Browsing by Author "Tani, C"
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- Neuropsychiatric Questionnaires in Systemic Lupus ErythematosusPublication . Tani, C; Moraes-Fontes, MF; Carli, L; Mauri, M; Bombardieri, S; Mosca, MPatients with systemic lupus erythematosus (SLE) can be affected by a multitude of neurologic and psychiatric symptoms with a wide range of prevalence and severity. Irrespectively from attribution to SLE or other causes, neuropsychiatric (NP) symptoms strongly impact short-term and long-term outcomes,thus NP evaluation during routine clinical practice in SLE should be undertaken regularly. The assessment of NP involvement in SLE patients is challenging and the available diagnostic tools fail to guarantee optimal diagnostic accuracy, sensitivity to changes as well as feasibility in routine clinical care. Standardised questionnaires (both physician-administered and self-reported) can offer valuable help to the treating physician to capture all possible NP syndromes; few SLE-specific NP questionnaire have been developed but validation in large cohort or cross-cultural adaptations are still pending. On the other hand, general instruments have been largely applied to SLE patients. Both kinds of questionnaires can address all possible NP manifestations either globally or, more frequently, focus on specific NP symptoms. These latter have been mainly used in SLE to detect and classify mild and subtle symptoms, more likely to be overlooked during routine clinical assessment such as headache, cognitive impairment and psychiatric manifestations. In conclusion, this literature review highlights a clear case for validation studies in this area and the wider implementation of questionnaires to assess NP involvement is still warranted. The broader use of such instruments could have important consequences; first of all, by standardising symptom assessment, a better definition of the prevalence of NP manifestation across different centres could be achieved. Secondly, prospective studies could allow for the evaluation of clinical significance of mild symptoms and their impact on the patient’s function and quality of life.
- Systemic Lupus Erythematosus: State of the Art on Clinical Practice GuidelinesPublication . Tamirou, F; Arnaud, L; Talarico, R; Scirè, CA; Alexander, T; Amoura, Z; Avcin, T; Bortoluzzi, A; Cervera, R; Conti, F; Cornet, A; Devilliers, H; Doria, A; Frassi, M; Fredi, M; Govoni, M; Houssiau, F; Lladò, A; Macieira, C; Martin, T; Massaro, Laura; Moraes-Fontes, MF; Pamfil, C; Paolino, S; Tani, C; Tas, SW; Tektonidou, M; Tincani, A; Van Vollenhoven, RF; Bombardieri, S; Burmester, G; Eurico, FJ; Galetti, I; Hachulla, E; Mueller-Ladner, U; Schneider, M; Smith, V; Cutolo, M; Mosca, M; Costedoat-Chalumeau, NSystemic lupus erythematosus (SLE) is the paradigm of systemic autoimmune diseases characterised by a wide spectrum of clinical manifestations with an unpredictable relapsing-remitting course. The aim of the present work was to identify current available clinical practice guidelines (CPGs) for SLE, to provide their review and to identify physicians' and patients' unmet needs. Twenty-three original guidelines published between 2004 and 2017 were identified. Many aspects of disease management are covered, including global disease management, lupus nephritis and neuropsychiatric involvement, management of pregnancies, vaccinations and comorbidities monitoring. Unmet needs relate with disease management of some clinical manifestations and adherence to treatment. Many patient's unmet needs have been identified starting with faster diagnosis, need for more therapeutic options, guidelines on lifestyle issues, attention to quality of life and adequate education.
- Undifferentiated connective tissue disease: state of the art on clinical practice guidelinesPublication . Antunes, M; Scirè, CA; Talarico, R; Alexander, T; Avcin, T; Belocchi, C; Doria, A; Franceschini, F; Galetti, I; Govoni, M; Hachulla, E; Launay, D; Lepri, G; Macieira, C; Matucci-Cerinic, M; Montecucco, CM; Moraes-Fontes, MF; Mouthon, L; Paolino, S; Ramoni, V; Tani, C; Tas, SW; Tincani, A; Van Vollenhoven, R; Zen, M; Fonseca, J; Bombardieri, S; Fonseca, JE; Schneider, M; Smith, V; Cutolo, M; Mosca, M; Beretta, LThe term 'undifferentiated connective tissue disease' (UCTD) is generally used to describe clinical entities characterised by clinical and serological manifestations of systemic autoimmune diseases but not fulfilling the criteria for defined connective tissue diseases (CTDs). In this narrative review, we summarise the results of a systematic literature research, which was performed as part of the ERN ReCONNET project, aimed at evaluating existing clinical practice guidelines (CPGs) or recommendations. No specific CPG on UCTD were found, potential areas of intervention are absence of a consensus definition of UCTD, need for specific monitoring and therapeutic protocols, stratification of UCTD based on the risk of developing a defined CTD and preventive measure for the future development of a more severe condition. Patients feel uncertainty regarding the name of the disease and feel the need of a better education and understanding of these conditions and its possible changes over time.