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Background Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. Viral organisms have been identified as the causal pathogen in approximately 20% of CAP. Nutritional status plays an important role in the response to pneumonia. This study aims to identify whether protein energy malnutrition (PEM) is an independent risk factor for mortality and morbidity in viral CAP. Materials and methods This was a retrospective cohort study involving adult hospitalizations for viral CAP in the United States using the Nationwide Inpatient Sample (NIS) database. This cohort was further divided based on the presence or absence of a secondary discharge diagnosis of PEM. The primary outcome was inpatient mortality. Secondary outcomes included the rate of mechanical ventilation among other complications. Results The in-hospital mortality for viral CAP was 2.22%. Patients with PEM had over two-fold high adjusted odds of inpatient mortality (aOR 2.42, 95% CI 1.746-3.351, p less then 0.001) compared with patients without PEM. Patients with PEM had higher adjusted odds of having septic shock (aOR 3.34, 95% CI 2.158-5.160, p less then 0.001). NSTEMI (aOR 1.75, 95% CI 1.163-2.621, p = 0.007), need for mechanical ventilation (aOR 3.13, 95% CI 2.448-4.006, p less then 0.001), CVA (aOR 3.49, 95% CI 1.687-7.220, p = 0.001), DVT (aOR 2.19, 95% CI 1.453-3.295, p less then 0.001), and PE (aOR 2.24, 95% CI 1.152-4.357, p = 0.017) relative to patients without PEM. Conclusion In conclusion, coexisting PEM is associated with a higher rate of in-hospital morbidity and mortality in patients with viral CAP. Early identification and treatment of nutritional deficiencies can lead to improved outcomes and reduced costs.Background Patients with psychogenic hyperventilation frequently visit emergency departments (EDs). Arterial blood gas (ABG) analysis is performed to evaluate patients with dyspnea. This may show respiratory alkalosis in patients with hyperventilation. ABG may also reveal elevated serum lactate levels, although psychogenic hyperventilation syndrome is a benign condition. However, arterial puncture is a painful and risky procedure. We hypothesized that venous blood gas (VBG) analysis would be sufficient for evaluating patients with suspected psychogenic hyperventilation. Objectives To compare the clinical utility of VBG analysis with ABG analysis for evaluating psychogenic hyperventilation. check details Methods This was a single-center retrospective cross-sectional study of patients aged ≥18 years with psychogenic hyperventilation attending a tertiary care hospital. We extracted data on age, sex, vital signs, blood gas components, and serum lactate. Spearman's rank correlation coefficient (ρ) was used to examine the associations between the serum lactate levels and the carbon dioxide partial pressure (PCO2) in the ABG and VBG groups. Results A total of 236 patients (ABG group, n=57; VBG group, n=179) were included in the analysis. Both the ABG and VBG groups had respiratory alkalosis and similarly elevated serum lactate levels (p=0.44). The PCO2 and serum lactate levels were inversely correlated, and the ρ values were -0.74 and -0.50 for the ABG and VBG groups, respectively (both p less then 0.001). In addition, the bicarbonate ion ([Formula see text]) level was inversely correlated with the serum lactate level, and the pH was positively correlated with the serum lactate levels in both the ABG and VBG groups. Conclusions Among patients with psychogenic hyperventilation, respiratory alkalosis, and the correlation between the PCO2 and serum lactate levels were similar in the ABG and VBG groups, indicating that VBG analysis might be used as an alternative to ABG analysis for evaluating psychogenic hyperventilation.Intestinal tuberculosis is a frequent disease in developing countries, causing considerable morbidity and mortality. However, tuberculosis of the colon is rarer, and it also appears to be more common in immunosuppressed patients. We report the case of a 71-year-old immunocompetent man who was admitted to the emergency department with an acute abdomen and features of perforation peritonitis. A sigmoid perforation on cancer was suspected on computed tomography (CT) scan and surgical exploration. A standard sigmoidectomy with end colostomy (Hartmann's procedure) and peritoneal toileting was done. The pathological assessment of the surgical specimen revealed the sigmoid colon tuberculosis, complicated by perforation and peritonitis. Thus, the unexpected diagnosis of sigmoid colon tuberculosis was only made after the histopathological examination. Then, he received anti-tuberculosis treatment for six months. Therefore, a complete colonoscopy was performed at the end of the treatment, which returned to be normal. Thereafter, the restoration of intestinal continuity was performed. Colon tuberculosis is a rare disease and even rarer in people without immunodeficiency or on immunosuppressive therapy. If diverticulitis is the most common cause of sigmoid perforation, sigmoid perforation because of tuberculosis is extremely rare. However, an isolated primary sigmoid perforation of tubercular origin is not reported. We report this exceptional case of sigmoid colon tuberculosis complicated by perforation and generalized peritonitis to sensitize the medical team to its rare occurrence, which will be of paramount importance due to the increasing incidence of tuberculosis worldwide.Background We used a large United States population-based database to analyze the reasons for hospitalization of psoriasis patients. Methods International Classification of Diseases, 10th revision (ICD-10) code was used to identify hospitalizations in National Inpatient Sample (NIS) 2017 with a principal or secondary diagnosis of psoriasis. The reasons for hospitalization were divided into 19 categories based on their principal discharge ICD-10 diagnosis code. We also ranked the five most common specific reasons for hospitalization of psoriasis patients. Results There were over 35 million discharges included in the 2017 NIS database. A total of 165215 hospitalizations had either a principal or secondary ICD 10 code for psoriasis. Based on ICD-10 code categories, the top five reasons for hospitalization in patients with history of psoriasis were Cardiovascular (CV) (26605, 16.10%), rheumatologic (19555, 11.84%), digestive (18465, 11.18%), infection (16395, 9.92%), and respiratory (14865, 9.00%). Sepsis was the most common principal diagnosis of psoriasis hospitalizations.