Systemic lupus erythematosus is an autoimmune disease associated with mild valvular regurgitation. However, there have been no detailed reports of infective endocarditis in patients with systemic lupus erythematosus. Here, we describe a case of a 55-year-old woman without any cardiac abnormalities who was diagnosed with lupus nephritis by renal biopsy; she contracted infective endocarditis while receiving immunosuppressive therapy. Our case emphasizes that special consideration of the occurrence of infective endocarditis, and its early diagnosis and treatment are mandatory for patient survival. We propose that echocardiography should be performed before treating patients with systemic lupus erythematosus who have an uncertain cardiac status.

Objective：We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods：Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results：During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio：1.54；95% confidence intervals：1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80；specificity, 0.94；area under the curve, 0.94；positive predictive value：0.99, negative predictive value：0.32).Conclusions：These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.

Objective：We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods：Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results：During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio：1.54；95% confidence intervals：1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80；specificity, 0.94；area under the curve, 0.94；positive predictive value：0.99, negative predictive value：0.32).Conclusions：These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.

BACKGROUND: Ibaraki's Amabie-chan is a COVID-19 infection control system unique to Ibaraki prefecture, Japan. It requires residents to register each time they visit events, commercial facilities, and restaurants. The number of registrations has been limited, and its function alerting about people positive for COVID-19 infection seems not to be working. Nevertheless, registration with the system might have some impact on the user's behavior. In the current preliminary survey, the possible impact of Ibaraki's Amabie-chan on infection prevention behavior and fear of COVID-19 was investigated. METHODS: A cross-sectional, web-based, anonymous, and self-administered survey was conducted at two workplaces in Tsukuba Science City, Ibaraki, Japan. The first survey was conducted at one of the workplaces in November 2020, and the second survey, at the other workplace in February 2021. Variables of interest were sex, age group, marital status, employment status, Ibaraki's Amabie-chan use, COVID-19 Contact-Confirming Application use, ten items of infection prevention behaviors, and fear of COVID-19. Hierarchical linear regression analysis was performed. RESULTS: In both surveys, use of Ibaraki's Amabie-chan was significantly associated with COCOA use and with "physical condition management such as body temperature measurement." No association was found with other infection prevention behaviors or with fear of COVID-19. CONCLUSIONS Our findings did not provide sufficient evidence for the effectiveness of Ibaraki's Amabie-chan in regard to users' infection control behavior. Further detailed study is needed to investigate the effectiveness in terms of infection prevention and the cost-effectiveness of Ibaraki's Amabie-chan.
COVID-19/prevention & control* ; Cohort Studies ; Cross-Sectional Studies ; Fear ; Humans ; SARS-CoV-2