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Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P  0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P  0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P  0.003), obesity (P  0.014), pneumonia (P  0.038), and development of septic shock (P  0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome.

We studied 29 patients in the final stage of head or neck cancer who were suffering pain that was not relieved by oral morphine. Cervical or thoracic epidural morphine was administered to relieve the pain. The quality of analgesia was equally good for both techniques. However, cervical epidural administration appeared to be superior, because much smaller doses of morphine were required in order to induce more rapid and longer analgesia.

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We report a case of laparoscopic management of a primary malignant melanoma of the left adrenal gland. A 42-year-old male presented a 55 x 60-mm round, inhomogeneous, noninvasive mass of the left adrenal gland. Hormone-activity values were within normal range. The mass was removed laparoscopically en bloc along with the left adrenal gland, and its histopathologic evaluation was consistent with the features of a malignant melanocytic tumor. Postoperatively, the patient presented no signs of fever or remarkable blood loss and was discharged on the third day in good clinical condition. He is free of disease 1 year later.

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