Clinical rheumatology
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Clinical rheumatology · Oct 2019
Factors influencing implementation of a computerized, individualized, culturally tailored lupus decision aid in lupus clinics: a qualitative semi-structured interview study.
To identify factors that might facilitate or impede the implementation of a shared decision-making in lupus electronic tool (SMILE) in clinics by assessing perspectives of clinicians, clinic champions, and patient advocacy organization leaders. ⋯ Physicians, staff, and patient advocacy leaders perceived the SMILE as a promising tool to facilitate patient-provider communication and quality improvement in lupus. Identification of the patient-, clinic-, technology-, and management-related barriers to the SMILE implementation will allow its integration into busy clinical practice workflow. Key Points • Physicians, staff and patient advocacy leaders perceived computerized lupus decision aid to be a promising tool to facilitate shared decision-making for lupus treatment. • Stakeholder identified patient-related, clinic-resource-related, technology-related and clinic-management related themes as barriers or facilitators to viewing computerized lupus decision aid during regular clinic visits.
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Clinical rheumatology · Aug 2019
Comparative StudyValue of hematological indices versus VEGF as biomarkers of activity in Behçet's disease.
The aim of this study is to investigate the value of several hematological indices, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), versus vascular endothelial growth factor (VEGF) as biomarkers of activity in Behçet's disease (BD). ⋯ The NLR, PLR, and RDW are significantly higher in BD patients, suggesting their value as promising inflammatory biomarkers in BD. NLR and PLR are the most valuable predictors of vascular activity, while RDW and MPV were not valuable predictors of BD activity, rather implicated in the ongoing vascular inflammatory process in BD. The VEGF was neither a surrogate biomarker of BD activity nor reflecting the ongoing inflammatory process in BD.
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Clinical rheumatology · Aug 2019
Systematic reviews and meta-analysis in rheumatology: a gentle introduction for clinicians.
Given the plethora of studies today on the same topic, clinicians in rheumatology as well as others increasingly rely on systematic reviews, with or without meta-analysis, to aid in their evidence-based decision-making. However, given time constraints, staying up-to-date on current methods for conducting systematic reviews and meta-analyses as well as interpreting the results of these reviews for application in clinical practice can be challenging. ⋯ Included is a broad, five-question checklist to aid clinicians in rheumatology for making decisions about the utility of a systematic review. It is the hopes that this paper will aid clinicians in rheumatology as well as other consumers of systematic reviews and meta-analyses with the information necessary for judging the utility of systematic reviews and meta-analyses in their own work.
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Clinical rheumatology · Jul 2019
Prevalence of frailty and its associated factors in patients with rheumatoid arthritis: a cross-sectional analysis.
The aims of the present research were to assess the prevalence of frailty and its potential associated factors in a cohort of adult patients with rheumatoid arthritis (RA). ⋯ Frailty or pre-frailty are common in RA. The SHARE-FI may be a useful tool for the screening of frailty in RA and may summarize the results of a comprehensive RA assessment providing a marker of deficits accumulation.
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Clinical rheumatology · Jul 2019
Multicenter StudyRituximab in connective tissue disease-associated interstitial lung disease.
To evaluate rituximab (RTX) effectiveness and safety in patients with interstitial lung disease (ILD) related to connective tissue diseases (CTD). ⋯ RTX seems to be a promising treatment for CTD-ILD patients, particularly when NSIP pattern is present. Key points • The use of rituximab in patients with interstitial lung disease related to connective tissue disease is associated with long-standing disease stability in a wide range of systemic rheumatic diseases. • Efficacy results were particularly impressive in patients with non-specific interstitial pneumonia pattern, although in a subgroup of patients with usual interstitial pneumonia pattern, disease progression was also hold with this treatment. • In a large number of patients, rituximab was used in monotherapy and as first-line treatment.