Hospitalization of individuals with systemic lupus erythematosus: characteristics and predictors of outcome

We performed a retrospective study of patients with systemic lupus erythematosus (SLE) admitted to hospital during a one-year period to describe characteristics associated with a poor outcome. There were 348 episodes of hospitalization of 223 individuals. The cause of admission was clinical flare of SLE (58%), infection (37%) and thromboembolic disease (8%). Readmission occurred in 35.8% and was associated with: active nephritis (HR 2.53, P < 0.01), flare of lupus (HR 2.0, P < 0.01) and more ACR criteria (HR 1.34 per extra criteria, P < 0.01). Individuals with multiple reasons for admission had a longer duration of stay [one = four days (2,6), two = five days (3,7) and three = 9.5 days (6.5,14.5), P < 0.01]. There were 11 deaths (3.2% of admissions). The deaths were due to infection in nine cases (four with concurrent active SLE). In multivariate modelling, the main predictors of death were: previous multiple admissions (OR 12.4, P < 0.01), the presence of infection (OR 7.3, P < 0.01) and youngerage (OR 0.93 perincrease of one year, P = 0.03). The presence of active lupus nephritis and multisystem disease makes readmission more likely and individuals with multiple problems at the time of admission have longer hospital stays. Young patients with frequent readmissions and coexistent infections are most likely to die

Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications

We sought to test our clinical impression that using a low dose methylprednisolone pulse (MEP; 1500mg over 3 days) in treating flares of systemic lupus erythematosus (SLE) was effective and associated with fewer serious infections. We retrospectively studied SLE patients who received MEP between 1989 and 2000. A 'low dose' group of 26 patients who had received 1-1.5g and a 'high dose' group of 29 patients who received 3-5g of MEP were identified. SLEDAI scores and prednisolone doses were recorded at the time of MEP pulses and 6 months later. All serious infections (requiring admission and i.v. antibiotics) occurring during this 6 month period and their outcomes were recorded. Both groups had similar demographic data, initial SLEDAI scores, i.v. cyclophosphamide use, and SLE organ involvement. Despite high- and low-dose MEP being efficacious in controlling disease activity (lowering of SLEDAI scores and subsequent prednisolone dose) there were only nine episodes of serious infection in seven patients in the low-dose group compared with 20 episodes in 17 patients from the high-dose group (P=0.04). In both groups a majority of infections (75 and 77% in the high- and low-dose groups) occurred in the first month after MEP. Those with a low serum albumin (<20g/l) had an increased risk of mortality (OR 44, 90% CI 6.19-312.98) and a trend towards greater numbers of infections. Low-dose MEP was effective in controlling SLE flares and associated with fewer serious infections than traditional high-dose MEP

Use of GoPro point-of-view camera in intubation simulation—A randomized controlled trial

10.1371/journal.pone.0243217PLoS ONE1512-Dece024321

Urine sVCAM-1 and sICAM-1 levels are elevated in lupus nephritis

10.1111/j.1756-185X.2012.01720.xInternational Journal of Rheumatic Diseases15113-1

Transforming growth factor beta-1 and gene polymorphisms in oriental ankylosing spondylitis

10.1093/rheumatology/keh426Rheumatology44151-54RUMA

Elucidating the secretion proteome of human embryonic stem cell-derived mesenchymal stem cells

10.1074/mcp.M600393-MCP200Molecular and Cellular Proteomics6101680-168

Macrocyclization of an all-dlinear α-helical peptide imparts cellular permeability

10.1039/c9sc06383hChemical Science11215577-559