Risk factors for 1-year hospital readmissions in patients with systemic lupus erythematosus.

To reveal the characteristics of and risk factors for systemic lupus erythematosus (SLE) patients with frequent readmission aiming at intervening early and improve the quality of care during initial hospitalizations. This was a single-center, retrospective case-control study involving 521 hospitalized patients with SLE from January 2014 to December 2016 in the Affiliated Hospital of Guangdong Medical University. A total of 521 patients were enrolled, including 400 patients who were hospitalized once and 121 patients who were hospitalized repeatedly, and 23.2% of the patients were readmitted within 1 year. The results showed that the age of SLE onset (odds ratio [OR] 1.022, 95% confidence interval [CI] 1.007-1.036), serum albumin (OR 0.965, 95% CI 0.942-0.989), and cystatin C (OR 1.404, 95% CI 1.180-1.670) were closely related to readmission. The most common causes of readmission were infections (52 cases, 28.4%), especially respiratory tract infections, and lupus activity or recurrence (45 cases, 24.6%). Special attention should be paid to SLE patients with older age of onset, low serum albumin levels, and high cystatin C levels to avoid infection and recurrence with the aim of reducing the hospital readmission rate.

Red Cell Distribution Width to Platelet Ratio Is Associated with Increasing In-Hospital Mortality in Critically Ill Patients with Acute Kidney Injury.

BACKGROUND: Inflammation plays a key role in the pathophysiology and progression of acute kidney injury (AKI). Red cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory index, and its prognostic effect on critically ill patients with AKI is rarely investigated. This work is aimed at investigating the association between RPR and in-hospital mortality in these patients. METHODS: Data were extracted from the Medical Information Mart for Intensive Care III database. All-cause death during hospitalization was selected as the primary outcome. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value, and the area under the curve (AUC) was applied to compare predictive ability among different indices. Cox proportional hazard models were utilized to assess the association between RPR and in-hospital mortality. Restricted cubic spline analysis for multivariate Cox model was performed to explore the shape of the relationship between RPR and mortality. RESULTS: A total of 24,166 critically ill patients with AKI were included. The relationship of RPR and in-hospital mortality was nonlinear with a trend to rise rapidly and then gradually. For mortality prediction, RPR had the optimal cut-off value of 0.093, of which the AUC was 0.791 (95% confidence interval (CI): 0.773-0.810), which was higher than those of RDW, platelet, sequential organ failure assessment score, simplified acute physiology score II, neutrophil to lymphocyte ratio, and platelet to lymphocytes ratio. After adjustments for various confounders, high RPR showed a significant association with increased mortality with hazard ratios of 1.46 (95% CI: 1.40-1.55) for categorical variable and 1.88 (95% CI: 1.80-1.97) for continuous variables in the fully adjusted model. CONCLUSIONS: Elevated RPR on admission is substantially associated with high risk of in-hospital mortality in critically ill patients with AKI and thus may serve as a novel predictor of prognosis for these patients.

[Investigation on spread and hazards of human parasites in Qushui Village, Suixi County, Zhanjiang City].

OBJECTIVE: To understand the transmission of human parasites in Qushui Village, Yangqing Town, Suixi County, Zhanjing City, Guangdong Province. METHODS: The direct stool smear, floatation, Kato-Katz technique, and hookworm larva culture were used for the parasite infections. The questionnaire survey was applied for the hazards of parasites. The dissections on rats and snails were used for Angiostrongylus cantonensis infection. RESULTS: Five parasites were found and the total infection rate was 10.75%. The infection rates of hookworm (Necator americanus), Ascaris lumbricoides and Trichuris trichiura were 6.07%, 1.87% and 1.87%, respectively, and the infection rates of Enterobius vermicularis and Tyroglyrhus farinae were both 0.47%. The infections were not correlated with the career and age but preferred to males. The densities of infections were slight. The rate of dermatitis caused by hookworm larvae was 69.23%. The infection rates of Angiostrongylus cantonensis were 16.66%, 13.04% and 10.00%, respectively in rats, Achatina fulica and Ampularum crossean. CONCLUSION: The main species of human parasites are nematodes, with hookworm predominately, in Qushui Village, Suixi County. This area is the natural foci of Angiostrongylus cantonensis.