Worldwide incidence of obesity is increasing and impaired outcome in postoperative patients has been described. Antibiotic prescribing is complicated by different pharmacology in this population. This study evaluates mortality and morbidity of obese postoperative patients and explores possible relation to antibiotic therapy. Therefore, data obtained in a prospective study in 2009-2010 were analysed. Postoperative patients on 5 ICUs were included with >48h of ICU treatment and documented body-mass-index (BMI). Altogether 451 non-obese patients (BMI<30kg/m(2)) were compared with 130 obese patients including propensity score matching. There was significant heterogeneity of baseline characteristics. ICU-mortality was 7.5% in non-obese and 7.7% in obese patients (p>0.999), but 65.4% of obese patients required mechanical ventilation compared with only 53.2% of non-obese patients (p=0.016). These findings were validated in multivariate regression analyses (adjusted OR for ICU-mortality for obese patients 0.53, 95%-CI 0.188-1.321, p=0.197; adjusted OR for mechanical ventilation 1.841, 95%-CI 1.113-3.076, p=0.018). Results were confirmed by propensity score matching. Therapeutic drug monitoring for vancomycin (TDM) showed that underdosing and overdosing occurred more often in obese patients and sufficient TDM levels were less often achieved. In conclusion, obesity is associated with increased morbidity but ICU mortality is equal compared with a non-obese population. Pharmacological differences might explain observed differences in antibiotic therapy and in obese patients TDM might be especially of importance.
Transmission electron micrograph and atom probe tomography were used to characterize the distribution, sizes, and compositions of precipitates in a Ti microalloyed steel. At 650 and 7008C with holding time 600 and 1800 s, respectively, the dispersion precipitates were obtained in all specimens, and the interphase precipitates were only observed at short holding time, but this interphase precipitation was unstable at long holding time. The kinetics of precipitates in ferrite depended on both coiling temperature and holding time. A lot of small precipitates were obtained at 650 8C with holding time 600 s, and these nanoprecipitates can strengthen the ferrite matrix largely. The average Guinier radius of nanoprecipitate was about 4.3 nm, and the large precipitates (Guinier radius $7-9 nm) with small precipitates (Guinier radius $3-5 nm) within an interphase sheet were also observed due to the growth of some precipitates at the cost of small precipitates. The nano-precipitates were mainly titanium carbide, and the atomic ratio of Ti/C was about 0.55, and this value was changed regularly in one precipitate.[ Ã ] Prof.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.