No abstract available.
Humans ; Hypoglycemia ; Infant ; Pancreatectomy

BACKGROUND: Malnutrition is common in hospitalized patients, especially in critically ill patients and affects their mortality and morbidity. However, the correlation between malnutrition and poor outcome is not fully understood. Our hypothesis is that the nutritional effect on the patient's prognosis would differ depending on the severity of the disease. METHODS: 3,758 patients admitted to the intensive care unit (ICU) were observed retrospectively. Patients were divided into well, moderate and severe groups, according to their nutritional status as assessed by their serum albumin level and total lymphocyte count (TLC). The severity of the disease was assessed by the Acute Physiologic and Chronic Health Evaluation (APACHE II score). All patients were followed clinically until discharge or death and ICU days, hospital days, ventilator days, and mortality rates were recorded. RESULTS: Depending on the definition used, the prevalence of hospital malnutrition is reported to be 68.3%. Hospital days, ICU days, as well as ventilator days of moderate and severe groups were longer than the well group. In patients exhibiting mild severity of disease, moderate and severe malnutrition groups have 3-5 times the mortality rate than the well group. CONCLUSIONS: Malnutrition affects the prognosis of patients who have an APACHE II score ranging from 4-29 points. Active nutritional support may be more effective for patients with a disease of mild severity.
APACHE ; Critical Illness ; Humans ; Intensive Care Units ; Lymphocyte Count ; Malnutrition ; Nutritional Status ; Nutritional Support ; Prevalence ; Prognosis ; Retrospective Studies ; Serum Albumin ; Ventilators, Mechanical

Prolonged inflammation or immunosuppression may cause lymphoproliferative disorders (LPD). Rheumatoid arthritis (RA) itself causes LPD. The immunosuppressive drug methotrexate (MTX) is used widely to treat RA, and is also related to the development of lymphoma. Although the detailed pathogenesis and association are still controversial, care is needed when managing patients with RA treated with MTX. Many reports indicate that discontinuing MTX can induce the regression of LPD. Here, we describe a case of diffuse large B-cell lymphoma that presented with liver involvement in a 67-year-old woman who had used MTX for RA for 15 years.
Aged* ; Arthritis, Rheumatoid* ; Female ; Humans ; Immunosuppression ; Inflammation ; Liver* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoproliferative Disorders ; Methotrexate*

Systemic capillary leak syndrome is a rare disease characterized by life-threatening attacks of reversible plasma extravasation and vascular collapse accompanied by hypotension, hemoconcentration, and hypoalbuminemia. A 36-year-old woman was admitted to this hospital with a fever, along with symptoms consistent with an upper respiratory tract infection and hypotension. Initial laboratory tests revealed several abnormal findings, including an elevated leukocyte count and hematocrit, hypoalbuminemia, and acute renal failure. Here, we report a case of successful treatment of systemic capillary leak syndrome, which can be difficult to distinguish from septic shock.
Acute Kidney Injury ; Adult ; Capillary Leak Syndrome* ; Female ; Fever ; Hematocrit ; Humans ; Hypoalbuminemia ; Hypotension ; Leukocyte Count ; Plasma ; Rare Diseases ; Respiratory Tract Infections ; Shock, Septic*