Clara Cena - Academia.edu (original) (raw)

Papers by Clara Cena

Geriatrics & Gerontology International, Aug 1, 2017

Healthcare, Jun 5, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

European Journal of Hospital Pharmacy, 2019

PubMed, May 1, 2023

Objective: Clinical decision support systems (CDSSs) can reduce medical errors increasing drug pr... more Objective: Clinical decision support systems (CDSSs) can reduce medical errors increasing drug prescription appropriateness. Deepening knowledge of existing CDSSs could increase their use by healthcare professionals in different settings (ie, hospitals, pharmacies, health research centres) of clinical practice. This review aims to identify the characteristics common to effective studies conducted with CDSSs. Materials and methods: The article sources were Scopus, PubMed, Ovid MEDLINE and Web of Science, queried between January 2017 and January 2022. Inclusion criteria were prospective and retrospective studies that reported original research on CDSSs for clinical practice support; studies should describe a measurable comparison of the intervention or observation conducted with and without the CDSS; article language Italian or English. Reviews and studies with CDSSs used exclusively by patients were excluded. A Microsoft Excel spreadsheet was prepared to extract and summarise data from the included articles. Results: The search resulted in the identification of 2424 articles. After title and abstract screening, 136 studies remained, 42 of which were included for final evaluation. Most of the studies included rule-based CDSSs that are integrated into existing databases with the main purpose of managing disease-related problems. The majority of the selected studies (25 studies; 59.5%) were successful in supporting clinical practice, with most being pre-post intervention studies and involving the presence of a pharmacist. Discussion and conclusion: A number of characteristics have been identified that may help the design of studies feasible to demonstrate the effectiveness of CDSSs. Further studies are needed to encourage CDSS use.

Research in Social & Administrative Pharmacy, Jun 1, 2021

Background: The absence of collaboration between health professionals is known to influence presc... more Background: The absence of collaboration between health professionals is known to influence prescriptions' quality, also disadvantaging elderly frail patients' polytherapies. Objectives: This study aims to improve the adherence to medications of elderly patients suffering from multiple diseases through interpersonal continuing medical education (CME). The CME was organized for general practitioners (GPs) by hospital pharmacists (HPs) from a Territorial Pharmaceutical Centre of Piedmont, in collaboration with pharmacists from the Drug Science and Technology Department of the University of Turin, to enhance awareness on the management of chronic therapies and de-prescription. Methods: Pharmacists set face-to-face lessons for GPs between April 2018 and November 2018, while therapies' reconciliation and delivery of the Illustrated Therapy Schedules (ITS) lasted until September 2019. Polytherapies were evaluated by pharmacists and GPs in terms of appropriateness (number of potentially inappropriate prescriptions-PIPs according to 2019 Beers Criteria) and number of drug-drug interactions (DDIs), using a clinical decision support system (CDSS-NavFarma©) to help health professionals dealing with the process of review, reconciliation and individuation of possible adverse reactions. Results: From the CME organization it emerged that the collaboration between health professionals supported by a CDSS could improve the quality of elderly patients polytherapies. Two-hundred fifteen patients were enrolled by GPs; patients included were agedresults reported as average (sd)-76.4 (6.3), mostly men (54.9%), number of daily medications per patient was 8.1(2.4); 2.1(1.8) DDIs per patient were individuated, 12.9% of which were solved thanks to the CME. Average number of PIPs found was 2.5 (1.4) per patient. Conclusions: The CME represented a proactive approach by HPs to the management of elderly patients' polytherapies. Moreover, clinicians' engagement is a mean to enhance quality, safety, professionalism and communication in health processes.

ChemMedChem, Sep 15, 2008

DFT calculations were performed on nine flavones and flavonols to explain their high antioxidant ... more DFT calculations were performed on nine flavones and flavonols to explain their high antioxidant activity and variations in their activity. Conformational analysis showed that only flavonols with 3-OH directed toward the Bring are nonplanar; however, flavones and resulted radicals are planar. Hydroxyl group eligible for dissociation is the one with ortho OH directed toward it; otherwise, one of Bring (in 2′ or 4′-position) hydroxyl group. There are two main factors responsible for stabilizing the resulted radicals and lowering the bond dissociation energy and hence there were found well correlated with the experimental activity. First, driving force resulted from the conversion of nonplanar flavonols to planar radicals accompanied by resonance toward the carbonyl group and H-bond formation with 3-OH and second, radical stabilization by H-bond with ortho hydroxyl group with resonance toward carbonyl or pyrone oxygen. All resonance and H-bonds were confirmed by spin density, bond length, and molecular orbital calculations.

Geriatrics & Gerontology International, May 30, 2019

Frailty is a geriatric multidimensional syndrome whose signs and symptoms of which are predictors... more Frailty is a geriatric multidimensional syndrome whose signs and symptoms of which are predictors of increased vulnerability to minor stress events and risk of adverse outcomes such as falls, fractures, hospitalisation, disability and death. In this work, we aimed to update the data of frailty status in the European community dwelling population, based on the latest data released (wave 6) of the Survey of Health, Ageing and Retirement in Europe (SHARE) database. Frailty status was assessed applying a version of the Fried Phenotype operationalised for SHARE. Moreover, we aimed to study the impact of each of the five criteria in frailty assessment. We included all participants who answered all the questions used in a frailty assessment and who disclosed their gender and, further, whose age was 50 or more. Our final sample was 60,816 individuals. Of these, the mean age was 67.45 ± 9.71 years; 38,497 (56.4%) were female. The global prevalence of pre-frailty and frailty was 42.9% (ranging from 34.0% in Austria to 52.8% in Estonia) and 7.7% (ranging from 3.0% in Switzerland to 15.6% in Portugal). Pre-frailty and frailty prevalence increased along age and were more frequent among women. Regarding the five criteria considered on frailty assessment, exhaustion seems to be the criterion that contributes most to frailty status, followed by low activity, weakness, loss of appetite and slowness. With this work, we demonstrated that more than 50% of the 50+ European population are prefrail/frail, which must be considered when designing interventions to reduce/postpone/mitigate the progression of this condition, reducing the burden associated with it.

Digital medicine, 2016

health and social care services as well as high public and private expenditure). [3] Patient adhe... more health and social care services as well as high public and private expenditure). [3] Patient adherence is defined as the extent to which a person's behavior, (taking medication, following a diet, or executing lifestyle changes) corresponds with agreed recommendations from a health care provider. Polypharmacy and patient adherence and the importance (Scottish Polypharmacy 2015 guidance. Model of care group, Scottish Government 2015. http:// www.polypharmacy.scot.nhs.uk/) to involve patients and families with regard to goal setting are problems that patients with multimorbidity are facing. [4] More specifically polypharmacy is associated with several risks, including adverse drug reactions, risk of medication and disease interactions, and inappropriate dosing and adherence. On the other hand, patients could benefit from multiple medications if properly addressed when medications are combined to cure, slow the progression or reduce the symptoms of the diseases. [5] As the consequence of morbidity, polypharmacy is associated with age and poor self-rated health. [6] Furthermore, many patients with multi-morbidity experience difficulty in following (agreed upon) treatment recommendations. According to the WHO, only 50% of patients are adherent to long-term therapy for chronic illnesses. [7] Consequently, if patient complexity can be challenging when addressing treatment goals for one condition, it will become ever more complex when attempting to prioritize treatment

Helvetica Chimica Acta, Oct 30, 1996

The synthesis, structural characterization, and NO donor properties of a series of terfuroxan (= ... more The synthesis, structural characterization, and NO donor properties of a series of terfuroxan (= terfurazan trioxide) derivatives 1a–h and 2a–j are reported (Schemes 1 and 2). Structural assignments were confirmed principally by mass and 13C‐ and 1H‐NMR spectroscopy. The extent and the initial rate of NO release in the presence of thiol cofactor was evaluated for each derivative. Vasodilator effects of all the terfuroxan derivatives were evaluated on endothelium‐denuded strips of rat aorta precontracted with noradrenaline. Concentration‐response curves were also evaluated in the presence of 10 m̈M oxyhemoglobin (HbO2), a well known NO scavenger. The whole series displays high vasodilating potency; the most active terfuroxans (1a, b, g and 2i) are 5–10 times as potent as glyceryl trinitrate taken as reference (see Table 3). The potency decrease observed in the presence of HbO2 agrees with the involvement of NO in the vasorelaxing action. The 4,3′:4′,4″ connection (series 1; furoxan numbering) gives rise to the most potent compounds. The conformational factors seem to play important roles in the activity. No clear relationship between physico‐chemical properties of the substituents and potencies of derivative emerges.

European Food Research and Technology, Jul 1, 2016

The best results were obtained under MAE at 90 °C for 10 min with the highest yields in terms of ... more The best results were obtained under MAE at 90 °C for 10 min with the highest yields in terms of total carotenoids and β-carotene (>2.6 and >1.0 mg/g algae, respectively). MAE with ethanol (90 °C, 30 min) allowed maximization of total carotenoids and β-carotene amount (3.12 and 1.37 mg/g algae, respectively) thanks to the very good extraction yields. Moreover, this technique gave an extract with the highest antioxidant activity (812 and 519 µmol Trolox/g extract for TEAC and ORAC, respectively). Surprisingly, polyphenols were not detected in A. maxima extracts analyzed by HPLC.

Food Chemistry, Feb 1, 2012

(AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier a... more (AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier and the University of Turin. Changes resulting from the publishing process-such as editing, corrections, structural formatting, and other quality control mechanisms-may not be reflected in this version of the text. The definitive version of the text was subsequently published in [

Healthcare, Mar 13, 2023

ChemInform, Aug 4, 2010

ChemInform Abstract The title solid solutions are obtained from stoichiometric mixtures of Cd(OH)... more ChemInform Abstract The title solid solutions are obtained from stoichiometric mixtures of Cd(OH)2, ZnO, and B(OH)3 at relatively low temp. (523-623 K, 10-4-10-5 torr). All solid solutions are orthorhombic, space group Pbca, Z = 8. Lattice parameters of all the five compounds are given.

European Journal of Hospital Pharmacy, Aug 1, 2017

Objectives (1) To evaluate drug-drug interactions (DDIs) in general practitioners' (GPs) prescrip... more Objectives (1) To evaluate drug-drug interactions (DDIs) in general practitioners' (GPs) prescriptions; (2) to implement a cooperation project between pharmacists and GPs to improve DDI management and patient care. Methods In 2013, pharmacists from the Community Drug Assistance ASL TO1 launched a cooperation project involving 48 GPs. As a first step, GPs were asked to select, from a list, drug associations for which they recommended analysis of occurrence in their prescriptions. The pharmacists (1) analysed GPs' prescriptions dated 2012-2014, according to the list of DDIs selected (n= 9); (2) evaluated solutions for DDI management, using the Micromedex DDI checker database and literature analysis; they then (3) disseminated DDI-related information to GPs through training meetings and (4) assessed the efficacy of these actions through a questionnaire submitted to the GPs in 2013. results (1) Prescriptions analysis: a reduction in the number of DDIs was observed (−14% in 2013 vs 2012,-9% in 2014 vs 2012); in some cases these reductions were statistically significant (calcium carbonate + proton pump inhibitors (PPIs) −50%, p<0.0041, amoxicillin+lansoprazole −42%, p<0.0088). (2) Questionnaire: this was completed by 75% of GPs. The literature analysis was considered interesting by 94% of GPs; solutions were adopted by 89% of GPs and 34% of GPs affirmed that clinical improvements after application of the measures were observed in their patients, even if they could not provide quantitative data for this outcome. Conclusion The cooperation project between pharmacists and GPs was effective because it established a professional exchange between the two health professionals. The pharmacist gave support to GPs, which benefited the patients, who gained clinical improvements and improved satisfaction with their medical care, as declared by the GPs in answers to the questionnaire.