RESUMEN
BACKGROUND: Malnutrition is common among the elderly and has significant implications for hospitalization outcomes. This is particularly true for severe illnesses such as sepsis, given age-related physiological changes and comorbidities. OBJECTIVE: This study examined how malnutrition affected hospitalization outcomes in older adults admitted for sepsis. MATERIALS & METHODS: A prospective cohort study was conducted at Lady Reading Hospital in Peshawar, Pakistan, from January to December 2023, focusing on 390 sepsis patients aged 55 years and older. Data on clinical history, length of stay, mortality rates, comorbidities, and nutritional assessments were collected using standardized forms. After controlling for confounding variables, statistical analysis using SPSS version 23 (IBM Corp., Armonk, NY) examined the relationship between hospitalization outcomes and nutritional status. RESULTS: The research included 390 elderly sepsis patients and showed significant variations in the demographics, comorbidities, and severity of disease between the well-nourished and malnourished groups. Malnourished patients had higher rates of ICU admission (52.82% vs. 29.23%), mechanical ventilation (45.13% vs. 16.41%), mortality (27.18% vs. 14.87%), and 30-day readmission (28.21% vs. 12.82%) as compared to the well-nourished group. They also had longer hospital stays (18.1 days vs. 12.6 days). Malnutrition significantly influenced outcomes, with multivariate analysis indicating it as a predictor of longer stays (ß = 2.8, p < 0.001) and increased mortality risk (OR = 3.2, 95% CI: 1.9-5.4, p < 0.001). CONCLUSION: Malnutrition significantly worsens outcomes for elderly sepsis patients, increasing ICU admissions, ventilation needs, mortality rates, and readmissions, emphasizing the need for proactive nutritional interventions.
RESUMEN
AISI 1045 medium carbon steel sheets having 10 mm thickness were subjected to the shielded metal arc welding process with three, five, and seven passes. The variations in the microstructure due to multiple thermal cycles in the heat-affected zone (HAZ), base metal (BM), and fusion zone (FZ) have been investigated and correlated with measured mechanical properties. Upon comparing fracture mechanics and mechanical properties with microstructural observations, it is elucidated that samples become ductile by increasing the number of thermal cycles which can be attributed to the transformations in the ferrite morphology in the HAZ. Based on mechanical, microstructural, and fracture analysis, it is concluded that post-weld heat treatment can be avoided if the number of passes during welding is increased.
RESUMEN
Intestinal pseudo-obstruction (IPO) is a rarely recognized complication of systemic lupus erythematosus (SLE). We present a 36-year-old African American female, with only known past medical history of anemia, admitted for frequent vomiting, abdominal distension, abdominal pain, diarrhea, and fever that had been ongoing for 5 days. Laboratory results revealed leukopenia and thrombocytopenia. Imaging revealed dilated small bowel loops, abdominal ascites, as well as mild bilateral hydroureteronephrosis without obstructing calculus. Serologic testing confirmed a diagnosis of SLE. The patient was placed on immunosuppressive therapy and responded well. IPO has previously been described as a rare finding in patients with SLE, with bilateral hydroureteronephrosis and lupus interstitial cystitis having been noted as common concomitant factors. One must have a high level of suspicion to recognize it as being one of the initial clinical presentations. Early recognition and appropriate management preclude unnecessary invasive procedures that do not take into account the pathophysiology of the condition and allow for appropriate management and return of peristaltic function.