Aboutopen Pub Date : 2024-06-14 DOI: 10.33393/ao.2024.3084

Vincenzo Adamo, Mario Airoldi, Gianni Amunni

{"title":"Innovation in the management of the breast cancer patient pathway: from correct identification to target therapies. Perspectives, opportunities and insights","authors":"Vincenzo Adamo, Mario Airoldi, Gianni Amunni","doi":"10.33393/ao.2024.3084","DOIUrl":"https://doi.org/10.33393/ao.2024.3084","url":null,"abstract":"Considering the current and future therapeutic options that are or will be available in the adjuvant treatment of breast cancer, this document reports on the insights from two multi-regional expert meetings aimed at investigating possible problems of access to the treatment pathway involving the BRCA (BReast CAncer) test.\u0000The experts stated that the update of the AIOM guidelines (diagnostic and therapeutic innovations) will require a correction of clinicians’ behaviors and a partial reorganization of the current Integrated Care Pathways (ICPs).\u0000From this point of view, the update of the AIOM GLs could supply to Regions and, above all, to all cancer networks a valid rationale for starting a process of harmonization of ICPs aimed at guaranteeing the rapid access to treatments by improving the quality of the service provided by the National Health Service (SSN).\u0000To ensure to breast cancer patients a rapid access to the latest approved treatments, experts believe that it will be necessary to update the access pathway to genetic tests. This could lead to an increase in the use of genetic tests, creating one of the main organizational and economic challenge that regions and cancer networks will have to face.","PeriodicalId":495210,"journal":{"name":"Aboutopen","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vitreoretinal interface disorders 玻璃体视网膜界面紊乱

Aboutopen Pub Date : 2024-04-12 DOI: 10.33393/ao.2024.2695

M. Pastore, Antonio Gemito, Daniele Tognetto

引用次数: 0

Vulvodynia: when a training program to increase muscle mass in the lower limbs does some good! 外阴痛:当一个训练项目对增加下肢肌肉量有一定好处!

Aboutopen Pub Date : 2023-10-30 DOI: 10.33393/ao.2023.2633

Lara Tiranini, Marco Cantamessi, Emanuela Serra, Giacomo Mariacci, Cristina Tassorelli, Rossella Elena Nappi

{"title":"Vulvodynia: when a training program to increase muscle mass in the lower limbs does some good!","authors":"Lara Tiranini, Marco Cantamessi, Emanuela Serra, Giacomo Mariacci, Cristina Tassorelli, Rossella Elena Nappi","doi":"10.33393/ao.2023.2633","DOIUrl":"https://doi.org/10.33393/ao.2023.2633","url":null,"abstract":"Vulvodynia is a chronic pain condition, without clearly identifiable and visible causes, associated with disability, sexual disfunction, and impaired quality of life. It is frequently under-reported and under-diagnosed, resulting in significant emotional burden. The pathophysiology of vulvodynia is complex and multidimensional. According to the integrated biopsychosocial model, main triggers of vulvodynia may be biological (infectious or inflammatory conditions inducing severe or prolonged nociceptive or neuropathic pain, genetic predisposition, hormonal imbalance), psychological (depression, anxiety), sexual (traumatic experiences, unhealthy intimate relationship), and social (adverse childhood experiences). The diagnostic approach is based on accurate medical history exploring the characteristics and timing of vulvar pain, as well as the presence of other chronic pain conditions that are often comorbid. Pelvic examination (vulvar and vaginal appearance, cotton swab test for vulvar sensitivity, pelvic floor evaluation) supports the diagnosis and excludes secondary vulvar pain disorders. Considering that pain is a complex human experience within a multidimensional frame, the best therapeutic strategy should be multidisciplinary encompassing different therapeutic targets. Pharmacological therapies have anti-nociceptive, neuromodulating, and anti-inflammatory purposes and include both topical and systemic treatments (antidepressants, anticonvulsants, hormonal creams). Physical therapy consists of pelvic floor physiotherapy, electrostimulation, and neuromodulation techniques, while cognitive behavioral therapy, psychosexual intervention, and neurobiological education address the psychosocial dimension of vulvodynia. If results are insufficient, a surgical approach is allowed. We present a clinical case linking amelioration of vulvodynia to a training program to increase muscle mass, especially in the lower limbs, in a girl reporting an eating disorder.","PeriodicalId":495210,"journal":{"name":"Aboutopen","volume":"49 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136067442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to manage symptoms in pediatric cancer patients enrolled in clinical trials? A review of principal patient-reported outcome screening tools 如何管理临床试验中儿童癌症患者的症状?回顾主要患者报告的结果筛选工具

Aboutopen Pub Date : 2023-10-06 DOI: 10.33393/ao.2023.2630

Giulia Zucchetti, Celeste Cagnazzo, Sabrina Ciappina, Nicoletta Bertorello, Francesca Resente, Manuela Spadea, Valeria Ceolin, Franca Fagioli

{"title":"How to manage symptoms in pediatric cancer patients enrolled in clinical trials? A review of principal patient-reported outcome screening tools","authors":"Giulia Zucchetti, Celeste Cagnazzo, Sabrina Ciappina, Nicoletta Bertorello, Francesca Resente, Manuela Spadea, Valeria Ceolin, Franca Fagioli","doi":"10.33393/ao.2023.2630","DOIUrl":"https://doi.org/10.33393/ao.2023.2630","url":null,"abstract":"Background: In adult oncology, the practice of tracking symptoms and toxicities using patient-reported outcomes (PROs) has increased and correlates with increased survival. In contrast, symptom monitoring using PROs is not common in pediatric oncology. Only in the last couple of years attention has also been paid to the patient’s perception in pediatrics and listening to the voice of children and to making them participate in the treatment. Methods: A comprehensive literature search was conducted in MEDLINE/PubMed and PsycINFO to identify relevant articles published through December 2022. Results: From 58 non-duplicate articles, 33 met our eligibility criteria. Of these, 17 were used in clinical trials. Conclusions: The dissemination and use of these tools will therefore have surprising repercussions on the control of pain and physical symptoms of small patients as well as on physical and psychological aspects. The administration and use of the PROs ensures optimal use of the drugs currently present in clinical trials by researcher and nurse and aims at a safer and more controlled approval of new drugs.","PeriodicalId":495210,"journal":{"name":"Aboutopen","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134945283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brentuximab vedotin + AVD in cHL: cost impact on adverse events, toxicity, second malignancies, end-of-life and subsequent lines of therapy in Italy Brentuximab vedotin + AVD治疗cHL:成本对不良事件、毒性、第二次恶性肿瘤、生命末期和后续治疗的影响

Aboutopen Pub Date : 2023-10-02 DOI: 10.33393/ao.2023.2609

Francesca Fiorentino, Chiara Vassallo, Beatrice Canali, Paolo Morelli, Silvia Ripoli, Laura Fioravanti

{"title":"Brentuximab vedotin + AVD in cHL: cost impact on adverse events, toxicity, second malignancies, end-of-life and subsequent lines of therapy in Italy","authors":"Francesca Fiorentino, Chiara Vassallo, Beatrice Canali, Paolo Morelli, Silvia Ripoli, Laura Fioravanti","doi":"10.33393/ao.2023.2609","DOIUrl":"https://doi.org/10.33393/ao.2023.2609","url":null,"abstract":"Introduction: In classical Hodgkin lymphoma (cHL), the delayed effects of therapies, such as second malignancies and toxicity, and the high relapse rate are potentially associated with an expense for the National Health Service (NHS). Objective: The objective of the study was to estimate the impact of introducing the combination of brentuximab vedotin (Adcetris®), doxorubicin, vinblastine and dacarbazine (A+AVD) for the first line (1L) treatment of stage III/IV cHL on costs associated with adverse events (AEs), pulmonary toxicity, second malignancies, end-of-life and second and subsequent lines (2L+) treatments. Method: The incidence of the events analysed was derived from clinical trials and Italian reports. Unit costs were estimated based on the national tariffs and the Italian literature. The results were modelled and extrapolated to the population in two scenarios, a current one without A+AVD and a future one in which A+AVD is introduced. The time horizon was six years and the perspective is that of the Italian NHS. Results: The introduction of A+AVD in 1L is associated with a reduction in the costs of AEs, pulmonary toxicity, second malignancies and end-of-life following 1L and in the acquisition costs of 2L+ treatments of approximately € 10,400/patient corresponding to a total saving of € 18.46 M over six years for the NHS; this saving grows as the use of A+AVD increases. Conclusion: The introduction of A+AVD for the 1L treatment of stage III/IV cHL is associated with a reduction in costs for the NHS for the management of AEs, pulmonary toxicity, second malignancies, end-of-life and 2L+ treatments.","PeriodicalId":495210,"journal":{"name":"Aboutopen","volume":"239 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135899411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Manuscript formatting, delayed peer-reviews, and overemphasizing the impact factor: can something be done? 稿件格式、延迟同行评议、过分强调影响因子:我们能做些什么吗?

Aboutopen Pub Date : 2023-01-16 DOI: 10.33393/ao.2023.2530

Vijay Kothari

引用次数: 0

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