المؤلفون: de Sire,Roberto, Nardone,Olga Maria, Testa,Anna, Calabrese,Giulio, Caiazzo,Anna, Castiglione,Fabiana

مصطلحات موضوعية: Clinical and Experimental Gastroenterology

الوصف: Roberto de Sire, Olga Maria Nardone, Anna Testa, Giulio Calabrese, Anna Caiazzo, Fabiana Castiglione Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, ItalyCorrespondence: Fabiana CastiglioneDepartment of Clinical Medicine and Surgery, University Federico II of Naples, Via S. Pansini 5, Naples, 80131, ItalyEmail fabcasti@unina.itAbstract: Recently, the role of nutrition in the management of Crohn’s disease (CD) is of increasing interest and the exploration of novel nutritional interventions to improve long-term management of the disease is challenging. So far, the majority of the studies on the role of exclusive enteral nutrition (EEN) in CD are conducted in the pediatric population and have highlighted the efficacy of EEN for achieving mucosal healing. This implicates that a similar approach would be beneficial in adult patients. However, the evidence for EEN in adults is heterogeneous, with meta-analyses reporting it as inferior to steroids while growing data demonstrate improvement in complicated CD. Currently, EEN is less used in adult patients with IBD. Indeed, the lack of palatability of enteral formula leads to difficulties in acceptance and compliance. The search for more tolerable and still effective diets has become an intense area of research aiming to explore the potential role of diet to control inflammation in patients with CD. Thus, this narrative review provides the state-of-the-art on the use of EEN treatment in CD and highlights the perceived barriers to its implementation in adult CD patients.Keywords: Crohn’s disease, exclusive enteral nutrition, barriers, diet, nutritional interventions

وصف الملف: text/html

العلاقة: https://www.dovepress.com/exclusive-enteral-nutrition-in-adult-crohns-disease-an-overview-of-cli-peer-reviewed-fulltext-article-CEGTest

الإتاحة: https://doi.org/10.2147/CEG.S267172Test
https://www.dovepress.com/exclusive-enteral-nutrition-in-adult-crohns-disease-an-overview-of-cli-peer-reviewed-fulltext-article-CEGTest

المؤلفون: Pascarella,Giacomo, Rossi,Matteo, Montella,Emma, Capasso,Arturo, De Feo,Gianfranco, Botti,Gerardo, Nardone,Antonio, Montuori,Paolo, Triassi,Maria, D'Auria,Stefania, Morabito,Alessandro

مصطلحات موضوعية: Risk Management and Healthcare Policy

الوصف: Giacomo Pascarella,1 Matteo Rossi,2 Emma Montella,3 Arturo Capasso,2 Gianfranco De Feo,1 Gerardo Botti Snr,1 Antonio Nardone,3 Paolo Montuori,3 Maria Triassi,3 Stefania D’Auria,4 Alessandro Morabito5 1Scientific Directorate, Istituto Nazionale Tumori “Fondazione G. Pascaleâ€, IRCCS, Napoli, Italy; 2Wroclaw School of Banking Wyższa Szkoła Bankowa, Wrocalw, Poland; 3Department of Public Health, Università Federico II, Napoli, Italy; 4Department of Health Management, Istituto Nazionale Tumori, “Fondazione G. Pascaleâ€, IRCCS, Napoli, Italy; 5Thoracic Department, Istituto Nazionale Tumori “Fondazione G. Pascale†IRCCS, Napoli, ItalyCorrespondence: Giacomo PascarellaScientific Directorate, Istituto Nazionale Tumori “Fondazione G. Pascaleâ€, IRCCS, Via Mariano Semmola, 52, Napoli, 80131, ItalyEmail g.pascarella@istitutotumori.na.itPurpose: A risk assessment matrix is a widely used tool for analyzing, assessing and setting priorities in risk management in many fields. This paper overviews critical variables, advantages, disadvantages, strengths and weaknesses of this tool, according to the ISO 31000 risk management framework.Results: Risk assessment is one of the key stages in the Risk Management Process and involves specific steps: identifying hazards, analyzing and evaluating all possible risks. Several methods are developed to assess risks in the literature. A risk matrix method, also called “decision matrix risk assessment (DMRA) techniqueâ€, is a systematic approach used to determine the risk level and to compare different risks and define which threats need to be controlled first. The actors involved in risk assessment are called on to manage different issues related to the choice of the most appropriate methodological approach, the assessment of the adequacy of the existing control measures, the articulation of risk consequence domains, the definition of the impact-consequences, the explanation of risk likelihood scales and the development of a risk matrix.Conclusion: We highlighted a number of ...

وصف الملف: text/html

العلاقة: https://www.dovepress.com/risk-analysis-in-healthcare-organizations-methodological-framework-and-peer-reviewed-fulltext-article-RMHPTest

الإتاحة: https://doi.org/10.2147/RMHP.S309098Test
https://www.dovepress.com/risk-analysis-in-healthcare-organizations-methodological-framework-and-peer-reviewed-fulltext-article-RMHPTest

المؤلفون: Testa,Anna, Castiglione,Fabiana, Nardone,Olga Maria, Colombo,Giorgio Lorenzo

مصطلحات موضوعية: Patient Preference and Adherence

الوصف: Anna Testa,1 Fabiana Castiglione,1 Olga Maria Nardone,1 Giorgio L Colombo2 1Gastroenterology, University of Naples Federico II, Naples, 2Department of Drug Sciences, University of Pavia, Pavia, Italy Abstract: Medication adherence is an important challenge while treating chronic illnesses, such as ulcerative colitis (UC), that require a long-term management to induce and maintain clinical remission. This review provides an overview of the role that medication adherence plays in the routine management of UC, with a focus on the results of a recent Italian study reporting the perception of patients with UC regarding adherence to treatment. A literature analysis was conducted on topics, such as measurement of adherence in real practice, causes, risk factors and consequences of non-adherence and strategies, to raise patients’ adherence. Most of the data refer to adherence to 5-aminosalicylic acid, and standard of care for the induction and maintenance of remission in UC. The adherence rate to 5-aminosalicylic acid is low in clinical practice, thus resulting in fivefold higher risk of relapse, likely increased risk of colorectal cancer, reduced quality of life and higher health care costs for in- and outpatient settings. There are various causes affecting non-adherence to therapy: forgetfulness, high cost of drugs, lack of understanding of the drug regimen – which are sometimes due to insufficient explanation by the specialist – anxiety created by possible adverse events, lack of confidence in physicians’ judgment and complex dosing regimen. The last aspect negatively influences adherence to medication both in clinical trial settings and in real-world practice. Regarding this feature, mesalamine in once-daily dosage may be preferable to medications with multiple doses per day because the simplification of treatment regimens improves adherence. Keywords: adherence, ulcerative colitis, 5-ASA, mesalamine, once-daily

وصف الملف: text/html

العلاقة: https://www.dovepress.com/adherence-in-ulcerative-colitis-an-overview-peer-reviewed-fulltext-article-PPATest

الإتاحة: https://doi.org/10.2147/PPA.S127039Test
https://www.dovepress.com/adherence-in-ulcerative-colitis-an-overview-peer-reviewed-fulltext-article-PPATest

المؤلفون: Triassi,Maria, Giancotti,Elena, Nardone,Antonio, Mancini,Giulia, Rubba,Fabiana

مصطلحات موضوعية: Transplant Research and Risk Management

الوصف: Maria Triassi,1 Elena Giancotti,2 Antonio Nardone,1 Giulia Mancini,3 Fabiana Rubba1 1Public, Preventive and Social Medicine School, University Federico II of Naples, Naples, Italy; 2Procurement and Transplantation Coordination, Naples, Italy; 3Sociology Unit, G D'annunzio University, Chieti-Pescara, Italy Introduction: The growing disparity between organ availability for transplantation and the number of patients in need has challenged the donation and transplantation community to develop innovative processes, ideas, and techniques to bridge this gap. Advances in the sharing of best practices in the donation community have contributed greatly to this aim over the past 5 years. Studies published during the past five years (2010–2014) were analyzed to gain insight on the evolving organizational areas and tools that the procurement and transplantation pathways have been focused on. The hypothesis assessed is that networking and efficacious handling of this complex path may be ameliorated by an adaptive organizational toolbox. Methods: A thorough search has been conducted using various databases, ie, Cochrane library, PubMed, EMBASE, Federico II University Open Archive. The evidence was considered following the Effective Practice and Organization of Care Group checklist. Prevalent organizational attitudes and areas were assessed, and various scenarios were analyzed. Initially, all titles and abstracts were screened. In the next phase, the full text of all abstracts considered potentially relevant by at least one of the reviewers was evaluated. Inconsistencies in decision-making within this second phase were solved based on consensus between both reviewers. In this phase, for every study we defined whether the organization was considered relevant and what the scenario was. The information was extracted from each study based on bibliographic details (author, journal, year of publication, and language). As many as 1,071 studies were analyzed, and 81 were selected as potentially relevant. Results: We found three ...

وصف الملف: text/html

العلاقة: https://www.dovepress.com/organizational-determinants-in-the-procurement-and-transplantation-pat-peer-reviewed-fulltext-article-TRRMTest

الإتاحة: https://doi.org/10.2147/TRRM.S67467Test
https://www.dovepress.com/organizational-determinants-in-the-procurement-and-transplantation-pat-peer-reviewed-fulltext-article-TRRMTest

المؤلفون: Armuzzi,Alessandro, Pugliese,Daniela, Nardone,Olga Maria, Guidi,Luisa

مصطلحات موضوعية: Drug Design, Development and Therapy

الوصف: Alessandro Armuzzi, Daniela Pugliese, Olga Maria Nardone, Luisa Guidi IBD Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy Abstract: The treatment of ulcerative colitis has changed over the last decade, with the introduction of biological drugs. This article reviews the currently available therapies for ulcerative colitis and the specific use of these therapies in the management of patients in different settings, particularly the difficult-to-treat patients. The focus of this review is on adalimumab, which has recently obtained approval by the European Medicines Agency and the US Food and Drug Administration, for use in treating adult patients with moderate-to-severe, active ulcerative colitis, who are refractory, intolerant, or who have contraindications to conventional therapy, including corticosteroids and thiopurines. Since the results emerging from the pivotal trials have been subject to some debate, the aim of this review was to summarize all available data on the use of adalimumab in ulcerative colitis, focusing also on a retrospective series of real-life experiences. Taken together, the current evidence indicates that adalimumab is effective for the treatment of patients with different types of ulcerative colitis, including biologically naïve and difficult-to-treat patients. Keywords: randomized controlled trials, real-life experiences

وصف الملف: text/html

العلاقة: https://www.dovepress.com/management-of-difficult-to-treat-patients-with-ulcerative-colitis-focu-peer-reviewed-fulltext-article-DDDTTest

الإتاحة: https://doi.org/10.2147/DDDT.S33197Test
https://www.dovepress.com/management-of-difficult-to-treat-patients-with-ulcerative-colitis-focu-peer-reviewed-fulltext-article-DDDTTest