infection throughout life. The goal of this research was to determine the immune layer to the measles virus among women in labor and maternity ward personnel in the same medical institution. The levels of IgG antibodies to measles virus in the umbilical cord blood of 594 women in labor and 88 workers of the maternity ward were studied by ELISA. It was revealed that 22.7% of umbilical cord blood serum samples from parturient women and 21.4% of blood serum samples from maternity ward personnel were seronegative (<0.18 IU/ml). Levels of IgG antibodies to measles virus in low values (<1.0 IU/ml) were detected in 67% of blood serum samples among women in labor and 68.9% among employees of the maternity ward. Among women in labor, women under 35 years of age are at the highest risk of contracting measles; the proportion of women with low levels of protective antibodies in this age group was almost 70%, and the proportion of women without protective levels of antibodies was 23%. Compared with the age group 36–43, the age of women in labor under 35 was associated with a higher chance of not having immune protection against infection with measles virus OR [95% CI] = 2.2 [1.1–4.5] (p = 0.02) or had a low level of protection OR [95% CI] = 1.9 [1.2–3.0] (p = 0.001). It was also found that among women over 35 years of age, the proportion of persons with a high level of antibodies in women in labor was statistically significantly higher than among members of the maternity ward staff (13 and 0%, respectively, p = 0.007). Thus, maternity ward employees and women in labor constitute a risk group for measles due to the presence of a high proportion of seronegative persons among women of childbearing age (both maternity ward employees and women in labor). These conditions create the need to revise current approaches to present vaccination procedures, especially in the current epidemiological situation with COVID-19.

An innovative procedure for introducing the lean concept into the internal drug supply chain of a hospital

PurposeIn a hospital, the management of different materials (i.e. waste, drugs, equipment, etc.) is fundamental from an economical point of view and also when considering its impact on patient treatment. The purpose of this paper is to introduce by an innovative approach lean principles in the management of this supply chain.Design/methodology/approachAfter the contextualization of the importance of the drug management in hospitals, authors analyze the literature in particular discussing the points of weakness. They propose an innovative methodology to implement a lean principle in this particular supply chain. After a general discussion authors discuss the application of the proposed methodology in the largest Italian hospital, the Policlinico Sant’Orsola – Malpighi in Bologna.FindingsThe results are very encouraging, confirm the value of the methods and motivate the authors to do further research. The proposed methodology takes into account both a technical approach and the real behavior of a hospital including logistics knowledge and motivation for material management in ward personnel. Real results are interesting both in term of economic impact and in term of effect on patient care.Originality/valueMaximizing patient care is the mission of the healthcare system; however, poor management of drugs and materials can have serious effects on the quality of service. In the last years, several excellent technological solutions have been developed, but often their application in the field was limited and ineffective due to the gap in knowledge and commitment required and available in the ward’s personnel. The new methodology developed is focused to solve this gap and was tested in an important case study.

Psychopharmacological treatments strategies in consultation-liaison psychiatry: Clinical vignette and pros and cons

IntroductionMultimorbidity and polipharmacotherapy are crucial features influencing the psychiatrist's prescription in the consultation-liaison psychiatry (CLP) setting.Aimsto provide an example of computer-assisted decision-making in psychotropic prescriptions and to provide hints for developing pharmacological treatment strategies in the CLP setting.MethodsCase report. A clinical vignette is presented, followed by a review of available online computer-assisted prescription software.ResultsA woman in her seventies was repeatedly referred for psychiatric consultation. Eleven different medications were administered daily, because of multimorbidity. A diagnosis of distymia was established, with comorbid mixed pain (partly fulfilling the criteria of somatic symptom disorder) and substance use disorder (opioids). After the first assessment, six follow-up visits were needed during hospitalization. Mirtazapine and benzodiazepines were introduced. Beside the pharmacological intervention, conflict mediation was performed in the relationship with the patient, her relatives, the ward personnel and the GP, to develop a long-term rehabilitation project. Pros and cons of online computer-assisted prescription software were discussed together with the ward personnel, as well.ConclusionsComputer-assisted decision-making in psychotropic prescription is becoming more common and feasible. The use of available software may contribute to safety, effectiveness and cost-effectiveness of clinical decision-making. Risks are also possible: depending for example from regional differences in prescription indications, different guidelines, pharmacogenomics, frequency with which databases are updated, sponsorships, possible conflicts of interest, and real clinical significance of highlighted interactions – all issues the clinician willing to benefit from this modern tools should pay attention to.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cardiopulmonary Collapse during Labour

Cardiopulmonary collapse during labour is a catastrophic event caused by various medical, surgical and obstetrical conditions. It is an emergency that threatens the life of the mother and her unborn child. We present a case of a pregnant woman who suffered from preeclampsia and underwent induction of labour. Severe lung edema occurred early in labour that caused cardiopulmonary collapse. Advanced heart-lung resuscitation was established immediately and continued until an emergency cesarean section was performed few minutes later. The outcome was favourable for both mother and child. We further discuss some aspects of the pathophysiology and appropriate treatment of cardiorespiratory arrest during labour, which involves the coordinated action of the obstetric, pediatric and surgical ward personnel.

Die invloed van reuke op die werksatmosfeer van saalpersoneel binne 'n gespesialiseerde verpleegopset

The influence of odours on the work atmosphere of ward personnel within a specialised healthcare setting. The purpose of the investigation was to determine whether pleasant odours could make a positive contribution to the disposition of ward staff and their experience of the work ambience. A random test method was used to select two samples from a possible four wards. The sixteen men and women were allocated to experimental and control groups at random. The results indicate that odours could make a positive difference to the disposition of workers. No such positive influence was, however, observed with regard to the work ambience. Opsomming Die doel van die ondersoek was om vas te stel of aangename reuke die gemoedstoestand en belewenis van die werksatmosfeer van saalpersoneel positief kan beinvloed. Die lotingsmetode is gebruik om uit vier sale, twee ewekansige groepe te selekteer. Die sestien mans en vroue is ewekansig toegedeel aan 'n eksperimentele en kontrolegroep. Die resultate wys dat reuke wel 'n positiewe verskil aan die gemoedstoestand van 'n werker kan maak. Geen sodanige positiewe invloed is egter ten opsigte van werksatmosfeer waargeneem nie.