AboutOpen https://journals.aboutscience.eu/index.php/aboutopen <p>This open access journal publishes peer reviewed articles on clinical studies, real world evidence data, reviews, point of views, case series, and single clinical cases. The journal aim and scope encompasses clinical medicine, pharmacy, healthcare technology and other healthcare related disciplines with a focus on innovation in healthcare and policy. Articles may be in English, French, Italian and Spanish</p> AboutScience srl - Piazza Duca d'Aosta 12 - 20124 Milano MI (Italy) en-US AboutOpen 2465-2628 <p>Authors contributing to&nbsp;<em>AboutOpen</em>&nbsp;agree to publish their articles under the <a href="https://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener">Creative Commons NonCommercial 4.0 International License (CC BY-NC 4.0)</a>, which allows third parties to copy and redistribute the material providing appropriate credit and a link to the license but does not allow to use the material for commercial purposes and to use the material if it has been remixed, transformed or built upon.&nbsp;</p> The management of patient with osteoporosis in clinical practice https://journals.aboutscience.eu/index.php/aboutopen/article/view/2198 <p>Osteoporosis is a systemic skeletal disorder characterized by increased bone fragility, which is associated with&nbsp;an enhanced fracture risk. The first fracture often represents indeed the clinical manifestation of this condition.&nbsp;In the present document we provided an overview of the economic and clinical impact of a not-adequate therapeutic&nbsp;appropriateness and suboptimal adherence to osteoporosis therapy, that are both widely reported in literature&nbsp;despite osteoporotic treatments have proved their efficacy in reducing fracture risk. Adequate treatment&nbsp;and adherence were reported to be associated with a lower risk of re-fracture and all-cause mortality. Moreover,&nbsp;healthcare costs in osteoporotic patients with previous fractures were significantly lower in those receiving osteoporosis&nbsp;treatment rather than among untreated patients. Nevertheless, these two key-factors are not improving&nbsp;over time. The measurement of indicators of adherence and therapeutic appropriateness allows to analyse&nbsp;the utilization profile of the drugs indicated for the treatment of osteoporosis and to evaluate the presence of&nbsp;possible deviation between the prescriptive behaviours observed in clinical practice and the recommendations&nbsp;reported in the guidelines. The periodic monitoring of such indicators together with prescribing audit activity&nbsp;could represent a useful tool for the optimization of osteoporosis management and to achieve a correct resource&nbsp;allocation. (Rheumatology)</p> Luca Degli Esposti Elisa Giacomini Alessandro Ghigi Valentina Perrone ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-01-15 2021-01-15 8 1 1 5 10.33393/ao.2021.2198 The new formulation of the 0,05% sodium hypochlorite electrolytic solution for cutaneous use: reasons and advantages https://journals.aboutscience.eu/index.php/aboutopen/article/view/2221 <p class="abstract">Superinfection of skin lesions is quite common, and often delays wound recovery. Infection control plays therefore a key role in the management of skin lesions, requiring the use of specific antimicrobials. Among available agents, topic antiseptic drugs are currently recommended as a first-choice option, to be preferred to antibiotics, given the growing resistance to these drugs. Compared to antibiotics, antiseptic drugs have a wider spectrum of action, including bacteria, fungi, virus, protozoa, and prions. The ideal antiseptic for the management of an infected skin lesion is expected to be both highly effective and well tolerated, in order to promote the physiologic process of tissue restoration. Among available antiseptics, the 0,05% sodium hypochlorite electrolytic solution meets these criteria: the product proved to be effective <em>in vitro</em> and in animal experimental models against a wide range of microorganisms, besides exerting an anti-inflammatory action in the absence of any irritating, cytotoxic or carcinogenic adverse effect, and being useful in biofilm removal. Similarly, in several clinical trials, the 0,05% sodium hypochlorite electrolytic solution was demonstrated to be very effective and safe in the management of infected skin wounds: based on these results, this product should be strongly considered among the first-choice options for the disinfection of skin wounds. The new formulation, developed according to the latest reference standards for wound healing and in agreement with current guidelines, is qualitatively improved, with an expected positive impact in every field of clinical application and a subsequent benefit for treated patients.</p> Alessandro Scalise ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-03-22 2021-03-22 8 1 14 22 10.33393/ao.2021.2221 Microbiota and age-related macular degeneration: where are we today? https://journals.aboutscience.eu/index.php/aboutopen/article/view/2241 <p>Age-related macular degeneration (AMD) is a complex degenerative multifactorial retinal disease, representing a leading cause of legal blindness among elderly individuals. It is well known that age, family history, smoking, nutrition, and inflammation contribute to the development of AMD. Recent studies support the existence of a gut-retina axis involved in the pathogenesis of several ocular diseases, including AMD. High-fat and high simple sugar diets determine a derangement of the gut microbiota, with an increase of gut permeability and systemic low-grade inflammation. Leaky gut is correlated with higher levels of circulating microbial-associated pattern molecules, which trigger the systemic release of potent proinflammatory mediators and stimulate the specific immune cells of the retina, contributing to retinal damage. All these findings suggest that microbiota is closely related to AMD and that it may be targeted in order to influence AMD pathogenesis and/or its clinical course.</p> Angelo Maria Minnella Francesca Albanesi Martina Maceroni ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-04-07 2021-04-07 8 1 23 28 10.33393/ao.2021.2241 The impact of antimicrobial stewardship programs on the appropriateness of prophylaxis and antimicrobial therapy: the experience of the “F. Miulli” Hospital of Bari https://journals.aboutscience.eu/index.php/aboutopen/article/view/2199 <p class="abstract"><strong>Introduction:</strong> The continuous increase of antimicrobial resistance (AMR) requires antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, including selection, dose, duration, and way of administration.</p> <p class="abstract"><strong>Methods and Results:</strong> An “Antimicrobial Stewardship Team” (AST) was established at “F. Miulli” Hospital of Bari. The AST is a multidisciplinary group formed by a pharmacist, an infectious disease specialist, a microbiologist, an anesthetist and a hygienist. The AST has started a clinical path of professional interactions and optimization of antimicrobial use. The AST was focused on surgical antibiotic prophylaxis, planning events/meetings with 13 wards of “F. Miulli” hospital and writing 13 operating guidelines. The AST was focused on antimicrobial therapies too. On this occasion, the AST did not organize events or meetings but was focused on professional interactions with clinicians to optimize the antimicrobial use in the treatment of multi-drug resistant (MDR) pathogens. A reduction of antimicrobial use (defined daily dose, DDD) and pharmaceutical expenditure was reached in surgical wards during 2017-2018, while, in the same period, an increase of antimicrobial use (DDD) and pharmaceutical expenditure was observed in non-surgical wards.</p> <p class="abstract"><strong>Conclusions:</strong> The “Antimicrobial Stewardship Team” programs are essential to monitor the hospital economic resources and to support the purchase of the innovative antimicrobial therapies to treat multi-drug resistant pathogens.</p> Vincenzo Picerno Gisella Caracciolo Martina Cortelletti Maurizio Formoso Vincenzo Longobardo Angela Moramarco Fabrizio Celani ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-02-11 2021-02-11 8 1 6 13 10.33393/ao.2021.2199 Improving the diagnosis of X-linked hypophosphatemia: recommendations to optimize diagnostic flow and clinician/geneticist cooperation in the Italian clinical practice https://journals.aboutscience.eu/index.php/aboutopen/article/view/2235 <p class="abstract"><strong>Objective:</strong> To provide Italian expert opinion-based practical recommendations to improve the cooperation between clinicians and geneticists in order to optimize diagnostic flow and care of X-linked hypophosphatemia (XLH).</p> <p class="abstract"><strong>Methods:</strong> A panel of four geneticists and four clinicians from Italian reference centers for the diagnosis and management of XLH met virtually, first to highlight the critical issues in patient care and then to identify and share proposals to improve the diagnostic and care path of XLH.</p> <p class="abstract"><strong>Results:</strong> Critical issues emerged regarding the transfer of adequate clinical information from clinicians to geneticists, standardization and clarity of genetic reporting, and adequate interactions between clinicians and geneticists during patients’ follow-up. The necessary requirements for an appropriate request for evaluation of genetic variants and the need for a clear and clinically useful genetic report were agreed upon. Specifically designed template forms to be adopted with appropriate adjustments were defined and are here proposed for both the clinician’s request and the geneticist’s report.</p> <p class="abstract"><strong>Conclusions:</strong> The expert group strongly believes that collaboration between clinicians and geneticists should be encouraged in XLH, not only in the diagnostic phase but also during a patient’s follow-up, in order to manage patients more comprehensively and effectively.</p> Emanuele Agolini Roberto Chimenz Danilo Fintini Vito Guarnieri Laura Guazzarotti Stefano Mora Leonardo Salviati Giovanna Weber ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-04-19 2021-04-19 8 1 29 33 10.33393/ao.2021.2235 Orthopaedic device manufacturers’ perspective on MDR compliance https://journals.aboutscience.eu/index.php/aboutopen/article/view/2280 Peter Fennema Hassan Achakri ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2021-05-20 2021-05-20 8 1 34 34 10.33393/ao.2021.2280